WorldWideScience

Sample records for monthly clinic visit

  1. Doctor, Clinic, and Dental Visits

    Science.gov (United States)

    ... Viral Suppression Doctor, Clinical & Dental Visits Treatment Adherence Mental Health Substance Abuse Issues Sexual Health Nutrition & Food Safety Exercise Immunizations Aging with HIV/AIDS Women’s Health Housing ...

  2. Problem visits to a family planning clinic.

    Science.gov (United States)

    Blumenthal, P D; Jacobson, J; Gaffikin, L

    1988-01-01

    In order to obtain information necessary for optimum delivery of services, data were collected on the nature of the services provided at a family planing clinic. Clinic visits were divided into initial, annual, routine, problem, supply, educational and unknown. An analysis of the "problem" visits was undertaken to assess various epidemiologic aspects of such visits and to identify areas of clinic efficiency that could be improved. Problem visits were defined as any visits for which the patient had a presenting complaint. Age, level of education, method of contraception and parity were statistically associated with problem visits. When compared to Pill users, diaphragm users, intrauterine device users and non-users had a higher-than-expected number of problem visits. Less educated women and teenagers had a lower-than-expected number of problem visits when compared to more educated and older women. Socioeconomic status and problem visits were not statistically associated. Problem visits required more time, utilized more medical services and resulted in more referrals to the gynecology clinic than did other visit types. As a result of this analysis, we have increased our educational efforts for patients at high risk of problem visits and have instituted a special problem-oriented family planning clinic in which a full complement of house staff and ancillary personnel are available. This arrangement makes the uncomplicated family planning clinic run more smoothly and efficiently and obviates the need for time-consuming and cost-ineffective referrals.

  3. Effectiveness of Multidisciplinary Group-Based Intervention versus Individual Physiotherapy for Improving Chronic Low Back Pain in Nursing Staff: A Clinical Trial with 3- and 6-Month Follow-Up Visits from Tehran, Iran.

    Science.gov (United States)

    Ghadyani, Leila; Tavafian, Sedigheh Sadat; Kazemnejad, Anoshirvan; Wagner, Joan

    2017-06-01

    Clinical trial. To evaluate the effectiveness of a multidisciplinary group-based intervention on improving pain and disability among Iranian nurses with chronic low back pain in Tehran, Iran. Although low back pain (LBP) is one of the most important health problems, the challenge remains on how to find an effective intervention to reduce pain and related disabilities. Overall, 136 eligible nurses with chronic mechanical LBP were classified into two groups. The intervention group (n=66 participants) participated in a physiotherapy educational program (for 120 minutes) plus a health educational program based on predictive constructs of the social cognitive theory (for 120 minutes). These interventions were delivered by a physiotherapist and a health education specialist. The control group (n=70 participants) participated in a physiotherapy educational program (for 120 minutes). Disability rate, pain severity, and back pain prevention behavior were measured initially and at 3- and 6-month follow-up visits using the visual analogue scale, Roland-Morris Disability, and Nursing Low Back Pain Preventive Behaviors Questionnaire. Data were analyzed by SPSS ver. 16. There were statistically significant differences between the two groups in the main outcome measures immediately after the educational program and at 3- and 6-month follow-up visits. Preventive behaviors of participants in the intervention group were improved at 3- and 6- month follow-up visits (ppreventive behaviors in the intervention group were improved after 3 and 6 months (p<0.001). Finally, in the intervention group, pain severity and disability were decreased significantly. This study showed that a multidisciplinary educational program intervention can be an effective approach for reducing LBP and related disabilities among nurses.

  4. Knowledge and Behavior Regarding Cosmetics in Koreans Visiting Dermatology Clinics

    OpenAIRE

    Cho, Soyun; Oh, Sohee; Kim, Nack In; Ro, Young Suck; Kim, Joung Soo; Park, Young Min; Park, Chun Wook; Lee, Weon Ju; Kim, Dong Kun; Lee, Dong Won; Lee, Sang Jun

    2017-01-01

    Background Cosmetics can affect the skin condition profoundly, and yet no survey has been performed in Koreans visiting dermatology clinics. Objective To assess knowledge and consumer behavior regarding cosmetics in Koreans visiting dermatology clinics. Methods A questionnaire consisting of 43 questions concerning demographics and use/knowledge/selection/purchase of cosmetics was given to patients and accompanying persons who visited dermatologic clinics in university and private clinic setti...

  5. Junk food seen at pediatric clinic visits: is it a problem?

    Science.gov (United States)

    Frazier, Johnnie P; Land, Megan; Hsieh, Pei-Hsuan; Barratt, Michelle S

    2014-04-01

    To document the prevalence of junk foods seen at clinic visits. A cross-sectional 23-item survey of observed food items were completed by medical staff using a convenience sample of families from June 2, 2011 to March 2, 2012. The study was conducted in pediatric clinics affiliated with the University of Texas Medical School at Houston. A convenience sample consisting of 738 families with children from 4 months to 16 years old presenting for visits were included in the study. Children exclusively breast and formula fed was excluded. Junk food was observed 20.9% at the clinic visits. Junk food was often seen at clinic visits. There was a trend toward higher body mass index in patients whose families had junk food at the visit.

  6. The Impact on Child Developmental Status at 12 Months of Volunteer Home-Visiting Support

    Directory of Open Access Journals (Sweden)

    Jacqueline Barnes

    2012-01-01

    Full Text Available Home-visiting support during pregnancy or soon after the birth of an infant can be advantageous for maternal well-being and infant development. The best results have been identified when home visitors are professionals, especially nurses, and if a theoretically driven curriculum is followed with fidelity. Some suggest that disadvantaged families, who may avoid professional services, respond well to support from community volunteers, but there is less evidence about their impact. This study identified potentially vulnerable mothers during pregnancy in randomly allocated neighbourhoods where local volunteer home-visiting schemes agreed to offer proactive volunteer support and control areas where the local home-visiting schemes did not offer this proactive service. Taking demographic, child, and family factors into account, there were no significant differences in infant cognitive development at 12 months of age between families who had been supported by a volunteer and those who had not. Better cognitive development was predicted by less reported parenting stress when infants were 2 months and a more stimulating and responsive home environment at 12 months. The results suggest that unstructured proactive volunteer support for potentially vulnerable families is not likely to enhance infant development. Limitations of the cluster-randomised design are discussed.

  7. A clinical trial of in-home CBT for depressed mothers in home visitation.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Altaye, Mekibib; Stevens, Jack; Teeters, Angelique R; Van Ginkel, Judith B

    2013-09-01

    Despite negative outcomes for depressed mothers and their children, no treatment specifically designed to address maternal depression in the context of home visitation has emerged. In-Home Cognitive Behavioral Therapy (IH-CBT) is an adapted treatment that is delivered in the home, focuses on the needs of new mothers, and leverages ongoing home visiting to optimize engagement and outcomes. This study examined the efficacy of IH-CBT using a randomized clinical trial. Subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3months postpartum were randomized into IH-CBT and ongoing home visitation (n=47) or standard home visitation (SHV; n=46) in which they received home visitation alone and could obtain treatment in the community. Depression was measured at pre- and posttreatment, and 3-month follow-up using interviews, clinician ratings, and self-report. Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up. For example, 70.7% of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2% in the SHV group. These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs. Copyright © 2013. Published by Elsevier Ltd.

  8. Home telemonitoring and remote feedback between clinic visits for asthma.

    Science.gov (United States)

    Kew, Kayleigh M; Cates, Christopher J

    2016-08-03

    using random-effects models. We rated evidence for all outcomes using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation Working Group) approach. We found 18 studies including 2268 participants: 12 in adults, 5 in children and one in individuals from both age groups. Studies generally recruited people with mild to moderate persistent asthma and followed them for between three and 12 months. People in the intervention group were given one of a variety of technologies to record and share their symptoms (text messaging, Web systems or phone calls), compared with a group of people who received usual care or a control intervention.Evidence from these studies did not show clearly whether asthma telemonitoring with feedback from a healthcare professional increases or decreases the odds of exacerbations that require a course of oral steroids (OR 0.93, 95% confidence Interval (CI) 0.60 to 1.44; 466 participants; four studies), a visit to the emergency department (OR 0.75, 95% CI 0.36 to 1.58; 1018 participants; eight studies) or a stay in hospital (OR 0.56, 95% CI 0.21 to 1.49; 1042 participants; 10 studies) compared with usual care. Our confidence was limited by imprecision in all three primary outcomes. Evidence quality ratings ranged from moderate to very low. None of the studies recorded serious or non-serious adverse events separately from asthma exacerbations.Evidence for measures of asthma control was imprecise and inconsistent, revealing possible benefit over usual care for quality of life (MD 0.23, 95% CI 0.01 to 0.45; 796 participants; six studies; I(2) = 54%), but the effect was small and study results varied. Telemonitoring interventions may provide additional benefit for two measures of lung function. Current evidence does not support the widespread implementation of telemonitoring with healthcare provider feedback between asthma clinic visits. Studies have not yet proven that additional telemonitoring strategies lead to better symptom

  9. Knowledge and Behavior Regarding Cosmetics in Koreans Visiting Dermatology Clinics.

    Science.gov (United States)

    Cho, Soyun; Oh, Sohee; Kim, Nack In; Ro, Young Suck; Kim, Joung Soo; Park, Young Min; Park, Chun Wook; Lee, Weon Ju; Kim, Dong Kun; Lee, Dong Won; Lee, Sang Jun

    2017-04-01

    Cosmetics can affect the skin condition profoundly, and yet no survey has been performed in Koreans visiting dermatology clinics. To assess knowledge and consumer behavior regarding cosmetics in Koreans visiting dermatology clinics. A questionnaire consisting of 43 questions concerning demographics and use/knowledge/selection/purchase of cosmetics was given to patients and accompanying persons who visited dermatologic clinics in university and private clinic settings. In total 1,015 subjects (73.2% females, mean age 32.5 years) completed the survey. Education level was college or higher in 72.8%. Thirty-one percent had been diagnosed with a skin disorder, atopic dermatitis and seborrheic dermatitis being the most frequent diagnoses (33.7% and 16.8%, respectively). The frequency of makeup/sunscreen/functional cosmetics use, amount of sunscreen use, recognition of functional cosmetics, and knowledge of shelf life were significantly correlated with level of education. Among "functional cosmetics," whitening products were used most frequently (29.2%). Regardless of education level, 79.2% purchased cosmetics without checking ingredients, and 85.7% were unaware of the all-ingredient-labelling regulations, and yet subjects considered ingredient the most important factor when purchasing a product. Outpatient subjects in their twenties and thirties are the most knowledgeable about cosmetics in Korea.

  10. Visits to retail clinics grew fourfold from 2007 to 2009, although their share of overall outpatient visits remains low.

    Science.gov (United States)

    Mehrotra, Ateev; Lave, Judith R

    2012-09-01

    Retail clinics have rapidly become a fixture of the US health care delivery landscape. We studied visits to retail clinics and found that they increased fourfold from 2007 to 2009, with an estimated 5.97 million retail clinic visits in 2009 alone. Compared with retail clinic patients in 2000-06, patients in 2007-09 were more likely to be age sixty-five or older (14.7 percent versus 7.5 percent). Preventive care-in particular, the influenza vaccine-was a larger component of care for patients at retail clinics in 2007-09, compared to patients in 2000-06 (47.5 percent versus 21.8 percent). Across all retail clinic visits, 44.4 percent in 2007-09 were on the weekend or during weekday hours when physician offices are typically closed. The rapid growth of retail clinics makes it clear that they are meeting a patient need. Convenience and after-hours accessibility are possible drivers of this growth. However, retail clinics make up a small share of overall visits in the outpatient setting, which include 117 million visits to emergency departments and 577 million visits to physician offices annually.

  11. Clinical analysis of pediatric patients who visited Masan Samsung Emergency Center

    Directory of Open Access Journals (Sweden)

    Jae Wook Yoo

    2010-03-01

    Full Text Available Purpose : Through a clinical and retrospective analysis of pediatric patients who visited the Regional Emergency Medical Center of Masan Samsung Hospital from January 2007 to December 2008, we characterized pediatric and adolescent emergency patients to improve emergency care in future. Methods : We reviewed the medical records of 14,065 pediatric patients below 19 years of age. Results : The male to female ratio was 1.5:1, and the most common age group was less than 3 years (49.6%. The peak month was May (10.0%, the peak day of the week was Sunday (24.7%, and the peak time of day was 20:00&#8211;20:59 (8.5%. There was no difference in the number of visits per day based on weather (sunny, rain [below 10 mm per day], snow, and fog or daily temperature difference; however, visits increased on sandy, dusty days and decreased on rainy days with more than 10 mm of rain per day. Based on the international classification of disease (ICD-10 system, the most common disease code was code R (symptoms, sign, and abnormal clinical laboratory finding (31.5%, and the most common symptom was fever (13.1%. Final outcomes were discharged (73.8%, admitted (25.7%, transferred (0.4%, and expired (0.1%. In adolescent patients aged 15&#8211;19 years, the most common disease code was Injury & Poisoning (code S&T, 36.9%; the most common symptom was abdominal pain (9.6%. Conclusion : Pediatric patients visiting the emergency center were most likely to be male and under 3 years of age and to visit between 20:00 and 21:00 on Sundays and in May, and the most common symptom was fever. Differences between adolescents and pediatric patients showed that adolescents had a higher visiting rate with abdominal pain and a larger temperature difference.

  12. The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Maria Giné-Garriga

    Full Text Available Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity.To assess the effectiveness of a Primary Health Care (PHC based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period.Randomized controlled trial.Three hundred and sixty-two (n = 362 inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD; 68.3 (8.8 years; 118 women were randomly allocated to the physical activity program (IG. One hundred and seventy-nine patients (n = 179; 67.2 (9.1 years; 106 women were allocated to the control group (CG. The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources.The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2 was assessed at baseline (month 0, at the end of the intervention (month 3, and at 12 months follow-up after the end of the intervention (month 15.The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5. The CG remained about the same: 18.2 (11.1 (P = .002.Our findings indicate that a 3-month physical activity program linked to community resources is a short-duration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits.ClinicalTrials.gov NCT00714831.

  13. More Frequent Clinic Visits Are Associated with Improved Outcomes for Children with NAFLD

    Directory of Open Access Journals (Sweden)

    Carol Lam

    2016-01-01

    Full Text Available Objective. Adult data suggest that frequent monitoring of patients with nonalcoholic fatty liver disease (NAFLD may be associated with improved outcomes. The optimal frequency of outpatient visits for the management of pediatric NAFLD remains unknown. Study Design. In this retrospective study, two cohorts of patients with NAFLD, one followed on a yearly basis and one followed on 3-month intervals, were included. Both received similar advice regarding lifestyle changes. Primary outcome was change in BMI z-scores over a year. Secondary outcomes were the change in serum transaminases and markers of metabolic dysregulation. Results. Fifty-six patients were included (28 per group. The majority (71% were male with a mean (±SD age of 12.2 (±2.7 years. At baseline, there were no differences in BMI z-scores (2.8 versus 2.9; p=0.72 and ALT levels (101 versus 100 U/L; p=0.95 between the groups (yearly versus three-month, resp.. Twelve months later, those followed on a 3-month basis demonstrated a significant decrease in BMI (net BMI z-score change = −0.06; p=0.37, accompanied by a significant improvement in serum ALT (−25 U/L; p<0.01 and AST (−13 U/L; p=0.03 levels. There were no differences in fasting lipid profiles. Conclusion. Frequent clinic visits are associated with improved outcomes in pediatric NAFLD.

  14. The role of the visiting doctor in primary care clinics

    African Journals Online (AJOL)

    especially, District Management Teams, as these are thought to be critical for the development of the service. Across all ... respect as a basis for teamwork, and ensuring networking and co-ordination. (SA Fam ..... success of the doctor s visit is.

  15. Antenatal and neonatal visits increase complete immunization status among children aged 12-23 months in rural area of Indonesia

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    Suparmi Suparmi

    2015-01-01

    -23 months in rural area of Indonesia.Methods: The assessment used a part data of the 2013 Basic Health Research (Riskesdas. The sub- samples consisted of children aged 12-23 months livedin rural area. Out of the 8747 children aged 12-23 months who lived in rural area, 5452 children had complete data for the analysis. Complete basic immunization status based on record on immunization card and mother’s recall. Cox regression analysis with constant time was used for the analysis.Results: Out of 5452 children, 52.8% (2880/5452 had completed the basic immunization. Dominant factors related to basic complete immunization status were antenatal and neonatal visit, wealth index, mother’s education, and mother’s occupation. Compared with those who did not antenatal visit, those who had antenatal visit had 38% to be more complete basic immunization [adjusted relative risk (RRa = 1.38; 95% confidence interval (CI = 1.27 - 1.50; P = 0.000]. In term of neonatal visit, those who had neonatal visit had 37% to be more complete basic immunization compare to those who did not have neonatal visit (RRa = 1.37; 95% CI = 1.29 - 1.46; P = 0.000.Conclusion: In Indonesia rural areas the children who had antenatal and neonatal visits tend to have more complete basic immunization status. (Health Science Indones 2014;2:73-7Key words: complete basic immunization, antenatal and neonatal visits, rural

  16. An open cluster-randomized, 18-month trial to compare the effectiveness of educational outreach visits with usual guideline dissemination to improve family physician prescribing.

    Science.gov (United States)

    Pinto, Daniel; Heleno, Bruno; Rodrigues, David S; Papoila, Ana Luísa; Santos, Isabel; Caetano, Pedro A

    2014-01-15

    The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. The study will compare the effectiveness of educational outreach visits regarding the improvement of compliance with clinical guidelines in primary care against usual dissemination strategies. A cost-benefit analysis will also be conducted. We will carry out a parallel, open, superiority, randomized trial directed to primary care physicians. Physicians will be recruited and allocated at a cluster-level (primary care unit) by minimization. Data will be analyzed at the physician level. Primary care units will be eligible if they use electronic prescribing and have at least four physicians willing to participate. Physicians in intervention units will be offered individual educational outreach visits (one for each guideline) at their workplace during a six-month period. Physicians in the control group will be offered a single unrelated group training session. Primary outcomes will be the proportion of cyclooxygenase-2 inhibitors prescribed in the anti-inflammatory class, and the proportion of omeprazole in the proton pump inhibitors class at 18 months post-intervention. Prescription data will be collected from the regional pharmacy claims database. We estimated a sample size of 110 physicians in each group, corresponding to 19 clusters with a mean size of 6 physicians. Outcome collection and data analysis will be blinded to allocation, but due to the nature of the intervention, physicians and detailers cannot be blinded. This trial will attempt to address unresolved issues in the literature, namely, long term persistence of effect, the importance of sequential visits in an outreach program, and cost issues. If successful, this trial may be the cornerstone for deploying large scale educational outreach programs within the Portuguese

  17. Repeat retail clinic visits: impact of insurance coverage and age of patient.

    Science.gov (United States)

    Angstman, Kurt B; Bernard, Matthew E; Rohrer, James E; Garrison, Gregory M; Maclaughlin, Kathy L

    2012-12-01

    As retail clinics provide a less costly alternative for health care, it would be reasonable to expect an increase in multiple (repeat) retail visits by those patients who may have expenses for receiving primary care. If costs were not a significant factor, then repeat visits should not be significantly different between these patients and those with coverage for primary care visits. The hypothesis for this study was that patients with the potential for out-of-pocket expenses would have a higher frequency of repeat retail clinic visits within 180 days compared to those with primary care coverage. A retrospective chart review was conducted of 5703 patients utilizing a retail clinic in Rochester, Minnesota from January 1, 2009 through June 30, 2009. The first visit to the retail clinic was considered the index visit and the chart was reviewed for repeat retail clinic visits within the next 180 days. Using a multiple logistic regression model, the odds of a pediatric patient (N=2344) having a repeat retail visit within 180 days of the index visit were not significantly impacted by insurance coverage (P=0.4209). Of the 3359 adult patients, those with unknown coverage had a 25.6% higher odds ratio of repeat retail clinic visits than those with insurance coverage (odds ratio 1.2557, confidence interval 1.0421-1.5131). This study suggested that when cost is an issue, the adult patient may favor retail clinics for episodic, low-acuity health care. In contrast, the pediatric population did not, suggesting that other factors, such as convenience, may play more of a role in the choice of episodic health care for this age group.

  18. Early detection of parenting and developmental problems in toddlers : A randomized trial of home visits versus well-baby clinic visits in the Netherlands

    NARCIS (Netherlands)

    Staal, Ingrid I E; van Stel, Henk F.; Hermanns, Jo M A; Schrijvers, Augustinus J P

    2015-01-01

    Objective: The early detection of parenting and developmental problems by preventive child health care (CHC) services in the Netherlands takes place almost exclusively at the well-baby clinic. This study assesses whether, compared to a visit to the well-baby clinic, a home visit improves early detec

  19. Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits

    Science.gov (United States)

    Trojahn, Melina Maria; Ruschel, Karen Brasil; Nogueira de Souza, Emiliane; Mussi, Cláudia Motta; Naomi Hirakata, Vânia; Nogueira Mello Lopes, Alexandra; Rabelo-Silva, Eneida Rejane

    2013-01-01

    This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables (P ≤ 0.20), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention (P < 0.001), had more years of schooling (P = 0.016), and had more comorbidities (P = 0.008). Having received the intervention (P < 0.001) and having a greater number of comorbidities (P = 0.038) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care. PMID:24083023

  20. Preconsent video-assisted instruction improves the comprehension and satisfaction in elderly patient visiting pain clinic.

    Science.gov (United States)

    Kim, Sung Hoon; Koh, Won Uk; Rhim, Jin Ho; Karm, Myong Hwan; Yu, Hye Suk; Lee, Bo Yoeng; Shin, Jin Woo; Leem, Jeong Gill

    2012-10-01

    Elderly patients visiting pain clinic may be at greater risk of misunderstanding the explanation because of age-related cognitive decline. Video instruction may provide a consistent from of teaching in a visual and realistic manner. We evaluated the effect of educational video on the patient understanding and satisfaction in a group of geriatric patients visiting pain clinic. Ninety two patients aged more than 60 years old who were scheduled for transforaminal epidural block were recruited. After exposure to either video or paper instruction process, each patient was asked 5-item comprehension questions, overall satisfaction and preference question. During follow-up period, number of outpatient referral-line call for further explanation was counted. We observed significantly better comprehension in the video education compared with paper instruction (P video group (P = 0.015), and patients visiting pain clinic were more preferred video instruction (P Video approach to instruction process before consent improves treatment comprehension in geriatric patient visiting pain clinic.

  1. Clinical outcomes of patients living with HIV visiting ART centre at a ...

    African Journals Online (AJOL)

    Clinical outcomes of patients living with HIV visiting ART centre at a tertiary care ... at the antiretroviral therapy (ART) centre atMahatma Gandhi Memorial Hospital ... and 79 (0.61%) were males, females, children and transgender, respectively.

  2. Motivations for Adolescents' First Visit to a Family Planning Clinic.

    Science.gov (United States)

    Schwartz, Dana Belmonte; Darabi, Katherine F.

    1986-01-01

    New adolescent patients (N=150) at a large urban clinic were interviewed to determine what events or advice led to their decision to approach a family planning clinic for the first time. The roles of pregnancy scares, advice from significant others, and situational factors in motivating service use are presented. Program implications of these…

  3. Patients visiting the complementary medicine clinic for pain: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Press Yan

    2011-05-01

    Full Text Available Abstract Background Pain is one of the most common reasons for seeking medical care. The purpose of this study was to characterize patients visiting the complementary medicine clinic for a pain complaint. Methods This is a cross-sectional study. The study took place at Clalit Health Services (CHS complementary clinic in Beer-Sheva, Israel. Patients visiting the complementary clinic, aged 18 years old and older, Hebrew speakers, with a main complaint of pain were included. Patients were recruited consecutively on random days of the month during a period of six months. Main outcome measures were: pain levels, location of pain, and interference with daily activities. Once informed consent was signed patients were interviewed using a structured questionnaire by a qualified nurse. The questionnaire included socio-demographic data, and the Brief Pain Inventory (BPI. Results Three-hundred and ninety-five patients were seen at the complementary medicine clinic during the study period, 201 (50.8% of them met the inclusion criteria. Of them, 163 (81.1% agreed to participate in the study and were interviewed. Pain complaints included: 69 patients (46.6% with back pain, 65 (43.9% knee pain, and 28 (32.4% other limbs pain. Eighty-two patients (50.3% treated their pain with complementary medicine as a supplement for their conventional treatment, and 55 (33.7% felt disappointed from the conventional medicine experience. Eighty-three patients (50.9% claimed that complementary medicine can result in better physical strength, or better mental state 51 (31.3%. Thirty-seven patients (22.7% were hoping that complementary medicine will prevent invasive procedures. Conclusion Given the high proportion of patients with unsatisfactory pain relief using complementary and alternative medicine (CAM, general practitioners should gain knowledge about CAM and CAM providers should gain training in pain topics to improve communication and counsel patients. More clinical

  4. The research and practice based on the full-time visitation model in clinical medical education

    Directory of Open Access Journals (Sweden)

    Hong Zhang

    2015-01-01

    Full Text Available Most of the higher medical colleges and universities teaching hospital carry certain clinical teaching tasks, but the traditional teaching pattern of "two stage", including the early stage of the theory of teaching, the late arrangement of clinical practice, had some drawbacks such as practice time is too concentrated and the chasm between students' theory and practice. It is suggested that students contact clinical diagnosis and treatment earlier, visit more patients and increase the ratio of visitation and course. But as more and more students flood into university, clinical visitation has turned into a difficulty to improve students’ ability. To resolve this problem, we have made some efficient practice and exploration in Rizhao City People's Hospital from September 2005 to July 2014. The students were divided into full-time visitation model group and “two stage” pattern group randomly. The single factors are of great difference between the two groups. The full-time visitation model in clinical medical education builds a new mode of practice of clinical practice teaching in the medical stuents' concept of doctor-patient communication, humanistic care to patients, basic theoretical knowledge, clinical practice skills and graduate admission rate increased significantly. Continuous improvement of OSCE exam is needed to make evaluation more scientific, objective and fair.

  5. Assessment of prescription profile of pregnant women visiting antenatal clinics.

    Directory of Open Access Journals (Sweden)

    Eze UI

    2007-09-01

    Full Text Available Managing medical complications in pregnancy is a challenge to clinicians. Objectives: This study profiled some disease and prescription patterns for pregnant women attending antenatal clinics (ANCs in Nigeria. A risk classification of the medicines was also determined. Methods: Medical case files of 1,200 pregnant women attending antenatal clinics of 3 health facilities in Benin City, Nigeria were investigated. Disease pattern was determined from their diagnoses. The prescription pattern was assessed using WHO indicators, and the United States Food and Drug Administration classification of medicines according to risk to the foetus. Results: A total of 1,897 prescriptions of the 1,200 pregnant women attendees during the period under review were evaluated. Results indicated that malaria 554 (38% was the most prevalent disease, followed by upper respiratory tract infections (URTIs, 13% and gastrointestinal disturbances (GIT, 12%. The average number of drugs prescribed per encounter was found to be 3.0, and 2,434 (43% of medicines were prescribed by generic name. Minerals/ Vitamins 2,396 (42% were the most frequently prescribed medicines, and antibiotics occurred in 502 (8.8% of the total medicines. Of all medicines prescribed, 984 (17% were included in the foetal risk category C and 286 (5% in category D. Conclusion: The study concluded that malaria fever occurred most frequently followed by URTIs and GIT disturbances among the pregnant women. Minerals, vitamins and to a less extent anti-malarials topped the list of the prescribed medicines. The average number of medicines per encounter was much higher than WHO standards. The occurrence of contraindicated medicines was low.

  6. Assessing stress in dogs during a visit to the veterinary clinic

    DEFF Research Database (Denmark)

    Lind, Ann-Kristina; Hydbring-Sandberg, Eva; Forkman, Björn

    2017-01-01

    A visit to a veterinary clinic can be very stressful for the dog, and stress may interact with pain. The aim of this study was to observe the behavior of dogs in a veterinary clinic and to correlate it with subjective stress assessments by different persons. Systems have already been developed...... and to evaluate, overall, how the dog experienced the visit. Three behavior tests were also carried out to describe the dog's reaction in the veterinary clinic: a “social contact” test, a “play” test, and a “treat” test. The play and treat tests were carried out both inside and outside the veterinary clinic...... significantly more willing to play and eat a treat outside the veterinary clinic compared to inside the clinic (P

  7. Association of short-term exposure to ground-level ozone and respiratory outpatient clinic visits in a rural location – Sublette County, Wyoming, 2008–2011

    Energy Technology Data Exchange (ETDEWEB)

    Pride, Kerry R., E-mail: hgp3@cdc.gov [Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA (United States); Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States); Peel, Jennifer L. [Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523 (United States); Robinson, Byron F. [Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, E-92, Atlanta, GA 30333 (United States); Busacker, Ashley [Field Support Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States); Grandpre, Joseph [Chronic Disease Epidemiologist, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States); Bisgard, Kristine M. [Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 600 Clifton Road, NE, E-92, Atlanta, GA 30333 (United States); Yip, Fuyuen Y. [Air Pollution and Respiratory Disease Branch, Centers for Disease Control and Prevention, 600 Clifton Rd, NE, E-92, Atlanta, GA 30333 (United States); Murphy, Tracy D. [Wyoming Department of Health, 101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States)

    2015-02-15

    Objective: Short-term exposure to ground-level ozone has been linked to adverse respiratory and other health effects; previous studies typically have focused on summer ground-level ozone in urban areas. During 2008–2011, Sublette County, Wyoming (population: ~10,000 persons), experienced periods of elevated ground-level ozone concentrations during the winter. This study sought to evaluate the association of daily ground-level ozone concentrations and health clinic visits for respiratory disease in this rural county. Methods: Clinic visits for respiratory disease were ascertained from electronic billing records of the two clinics in Sublette County for January 1, 2008–December 31, 2011. A time-stratified case-crossover design, adjusted for temperature and humidity, was used to investigate associations between ground-level ozone concentrations measured at one station and clinic visits for a respiratory health concern by using an unconstrained distributed lag of 0–3 days and single-day lags of 0 day, 1 day, 2 days, and 3 days. Results: The data set included 12,742 case-days and 43,285 selected control-days. The mean ground-level ozone observed was 47±8 ppb. The unconstrained distributed lag of 0–3 days was consistent with a null association (adjusted odds ratio [aOR]: 1.001; 95% confidence interval [CI]: 0.990–1.012); results for lags 0, 2, and 3 days were consistent with the null. However, the results for lag 1 were indicative of a positive association; for every 10-ppb increase in the 8-h maximum average ground-level ozone, a 3.0% increase in respiratory clinic visits the following day was observed (aOR: 1.031; 95% CI: 0.994–1.069). Season modified the adverse respiratory effects: ground-level ozone was significantly associated with respiratory clinic visits during the winter months. The patterns of results from all sensitivity analyzes were consistent with the a priori model. Conclusions: The results demonstrate an association of increasing ground

  8. Oral Health Status and Behaviour of Mauritians Visiting Private Dental Clinics

    Science.gov (United States)

    Gunsam, P. Pugo; Banka, S.

    2011-01-01

    Purpose: This paper seeks to assess the oral health status and behaviour of a sample of the Mauritian population visiting private dental clinics. Design/methodology/approach: Oral health status was determined using the World Health Organization (Decayed, Missing, Filled Teeth (DMFT) index indicating the prevalence of caries, and factors associated…

  9. Oral Health Status and Behaviour of Mauritians Visiting Private Dental Clinics

    Science.gov (United States)

    Gunsam, P. Pugo; Banka, S.

    2011-01-01

    Purpose: This paper seeks to assess the oral health status and behaviour of a sample of the Mauritian population visiting private dental clinics. Design/methodology/approach: Oral health status was determined using the World Health Organization (Decayed, Missing, Filled Teeth (DMFT) index indicating the prevalence of caries, and factors associated…

  10. Predictors of custody and visitation decisions by a family court clinic.

    Science.gov (United States)

    Raub, Jonathan M; Carson, Nicholas J; Cook, Benjamin L; Wyshak, Grace; Hauser, Barbara B

    2013-01-01

    Children's psychological adjustment following parental separation or divorce is a function of the characteristics of the custodial parent, as well as the degree of postdivorce parental cooperation. Over time, custody has shifted from fathers to mothers and currently to joint arrangements. In this retrospective chart review of family court clinic records we examined predictors of custody and visitation. Our work improves on previous studies by assessing a greater number of predictor variables. The results suggest that parental emotional instability, antisocial behavior, and low income all decrease chances of gaining custody. The findings also show that income predicts whether a father is recommended for visitation rights and access to his child or children. Furthermore, joint custody is not being awarded as a function of parental postdivorce cooperation. At issue is whether parental emotional stability, antisocial behavior, and income are appropriate markers for parenting capacity and whether visitation rights and joint custody are being decided in a way that serves the child's best interests.

  11. Observational study to determine predictors of rheumatology clinic visit provider contact time

    Science.gov (United States)

    Davis, Lisa A.; Larson, Molly M.; Caplan, Liron

    2014-01-01

    Objective To address perceived inefficiencies in an academic rheumatology practice, a timing/work-flow evaluation was initiated to determine the factors that predict the Provider Contact Time (PCT)—the amount of time that attending physicians spend with patients during an outpatient encounter. Methods This prospective observational study was conducted at the University of Colorado Hospital rheumatology clinic for return patient visits in early 2008. Each patient encounter was subdivided into components and the time for each component was recorded. Up to 20 return visit encounters per provider were randomly selected for inclusion. Multivariate linear regression was used to predict the time, in minutes, that providers spend with patients and logistic regression was used to determine the time intervals associated with patients' perception that the visit ran on time. Results Variables associated with increased PCT were whether a procedure was performed in the clinic (p=0.037) and whether the visit occurred in the afternoon (p<0.025). For every minute a provider was late in beginning to see a patient, the PCT decreased by 0.32 minutes (C.I. 0.15-0.49). Variables associated with patient's perception that the visit ran on time include the Check In-To-Vital Delay (O.R. 0.95, C.I. 0.92-0.99) and the Provider Delay (O.R. 0.92, 95% CI 0.86-0.99). Conclusion Patients' punctuality and the presence of a resident were not significantly associated with the time that a provider spent with a patient. However, the degree to which the provider ran late was associated with decreased PCT and diminished the patient's perception that the visit ran on time. PMID:20583104

  12. Effects of air pollution on daily clinic visits for lower respiratory tract illness.

    Science.gov (United States)

    Hwang, Jing-Shiang; Chan, Chang-Chuan

    2002-01-01

    The authors used data obtained from clinic records and environmental monitoring stations in Taiwan during 1998 to estimate the association between air pollution and daily numbers of clinic visits for lower respiratory tract illness. A small-area design and hierarchical modeling were used for the analysis. Rates of daily clinic visits were associated with current-day concentrations of nitrogen dioxide, carbon monoxide, sulfur dioxide, and particulate matter less than or equal to 10 microm in aerometric diameter. People over age 65 years were the most susceptible, and estimated pollution effects decreased as the exposure time lag increased. The analysis also suggested that several community-specific variables, such as a community's population density and yearly air pollution levels, modified the effects of air pollution. In this paper, the authors demonstrate the use of a small-area design to assess acute health effects of air pollution.

  13. Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel.

    Science.gov (United States)

    Muhsen, Khitam; Chodick, Gabriel; Goren, Sophy; Anis, Emilia; Ziv-Baran, Tomer; Shalev, Varda; Cohen, Dani

    2015-01-01

    Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited. We used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n=302,445) before (2005-10) and after (2011-13) the introduction of universal rotavirus immunisation in Israel. We retrieved laboratory results of rotavirus antigen tests (n=18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5-16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8-62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes.

  14. Outreach visits by clinical pharmacists improve screening for the metabolic syndrome among mentally ill patients

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Hansen, Per Sveistrup; Kristensen, Anne Mette Fisker

    2013-01-01

    Background: Patients suffering from schizophrenia and affective disorder have an increased risk of the metabolic syndrome (MeS); hence identification of patients developing MeS may help preventing morbidity and mortality. Aims: The aim of the study was to evaluate the effect of outreach visit...... by clinical pharmacists to support the implementation of screening of MeS at a psychiatric ward. Methods: The study was conducted at the psychiatric ward, Odense University Hospital. In 2008, clinical guidelines for systematic screening and prevention of metabolic risk were developed and implemented...

  15. Simulating clinical trial visits yields patient insights into study design and recruitment

    Directory of Open Access Journals (Sweden)

    Lim SS

    2017-07-01

    Full Text Available S Sam Lim,1 Alan J Kivitz,2 Doug McKinnell,3 M Edward Pierson,4 Faye S O’Brien4 1Division of Rheumatology, Department of Medicine, Emory University, Atlanta, GA, USA; 2Altoona Center for Clinical Research, Altoona, PA, USA; 3Deloitte Life Sciences Advisory, Basel, Switzerland; 4Clinical Operations, Global Medicines Development, AstraZeneca, Gaithersburg, MD, USA Purpose: We elicited patient experiences from clinical trial simulations to aid in future trial development and to improve patient recruitment and retention.Patients and methods: Two simulations of draft Phase II and Phase III anifrolumab studies for systemic lupus erythematosus (SLE/lupus nephritis (LN were performed involving African-American patients from Grady Hospital, an indigent care hospital in Atlanta, GA, USA, and white patients from Altoona Arthritis and Osteoporosis Center in Altoona, PA, USA. The clinical trial simulation included an informed consent procedure, a mock screening visit, a mock dosing visit, and a debriefing period for patients and staff. Patients and staff were interviewed to obtain sentiments and perceptions related to the simulated visits.Results: The Atlanta study involved 6 African-American patients (5 female aged 27–60 years with moderate to severe SLE/LN. The Altoona study involved 12 white females aged 32–75 years with mild to moderate SLE/LN. Patient experiences had an impact on four patient-centric care domains: 1 information, communication, and education; 2 responsiveness to needs; 3 access to care; and 4 coordination of care; and continuity and transition. Patients in both studies desired background material, knowledgeable staff, family and friend support, personal results, comfortable settings, shorter wait times, and greater scheduling flexibility. Compared with the Altoona study patients, Atlanta study patients reported greater preferences for information from the Internet, need for strong community and online support, difficulties in

  16. Clinically useful predictors for premature mortality among psychiatric patients visiting a psychiatric emergency room

    DEFF Research Database (Denmark)

    Aagaard, Jørgen; Buus, Niels; Wernlund, Andreas Glahn;

    2016-01-01

    OBJECTIVE: The aim of this study was to examine changes in the distribution of causes of death and mortality rates among psychiatric patients visiting a psychiatric emergency room (PER), to determine clinically useful predictors for avoiding premature mortality among these patients and to discuss...... linked to the Cause of Death Register and the Central Psychiatric Research Register, and logistic predictor analyses for premature death were performed. RESULTS: The standardised mortality ratio (SMR) of all visitors compared to the general Danish population was approximately 5. Overall, patients...... was the strongest predictor of premature death among visitors to a PER (odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.5, 2.2). CONCLUSION: Persons visiting the PER had an increased SMR and substance use disorders were the strongest predictor of premature death within 3 years. However, death caused...

  17. Clinically useful predictors for premature mortality among psychiatric patients visiting a psychiatric emergency room

    DEFF Research Database (Denmark)

    Aagaard, Jørgen; Buus, Niels; Wernlund, Andreas Glahn

    2016-01-01

    OBJECTIVE: The aim of this study was to examine changes in the distribution of causes of death and mortality rates among psychiatric patients visiting a psychiatric emergency room (PER), to determine clinically useful predictors for avoiding premature mortality among these patients and to discuss...... linked to the Cause of Death Register and the Central Psychiatric Research Register, and logistic predictor analyses for premature death were performed. RESULTS: The standardised mortality ratio (SMR) of all visitors compared to the general Danish population was approximately 5. Overall, patients...... was the strongest predictor of premature death among visitors to a PER (odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.5, 2.2). CONCLUSION: Persons visiting the PER had an increased SMR and substance use disorders were the strongest predictor of premature death within 3 years. However, death caused...

  18. Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

    Directory of Open Access Journals (Sweden)

    Ricardo Tristão-Sá

    2012-12-01

    Full Text Available INTRODUCTION: To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. METHODS: A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV seropositive and pregnant women were excluded from the study. RESULTS: At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90 of dengue patients. We also observed that, 57.7% (15/26 of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT levels overcame aspartate aminotransferase (AST during the convalescent period. Male patients were more severely affected than females. CONCLUSIONS: Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.

  19. Clinical supervision in the provision of intensive home visiting by health visitors.

    Science.gov (United States)

    Jarrett, Patricia; Barlow, Jane

    2014-02-01

    The objective of this paper is to explore the perceptions of health visitors working in frontline child protection concerning the role of clinical supervision. Fifteen health visitors ('home visitors') providing an intensive home visiting service to high-risk families in the south east of England were interviewed about their experience of receiving supervision. The model of clinical supervision used was based on the Family Partnership Programme and delivered by two trained psychotherapists. The data were analysed using thematic analysis. Home visitors believed that clinical supervision enabled them to maintain boundaries, regulate and reflect on their practice, and develop a better understanding of the issues clients were facing. The model of supervision used and the organisational context were believed to be important factors in the delivery of clinical supervision and to have contributed to its success.

  20. CLINICAL PROFILE OF CHILDREN IN THE AGE GROUP 6 MONTHS TO 60 MONTHS WITH LOWER RESPIRATORY TRACT INFECTION

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    Bharath Kumar

    2015-05-01

    Full Text Available CONTEXT : Infections of the respiratory tract are perhaps the most common human ailments. Acute Respiratory Infections (ARI has quite a high morbidity and mortality in children in developing countries 1 ARI is responsible for about 30 - 50 percent of visits to health facilities and for about 20 - 40 percent of hospital admissions. Pneumonia is a leading cause of mortality in children worldwide. Because mortality due to pneumonia in developing countries is attributable mainly to bacterial etiology , IM NCI strategy recommends the use of antibiotics when a child presented with tachypnea as defined previously . AIMS : To re - define or refine tachypnea as a specific indicator of bacterial pneumonia. To identify other clinical predictors for identifying bacteri al pneumonia. DESIGNS : The study was designed to be done in two phases . In the first phase it is to be carried out as a descriptive study of children presenting with fever and respiratory distress in the OPD to identify the specific markers for bacterial p neumonia. In the second phase presenting clinical features in children with radiological pneumonia will be analysed to validate the findings from Phase I. MATERIALS AND METHODS : This was a hospital based study and was conducted in Sri Manakula V inayagar Me dical College and Hospital , Puducherry . The study included 100 Children in the age group 6 months to 5 years presenting in the out patients department with fever and respiratory distress Children attending the out - patient department on a fixed day of the w eek (Monday and who come under this study population during the study period were admitted and recruited in the study and informed verbal consent for participation was taken from the parents. Their clinical profiles were recorded as in phase I. All childr en coming under this study population were given antibiotics and supportive treatment. The cases were monitored for any worsening or improvement every 6 th hourly on day 1 and

  1. 小针刀配合运动疗法治疗膝骨关节炎:随机对照3个月随访%A randomized control clinical study on small-needle-knife therapy combined with exercise therapy for knee osteoarthritis:3-month follow-up visit

    Institute of Scientific and Technical Information of China (English)

    赵明雷; 白跃宏; 张颖; 施问民

    2016-01-01

    BACKGROUND:Smal-needle-knife therapy for knee osteoarthritis has no uniform location, operation and mechanisms of action. Studies have proved that exercise therapy can enhance muscle strength, increase stability of the knee, improve joint range of motion, and effectively relieve pain. OBJECTIVE:To observe the clinical effect of smal-needle-knife therapy combined with exercise therapy for treatment of knee osteoarthritisvia a randomized controled clinical trial. METHODS:122 patients were randomly divided into treatment group (n=61; smal-needle-knife therapy combined with exercise therapy) and control group (n=61; low-frequency therapy combined with exercise therapy). Then, clinical efficacy in the two groups were assessed by statistical analysis of visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), sweling degree of the knee joint, quadriceps circumference, flexion and extension of the knee joint before and after treatment. Meanwhile, adverse reactions in patients were recorded for safety evaluation. RESULTS AND CONCLUSION:(1) The visual analog scale and WOMAC scores in the two groups were both significantly improved at 2 weeks after treatment (P   目的:通过随机对照临床试验,观察小针刀联合运动疗法治疗膝骨关节炎的临床疗效。  方法:采用随机数字表将122例膝骨关节炎患者随机分为治疗组(n=61)和对照组(n=61),治疗组给予小针刀治疗,对照组予以低周波理疗,两组同时配合运动训练。统计分析治疗前、治疗后的疼痛目测类比评分、麦克马斯特大学骨关节炎指数问卷调查(W OMAC)、以及膝关节肿胀程度、股四头肌周径、膝关节屈伸活动度来评价两组的临床疗效;同时观察并记录患者的不良反应,评价综合治疗的安全性。  结果与结论:①治疗2周结束后,两组患者目测类比评分法、麦克马斯特大学骨关节炎指数评分,与治疗前相

  2. Annual patient and caregiver burden of oncology clinic visits for granulocyte-colony stimulating factor therapy in the US.

    Science.gov (United States)

    Stephens, J Mark; Li, Xiaoyan; Reiner, Maureen; Tzivelekis, Spiros

    2016-01-01

    Prophylactic treatment with granulocyte-colony stimulating factors (G-CSFs) is indicated for chemotherapy patients with a significant risk of febrile neutropenia. This study estimates the annual economic burden on patients and caregivers of clinic visits for prophylactic G-CSF injections in the US. Annual clinic visits for prophylactic G-CSF injections (all cancers) were estimated from national cancer incidence, chemotherapy treatment and G-CSF utilization data, and G-CSF sales and pricing information. Patient travel times, plus time spent in the clinic, were estimated from patient survey responses collected during a large prospective cohort study (the Prospective Study of the Relationship between Chemotherapy Dose Intensity and Mortality in Early-Stage (I-III) Breast Cancer Patients). Economic models were created to estimate travel costs, patient co-pays and the economic value of time spent by patients and caregivers in G-CSF clinic visits. Estimated total clinic visits for prophylactic G-CSF injections in the US were 1.713 million for 2015. Mean (SD) travel time per visit was 62 (50) min; mean (SD) time in the clinic was 41 (68) min. Total annual time for travel to and from the clinic, plus time at the clinic, is estimated at 4.9 million hours, with patient and caregiver time valued at $91.8 million ($228 per patient). The estimated cumulative annual travel distance for G-CSF visits is 60.2 million miles, with a total transportation cost of $28.9 million ($72 per patient). Estimated patient co-pays were $61.1 million, ∼$36 per visit, $152 per patient. The total yearly economic impact on patients and caregivers is $182 million, ∼$450 per patient. Data to support model parameters were limited. Study estimates are sensitive to the assumptions used. The burden of clinic visits for G-CSF therapy is a significant addition to the total economic burden borne by cancer patients and their families.

  3. Data analysis of 87 tic patients for 6 months' treatment in a Korean medicine clinic.

    Science.gov (United States)

    Chun, Young-Ho; Kim, Won-Ill; Kim, Bo-Kyung

    2013-10-01

    This study was carried out to investigate the relationship between the therapeutic effects of treatment for tic disorder and Korean medicine clinical tests, including body mass index (BMI) and heart variability rate (HRV). This study was not a clinical trial, but a data analysis of 87 tic patients who were treated for 6 months during the time period from Nov. 2010 to Jan. 2012. The clinical evaluation of the symptoms was recorded using the Korean version of the Yale Global Tic Severity Scale (YGTSS). The BMI and the HRV were measured according to a schedule, and various kinds of statistical methods were used. Among the 87 patients, the number of males was 3.34 times the number of females, and 58 patients (66.7%) had been suffering for more than 12 months. The onset age of the males was significantly lower than that of the females, and males had the symptoms longer than females had. Also, males with a family history of tics were 2.5 times as many as females, and their onset ages were substantially lower. At the first medical examinations, the average score on the YGTSS was 34.08, and it decreased linearly as the treatment progressed. After 4 and 6 months of treatment, it had decreased significantly. The YGTSS score and the period of suffering correlated positively. At the first visit, each HRV datum was in the normal range. After the 6 months' treatment, Ln (TP), Ln (LF), and Ln (HF) had dropped substantially in the normal range while Ln (VLF) and the LF/HF ratio had not changed in a meaningful way. During the treatment period, the BMI stayed relatively constant without any meaningful changes.

  4. Mental and somatic symptoms related to suicidal ideation in patients visiting a psychosomatic clinic in Japan

    Directory of Open Access Journals (Sweden)

    Kouichi Yoshimasu

    2009-08-01

    Full Text Available Kouichi Yoshimasu1, Tetsuya Kondo2,4, Shoji Tokunaga3, Yoshio Kanemitsu2, Hideyo Sugahara2, Mariko Akamine2, Kanichiro Fujisawa2, Kazuhisa Miyashita1, Chiharu Kubo21Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan; 2Department of Psychosomatic Medicine, Graduate school of Medical Sciences, Kyushu University, Fukuoka, Japan; 3Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan; 4Department of Acupuncture and Moxibustion, Kansai University of Health Sciences, Osaka, JapanAbstract: Patients with suicidal ideation (SI have various mental or somatic symptoms. A questionnaire-based interview elicited details concerning mental and somatic symptoms in patients visiting a psychosomatic clinic in Japan. Univariate logistic regression analyses followed by multiple regression models using a stepwise method were selected for identifying the candidate symptoms. Overall, symptoms related to depression were associated with SI in both sexes. Although women showed more various somatic symptoms associated with SI than men, many of those associations were diminished once severity of the depression was controlled. The current results suggest that a variety of self-reported symptoms, mainly related to depression, might reveal suicidal risk in outpatients with an urban hospital clinical setting.Keywords: suicidal ideation, psychosomatic clinic, subjective symptoms

  5. Evaluation of the Use of a Virtual Patient on Student Competence and Confidence in Performing Simulated Clinic Visits.

    Science.gov (United States)

    Taglieri, Catherine A; Crosby, Steven J; Zimmerman, Kristin; Schneider, Tulip; Patel, Dhiren K

    2017-06-01

    Objective. To assess the effect of incorporating virtual patient activities in a pharmacy skills lab on student competence and confidence when conducting real-time comprehensive clinic visits with mock patients. Methods. Students were randomly assigned to a control or intervention group. The control group completed the clinic visit prior to completing virtual patient activities. The intervention group completed the virtual patient activities prior to the clinic visit. Student proficiency was evaluated in the mock lab. All students completed additional exercises with the virtual patient and were subsequently assessed. Student impressions were assessed via a pre- and post-experience survey. Results. Student performance conducting clinic visits was higher in the intervention group compared to the control group. Overall student performance continued to improve in the subsequent module. There was no change in student confidence from pre- to post-experience. Student rating of the ease of use and realistic simulation of the virtual patient increased; however, student rating of the helpfulness of the virtual patient decreased. Despite student rating of the helpfulness of the virtual patient program, student performance improved. Conclusion. Virtual patient activities enhanced student performance during mock clinic visits. Students felt the virtual patient realistically simulated a real patient. Virtual patients may provide additional learning opportunities for students.

  6. Increased emergency room visits or hospital admissions in females after 12-month MMR vaccination, but no difference after vaccinations given at a younger age.

    Science.gov (United States)

    Wilson, Kumanan; Ducharme, Robin; Ward, Brian; Hawken, Steven

    2014-02-26

    Previous studies have suggested that a child's sex may be a predictor of vaccine reactions. We used a self-controlled case series design, an extension of retrospective cohort methodology which controls for fixed confounders using a conditional Poisson modeling approach. We compared a risk period immediately following vaccination to a control period farther removed from vaccination in each child and estimated the relative incidence of emergency room visits and/or hospital admissions following the 2-, 4-, 6-, and 12-month vaccinations to investigate the effect of sex on relative incidence. All infants born in Ontario, Canada between April 1, 2002 and March 31, 2009 were eligible for study inclusion. In analyses combining immunizations at 2, 4 and 6 months and examining these vaccinations separately, there was no significant relationship between the relative incidence of an event and sex of the child. At 12 months, we observed a significant effect of sex, with female sex being associated with a significantly higher relative incidence of events (P=0.0027). The relative incidence ratio (95% CI) comparing females to males following the 12-month vaccination was 1.08 (1.03 to 1.14), which translates to 192 excess events per 100,000 females vaccinated compared to the number of events that would have occurred in 100,000 males vaccinated. As the MMR vaccine is given at 12 months of age in Ontario, our findings suggest that girls may have an increased reactogenicity to the MMR vaccine which may be indicative of general sex differences in the responses to the measles virus. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Clinical application of the Omaha system with the Nightingale Tracker: a community health nursing student home visit program.

    Science.gov (United States)

    Sloan, Helen L; Delahoussaye, Carolyn P

    2003-01-01

    The application of computer use in the clinical and educational arena needs to be emphasized for both the improved management of patient data and nursing knowledge. Faculty commitment to automation of home visit documentation records was essential to sustain the trial of implementing the Nightingale Trackers in the clinical area. The Nightingale Tracker is a software program that automates the Omaha system, a community-friendly nursing language that encourages a focus on health promotion. A team approach involving students, faculty, and technical support enabled the automation of the patient record of a home visiting program in a community health nursing course.

  8. Cancer Patients? Willingness to Routinely Complete the EQ-5D Instrument at Clinic Visits.

    Science.gov (United States)

    Naik, Hiten; Qiu, Xin; Brown, M Catherine; Mahler, Mary; Hon, Henrique; Tiessen, Kyoko; Thai, Henry; Ho, Valerie; Gonos, Christina; Charow, Rebecca; Pat, Vivien; Irwin, Margaret; Herzog, Lindsay; Ho, Anthea; Xu, Wei; Howell, Doris; Seung, Soo Jin; Liu, Geoffrey; Mittmann, Nicole

    2016-09-13

    Health utility (HU) scores play an essential role in pharmacoeconomic analyses. Routine clinical administration of the EuroQol-5 Dimensions (EQ-5D) can allow for HU and health related quality of life (HRQOL) assessments in the real-world setting. The primary goals of this study were to evaluate whether patients were willing to complete the EQ-5D instrument on a routine basis and which clinical or demographic factors influence this willingness. 618 adult cancer survivors across multiple cancer disease sites at the Princess Margaret Cancer Centre completed an acceptability survey after completing the EQ-5D instrument. The mean (SD) EQ-5D score was 0.81 (0.15). Among those surveyed, 88% reported that the EQ-5D was easy to complete. 91% took under 5 minutes and 88% were satisfied with its length. 85% were satisfied with the types of questions asked on the EQ-5D. Importantly, 92% reported that they would complete the EQ-5D, even if it were used solely for research purposes; 73% agreed with the notion of completing it regularly at their clinic visits. Patients with lower EQ-5D scores (p=0.0006), and non-Caucasians (p=0.0024; 60% willing) were less willing to complete the instrument on a regular basis. Curability of tumour, disease site, age, and gender did not influence willingness. The majority of cancer patients across disease sites are willing to complete the EQ-5D instrument regularly, even if it were solely for research purposes, but up to 39% declined participation in the first place.

  9. Assessing outcomes of educational videos in group visits for patients with chronic pain at an academic primary care clinic.

    Science.gov (United States)

    Vogler, Carrie N; Sattovia, Stacy; Salazar, Laura Y; Leung, Tiffany I; Botchway, Albert

    2017-06-01

    This study evaluates the impact of pain education group visits on patients with chronic non-cancer pain (CNCP). The primary outcome of the study was to evaluate patients' functional status and secondary outcomes included knowledge, behavior, and satisfaction, before and after participation in the pain education group visits. Locally produced patient educational videos on chronic non-cancer pain were delivered during patient group visits led by a healthcare provider. Study participants included patients with CNCP pain in an academic general medicine practice. The primary outcome was functional status, measured by the Pain Intensity, Enjoyment of life, and General Activity (PEG) score and the Oswestry Disability Index. Secondary outcomes were evaluated through a pre- and post-intervention knowledge assessment and chart review of opioid use and utilization of emergency and urgent care services. A satisfaction survey was administered after each group visit. Thirty-five patient-group visits were analyzed and 14 patient charts reviewed. A moderately positive correlation was observed between PEG and Oswestry Disability Index (r = 0.47, p high. Group visits providing patient education about CNCP may benefit patients' knowledge about this clinical condition, and was received with high patient satisfaction. Further investigation is needed to evaluate longer-term knowledge retention, sustainability of improvements resulting from the intervention, and longer-term effects of the intervention on functional status.

  10. Prevalence of Trichomonas vaginalis in Women Visiting 2 Obstetrics and Gynecology Clinics in Daegu, South Korea.

    Science.gov (United States)

    Goo, Youn-Kyoung; Shin, Won-Sik; Yang, Hye-Won; Joo, So-Young; Song, Su-Min; Ryu, Jae-Sook; Lee, Won-Myung; Kong, Hyun-Hee; Lee, Won-Ki; Lee, Sang-Eun; Lee, Won-Ja; Chung, Dong-Il; Hong, Yeonchul

    2016-02-01

    This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.

  11. Real life clinic visits do not match the ideals of shared decision making.

    Science.gov (United States)

    Lipstein, Ellen A; Dodds, Cassandra M; Britto, Maria T

    2014-07-01

    To use observation to understand how decisions about higher-risk treatments, such as biologics, are made in pediatric chronic conditions. Gastroenterology and rheumatology providers who prescribe biologics were recruited. Families were recruited when they had an outpatient appointment in which treatment with biologics was likely to be discussed. Consent/assent was obtained to video the visit. Audio of the visits in which a discussion of biologics took place were transcribed and analyzed. Our coding structure was based on prior research, shared decision making (SDM) concepts, and the initial recorded visits. Coded data were analyzed using content analysis and comparison with an existing model of SDM. We recorded 21 visits that included discussions of biologics. In most visits, providers initiated the decision-making discussion. Detailed information was typically given about the provider's preferred option with less information about other options. There was minimal elicitation of preferences, treatment goals, or prior knowledge. Few parents or patients spontaneously stated their preferences or concerns. An implicit or explicit treatment recommendation was given in nearly all visits, although rarely requested. In approximately one-third of the visits, the treatment decision was never made explicit, yet steps were taken to implement the provider's preferred treatment. We observed limited use of SDM, despite previous research indicating that parents wish to collaborate in decision making. To better achieve SDM in chronic conditions, providers and families need to strive for bidirectional sharing of information and an explicit family role in decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. A nurse-driven outpatient clinic for thiopurine-treated inflammatory bowel disease patients reduces physician visits and increases follow-up efficiency.

    Science.gov (United States)

    López, María; Dosal, Angelina; Villoria, Albert; Moreno, Laura; Calvet, Xavier

    2015-01-01

    Patients on thiopurine therapy need frequent monitoring to prevent drug adverse events. To describe the structure and main results of a nurse-driven outpatient clinic (NDOC) program for the follow-up of patients receiving treatment with thiopurine immunosuppressants, we retrospectively reviewed patients' clinical charts on thiopurine drugs, azathioprine (AZA), and 6-mercaptopurine. We evaluated the efficacy of the NDOC by comparing the number of physician visits and the adequacy of laboratory controls for each patient before and after inclusion in the program. From January 2006 to December 2008, 179 patients were included. Of these, 102 had received thiopurines for at least 1 year before the start of the NDOC. Mean age was 42 ± 15 years; 83 were female. In all, 137 of the 179 patients (76%) had Crohn disease. AZA was the most frequent drug used (97%). Mean time of follow-up was 2.03 ± 0.9 years. Implementation of this program decreased the number of physician visits per year-from 4.6 ± 1.9 to 2.4 ± 1.3 (p < .001)-and the number of periods longer than 4 months without laboratory control (from 68% to 45%; p = .01). Leucopenia episodes and complications did not differ significantly before and after the start of the NDOC. Nurse-driven follow-up of these patients reduces physician visits while improving tightness of the follow-up.

  13. An Integrated Model for Patient Care and Clinical Trials (IMPACT) to support clinical research visit scheduling workflow for future learning health systems.

    Science.gov (United States)

    Weng, Chunhua; Li, Yu; Berhe, Solomon; Boland, Mary Regina; Gao, Junfeng; Hruby, Gregory W; Steinman, Richard C; Lopez-Jimenez, Carlos; Busacca, Linda; Hripcsak, George; Bakken, Suzanne; Bigger, J Thomas

    2013-08-01

    We describe a clinical research visit scheduling system that can potentially coordinate clinical research visits with patient care visits and increase efficiency at clinical sites where clinical and research activities occur simultaneously. Participatory Design methods were applied to support requirements engineering and to create this software called Integrated Model for Patient Care and Clinical Trials (IMPACT). Using a multi-user constraint satisfaction and resource optimization algorithm, IMPACT automatically synthesizes temporal availability of various research resources and recommends the optimal dates and times for pending research visits. We conducted scenario-based evaluations with 10 clinical research coordinators (CRCs) from diverse clinical research settings to assess the usefulness, feasibility, and user acceptance of IMPACT. We obtained qualitative feedback using semi-structured interviews with the CRCs. Most CRCs acknowledged the usefulness of IMPACT features. Support for collaboration within research teams and interoperability with electronic health records and clinical trial management systems were highly requested features. Overall, IMPACT received satisfactory user acceptance and proves to be potentially useful for a variety of clinical research settings. Our future work includes comparing the effectiveness of IMPACT with that of existing scheduling solutions on the market and conducting field tests to formally assess user adoption.

  14. Adherence to oral chemotherapy medications among gastroenterological cancer patients visiting an outpatient clinic.

    Science.gov (United States)

    Hirao, Chieko; Mikoshiba, Naoko; Shibuta, Tomomi; Yamahana, Reiko; Kawakami, Aki; Tateishi, Ryosuke; Yamaguchi, Hironori; Koike, Kazuhiko; Yamamoto-Mitani, Noriko

    2017-09-01

    The purpose of this study was to investigate medication adherence to oral chemotherapy medications and determinants of medication non-adherence to them among gastroenterological cancer patients. A cross-sectional study was conducted on 117 consecutive, consenting, eligible patients visiting an outpatient clinic of university hospital in Japan. Good medication adherence was defined as taking 100% of the prescribed dose. Medication adherence was measured via self-report. We hypothesized that there was a significant relationship between medication non-adherence and the five factors defined by the World Health Organization: patient-related, socioeconomic-related, condition-related, treatment-related, and healthcare-system/provider-related factors. Multiple logistic regression models were used to identify factors associated with oral chemotherapy medication non-adherence. The proportion of patients showing good medication adherence was 56.4%. The multiple logistic regression analysis revealed that the determinants of medication non-adherence to oral chemotherapy medications included having a history of patient-caused treatment interruptions due to worsening of symptoms (adjusted odds ratio [AOR] = 9.59, 95% confidence interval [CI] = 1.38-66.47), having diarrhea (AOR = 3.25, 95% CI = 1.13-9.34), experiencing pain (AOR = 0.17, 95% CI = 0.05-0.55), taking oral chemotherapy medication every 8 h (AOR = 5.52, 95% CI = 1.71-17.81), and diminished sense of priority for medication (AOR = 1.40, 95% CI = 1.21-1.63). This study suggests that many patients with gastroenterological cancer were non-adherent to oral chemotherapy medications. It might be necessary to conduct periodic screening and connect patients at a high risk of medication non-adherence to appropriate support.

  15. Characteristics of obese or overweight dogs visiting private Japanese veterinary clinics

    Institute of Scientific and Technical Information of China (English)

    Shiho Usui; Hidemi Yasuda; Yuzo Koketsu

    2016-01-01

    Objective:To characterize obese or overweight dogs that visited private Japanese veterinary clinics located in humid subtropical climate zones.Methods:Dogs were categorized into four body condition score groups and five body size groups based on their breed.Multilevel logistic regression models were applied to the data.A Chi-squared test was used to examine whether the percentage of obese or overweight dogs differed between breeds.Results:There were 15.1% obese dogs and 39.8% overweight dogs.Obese dogs were characterized by increased age and female sex,whereas overweight dogs were characterized by increased age and neuter status(P < 0.05).Peak probabilities of dogs being either obese or overweight were between 7 and 9 years of age,with the probabilities then declining as the dogs got older.For example,in toy sized dogs,the probability of dogs being overweight increased from 33.4% to a peak of 55.1% as dog age rose from 1 to 8years old.Also,in medium,small and toy sized dogs,neutered dogs were more likely to be overweight than intact dogs,whereas neutered small sized dogs were more likely to be obese than intact small sized dogs(P < 0.05).Additionally,the percentages of obese or overweight dogs differed between the 10 selected breeds with the highest percentage of obese or overweight dogs.Conclusions:By taking age,body size,sex and neuter status into account,veterinarians can advise owners about maintaining their dogs in ideal body condition.

  16. Experiences and preferences of patients visiting a head and neck oncology outpatient clinic: a qualitative study.

    Science.gov (United States)

    Bisschop, Jeroen A S; Kloosterman, Fabienne R; van Leijen-Zeelenberg, Janneke E; Huismans, Geert Willem; Kremer, Bernd; Kross, Kenneth W

    2017-05-01

    The objective of this study is to report on an in-depth evaluation of patient experiences and preferences at a Head and Neck Oncology outpatient clinic. A qualitative research design was used to determine the experiences and preferences of Head and Neck Cancer patients in an Oncology Outpatient Clinic, Maastricht University Medical Center, The Netherlands. Head and Neck Cancer Patients, treated for at least 6 months at the Oncology Clinic, were included. A qualitative research design with patient interviews was used. All interviews were recorded and transcribed verbatim to increase validity. Analysis was done with use of the template approach and qualitative data analysis software. Three of the six dimensions predominated in the interview: (1) respect for patients' values, preferences and expressed need, (2) information, communication and education and (3) involvement of family and friends. The dimensions physical comfort; emotional support; coordination and integration of care were considered to be of less significance. The findings from this study resulted in a deeper understanding of patients' experiences and preferences and can be useful in the transition towards a more patient-centered approach of health care.

  17. A clinical study of emergency room visits for oral and maxillofacial lacerations

    Science.gov (United States)

    Park, Kun-Hyo; Song, Jae-Min; Hwang, Dae-Seok; Kim, Yong-Deok; Shin, Sang-Hun; Kim, Uk-Kyu

    2015-01-01

    Objectives This study investigated patients with oral and maxillofacial lacerations who visited the emergency room over a three-year period in an effort to determine the optimal treatment for these injuries. Materials and Methods This study examined 1,742 patients with oral and maxillofacial lacerations with 2,014 different laceration locations who visited the emergency room of Pusan National University Hospital (Busan, Korea) over three years, from January 2011 to December 2013. Patients were classified by sex, age, visit day, cause of injury, injury site, and the presence or absence of soft tissue and tooth injuries. Results The male to female ratio was 2.50:1. Patients under 10 years old were seen most frequently. Most emergency room visits were on weekends. Among intra-oral lacerations, the lip area was the most vulnerable site; among extra-oral lacerations, the chin area was most frequently injured. The most frequent etiology was a slip down. Most lacerations occurred without bone fracture or tooth damage. Conclusion Laceration may differ in large part as compared with the fracture. Therefore, it is necessary to continue collecting data on oral and maxillofacial lacerations to establish optimal emergency room diagnosis and treatment strategies. PMID:26568926

  18. ICU visitation policies.

    Science.gov (United States)

    Cleveland, A M

    1994-09-01

    Critically ill patients need their families more than ever, but rigid policies often restrict family visitation in ICU. Family visitation is not a "privilege" granted by hospitals, it is a necessary adjunct to the therapeutic regimen. Though changing outdated visitation policies can be difficult, it must be done. The clinical nurse specialist can play an important role in planning and implementing needed change.

  19. Effects of dust storm events on weekly clinic visits related to pulmonary tuberculosis disease in Minqin, China

    Science.gov (United States)

    Wang, Yun; Wang, Ruoyu; Ming, Jing; Liu, Guangxiu; Chen, Tuo; Liu, Xinfeng; Liu, Haixia; Zhen, Yunhe; Cheng, Guodong

    2016-02-01

    Pulmonary tuberculosis (PTB) is a major public health problem in China. Minqin, a Northwest county of China, has a very high number of annual PTB clinic visits and it is also known for its severe dust storms. The epidemic usually begins in February and ends in July, while the dust storms mainly occur throughout spring and early summer, thereby suggesting that there might be a close link between the causative agent of PTB and dust storms. We investigated the general impact of dust storms on PTB over time by analyzing the variation in weekly clinic visits in Minqin during 2005-2012. We used the Mann-Whitney-Pettitt test and a regression model to determine the seasonal periodicity of PTB and dust storms in a time series, as well as assessing the relationships between meteorological variables and weekly PTB clinic visits. After comparing the number of weekly PTB cases in Gansu province with dust storm events, we detected a clear link between the population dynamics of PTB and climate events, i.e., the onset of epidemics and dust storms (defined by an atmospheric index) occurred in almost the same mean week. Thus, particulate matter might be the cause of PTB outbreaks on dust storm days. It is highly likely that the significant decline in annual clinic visits was closely associated with improvements in the local environment, which prevented desertification and decreased the frequency of dust storm events. To the best of our knowledge, this is the first population-based study to provide clear evidence that a PTB epidemic was affected by dust storms in China, which may give insights into the association between this environmental problem and the evolution of epidemic disease.

  20. Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study

    OpenAIRE

    2013-01-01

    Background Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Methods Study...

  1. Exploratory time varying lagged regression: modeling association of cognitive and functional trajectories with expected clinic visits in older adults.

    Science.gov (United States)

    Sentürk, Damla; Ghosh, Samiran; Nguyen, Danh V

    2014-05-01

    Motivated by a longitudinal study on factors affecting the frequency of clinic visits of older adults, an exploratory time varying lagged regression analysis is proposed to relate a longitudinal response to multiple cross-sectional and longitudinal predictors from time varying lags. Regression relations are allowed to vary with time through smooth varying coefficient functions. The main goal of the proposal is to detect deviations from a concurrent varying coefficient model potentially in a subset of the longitudinal predictors with nonzero estimated lags. The proposed methodology is geared towards irregular and infrequent data where different longitudinal variables may be observed at different frequencies, possibly at unsynchronized time points and contaminated with additive measurement error. Furthermore, to cope with the curse of dimensionality which limits related current modeling approaches, a sequential model building procedure is proposed to explore and select the time varying lags of the longitudinal predictors. The estimation procedure is based on estimation of the moments of the predictor and response trajectories by pooling information from all subjects. The finite sample properties of the proposed estimation algorithm are studied under various lag structures and correlation levels among the predictor processes in simulation studies. Application to the clinic visits data show the effect of cognitive and functional impairment scores from varying lags on the frequency of the clinic visits throughout the study.

  2. The Outcomes of Gestational Diabetes Mellitus after a Telecare Approach Are Not Inferior to Traditional Outpatient Clinic Visits

    Directory of Open Access Journals (Sweden)

    Laura del Valle

    2010-01-01

    Full Text Available Objective. To evaluate the feasibility of a telemedicine system based on Internet and a short message service in pregnancy and its influence on delivery and neonatal outcomes of women with gestational diabetes mellitus (GDM. Methods. 100 women diagnosed of GDM were randomized into two parallel groups, a control group based on traditional face-to-face outpatient clinic visits and an intervention group, which was provided with a Telemedicine system for the transmission of capillary glucose data and short text messages with weekly professional feedback. 97 women completed the study (48/49, resp.. Main Outcomes Measured. The percentage of women achieving HbA1c values <5.8%, normal vaginal delivery and having a large for-gestational-age newborn were evaluated. Results. Despite a significant reduction in outpatient clinic visits in the experimental group, particularly in insulin-treated women (2.4 versus 4.6 hours per insulin-treated woman resp.; P<.001, no significant differences were found between the experimental and traditional groups regarding HbA1c levels (all women had HbA1c <5.8% during pregnancy, normal vaginal delivery (40.8% versus 54.2%, resp.; P>.05 and large-for-gestational-age newborns (6.1% versus 8.3%, resp.; P>.05. Conclusions. The system significantly reduces the need for outpatient clinic visits and achieves similar pregnancy, delivery, and newborn outcomes.

  3. "Drop in" gastroscopy outpatient clinic - experience after 9 months

    Directory of Open Access Journals (Sweden)

    Huppertz-Hauss Gert

    2012-02-01

    Full Text Available Abstract Background Logistics handling referrals for gastroscopy may be more time consuming than the examination itself. For the patient, "drop in" gastroscopy may reduce uncertainty, inadequate therapy and time off work. Methods After an 8-9 month run-in period we asked patients, hospital staff and GPs to fill in a questionnaire to evaluate their experience with "drop in" gastroscopy and gastroscopy by appointment, respectively. The diagnostic gain was evaluated. Results 112 patients had "drop in" gastroscopy and 101 gastroscopy by appointment. The number of "drop in" patients varied between 3 and 12 per day (mean 6.5. Mean time from first GP consultation to gastroscopy was 3.6 weeks in the "drop in" group and 14 weeks in the appointment group. The half-yearly number of outpatient gastroscopies increased from 696 before introducing "drop in" to 1022 after (47% increase and the proportion of examinations with pathological findings increased from 42% to 58%. Patients and GPs expressed great satisfaction with "drop in". Hospital staff also acclaimed although it caused more unpredictable working days with no additional staff. Conclusions "Drop in" gastroscopy was introduced without increase in staff. The observed increase in gastroscopies was paralleled by a similar increase in pathological findings without any apparent disadvantages for other groups of patients. This should legitimise "drop in" outpatient gastroscopies, but it requires meticulous observation of possible unwanted effects when implemented.

  4. Rehabilitation after THR: Telephone interview and individual support versus visits in outpatient clinic

    DEFF Research Database (Denmark)

    Hørdam, Britta

    2011-01-01

    . Aim: To study the effect of intervention to patients after THR due to resources, organization and economy. Material and method: Based on power calculation 260 patients aged 18 years and over were enrolled from a waiting list. All patients had filled out SF-36 before surgery and 3, 6,9,12 months after...... by using SF-36 scores within 3 months after surgery, whereas the control group had improvement after 9 months. Both groups had SF-36 filled out preoperatively and 3, 6 and 9 months after THR. In a new study a sub group was identified by having a reduction in general health during 12 months postoperatively...

  5. Assessment of atrial fibrillation ablation outcomes with clinic ECG, monthly 24-h Holter ECG, and twice-daily telemonitoring ECG.

    Science.gov (United States)

    Kimura, Takehiro; Aizawa, Yoshiyasu; Kurata, Naomi; Nakajima, Kazuaki; Kashimura, Shin; Kunitomi, Akira; Nishiyama, Takahiko; Katsumata, Yoshinori; Nishiyama, Nobuhiro; Fukumoto, Kotaro; Tanimoto, Yoko; Fukuda, Keiichi; Takatsuki, Seiji

    2017-03-01

    Differences in the methodologies for evaluating atrial fibrillation (AF) ablation outcomes should be evaluated. In the present study, we compared the AF ablation outcomes among periodic clinic electrocardiography (ECG), 24-h Holter ECG, and telemonitoring ECG to evaluate the differences among these methods. In addition, we evaluated the AF-free survival rate for each method with different durations of the blanking period. A total of 30 AF patients were followed up for 6 months after initial catheter ablation, with clinic ECG on every clinic visit, monthly 24-h Holter ECG, and telemonitoring ECG twice daily and upon symptoms. AF relapse was defined as AF or atrial tachycardia detected with any of the methods. Two patients dropped out of the study, and 28 patients were followed up for 8.8 ± 2.7 months. Patients underwent 3.6 ± 0.8 clinic ECG, 5.1 ± 0.8 Holter ECG, and 273 ± 68 telemonitoring ECG examinations. During the first, second, third, fourth, fifth, and sixth months of follow-up, Holter ECG detected relapses in 11.1, 8.3, 11.5, 15.4, 4.2, and 4.8 % of patients and telemonitoring ECG detected relapses in 32.1, 25.0, 25.0, 17.9, 28.6, and 17.9 % of patients, respectively. When no duration was set for the blanking period, the AF-free survival rate was significantly lower with telemonitoring ECG (46.4 %) than with Holter ECG (78.6 %, P = 0.013) or clinic ECG (85.7 %, P = 0.002). In addition, when the duration of the blanking period was set to 3 months, the AF-free survival rate was significantly lower with telemonitoring ECG than with clinic ECG (92.9 vs. 71.4 %, P = 0.041). The AF ablation outcomes with twice-daily telemonitoring ECG might differ from those with clinic ECG when the duration of the blanking period is 0-3 months. A follow-up based solely on clinic ECG might underestimate AF recurrence.

  6. Initiating Antiretroviral Therapy for HIV at a Patient's First Clinic Visit: The RapIT Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Sydney Rosen

    2016-05-01

    Full Text Available High rates of patient attrition from care between HIV testing and antiretroviral therapy (ART initiation have been documented in sub-Saharan Africa, contributing to persistently low CD4 cell counts at treatment initiation. One reason for this is that starting ART in many countries is a lengthy and burdensome process, imposing long waits and multiple clinic visits on patients. We estimated the effect on uptake of ART and viral suppression of an accelerated initiation algorithm that allowed treatment-eligible patients to be dispensed their first supply of antiretroviral medications on the day of their first HIV-related clinic visit.RapIT (Rapid Initiation of Treatment was an unblinded randomized controlled trial of single-visit ART initiation in two public sector clinics in South Africa, a primary health clinic (PHC and a hospital-based HIV clinic. Adult (≥18 y old, non-pregnant patients receiving a positive HIV test or first treatment-eligible CD4 count were randomized to standard or rapid initiation. Patients in the rapid-initiation arm of the study ("rapid arm" received a point-of-care (POC CD4 count if needed; those who were ART-eligible received a POC tuberculosis (TB test if symptomatic, POC blood tests, physical exam, education, counseling, and antiretroviral (ARV dispensing. Patients in the standard-initiation arm of the study ("standard arm" followed standard clinic procedures (three to five additional clinic visits over 2-4 wk prior to ARV dispensing. Follow up was by record review only. The primary outcome was viral suppression, defined as initiated, retained in care, and suppressed (≤400 copies/ml within 10 mo of study enrollment. Secondary outcomes included initiation of ART ≤90 d of study enrollment, retention in care, time to ART initiation, patient-level predictors of primary outcomes, prevalence of TB symptoms, and the feasibility and acceptability of the intervention. A survival analysis was conducted comparing attrition

  7. Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study

    Directory of Open Access Journals (Sweden)

    Ipsita Maity

    2014-01-01

    Full Text Available Aims: The aim of this study was to assess the outcome of single sitting root canal treatment (RCT of asymptomatic teeth with periapical cysts. Materials and Methods: Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Results: Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. Conclusions: It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases.

  8. A prospective 9-month human clinical evaluation of Laser-Assisted New Attachment Procedure (LANAP) therapy.

    Science.gov (United States)

    Nevins, Marc; Kim, Soo-Woo; Camelo, Marcelo; Martin, Ignacio Sanz; Kim, David; Nevins, Myron

    2014-01-01

    This investigation was designed and implemented as a single-center, prospective study to evaluate the clinical response to the Laser-Assisted New Attachment Procedure (LANAP). Eight patients with advanced periodontitis were enrolled and treated with full-mouth LANAP therapy and monitored for 9 months. Fullmouth clinical measurements, including clinical attachment level (CAL), probing depth (PD), and recession, were provided at baseline and after 9 months of healing by a single calibrated examiner, including a total of 930 sites and 444 sites with initial PD equal to or greater than 5 mm. Clinical results for the 930 sites measured pre- and postoperatively revealed that mean PD was reduced from 4.62 ± 2.29 mm to 3.14 ± 1.48 mm after 9 months (P LANAP therapy should be further investigated with long-term clinical trials to compare the stability of clinical results with conventional therapy.

  9. Visit safety

    CERN Multimedia

    2012-01-01

    Experiment areas, offices, workshops: it is possible to have co-workers or friends visit these places.     You already know about the official visits service, the VIP office, and professional visits. But do you know about the safety instruction GSI-OHS1, “Visits on the CERN site”? This is a mandatory General Safety Instruction that was created to assist you in ensuring safety for all your visits, whatever their nature—especially those that are non-official. Questions? The HSE Unit will be happy to answer them. Write to safety-general@cern.ch.   The HSE Unit

  10. My favorite tips from the "clinical interviewing tip of the month" archive.

    Science.gov (United States)

    Shea, Shawn Christopher

    2007-06-01

    The "Interviewing Tips of the Month" on the Website of the Training Institute for Suicide Assessment and Clinical Interviewing are supplied by visitors to the Website or by participants in the author's workshops. Each month the author chooses a favorite tip for posting and then adds the past month's tip to the "Tip Archive." This article describes eight effective tips for uncovering sensitive material such as antisocial behavior, substance abuse, and physical violence as well as a technique for improving medication adherence.

  11. Usage report of pharmacopuncture in musculoskeletal patients visiting Korean medicine hospitals and clinics in Korea

    OpenAIRE

    Lee, Yoon Jae; Shin, Joon-Shik; Lee, Jinho; Kim, Me-Riong; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Hong, Jungwan; Ha, In-Hyuk

    2016-01-01

    Background Pharmacopuncture is a relatively new acupuncture therapy combining acupuncture with herbal medicine. While pharmacopuncture is applied extensively in Korean medicine treatment, there are no clinical reports regarding what types of pharmacopuncture are used for which diseases. Methods Data was extracted retrospectively from the electronic medical records of all inpatients and outpatients at 12 Korean medicine hospitals and clinics during the period of December 17, 2010 to October 2,...

  12. Six-month IVUS and two-year clinical outcomes in the EVOLVE FHU trial

    DEFF Research Database (Denmark)

    Meredith, Ian T; Verheye, Stefan; Weissman, Neil J

    2013-01-01

    The EVOLVE FHU trial demonstrated non-inferiority of six-month late loss with two dose formulations of SYNERGY, a novel bioabsorbable polymer everolimus-eluting stent (EES) compared with the durable polymer PROMUS Element (PE) EES. The current analysis describes the six-month IVUS and clinical re...

  13. Visit ISOLDE!

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    CERN Internal Communication is organising a visit to ISOLDE – an opportunity for you to see the CERN set-up that can produce over 1000 different isotopes!   If you wish to participate, you can sign up for a visit by sending us an e-mail. Note that the visits will take place between 18 and 22 February, and will be open only to CERN access-card holders.   The visit will include an introduction by experts and a tour of the ISOLDE set-up. NB: For security reason, pregnant women and kids under the age of 16 can not take the tour.  

  14. STUDY OF CLINICAL PRESENTATIONS OF PATIENTS WITH HYPERPROLACTINAEMIA VISITING A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Binoy Kumar Mohanty

    2016-06-01

    Full Text Available BACKGROUND Hyperprolactinaemia is one of the common endocrine disorders seen in clinical practice. It may result due to various causes and elucidating the exact cause is necessary to formulate the right therapy. OBJECTIVE To study the various aetiologies and clinical presentation of patients presenting with hyperprolactinaemia to a tertiary care hospital. DESIGN Cross-sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 74 consecutive patients who presented to our department from June 2015 to May 2016 for evaluation of hyperprolactinaemia. RESULTS Majority of the subjects studied belonged to 20-29 years group (47.29% followed by 30-39 years age group (24.32%. The most common cause in our population was due to drug-induced causes (35.13%. The next common causes included idiopathic group (20.4% followed by pituitary adenomas (16.21%. There was significant female predominance (83.78% among total cases. Among women who presented with hyperprolactinaemia, menstrual irregularity (69.35% followed by galactorrhoea (35.48% were the most common presentations. CONCLUSIONS Hyperprolactinaemia is frequently seen among women who presented with either menstrual irregularity or galactorrhoea or both. Drug-induced hyperprolactinaemia is the most common cause seen in our study population.

  15. Care and economic impact of thyroid ultrasound examination at single visits to endocrinology clinics (the ETIEN 1 study).

    Science.gov (United States)

    Carral, Florentino; Ayala, María del Carmen; Jiménez, Ana Isabel; García, Concepción

    2016-02-01

    Routine thyroid ultrasound examination in a single medical appointment is rarely performed in Spain. The objective of this study was to evaluate the care and economic impact of thyroid US examination in a single endocrine appointment. A prospective, observational, descriptive study was conducted to analyze data from 2274 patients (mean age, 59±16 years; 83% females) performed at least one thyroid US in a single visit to an endocrinology clinic during 2013 and 2014. The number of endocrine acts with thyroid US, single endocrine and US acts without review, and the change in the number of thyroid US requested by endocrinologists to the radiology department and total thyroid US examinations performed at the radiology department during the study period were assessed. In 2013 and 2014, 2558 endocrine acts with thyroid US were performed, of which 42.2% were single endocrine and US appointments without a second endocrine act, with estimated savings of €58,946.40. As compared to 2012, the number of thyroid US requested by endocrinologists to the radiology department decreased by 43.3% and 86.0% in 2013 and 2014 respectively, and total thyroid US performed by the radiology department decreased by 28.1% and 68.3% respectively, with estimated savings of €94,441.36. Thyroid US examination in a single endocrine appointment allows for decreasing the number of both second endocrine acts and thyroid US examinations performed at the radiology department, thus reducing the number of unnecessary clinic visits and promoting considerable economic savings. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  16. Effect of frequency of clinic visits and medication pick-up on antiretroviral treatment outcomes: a systematic literature review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Tsitsi Mutasa-Apollo

    2017-07-01

    Conclusions: Our systematic review suggests that reduction of clinical visits (and likely ARVs pick-ups may improve clinical outcomes, and that they are a viable option to relieve health systems and reduce burden of care for PLHIV. Strategies aimed at reducing clinic visits or drug refill services should focus on stable patients who are virally suppressed, tolerant to their drug regimen and fully adherent. These strategies may be critical to the current changes taking place in HIV treatment policy; thus, due to the data limitations, further high quality research is needed to inform policy and programmatic interventions.

  17. Visit Itinerary

    CERN Multimedia

    2002-01-01

    The visit itinerary includes five area of halls 191 and 180:. End-Cap Toroid Integration Area . Barrel Toroid Integration Area . Cryogenic Test Facility for Toroid Magnets and Helium Pumps . Liquid Argon Cryostats Assembly Area . Central Solenoid Magnet Test Station

  18. The construction and implementation of a clinical decision-making algorithm reduces the cost of adult fracture clinic visits by up to £104,800 per year: a quality improvement study.

    Science.gov (United States)

    Legg, P; Ramoutar, D; Shivji, F; Choudry, B; Milner, S

    2017-04-01

    INTRODUCTION Inappropriate referrals to the new patient fracture clinic unnecessarily consume hospital resources and many hospitals lack clear guidelines as to what should be referred. Many of these injuries can be definitively managed by the emergency department. Our aim was to construct and disseminate a clinical decision-making algorithm to reduce the frequency of inappropriate referrals to fracture clinics at our institution, to improve the management of patients with minor injuries and save the hospital and the patient the cost of unnecessary visits. MATERIALS AND METHODS Data were prospectively collected for all new fracture clinic referrals over two separate 1-week cycles with cohorts of 94 and 74 patients, respectively. After the first cycle, the referral algorithm was disseminated both electronically (intranet) and orally (presentations to emergency department staff). The results of this intervention were examined in the second cycle, which took place 6 months after the first cycle. RESULTS The introduction of this algorithm significantly reduced inappropriate referrals by almost 20% (P = 0.0445). DISCUSSION This simple intervention highlighted a potential annual cost saving of up to £104,000. We advocate the use of this concise algorithm in improving the efficiency of the referral system to fracture clinics.

  19. Knowledge of complications of diabetes mellitus among patients visiting the diabetes clinic at Sampa Government Hospital, Ghana: a descriptive study.

    Science.gov (United States)

    Obirikorang, Yaa; Obirikorang, Christian; Anto, Enoch Odame; Acheampong, Emmanuel; Batu, Emmanuella Nsenbah; Stella, Agyemang Duah; Constance, Omerige; Brenya, Peter Kojo

    2016-07-26

    Diabetes mellitus (DM) appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent society. The study aimed to determine the knowledge of diabetic complications among diabetes mellitus clients visiting the Diabetic Clinical at Sampa Government Hospital, Ghana. This questionnaire-based descriptive study recruited a total 630 patients visiting the Diabetes Clinic at the Sampa Government Hospital. Structured questionnaire was used to obtain information such as socio-demographic and knowledge on complications of diabetes. Out of a total of 630 participants, 325 (51.5 %) knew diabetic foot as the most common complication followed by hypertension 223(35.4 %), neuropathy 184 (29.2 %), hypoactive sexual arousal 160(25.4 %), arousal disorder 135(21.5 %), eye diseases 112(17.7 %), heart disease 58(9.2 %), and renal disease 34(5.4 %). Comprehensive assessment of level of knowledge on the complications showed that majority 378(60.0 %) of T2D patients did not have knowledge on diabetes complications, 169(26.9 %) had inadequate knowledge on diabetics complication while 82(13.1 %) had adequate knowledge. The risk factors associated with the level of knowledge of diabetic complications were female gender adjusted odd ratio (AOR) =2.31 (1.56-3.41) married participants AOR = 3.37 (1.44-7.93), widowed AOR = 2.98 (1.10-8.08), basic level of education AOR =0.18 (0.082-0.50), Junior High School (JHS) and above of education level AOR = 0.035(0.017-0.75), 5-9 years of T2D duration AOR = 0.31(0.018-0.57), ≥10 years T2D duration AOR = 0.042 (0.02-0.10) and urban dwellers AOR = 0.36 (0.22-0.68) respectively. Participants knew the individual complication of diabetic mellitus but lack an in-depth knowledge on the complications. Further expansion of diabetic educative programs like using mass media and involving national curriculum of education can improve self-regulatory awareness of

  20. Completion of treatment for latent tuberculosis infection with monthly drug dispensation directly through the tuberculosis clinic.

    Directory of Open Access Journals (Sweden)

    Claudia C Dobler

    Full Text Available SETTING: An Australian metropolitan TB clinic where treatment for latent tuberculosis infection (LTBI comprises six months of isoniazid, self-administered but dispensed monthly by the clinic. OBJECTIVE: To determine the proportion of patients who complete treatment for LTBI and to identify factors associated with non-completion. METHODS: Clinical files of all patients receiving treatment for LTBI between 01/2000 and 12/2010 were reviewed. The study population comprised all patients who were commenced on isoniazid as treatment for LTBI. Odds ratios (OR for completing treatment were estimated by logistic regression. RESULTS: Of 216 patients who commenced isoniazid treatment for LTBI, 163 (75% completed six months treatment [corrected]. Fifty-three percent of the 53 patients who did not complete treatment dropped out after three months treatment. The mean (SD age of the patients was 27 (16 years and 123 (57% were female. The majority of patients (59% were born overseas and 69% received treatment for LTBI because they were contacts of patients with TB. Patients' sex, age, country of birth, time since immigration for overseas born people, health care worker status, TST conversion status, chest x-ray findings, language, employment status and the indication for which treatment of LTBI was prescribed were not significantly related to treatment completion. CONCLUSION: In a setting where isoniazid is dispensed monthly by the TB clinic, a relatively high proportion of patients who commence treatment for LTBI complete the six month scheduled course of treatment. The study did not identify any patient characteristics that predicted treatment completion. Interventions to improve completion rates should extend over the whole duration of treatment.

  1. Between-Scanner and Between-Visit Variation in Normal White Matter Apparent Diffusion Coefficient Values in the Setting of a Multi-Center Clinical Trial.

    Science.gov (United States)

    Huo, J; Alger, J; Kim, H; Brown, M; Okada, K; Pope, W; Goldin, J

    2016-12-01

    To study the between-scanner variation and the between-visit reproducibility of brain apparent diffusion coefficient (ADC) measurements in the setting of a multi-center chemotherapy clinical trial for glioblastoma multiforme. ADC maps of 52 patients at six sites were calculated in-house from diffusion-weighted images obtained by seven individual scanner models of two vendors. The median and coefficient of variation (CV) of normal brain white matter ADC values from a defined region of interest were used to evaluate the differences among scanner models, vendors, magnetic fields, as well as successive visits. All patients participating in this study signed institutional review board approved informed consent. Data acquisition was performed in compliance with all applicable Health Insurance Portability and Accountability Act regulations. The study spanned from August 1, 2006, to January 29, 2008. For baseline median ADC, no difference was observed between the different scanner models, different vendors, and different magnetic field strength. For baseline ADC CV, a significant difference was found between different scanner models (p = 0.0002). No between-scanner difference was observed in ADC changes between two visits. For between-visit reproducibility, significant difference was seen between the ADC values measured at two successive visits for the whole patient group. The CVs varied significantly between scanners, presumably due to image noise. Consistent scanner parameter setup can improve reproducibility of the ADC measurements between visits.

  2. Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study

    Science.gov (United States)

    2013-01-01

    Background Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Methods Study subjects were children aged 6 to 15 years who participated in the school-based dental sealant program through the mobile dental clinic operated by the Institute for Rural Health at Western Kentucky University between September 2006 and May 2011 (n = 2,453). Descriptive statistics were calculated for sociodemographic factors (age, gender, race/ethnicity, insurance status, and urban versus rural residential location) and caries status. We used chi-square tests to compare sociodemographic differences of children stratified by caries and no caries status as well as three levels of caries severity. We developed a logistic regression model to investigate factors associated with untreated dental caries while controlling for sociodemographic characteristics. Results The proportion of children having untreated dental caries was 49.7% and the mean number of untreated dental caries was 2.0. The proportion of untreated dental caries was higher in older children, children with no insurance and living in rural residential locations, and caries severity was also higher in these groups. Odds ratio indicated that older ages, not having private insurance (having only public, government-sponsored insurance or no insurance at all) and rural residential location were associated with having untreated dental caries after controlling for sociodemographic characteristics of children. Conclusions Untreated dental caries was more likely to be present in older children living in rural areas without

  3. Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study.

    Science.gov (United States)

    Dawkins, Erika; Michimi, Akihiko; Ellis-Griffith, Gregory; Peterson, Tina; Carter, Daniel; English, Gary

    2013-05-02

    Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Study subjects were children aged 6 to 15 years who participated in the school-based dental sealant program through the mobile dental clinic operated by the Institute for Rural Health at Western Kentucky University between September 2006 and May 2011 (n = 2,453). Descriptive statistics were calculated for sociodemographic factors (age, gender, race/ethnicity, insurance status, and urban versus rural residential location) and caries status. We used chi-square tests to compare sociodemographic differences of children stratified by caries and no caries status as well as three levels of caries severity. We developed a logistic regression model to investigate factors associated with untreated dental caries while controlling for sociodemographic characteristics. The proportion of children having untreated dental caries was 49.7% and the mean number of untreated dental caries was 2.0. The proportion of untreated dental caries was higher in older children, children with no insurance and living in rural residential locations, and caries severity was also higher in these groups. Odds ratio indicated that older ages, not having private insurance (having only public, government-sponsored insurance or no insurance at all) and rural residential location were associated with having untreated dental caries after controlling for sociodemographic characteristics of children. Untreated dental caries was more likely to be present in older children living in rural areas without insurance. Health interventionists may use

  4. Austrian visit

    CERN Multimedia

    2003-01-01

    Hans Hoffmann, Director for Technology Transfer and Scientific Computing, and Maria Rauch-Kallat, Minister of Health and Women's Issues, Austria, signing the visitors' book.Maria Rauch-Kallat, Minister of Health and Women's Issues, Austria, was welcomed by Hans Hoffmann, Director for Technology Transfer and Scientific Computing, on her visit to CERN on 19 May 2003. The theme of the visit was Technology Transfer and spin-offs from CERN for medical applications. Maria Rauch-Kallat toured also the installations of ATLAS.

  5. Polish visit

    CERN Multimedia

    2003-01-01

    On 6 October, Professor Michal Kleiber, Polish Minister of Science and Chairman of the State Committee for Scientific Research, visited CERN and met both the current and designated Director General, Luciano Maiani and Robert Aymar. Professor Kleiber visited the CMS and ATLAS detector assembly halls, the underground cavern for ATLAS, and the LHC superconducting magnet string test hall. Michal Kleiber (left), Polish minister of science and Jan Krolikowski, scientist at Warsaw University and working for CMS, who shows the prototypes of the Muon Trigger board of CMS.

  6. The clinical effectiveness of various adhesive systems: an 18-month evaluation.

    Science.gov (United States)

    Moosavi, H; Kimyai, S; Forghani, M; Khodadadi, R

    2013-01-01

    The aim of this clinical trial was to compare the clinical performance of three different adhesive systems over 18 months in noncarious cervical lesions (NCCLs). Thirty patients, with at least three noncarious cervical lesions, were enrolled in the study. One operator randomly restored a total of 90 lesions with resin composite (Herculite XRV). The restorations were bonded with either Optibond FL (OF), three-step total-etch; Optibond Solo Plus (OS), two-step total-etch; or Optibond All-In-One (OA), one step self-etch. The restorations were clinically evaluated at baseline and after six, 12, and 18 months using the eight United States Public Health Services criteria. Data were analyzed using Friedman and Wilcoxon signed ranks tests (p0.05). With the exception of marginal discoloration, the clinical effectiveness of three types of adhesive systems in NCCLs was acceptable after 18 months. However, using the one-step self-etch adhesive may lead to some marginal discolorations.

  7. CLINICAL PROFILE OF ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN BETWEEN 2MONTHS TO 5 YEARS

    Directory of Open Access Journals (Sweden)

    Amitoj Singh Chhina

    2015-08-01

    Full Text Available BACKGROUND : Acute respiratory infections are a leading cause of morbidity and mortality in under - five children in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI in children aged 2 month to 5 years. OBJECTIVE : clinical features, laborato ry assessment and morbidity and mortality pattern associated with acute lower respiratory tract infections in children aged 2 months to 5 years. METHODS: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for clinical profile as per a predesigned proforma in a rural medical college. RESULTS : Of cases 61% were infants and remaining 39%12 - 60 months age group, males outnumbered females with sex ratio of 1.3;1. Elevated total leukocyte counts for age were observed in only 22% of cases, of these 3% were having pneumonia, 9% severe pneumonia and 10% very severe pneumonia. Significant association was found between leukocytosis and ALRI severity (p= 0.0001 Positive blood culture was obtained in 8% of cases and was significantly associated with ALRI severity (p=. 0.027. Among the ALRI cases, 84% required oxygen supplementation at any time during the hospital stay and 8% required mechanical ventilation. The mortality rate was 1%; with 99% of cases recovering and getting discharged uneventfully. CONCLUSION : Among the clinical variables, the signs and symptoms of ALRI as per the WHO ARI Control Programme were found in almost all cases. Regarding the laboratory profile, leukocytosis and blood culture positivity w ere observed in a small percentage, but significant association with ALRI severity was observed for both. Thus, clinical signs, and not invasive blood tests are a better diagnostic tools, though the latter may provide additional therapeutic and prognostic information in severe disease

  8. European visit

    CERN Multimedia

    2006-01-01

    The European Commissioner for Science and Research, Janez Potočnik, (on the right) visited the CMS assembly hall accompanied by Jim Virdee, Deputy Spokesman of CMS (on the left), and Robert Aymar, Director-General of CERN. The European Commissioner for Science and Research, Janez Potočnik, visited CERN on Tuesday 31 January. He was welcomed by the Director-General, Robert Aymar, who described the missions and current activities of CERN to him, in particular the realisation of the LHC with its three components: accelerator, detectors, storage and processing of data. The European Commissioner then visited the CMS assembly hall, then the hall for testing the LHC magnets and the ATLAS cavern. During this first visit since his appointment at the end of 2004, Janez Potočnik appeared very interested by the operation of CERN, an example of successful scientific co-operation on a European scale. The many projects (30 on average) that CERN and the European Commission carry out jointly for the benefit of res...

  9. Medical claims-based case–control study of temporal relationship between clinical visits for hand syndromes and subsequent diabetes diagnosis: implications for identifying patients with undiagnosed type 2 diabetes mellitus

    Science.gov (United States)

    Hou, Wen-Hsuan; Li, Chung-Yi; Chen, Lu-Hsuan; Wang, Liang-Yi; Kuo, Li-Chieh; Kuo, Ken N; Shen, Hsiu-Nien; Chiu, Chang-Ta

    2016-01-01

    Objectives To investigate whether a temporal relationship is present between clinical visits for diabetes-related hand syndromes (DHSs) and subsequent type 2 diabetes mellitus (T2DM) diagnosis and, accordingly, whether DHSs can be used for identifying patients with undiagnosed T2DM. Design This study had a case–control design nested within a cohort of 1 million people from the general population, which was followed from 2005 to 2010. The odds of prior clinical visits for DHSs, namely carpal tunnel syndrome (CTS), flexor tenosynovitis, limited joint mobility and Dupuytren's disease, were estimated for cases and controls. We used a conditional logistic regression model to estimate the OR and 95% CI of T2DM in association with a history of DHSs. The validity and predictive value of using the history of DHSs in predicting T2DM diagnosis were calculated. Setting Taiwan National Health Insurance medical claims. Participants We identified 33 571 patients receiving a new diagnosis of T2DM (cases) between 2005 and 2010. Each T2DM case was matched with 5 controls who had the same sex and birth year and were alive on the date of T2DM diagnosis. Primary and secondary outcome measures The primary outcome measure was T2DM diagnosis. Results The OR of T2DM in association with prior clinical visits was significantly increased for overall DHS and CTS, being 1.15 (95% CI 1.10 to 1.20) and 1.22 (95% CI 1.16 to 1.29), respectively. Moreover, 11% of patients with T2DM made clinical visits for CTS within 3 months prior to T2DM diagnosis. The history of DHSs had low sensitivity (<0.1% to 5.2%) and a positive predictive value (9.9% to 11.7%) in predicting T2DM. Conclusions Despite the unsatisfactory validity and performance of DHSs as a clinical tool for detecting patients with undiagnosed T2DM, this study provided evidence that clinical visits for DHSs, particularly for CTS, can be a sign of undiagnosed T2DM. PMID:27798003

  10. Text messaging to improve attendance at post-operative clinic visits after adult male circumcision for HIV prevention: a randomized controlled trial.

    Science.gov (United States)

    Odeny, Thomas A; Bailey, Robert C; Bukusi, Elizabeth A; Simoni, Jane M; Tapia, Kenneth A; Yuhas, Krista; Holmes, King K; McClelland, R Scott

    2012-01-01

    Following male circumcision for HIV prevention, a high proportion of men fail to return for their scheduled seven-day post-operative visit. We evaluated the effect of short message service (SMS) text messages on attendance at this important visit. We enrolled 1200 participants >18 years old in a two-arm, parallel, randomized controlled trial at 12 sites in Nyanza province, Kenya. Participants received daily SMS text messages for seven days (n = 600) or usual care (n = 600). The primary outcome was attendance at the scheduled seven-day post-operative visit. The primary analysis was by intention-to-treat. Of participants receiving SMS, 387/592 (65.4%) returned, compared to 356/596 (59.7%) in the control group (relative risk [RR] = 1.09, 95% confidence interval [CI] 1.00-1.20; p = 0.04). Men who paid more than US$1.25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤ US$1.25 (adjusted relative risk [aRR] 1.35, 95% CI 1.15-1.58; pText messaging resulted in a modest improvement in attendance at the 7-day post-operative clinic visit following adult male circumcision. Factors associated with failure to return were mainly structural, and included transportation costs and low educational level. ClinicalTrials.govNCT01186575.

  11. Transepithelial corneal collagen crosslinking for progressive keratoconus: 24-month clinical results.

    Science.gov (United States)

    Caporossi, Aldo; Mazzotta, Cosimo; Paradiso, Anna Lucia; Baiocchi, Stefano; Marigliani, Davide; Caporossi, Tomaso

    2013-08-01

    To assess the clinical results of transepithelial collagen crosslinking (CXL) in patients 26 years and younger with progressive keratoconus suitable for epithelium-off (epi-off) CXL. Department of Ophthalmology, Siena University Hospital, Siena, Italy. Prospective case series. The study included 26 eyes (26 patients) treated by transepithelial (epithelium-on) CXL. The mean age was 22 years (range 11 to 26 years) (10 younger than 18 years; 16 between 19 years and 26 years). Preoperative and postoperative examinations included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, simulated maximum keratometry (K), coma and spherical aberration, and corneal optical coherence tomography optical pachymetry. The solution for transepithelial CXL (Ricrolin TE) comprised riboflavin 0.1%, dextran 15.0%, trometamol (Tris), and ethylenediaminetetraacetic acid. Ultraviolet-A treatment was performed with the Caporossi Baiocchi Mazzotta X Linker Vega at 3 mW/cm(2). After relative improvement in the first 3 to 6 months, the UDVA and CDVA gradually returned to baseline preoperative values. After 12 months of stability, the simulated maximum K value worsened at 24 months. Coma aberration showed no statistically significant change. Spherical aberration increased at 24 months. Pachymetry showed a progressive, statistically significant decrease at 24 months. Fifty percent of pediatric patients were retreated with epi-off CXL due to significant deterioration of all parameters after 12 months of follow-up. Functional results after transepithelial CXL showed keratoconus instability, in particular in pediatric patients 18 years old and younger; there was also functional regression in patients between 19 years and 26 years old after 24 months of follow-up. mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. Cosmic visits

    CERN Multimedia

    Stefania Pandolfi

    2015-01-01

    On Saturday, 19 September, ESA astronaut Luca Parmitano and Amalia Ercoli Finzi, Principal Investigator of the SD2 experiment on board the ESA Rosetta spacecraft, visited the AMS Control Centre and other CERN installations.   From left to right: Sergio Bertolucci (CERN Director of Research and Computing), Amalia Ercoli Finzi (Emeritus Professor in the Aerospace department of the Polytechnic University of Milan and Principal Investigator of the SD2 experiment on board the ESA Rosetta spacecraft), Maurice Bourquin (AMS-02 Senior Scientist and Honorary Professor in the Nuclear and Corpuscular Physics department of the University of Geneva) and Luca Parmitano (Major in the Italian Air Force and European Space Agency astronaut) in the AMS Payload and Operation Control Centre. They were welcomed in the early morning by Sergio Bertolucci and then headed to the Prévessin site to visit the CERN Control Centre and the Payload and Operation Control Centre (POCC) of the Alpha Magnetic Sp...

  13. Randomized clinical trial of four adhesion strategies in cervical lesions: 12-month results.

    Science.gov (United States)

    de Paula, Eloisa Andrade; Tay, Lidia Yileng; Kose, Carlos; Mena-Serrano, Alexandra; Reis, Alessandra; Perdigão, Jorge; Loguercio, Alessandro D

    2015-01-01

    The aim of this study was to evaluate the 6- and 12-month clinical performance of four adhesion strategies from the same manufacturer (Kerr) in non-carious cervical lesions (NCCLs) using two evaluation criteria. Thirty-five patients, with at least four NCCLs each, participated in this study. After samplesize calculation, 180 restorations were assigned to one of the following groups: OFL (Optibond FL), OSP (Optibond Solo Plus), XTR (Optibond XTR), and AIO (Optibond All-In-One). The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline, after 6 months, and after 12 months, using both the FDI and the USPHS-modified criteria. Statistical analyses were performed with Friedman repeated measures, ANOVA by rank, and the McNemar test for significance in each pair (α=0.05). Six restorations (2 for OFL, 1 for OSP, 2 for XTR, and 1 for AIO) were lost at 12 months (P>0.05 for both evaluation criteria). Marginal staining was observed in seven restorations using the FDI criteria (P>0.05) and three restorations using the USPHSmodified criteria (P>0.05). Eight restorations (2 for OSP, 3 for XTR, and 3 for AIO) were classified as Bravo for marginal adaptation using the USPHSmodified criteria (P>0.05). However, 62 restorations (14 for OFL, 12 for OSP, 15 for XTR, and 21 for AIO) were classified as Bravo using the FDI criteria (P>0.05). The four adhesion strategies showed similar clinical retention at 6 and 12 months. The FDI evaluation criteria tend to be more sensitive than the USPHS-modified criteria.

  14. Randomized clinical trial to comparing efficacy of daily, weekly and monthly administration of vitamin D3.

    Science.gov (United States)

    Takács, István; Tóth, Béla E; Szekeres, László; Szabó, Boglárka; Bakos, Bence; Lakatos, Péter

    2017-01-01

    The comparative efficacy and safety profiles of selected daily 1000 IU, weekly 7000 IU and monthly 30,000 IU vitamin D 3-not previously investigated-will be evaluated. Here, a prospective, randomized clinical trial, comparing efficacy and safety of a daily single dose of 1000 IU (group A) to a once-weekly 7000 IU dose (group B), or monthly 30,000 IU dose (group C) of vitamin D3. The present study is a controlled, randomized, open-label, multicenter clinical trial, 3  months in duration. Sixty-four adult subjects with vitamin D deficiency (25OHD<20 ng/ml), were included according to the inclusion and exclusion criteria. Dose-responses for increases in serum vitamin 25OHD were statistically equivalent for each of the three groups: A, B and C. Outcomes were 13.0 ± 1.5; 12.6 ± 1.1 and 12.9 ± 0.9 ng/ml increases in serum 25OHD per 1000 IU, daily, weekly and monthly, respectively. The treatment of subjects with selected doses restored 25OHD values to levels above 20 ng/ml in all groups. Treatment with distinct administration frequency of vitamin D3 did not exhibit any differences in safety parameters. The daily, weekly and monthly administrations of daily equivalent of 1000 IU of vitamin D3 provide equal efficacy and safety profiles.

  15. Prime time: 18-month violence outcomes of a clinic-linked intervention.

    Science.gov (United States)

    Sieving, Renee E; McMorris, Barbara J; Secor-Turner, Molly; Garwick, Ann W; Shlafer, Rebecca; Beckman, Kara J; Pettingell, Sandra L; Oliphant, Jennifer A; Seppelt, Ann M

    2014-08-01

    Prime Time, a youth development intervention, aims to reduce multiple risk behaviors among adolescent girls seeking clinic services who are at high risk for pregnancy. The purpose of the current study was to examine whether Prime Time involvement produced changes in relational aggression, physical violence, and related psychosocial and behavioral outcomes. Qualitative case exemplars illustrated social contexts of intervention participants with differing longitudinal patterns of relational aggression and physical violence. Data were from a randomized efficacy trial with 13-17 year-old girls (n = 253) meeting specified risk criteria. Intervention participants were involved in Prime Time and usual clinic services for 18 months, control participants received usual clinic services. Participants in the current study completed self-report surveys at baseline and 18 months following enrollment. Outcomes analyses revealed significantly lower levels of relational aggression perpetration in the intervention group versus controls. In contrast, Prime Time involvement did not result in significant reductions in physical violence. Exploratory dose-response analyses indicated that reductions in relational aggression may have been most pronounced among girls actively involved in Prime Time case management and peer leadership activities. Qualitative findings suggested that the intervention's emphasis on modeling and building supportive relationships contributed to reductions in relational aggression. This study contributes to what has been a very limited evidence base regarding effective approaches to preventing violence among high-risk adolescent girls. Findings suggest that offering youth development interventions through clinic settings hold promise in reducing violence risk among vulnerable youth.

  16. Armenian visit

    CERN Multimedia

    2003-01-01

    During his visit to CERN on 4 July 2003, Karen Chshmaritian, Armenian Minister for Trade and Economic Development, toured the ATLAS experimental cavern and assembly hall. From left to right: Aram Kotzinian, from the international organization JINR from Dubna, Marzio Nessi from ATLAS, Karen Chshmaritian, Armenian Minister for Trade and Economic Development, Zohrab Mnatsakanian, Ambassador at the Permanent Mission of the Republic of Armenia to the United Nations in Geneva, Alexandre Sissakian, Vice-Director of JINR and Peter Jenni, ATLAS spokesman.

  17. Effects of home visits by home nurses to elderly people with health problems: design of a randomised clinical trial in the Netherlands [ISRCTN92017183

    Directory of Open Access Journals (Sweden)

    Kempen Gertrudis IJM

    2004-12-01

    Full Text Available Abstract Background Preventive home visits to elderly people by public health nurses aim to maintain or improve the functional status of elderly and reduce the use of institutional care services. A number of trials that investigated the effects of home visits show positive results, but others do not. The outcomes can depend on differences in characteristics of the intervention programme, but also on the selection of the target population. A risk group approach seems promising, but further evidence is needed. We decided to carry out a study to investigate the effects in a population of elderly with (perceived poor health rather than the general population. Also, we test whether nurses who are qualified at a lower professional level (home nurses instead of public health nurses are able to obtain convincing effects. The results of this study will contribute to the discussion on effective public health strategies for the aged. Methods/design The study is carried out as a parallel group randomised trial. To screen eligible participants, we sent a postal questionnaire to 4901 elderly people (70–84 years living at home in a town in the south of the Netherlands. After applying inclusion criteria (e.g., self-reported poor health status and exclusion criteria (e.g., those who already receive home nursing care, we selected 330 participants. They entered the randomisation procedure; 160 were allocated to the intervention group and 170 to the control group. The intervention consists of (at least 8 systematic home visits over an 18 months period. Experienced home nurses from the local home care organisation carry out the visits. The control group receives usual care. Effects on health status are measured by means of postal questionnaires after 12 months, 18 months (the end of the intervention period and after 24 months (the end of 6-months follow-up, and face-to-face interviews after 18 months. Data on mortality and service use are continuously registered

  18. 56-month clinical performance of Class I and II resin composite restorations

    Directory of Open Access Journals (Sweden)

    Flavia Bittencourt Pazinatto

    2012-06-01

    Full Text Available OBJECTIVE: This study evaluated the 56-month clinical performance of Class I and II resin composite restorations. Filtek P60 was compared with Filtek Z250, which are both indicated for posterior restorations but differ in terms of handling characteristics. The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth. MATERIAL AND METHODS: Thirty-three patients were treated by the same operator, who prepared 48 Class I and 42 Class II cavities, which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems. Restorations were evaluated by two independent examiners at baseline and after 56 months, using the modified USPHS criteria. Data were analyzed statistically using Chi-square and Fisher's Exact tests (a=0.05. RESULTS: After 56 months, 25 patients (31 Class I and 36 Class II were analyzed. A 3% failure rate occurred due to secondary caries and excessive loss of anatomic form for P60. For both restorative systems, there were no significant differences in secondary caries and postoperative sensitivity. However, significant changes were observed with respect to anatomic form, marginal discoloration, and marginal adaptation. Significant decreases in surface texture were observed exclusively for the Z250 restorations. CONCLUSIONS: Both restorative systems can be used for posterior restorations and can be expected to perform well in the oral environment.

  19. Crown lengthening in the maxillary anterior region: a 6-month prospective clinical study.

    Science.gov (United States)

    Deas, David E; Mackey, Scott A; Sagun, Ruben S; Hancock, Raymond H; Gruwell, Scott F; Campbell, Casey M

    2014-01-01

    The purpose of this study was to assess osseous parameters and stability of maxillary anterior teeth following crown lengthening surgery. Thirty-six patients requiring facial crown lengthening of 277 maxillary anterior and first premolar teeth were included. Presurgical and intraoperative clinical measurements were recorded at baseline and 1, 3, and 6 months postsurgery at midfacial, mesiofacial, and distofacial line angles. The data presented here suggest that when crown lengthening anterior maxillary teeth, the distance between the desired gingival margin and alveolar crest is usually insufficient to allow for biologic width. In addition, there is significant tissue rebound that may stabilize by 6 months. Tissue rebound appears related to flap position relative to the alveolar crest at suturing. These findings suggest that clinicians should establish proper anterior crown length with osseous resection.

  20. Effect of Comorbid Knee and Hip Osteoarthritis on Longitudinal Clinical and Health Care Use Outcomes in Older Adults With New Visits for Back Pain.

    Science.gov (United States)

    Rundell, Sean D; Goode, Adam P; Suri, Pradeep; Heagerty, Patrick J; Comstock, Bryan A; Friedly, Janna L; Gold, Laura S; Bauer, Zoya; Avins, Andrew L; Nedeljkovic, Srdjan S; Nerenz, David R; Kessler, Larry; Jarvik, Jeffrey G

    2017-01-01

    To examine if a comorbid diagnosis of knee or hip osteoarthritis (OA) in older adults with new back pain visits is associated with long-term patient-reported outcomes and back-related health care use. Prospective cohort study. Three integrated health systems forming the Back pain Outcomes using Longitudinal Data cohort. Participants (N=5155) were older adults (≥65y) with a new visit for back pain and a complete electronic health record data. Not applicable; we obtained OA diagnoses using diagnostic codes in the electronic health record 12 months prior to the new back pain visit. The Roland-Morris Disability Questionnaire (RDQ) and the EuroQol-5D (EQ-5D) were key patient-reported outcomes. Health care use, measured by relative-value units (RVUs), was summed for the 12 months after the initial visit. We used linear mixed-effects models to model patient-reported outcomes. We also used generalized linear models to test the association between comorbid knee or hip OA and total back-related RVUs. Of the 5155 participants, 368 (7.1%) had a comorbid knee OA diagnosis, and 94 (1.8%) had a hip OA diagnosis. Of the participants, 4711 (91.4%) had neither knee nor hip OA. In adjusted models, the 12-month RDQ score was 1.23 points higher (95% confidence interval [CI], 0.72-1.74) for patients with knee OA and 1.26 points higher (95% CI, 0.24-2.27) for those with hip OA than those without knee or hip OA, respectively. A lower EQ-5D score was found among participants with knee OA (.02 lower; 95% CI, -.04 to -.01) and hip OA diagnoses (.03 lower; 95% CI, -.05 to -.01) compared with those without knee or hip OA, respectively. Comorbid knee or hip OA was not significantly associated with total 12-month back-related resource use. Comorbid knee or hip OA in older adults with a new back pain visit was associated with modestly worse long-term disability and health-related quality of life. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All

  1. What Strategies Do Physicians and Patients Discuss to Reduce Out-of-Pocket Costs? Analysis of Cost-Saving Strategies in 1,755 Outpatient Clinic Visits.

    Science.gov (United States)

    Hunter, Wynn G; Zhang, Cecilia Z; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A

    2016-10-01

    More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs. Retrospective analysis of dialogue from 1,755 outpatient visits in community-based practices nationwide from 2010 to 2014. The study population included 677 patients with breast cancer, 422 with depression, and 656 with rheumatoid arthritis visiting 56 oncologists, 36 psychiatrists, and 26 rheumatologists, respectively. Thirty percent of visits contained cost conversations (95% confidence interval [CI], 28 to 32). Forty-four percent of cost conversations involved discussion of cost-saving strategies (95% CI, 40 to 48; median duration, 68 s). We identified 4 strategies to lower costs without changing the care plan. They were, in order of overall frequency: 1) changing logistics of care, 2) facilitating co-pay assistance, 3) providing free samples, and 4) changing/adding insurance plans. We also identified 4 strategies to reduce costs by changing the care plan: 1) switching to lower-cost alternative therapy/diagnostic, 2) switching from brand name to generic, 3) changing dosage/frequency, and 4) stopping/withholding interventions. Strategies were relatively consistent across health conditions, except for switching to a lower-cost alternative (more common in breast oncology) and providing free samples (more common in depression). Focus on 3 conditions with potentially high out-of-pocket costs. Despite price opacity, physicians and patients discuss a variety of out-of-pocket cost reduction strategies during clinic visits. Almost half of cost discussions mention 1 or more cost-saving strategies, with more frequent mention of those not requiring care-plan changes. © The Author(s) 2016.

  2. Study of clinical profile of hyperthermia in neonate admitted in NICU during summer months 2010

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    Kakkad Khyati

    2014-03-01

    Full Text Available Research Question: What is the effect of environmental heat & hyperthermia on neonates? Objectives: 1. To study the clinical and biochemical profile of neonate presented with hyperthermia and heat related illnesses. 2. To study the outcome of neonates presented with hyperthermia and heat related illnesses. Materials & Methods: A retrospective cross sectional study was carried out to study an unusually high number of neonatal hyperthermia cases at the NICU of a tertiary care teaching hospital during summer months (April-June 2010. Their case records were primarily reviewed for presenting signs and symptoms. Findings of clinical assessment and appropriate laboratory investigations were used as tools to rule out hyperpyrexia and other causes. An effort was made to correlate hyperthermia with various other determinant factors which might have a role in increased vulnerability of neonates to hyperthermia. Results: Clinical Profile, signs & symptoms, biochemical profile & outcome of 24 cases of hyperthermia were studied. All were successfully treated and discharged within short time. Normal weight, normally delivered, full term babies in their early neonatal period who are kept in nonthermoregulated ward/unit were most commonly affected. Inadequacy of feeding especially in early neonatal period during summer months with high environmental temperature (heat wave plays an important role in developing hyperthermia in neonates. Hyperthermia & dehydration have bidirectional relationship making hyperthermia an important acute illness among neonates. Conclusions: Inadequacy of feeding, postnatal ward on the topmost and hottest floor of a non-climate controlled hospital building along with coating of Tar on the rooftop (to prevent water leakage from the roof played a crucial role in higher number of hyperthermia cases during heat wave of 2010. Hyperthermia is an acute illness with very good prognosis if identified & treated, timely and promptly

  3. Long-term adherence to daily controller medication in children with asthma : The role of outpatient clinic visits

    NARCIS (Netherlands)

    Keemink, Yvette S.; Klok, Ted; Brand, Paul L. P.

    2015-01-01

    ObjectiveTo investigate changes in inhaled corticosteroids adherence, both before and after a scheduled follow-up visit, in young children in a comprehensive asthma management program. Study designOne-year prospective follow-up study in 104 asthmatic children (mean age 4.8 years). Adherence to inhal

  4. Spanish Visit

    CERN Multimedia

    2004-01-01

    On 23 January, CERN welcomed a visit by Pedro Morenés Eulate, Spanish Secretary of State for Scientific and Technological Policy. He was taken on a tour of the LHC Superconducting test facility, the CMS magnet assembly hall and the civil engineering works at Point 5. After a brief presentation on the AMS (Alpha Magnetic Spectrometer) experiment, delivered by Sam Ting, and lunch hosted by Director General Robert Aymar, he continued his tour of the ATLAS assembly hall and the ISOLDE experimental hall. Pedro Morenés finished his visit by meeting with the Spanish scientific community working at CERN. From left to right: Juan-Antonio Rubio, CERN, Responsible for the Education & Communication, Technology transfer and Scientific Information groups; Gonzalo León, General Secretary of the Spanish Ministry; Joaquín Pérez-Villanueva y Tovar, Ambassador, Permanent Representative of Spain to the United Nations Office; Robert Aymar, CERN Director General; Maria-José Garcia-Borge, ISOLDE and NTOF, CSIC Madrid Tea...

  5. CT and Clinical Predictors of Fatigue at One Month after Stroke

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    Mansur A. Kutlubaev

    2013-03-01

    Full Text Available Background: Fatigue is a common and distressing consequence of stroke, and the aetiology of post-stroke fatigue (PSF is poorly understood. It is unclear whether chronic brain changes [cerebral atrophy and white matter lesions (WML], stroke lesion location or certain clinical features are related to its development. The aim of this study was to identify, in patients with acute stroke, whether features in different brain regions on routine CT imaging or routinely collected clinical features predicted PSF at 1 month. Methods: In total, 107 patients (62% male with acute ischaemic or haemorrhagic stroke were assessed for fatigue (Fatigue Assessment Scale, anxiety and depression (Hospital Anxiety and Depression Scale at 1 month. Admission brain CT was rated using a structured scoring system for (i severity of atrophy and (ii severity of WML in different regions of the brain, and (iii site of acute and previous vascular lesions. Results: Cerebral atrophy of mild or greater severity was present in 84 patients (77.5% and WML of mild or greater severity was present in 54 patients (50.5% in at least one of the evaluated brain regions. There was no association between PSF and severity of atrophy or WML, or presence of acute or previous vascular lesions. We used the Oxfordshire Community Stroke Project (OCSP classification to explore the possible influence of lesion location because a minority of the patients (37.4% had visible acute lesions. Fatigue scores were higher in patients with clinically diagnosed posterior strokes (p = 0.046, in females (p = 0.05 and in those with higher depression and anxiety scores (ρ = 0.52; p 2 = 0.254. Stroke subtype (according to the OCSP classification was marginally predictive (β = 0.17; p = 0.05 and sex was not statistically significant (β = 0.15; p = 0.08. Conclusions: Features on routine post-stroke CT do not appear to associate with fatigue at 1 month. However, clinically diagnosed posterior strokes as well as female

  6. Clinical Pathway and Monthly Feedback Improve Adherence to Antibiotic Guideline Recommendations for Community-Acquired Pneumonia.

    Directory of Open Access Journals (Sweden)

    Maher Almatar

    Full Text Available Compliance with community-acquired pneumonia (CAP guidelines remains poor despite a substantial body of evidence indicating that guideline-concordant care improves patient outcomes. The aim of this study was to compare the relative effectiveness of a general educational and a targeted emergency department intervention on improving physicians' concordance with CAP guidelines.Two distinct interventions were implemented over specific time periods. The first intervention was educational, focusing on the development of local CAP guidelines and their dissemination through hospital-wide educational programmes. The second intervention was a targeted one for the emergency department, where a clinical pathway for the initial management of CAP patients was introduced, followed by monthly feedback to the emergency department (ED physicians about concordance rates with the guidelines. Data on the concordance rate to CAP guidelines was collected from a retrospective chart review.A total of 398 eligible patient records were reviewed to measure concordance to CAP guidelines over the study period. Concordance rates during the baseline and educational intervention periods were similar (28.1% vs. 31.2%; p > 0.05. Significantly more patients were treated in accordance with the CAP guidelines after the ED focused intervention when compared to the baseline (61.5% vs. 28.1%; p < 0.05 or educational period (61.5% vs. 31.2%; p < 0.05.A targeted intervention with a CAP clinical pathway and monthly feedback was a successful strategy to increase adherence to empirical antibiotic recommendations in CAP guidelines.

  7. Text messaging to improve attendance at post-operative clinic visits after adult male circumcision for HIV prevention: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Thomas A Odeny

    Full Text Available BACKGROUND: Following male circumcision for HIV prevention, a high proportion of men fail to return for their scheduled seven-day post-operative visit. We evaluated the effect of short message service (SMS text messages on attendance at this important visit. METHODOLOGY: We enrolled 1200 participants >18 years old in a two-arm, parallel, randomized controlled trial at 12 sites in Nyanza province, Kenya. Participants received daily SMS text messages for seven days (n = 600 or usual care (n = 600. The primary outcome was attendance at the scheduled seven-day post-operative visit. The primary analysis was by intention-to-treat. PRINCIPAL FINDINGS: Of participants receiving SMS, 387/592 (65.4% returned, compared to 356/596 (59.7% in the control group (relative risk [RR] = 1.09, 95% confidence interval [CI] 1.00-1.20; p = 0.04. Men who paid more than US$1.25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤ US$1.25 (adjusted relative risk [aRR] 1.35, 95% CI 1.15-1.58; p<0.001. Men with secondary or higher education had a lower risk of failure to return compared to those with primary or less education (aRR 0.87, 95% CI 0.74-1.01; p = 0.07. CONCLUSIONS: Text messaging resulted in a modest improvement in attendance at the 7-day post-operative clinic visit following adult male circumcision. Factors associated with failure to return were mainly structural, and included transportation costs and low educational level. TRIAL REGISTRATION: ClinicalTrials.govNCT01186575.

  8. Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months

    Directory of Open Access Journals (Sweden)

    Chiang Yuan-Lin

    2011-04-01

    Full Text Available Abstract Background The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder (ADHD clinical symptoms and neurocognitive function in a realistic clinical setting, and the differences in ADHD symptom improvement using different classifications of ADHD subtypes. Methods The Child Behavior Checklist (CBCL was completed by parents of ADHD children at the initial visit. The computerized Continuous Performance Test (CPT, Swanson, Nolan, and Pelham, and Version IV Scale for ADHD (SNAP-IV, and ADHD Rating Scale (ADHD-RS were performed at baseline, one month, three months, and six months later, respectively. Patient care including drug therapy was performed at the discretion of the psychiatrist. The ADHD patients were divided into DSM-IV subtypes (Inattentive, Hyperactive-impulsive and Combined type, and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons. Results There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years; 15 of them were inattentive type, 11 were hyperactive-impulsive type, and 24 were combined type. In addition, 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes. There were significant improvements in clinical symptoms of hyperactivity and inattention, and impulsivity performance in CPT during the 6-month treatment. The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression. Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients. Conclusions We found that ADHD symptoms, which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions, had improved significantly over 6 months under pragmatic treatments. The non-aggressive ADHD patients might have a higher potential

  9. [Children less than 3 months hospitalised due to acute febrile syndrome. 5 years clinical experience].

    Science.gov (United States)

    Méndez Espinola, Benigno Miguel; Herrera Labarca, Patricio

    2015-01-01

    Acute fever of unknown origin (AFUO) is established when the anamnesis and physical examination cannot identify the cause. In infants less than 3 months-old this is situation for concern, due to the risk of a serious bacterial infection. To describe the clinical and laboratory variable of patients with AFUO, in order to look for clues in order to base studies on the decisions arising drom this problem. A report is presented on a retrospective study conducted on a cohort of children less than three months-old admitted to the Hospital Roberto del Río (2007-2011) due to an AFUO. Clinical histories were reviewed and the patients were grouped, according to the severity of the admission diagnosis, into severe and non-severe. They were compared in strata determined by the variables of clinical interest. A total of 550 children were admitted with AFUO during the study period. There was low agreement between the severity on admission and at discharge (kappa=0.079; P=.26). There were 23.8% of children in the severe group and 76.2% in the non-severe group. Urinary tract infection predominated in the severe group (68.7%) and 40.7% with acute febrile syndrome in the non-severe group. The cut-off levels for C-reactive protein, white cells, and neutrophils per mm(3), to calculate the fixed and variable indices, only showed negative predictive values of some use for ruling out serious bacterial infection. The ROC curves with white cell and neutrophil counts and C-reactive protein, did not provide andy fixed indices of clinical use. More than one-third (34.6%) of lumbar punctures were traumatic or failures. According to the results of this study, there is an obvious excess of hospital admissions, little usefulness in the examinations to identify serious bacterial infection, a high percentage lumbar punctures traumatic and lumbar punctures failures, and an excess of antibiotic treatments. A review of clinical criteria and procedures is needed. Copyright © 2015 Sociedad Chilena de

  10. The effect of systematic clinical interventions with cigarette smokers on quit status and the rates of smoking-related primary care office visits.

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    Thomas G Land

    Full Text Available BACKGROUND: The United States Public Health Service (USPHS Guideline for Treating Tobacco Use and Dependence includes ten key recommendations regarding the identification and the treatment of tobacco users seen in all health care settings. To our knowledge, the impact of system-wide brief interventions with cigarette smokers on smoking prevalence and health care utilization has not been examined using patient population-based data. METHODS AND FINDINGS: Data on clinical interventions with cigarette smokers were examined for primary care office visits of 104,639 patients at 17 Harvard Vanguard Medical Associates (HVMA sites. An operational definition of "systems change" was developed. It included thresholds for intervention frequency and sustainability. Twelve sites met the criteria. Five did not. Decreases in self-reported smoking prevalence were 40% greater at sites that achieved systems change (13.6% vs. 9.7%, p<.01. On average, the likelihood of quitting increased by 2.6% (p<0.05, 95% CI: 0.1%-4.6% per occurrence of brief intervention. For patients with a recent history of current smoking whose home site experienced systems change, the likelihood of an office visit for smoking-related diagnoses decreased by 4.3% on an annualized basis after systems change occurred (p<0.05, 95% CI: 0.5%-8.1%. There was no change in the likelihood of an office visit for smoking-related diagnoses following systems change among non-smokers. CONCLUSIONS: The clinical practice data from HVMA suggest that a systems approach can lead to significant reductions in smoking prevalence and the rate of office visits for smoking-related diseases. Most comprehensive tobacco intervention strategies focus on the provider or the tobacco user, but these results argue that health systems should be included as an integral component of a comprehensive tobacco intervention strategy. The HVMA results also give us an indication of the potential health impacts when meaningful use core

  11. Enamel wear caused by monolithic zirconia crowns after 6 months of clinical use.

    Science.gov (United States)

    Stober, T; Bermejo, J L; Rammelsberg, P; Schmitter, M

    2014-04-01

    The purpose of this study was to evaluate enamel wear caused by monolithic zirconia crowns and to compare this with enamel wear caused by contralateral natural antagonists. Twenty monolithic zirconia crowns were placed in 20 patients requiring full molar crowns. For measurement of wear, impressions of both jaws were made at baseline after crown cementation and at 6-month follow-up. Mean and maximum wear of the occlusal contact areas of the crowns, of their natural antagonists and of the two contralateral natural antagonists were measured by the use of plaster replicas and 3D laser scanning methods. Wear differences were investigated by the use of two-sided paired Student's t-tests and by linear regression analysis. Mean vertical loss (maximum vertical loss in parentheses) was 10 (43) μm for the zirconia crowns, 33 (112) μm for the opposing enamel, 10 (58) μm for the contralateral teeth and 10 (46) μm for the contralateral antagonists. Both mean and maximum enamel wear were significantly different between the antagonists of the zirconia crowns and the contralateral antagonists. Gender and activity of the masseter muscle at night (bruxism) were identified as possible confounders which significantly affected wear. Under clinical conditions, monolithic zirconia crowns seem to be associated with more wear of opposed enamel than are natural teeth. With regard to wear behaviour, clinical application of monolithic zirconia crowns is justifiable because the amount of antagonistic enamel wear after 6 months is comparable with, or even lower than, that caused by other ceramic materials in previous studies.

  12. How we used a patient visit tracker tool to advance experiential learning in systems-based practice and quality improvement in a medical student clinic.

    Science.gov (United States)

    Chen, Chen Amy; Park, Ryan J; Hegde, John V; Jun, Tomi; Christman, Mitalee P; Yoo, Sun M; Yamasaki, Alisa; Berhanu, Aaron; Vohra-Khullar, Pamela; Remus, Kristin; Schwartzstein, Richard M; Weinstein, Amy R

    2016-01-01

    Poorly designed healthcare systems increase costs and preventable medical errors. To address these issues, systems-based practice (SBP) education provides future physicians with the tools to identify systemic errors and implement quality improvement (QI) initiatives to enhance the delivery of cost-effective, safe and multi-disciplinary care. Although SBP education is being implemented in residency programs and is mandated by the Accreditation Council for Graduate Medical Education (ACGME) as one of its core competencies, it has largely not been integrated into undergraduate medical education. We propose that Medical Student-Faculty Collaborative Clinics (MSFCCs) may be the ideal environment in which to train medical students in SBPs and QI initiatives, as they allow students to play pivotal roles in project development, administration, and management. Here we describe a process of experiential learning that was developed within a newly established MSFCC, which challenged students to identify inefficiencies, implement interventions, and track the results. After identifying bottlenecks in clinic operations, our students designed a patient visit tracker tool to monitor clinic flow and implemented solutions to decrease patient visit times. Our model allowed students to drive their own active learning in a practical clinical setting, providing early and unique training in crucial QI skills.

  13. [Etiology and clinical course of urinary tract infections in infants less than 3 months-old].

    Science.gov (United States)

    Hernández-Bou, Susanna; Trenchs Sainz de la Maza, Victoria; Alarcón Gamarra, Marcela; Camacho Díaz, Juan A; Gené Giralt, Amadeu; Luaces Cubells, Carles

    2015-10-01

    Infants less than 3 months of age with urinary tract infection are usually hospitalized. Recent studies show that a less aggressive management for those patients aged ≥ 29 days may be feasible. To determine the complication rate in infants<3 months of age with urinary tract infection, and to identify the causative agents and their antibiotic susceptibility. A retrospective study was conducted on infants<3 months of age with positive urinalysis results, together with a positive urine culture from a catheterized specimen and seen in the Emergency Department from 2007 to 2012. Demographics, clinical and microbiology (microorganism isolated and antibiotic susceptibility) data were collected. The complications rate (bacteremia, bacterial meningitis, renal abscess, surgical intervention, Intensive Care Unit admission, or death) were calculated for the overall sample and for different age groups (<29, 29-60, and 61-90 days). A total of 460 patients are included; 137 (29.8%)<29, 166 (36.1%) 29-60, and 157 (34.1%) 61-90 days of age. Twenty four (5.4%; 95% CI: 3.6-7.8) had bacteremia; 15 (10.9%; 95% CI: 6.7-17.3) were<29 days; 8 (4.9%; 95% CI: 2.5-9.4) were 29-60 days, and one (0.7%; 95% CI: 0.1-3.7) was 61-90 days of age (P<.001). One neonate (0.8%; 95% CI: 0.1-4.1) had bacterial meningitis, and 2, renal abscess. Escherichia coli was the common pathogen identified (87.2%) in the urine culture, with a susceptibility to amoxicillin-clavulanate, gentamicin, and cefixime of 89.2, 97.0, and 96.0%, respectively. Complications are low in infants<3 months of age with UTI, especially in those ≥ 29 days of age. The identification of patients at very low risk for complications would allow a less aggressive management. Escherichia coli antibiotic susceptibility remains stable, but continuing careful surveillance is essential to optimize empirical antibiotic treatment. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Cl

  14. Clinical utility of chromosomal microarray analysis in prenatal diagnosis: report of first 6 months in clinical practice.

    Science.gov (United States)

    Klugman, Susan; Suskin, Barrie; Spencer, Brianna L; Dar, Pe'er; Bajaj, Komal; Powers, Judith; Reichling, Julie; Wasserman, David; Dolan, Siobhan M; Merkatz, Irwin R

    2014-09-01

    We studied the clinical utility of chromosomal microarray analysis (CMA) in prenatal diagnosis in a clinical setting in New York City. Our center began offering CMA to pregnant women undergoing invasive diagnostic procedures for an abnormal structural finding on ultrasound, maternal age of 35 years or older, or elevated risk on aneuploidy screening, beginning March 2012. Our first six months experience is reported. Benign familial variants were the most common finding (16/22 fetuses). Variants of uncertain significance were frequent, especially when fathers were not available for testing (4/22 fetuses). Most patients undertook CMA as part of evaluation of an ultrasound anomaly (52%). One patient terminated a pregnancy based on an ultrasound finding in the setting of a benign familial variant on CMA, and a second terminated a pregnancy based on a copy number variant identified on CMA. For CMA to be maximally useful in prenatal diagnosis, parental DNA samples as well as robust datasets to provide predictive phenotypic information are required. The most common reason for undertaking CMA was to evaluate an ultrasound anomaly, and benign familial variants were a common finding. Genetic services are required to provide pre- and post-test genetic counseling and help families interpret results.

  15. What Happens during Prenatal Visits?

    Science.gov (United States)

    ... at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications What happens during prenatal visits? Skip sharing on social media links Share this: Page Content What happens during ...

  16. Patient Education in a 14-month Randomised Trial Fails to Improve Adherence in Ulcerative Colitis: Influence of Demographic and Clinical Parameters on Non-adherence.

    Science.gov (United States)

    Nikolaus, S; Schreiber, S; Siegmund, B; Bokemeyer, B; Bästlein, E; Bachmann, O; Görlich, D; Hofmann, U; Schwab, M; Kruis, W

    2017-09-01

    Recent observational studies document that non-adherence to mesalamine therapy during remission is frequent. We aimed to investigate patient impact of patient education using objective assessments of adherence. A 14-month randomised, prospective clinical trial of adherence to mesalamine was conducted in 248 patients with ulcerative colitis [UC], Colitis Activity Index [CAI] ≤ 9, receiving standard care [n = 122] versus a standardised patient education programme [n = 126]. Primary endpoint was adherence at all visits (5-aminosalicylic acid [5-ASA] urine levels). Secondary endpoints included quality of life (inflammatory bowel disease questionnaise [IBDQ]), disease activity, partial adherence, and self-assessment of adherence. Patient allocation was well balanced. Baseline non-adherence was high in quiescent/mildly active UC [52.4%] without difference between the groups (52.4% of patients in the education group versus 52.5% in the standard care group [p = 0.99]). No difference between the intervention group and standard care was seen in IBDQ, partial adherence, self-assessment of adherence, or therapy satisfaction at all visits. We suggest a model in which individual risks for non-adherence are driven by patients with young age, short disease duration, and low education levels. Non-adherence is frequent in a population with quiescent/mildly active UC. Although more than 25% of the population was not in remission at the various time points, no relationship between disease activity and adherence was seen over the 14-month observation period. Physicians should maximise their efforts to motivate high-risk patients for adherence. Future trials should use objective exposure assessments to examine the impact of continuous education and consultations on the background of individual risks to develop non-adherence.

  17. Acute effects of outdoor air pollution on emergency department visits due to five clinical subtypes of coronary heart diseases in shanghai, china.

    Science.gov (United States)

    Xie, Juan; He, Mingzhen; Zhu, Weiying

    2014-01-01

    Air pollution can be a contributing cause to the development and exacerbation of coronary heart disease (CHD), but there is little knowledge about the acute effects of air pollution on different clinical subtypes of CHD. We conducted a time-series study to investigate the association of air pollution (particulate matter with an aerodynamic diameter emergency department (ED) visits due to five different subtypes of CHD in Shanghai, China, from 2010 to 2012. We applied an over-dispersed Poisson generalized addictive model to analyze the associations after controlling for the seasonality, day of the week, and weather conditions. We identified a total of 47 523 ED visits for CHD. A 10-µg/m(3) increase in the present-day concentrations of PM10, SO2, and NO2 was associated with respective increases of 1.10% (95% confidence interval [CI] 0.33%-1.87%), 0.90% (95% CI -0.14%-1.93%), and 1.44% (95% CI 0.63%-2.26%) for total ED visits for CHD. These associations varied greatly by clinical type, with strong effects on sudden cardiac death, moderate effects on acute myocardial infarction and angina, weak effects on ischemic cardiomyopathy, and no effect on occult CHD. The associations were stronger among people aged 65 years or more than in younger individuals and in the cool season versus the warm one. Outdoor air pollution may have different effects of air pollution on 5 subtypes of CHD. Our results might be useful for the primary prevention of various subtypes of CHD exacerbated by air pollution.

  18. Comparison of Single Visit Post Endodontic Pain Using Mtwo Rotary and Hand K-File Instruments: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohamad Kashefinejad

    2016-08-01

    Full Text Available Objectives: Pain is an unpleasant outcome of endodontic treatment that can be unbearable to patients. Instrumentation techniques may affect the frequency and intensity of post-endodontic pain. This study aimed to compare single visit post endodontic pain using Mtwo (NiTi rotary and hand K-file instruments.Materials and Methods: In this randomized controlled trial, 60 teeth with symptomatic irreversible pulpitis in 53 patients were selected and randomly assigned into two groups of 30 teeth. In group A, the root canals were prepared with Mtwo (NiTi rotary instruments. In group B, the root canals were prepared with hand K-file instruments. Pain assessment was implemented using visual analog scale (VAS at four, eight, 12 and 24 hours after treatment. The acquired data were analyzed using chi-square, Mann-Whitney U and Student’s t-test (P<0.05.Results: Patients treated with rotary instruments experienced significantly less post-endodontic pain than those treated with hand instruments (P<0.001.Conclusion: The use of Mtwo (NiTi rotary instruments in root canal preparation contributed to lower incidence of postoperative pain than hand K-files.

  19. A Single Visit Direct Technique to Provisionally Restore Occlusion for a Full-Mouth Rehabilitation: A Clinical Report.

    Science.gov (United States)

    El-Kerdani, Tarek; Nimmo, Arthur

    2016-01-01

    Attrition of the dentition can negatively affect esthetics and function. When reconstructing patients with attrition who require restoration at increased occlusal vertical dimension (OVD), it is necessary to first evaluate the OVD using a removable interim prosthesis to ensure that the patient will tolerate the new position. The transition to fixed interim prostheses has to be carefully planned to achieve the desired OVD. One approach is to prepare all teeth in a single day and place full-arch interim prostheses; however, this can be tiring for the patient and prosthodontist. An alternative approach is to prepare one arch and place interim prostheses, while using composite resin in the opposing arch to maintain the newly established OVD. A diagnostic wax-up at the proposed OVD is completed and duplicated in stone. A vacuform matrix is loaded with composite resin and applied to the unprepared etched teeth of the opposing arch to restore form and occlusion until full contour interim prostheses are placed at a later visit.

  20. Adherence to yoga and exercise interventions in a 6-month clinical trial

    Directory of Open Access Journals (Sweden)

    Haas M

    2007-11-01

    Full Text Available Abstract Background To determine factors that predict adherence to a mind-body intervention in a randomized trial. Design We analyzed adherence data from a 3-arm trial involving 135 generally healthy seniors 65–85 years of age randomized to a 6-month intervention consisting of: an Iyengar yoga class with home practice, an exercise class with home practice, or a wait-list control group. Outcome measures included cognitive function, mood, fatigue, anxiety, health-related quality of life, and physical measures. Adherence to the intervention was obtained by class attendance and biweekly home practice logs. Results The drop-out rate was 13%. Among the completers of the two active interventions, average yoga class attendance was 77% and home practice occurred 64% of all days. Average exercise class attendance was 69% and home exercise occurred 54% of all days. There were no clear effects of adherence on the significant study outcomes (quality of life and physical measures. Class attendance was significantly correlated with baseline measures of depression, fatigue, and physical components of health-related quality of life. Significant differences in baseline measures were also found between study completers and drop-outs in the active interventions. Adherence was not related to age, gender, or education level. Conclusion Healthy seniors have good attendance at classes with a physically active intervention. Home practice takes place over half of the time. Decreased adherence to a potentially beneficial intervention has the potential to decrease the effect of the intervention in a clinical trial because subjects who might sustain the greatest benefit will receive a lower dose of the intervention and subjects with higher adherence rates may be functioning closer to maximum ability before the intervention. Strategies to maximize adherence among subjects at greater risk for low adherence will be important for future trials, especially complementary

  1. Clinical Evaluation of Indirect Particle-Filled Composite Resin CAD/CAM Partial Crowns after 24 Months.

    Science.gov (United States)

    Zimmermann, Moritz; Koller, Christina; Reymus, Marcel; Mehl, Albert; Hickel, Reinhard

    2017-04-19

    Resin-based CAD/CAM compound materials might be promising for single-tooth restorations. Insufficient clinical data are available for this new material class. The purpose of this study was to describe initial clinical in vivo results for indirect particle-filled composite resin CAD/CAM restorations after 24 months. Indirect particle-filled composite resin restorations were fabricated with a CAD/CAM method (CEREC Bluecam intraoral scanner, CEREC MCXL milling unit) by calibrated dental students. Forty-two partial crown restorations were seated adhesively in 30 patients with caries lesions or insufficient restorations (baseline). Strict inclusion criteria were defined for the patient collective. Follow-up evaluation comprised 40 restorations after 12 months and 33 restorations after 24 months. Evaluation criteria were modified FDI criteria with grades (1) to (5). Rating with FDI criteria (5) was defined as clinical failure. Statistical analysis was performed with Wilcoxon-Test (p CAD/CAM restorations after 12 months was 95.0% with two debondings observed. The cumulative success rate for indirect particle-filled composite resin CAD/CAM restorations after 24 months was 85.7% with two tooth fractures and one debonding. Statistically significant differences were found for baseline and 24-month follow-up evaluation for anatomic form and marginal adaptation criterion examined in respect to FDI criteria guidelines (Wilcoxon-Test, p CAD/CAM restorations having a clinical success rate of 85.7% after 24 months. Adhesive bonding procedures need to be ensured carefully. A longer clinical evaluation period is necessary to draw further conclusions. © 2017 by the American College of Prosthodontists.

  2. [Clinical and electrophysiological evolution of infants presenting with partial seizures before the age of two months (author's transl)].

    Science.gov (United States)

    Isch-Treussard, C; Terrade, E; Bapst-Reiter, J

    1977-01-01

    The study was carried out on 28 children: 18 with partial seizures in the first five days of life, and among them 4 with status epilepticus; 7 had focal seizures between the first and eight week, 3 generalised tonic seizures with assymetrical EEGs. A clinical and electro-physiological study was carried out at the time of onset, 1 month later and again at 4 months. The results of the clinical and EEG examinations showed: -firstly during the seizures, the gravity of neonatal status epilepticus and of certain EEG patterns, the lack of localising value of seizures and of electroencephalographic critical discharges whereas permanent assymetry of background activity can precede by several months the appearance of clinical signs. -at the examination one month later the prognostic importance of definite neurological signs always associated with EEG abnormalities whereas some isolated EEG abnormalities do not have any prognostic value as far cerebral maturation is concerned. -at the final examination: the possibility after 4 months of age, of focal neurological signs not present at the earlier examinations. This study underlines the importance of precise electroclinical correlations at different developmental stages, specifically at one and four months of age in children with neonatal seizures.

  3. Incidence, degree, and development of graft hypertrophy 24 months after matrix-induced autologous chondrocyte implantation: association with clinical outcomes.

    Science.gov (United States)

    Ebert, Jay R; Smith, Anne; Fallon, Michael; Butler, Rodney; Nairn, Robert; Breidahl, William; Wood, David J

    2015-09-01

    Graft hypertrophy is a common occurrence after periosteal, collagen-covered and matrix-induced autologous chondrocyte implantation (MACI). The purpose of this study was to investigate the incidence, development, and degree of graft hypertrophy at 24 months after MACI. The hypothesis was that graft hypertrophy would not be associated with clinical outcome at 24 months. Case series, Level of evidence, 4. This study was undertaken in 180 consecutive patients (113 male, 67 female) after MACI in the knee. All patients were assessed clinically using the Knee injury and Osteoarthritis Outcome Score (KOOS) and underwent magnetic resonance imaging (MRI) at 3, 12, and 24 months after surgery. The incidence of hypertrophy relevant to anatomic graft site was investigated, as was the progressive change in hypertrophic studies postoperatively. The degree of tissue overgrowth in hypertrophic cases was investigated, as was its association with patient clinical outcome at 24 months after surgery. Of the 180 patients, 50 demonstrated a hypertrophic graft at 1 or more postoperative time points. This included 9 grafts (5.0%) at 3 months and 32 grafts (18.7%) at 12 months. At 24 months, 47 grafts (26.1%)-43 (32.1%) tibiofemoral and 4 (8.7%) patellofemoral-were hypertrophic. Patients with hypertrophic grafts at 24 months (n = 47) were younger (P = .051), they had a lower body mass index (BMI; P = .069), and significantly fewer of them had patellofemoral grafts (P = .007) compared with patients who had grafts with full (100%) tissue infill (n = 61). There were no significant differences in any of the KOOS subscales between patients with graft hypertrophy or full (100%) tissue infill at 24 months after surgery, while the severity of graft hypertrophy was not associated with KOOS subscales at 24 months. Hypertrophic grafts after MACI were common and continued to develop through to 24 months after surgery. Hypertrophic growth was associated with being younger and having a lower BMI, was

  4. VA Outpatient Visits by Administrative Parent, FY2010-2014

    Data.gov (United States)

    Department of Veterans Affairs — Outpatient visits by Administrative Parent. A visit is counted as a visit to one or more clinics or units within 1 calendar day at the site of care level. A patient...

  5. New EMA report on paliperidone 3-month injections: taking clinical and policy decisions without an adequate evidence base.

    Science.gov (United States)

    Ostuzzi, G; Papola, D; Gastaldon, C; Barbui, C

    2016-12-22

    Three-month long-acting paliperidone is a new, recently marketed, formulation of paliperidone, characterised by the longest available dosing interval among long-acting antipsychotics. The clinical profile of 3-month long-acting paliperidone was recently summarised by the European Medicines Agency (EMA) in a public assessment report, released in April 2016. In this commentary, the main strengths and limitations of the EMA assessment report were appraised and discussed, in order to highlight possible implications for clinical practice, future research and regulatory practices for drug approval.

  6. Three European ministers visit CERN

    CERN Multimedia

    2007-01-01

    There have been three ministerial visits to CERN this month. Gediminas Kirkilas, Prime Minister of Lithuania, and Robert Aymar, CERN’s Director-General.On 2 July, the Prime Minister of Lithuania, Gediminas Kirkilas, was welcomed by CERN’s Director-General, Robert Aymar, before being taken on a visit of the ATLAS cavern at Point 2 and the LHC tunnel. Michal Sewerynski, Poland’s Minister for Science and Higher Education, and Robert Aymar, CERN’s Director-General.Ten days later, Poland’s Minister for Science and Higher Education, Michal Sewerynski, visited the CMS cavern and assembly hall and the LHC tunnel. He was also given a tour of the LHC Computer Centre and the CERN Control Centre. His visit was rounded off with a presentation of Polish companies involved in CERN’s activities, followed by a meeting with Polish personnel working at CERN. J�...

  7. Clinical evaluation of ultrasound screening in follow-up visits of infants with cerebral palsy at high risk for developmental dysplasia of the hip.

    Science.gov (United States)

    Qiu, Aizhen; Yang, Zhongxiu; Wang, Jiping; Wang, Taotao

    2016-10-01

    The aim of the study was to assess the clinical value of ultrasound screenings for the developmental dysplasia of the hip (DDH) and explore its etiology in high-risk infants with cerebral palsy in follow-up visits. A group of 98 cases of infants at high-risk of cerebral palsy who received rehabilitation treatment between July, 2009 and July, 2010 were selected. Infants included 58 men and 40 women, aged hips was performed and the infants with abnormalities were given clinical intervention, and 1- to 2-year-old infants were given outpatient follow-ups. The results were analyzed and there were 40 abnormal cases among the 98 cases of infants at high risk of cerebral palsy, including 18 cases of unstable hip joint, and 22 cases of DDH (12 cases of hip dysplasia, 3 cases of hip subluxation and 7 cases of hip dislocation). Early clinical intervention for infants with hip dysplasia and outpatient follow up for infants aged 1-2 years was carried out and had ischemic necrosis of femoral head, with the exception of 1 case of femoral detorsion that was poorly restored. In conclusion, the probability of DDH was higher in infants at high-risk of cerebral palsy compared to the normal infants. Hip ultrasound is a safe, simple, and effective screening method for these infants, which is of great clinical significance for an earlier diagnosis and treatment of DDH in infants with cerebral palsy.

  8. Quality in Australian after-hours doctor home visits: exploring the clinical, professional and security supports available to involved practitioners.

    Science.gov (United States)

    Ifediora, Chris Onyebuchi

    2017-04-01

    The after-hours house call (AHHC) services in Australia has gained huge popularity in recent years, but it is not clear how well supported the involved doctors feel regarding the clinical, professional and security aspects of their work. It is important that this knowledge gap is filled given that appropriate support helps engender quality in health service delivery. This is a questionnaire-based electronic survey involving a sample frame of all 300 doctors participating in AHHC through the National Home Doctor Service. National Home Doctor Service is Australia's largest AHHC service provider. A total of 168 valid responses (56.0%) were received. Overall, the mean support levels were mild to moderate, ranging from 2.4 to 2.8 out of 4.0 for all three parameters. Specifically, 65.3% of the respondents felt well-supported on clinical issues, 64.7% on professional issues and 43.2% on security issues. Australian-trained doctors were less likely to feel well supported on all aspects [Clinical: odds ratio (OR) 0.38, confidence interval (CI) 0.16 to 0.90; Professional: OR 0.30, CI 0.13 to 0.72; and Security: OR 0.22; CI 0.09 to 0.53] compared with overseas-trained ones. Unsurprisingly, doctors who adopted protective measures felt significantly better supported regarding security (OR 2.75; CI 1.31 to 5.78). There is room for improvement regarding support on AHHC in Australia, and concerned Surgeries should ensure that where available these supports are appropriately utilized. © 2016 John Wiley & Sons, Ltd.

  9. Relation between endometrial thickness with serum estradiol and progesterone levels in patients visited at Ob&Gyn clinic of Shahid Sadoughi hospital

    Directory of Open Access Journals (Sweden)

    Robab Davar

    2015-01-01

    Full Text Available Background: The endometrial thickness is an important determinant for the successful implantation and pregnancy. This research was aimed to evaluate relationship between the endometrial thickness with serum estradiol and progesterone levels in patients visited in Ob&Gyn clinic of Shahid Sadoughi hospital. Material and Methods: Enrolled in the study were 440 patients visited in Ob&Gyn clinic of Shahid Sadoughi hospital between Jan. 2011 to Sep. 2012. Only patients with regular menstrual cycle were included in study. Patients with myoma, adenomyosis, endometrial polyps or other uterine anomaly, those who smoked, women with BMI greater than 30 and who were taking medications that could affect endometrial thickness were excluded. Endometrial thickness one day before and 5-7 days after ovulation was measured by using trans-vaginal ultrasonography. Also, serum estradiol and progesterone levels were measured in 5-7 days after ovulation. Data analysis was done through SPSS version 16 with using descriptive statistics and ANOVA. Results: The mean age of patients was 27.37±4.44. Endometrial thicknesses were 9.80±0.80 and 10.13±1. one day before and 5-7 days after ovulution, respectively. 5% of patients had thin endometrium (<7 mm in two measurements. Serum estradiol and progesterone levels were respectively 169.88±17.64 pg/ml and 7.32±6.93 mg/ml. There were no significant association between endometrial thickness and age, and also endometrial thickness and progesterone level. The same relation between endometrial thickness and estradiol serum level was observed only in age group of <20 years. (P=0.000 Conclusion: The results showed that serum stradiol and progesterone levels can not be the determinants of endometrial thickness in women.

  10. Clinical features and prognosis of a unilateral fibroadenoma of the breast in a 16-month-old female.

    Science.gov (United States)

    Shi, Aiping; Li, Sijie; Xu, Ning; Nie, Gang; Li, Xingliang; Zhang, Tianwei; Fan, Zhimin

    2011-02-01

    Fibroadenoma of the breast is a common benign disease, occurring mainly in females younger than 30 years of age. Infant fibroadenoma is extremely rare. Here, we report on a 16-month-old female with a 6 month history of unilateral progressive breast enlargement. Upon clinical evaluation, a palpable mass was observed in the upper and outer quarter of the right breast. The single tumor was solid and well circumscribed. Various clinical examinations were performed, including determination of hormone levels, ultrasound, mammography, magnetic resonance imaging, as well as the collection of a fine needle aspiration. The results showed that the sex hormones were present at normal levels. The size of the tumor was approximately 3 × 3 × 3 cm. Enlarged lymph nodes were not detected in the axillary region or any other regions. The tumor was removed surgically and fibroadenoma was diagnosed post-operatively. The patient was followed up for 38 months and no tumor recurrence was observed.

  11. Prospective cohort pilot study of 2-visit CAD/CAM monolithic complete dentures and implant-retained overdentures: Clinical and patient-centered outcomes.

    Science.gov (United States)

    Bidra, Avinash S; Farrell, Kimberly; Burnham, David; Dhingra, Ajay; Taylor, Thomas D; Kuo, Chia-Ling

    2016-05-01

    Presently, no studies have evaluated clinical outcomes or patient-centered outcomes for complete dentures fabricated with computer-aided design and computer aided manufacturing (CAD/CAM) technology. The purpose of this prospective cohort pilot study was to evaluate the clinical and patient-centered outcomes for CAD/CAM monolithic dentures fabricated in 2 visits. Twenty participants with an existing set of maxillary complete dentures opposing either mandibular complete dentures or implant-retained overdentures that required replacement were recruited in this study. A 2-visit duplicate denture protocol was used to fabricate 40 arches of monolithic dentures with CAD/CAM technology. A 100-mm visual analog scale (VAS) instrument was then used to record 12 outcomes at baseline and at 1-year follow-up. Predetermined values were assigned to grade the VAS rating of each outcome as favorable (70.1-100) and unfavorable (≤70). Favorable ratings were sub-divided as excellent (90.1-100), good (80.1-90), and fair (70.1-80). The clinical outcomes were evaluated independently by 2 experienced prosthodontists at baseline and at 1-year follow-up. Patients evaluated the corresponding patient-centered outcomes during the same time intervals. Additional descriptive variables were also recorded. Each clinical and patient-centered outcome was summarized by medians and ranges. Differences in all ratings recorded at baseline and at 1 year were tested by 1-sided sign test (α=.05). Of 20 participants, 3 were lost to follow-up, and 3 were unsatisfied with the digital dentures and withdrew from the study. These 3 participants were considered treatment failures. Of the 14 remaining participants, 9 had implant-retained mandibular overdentures, and 5 had conventional mandibular complete dentures. For clinical outcomes, the 12 studied outcomes were favorably evaluated by the 2 prosthodontist judges at the 1-year follow-up. Evaluations showed minimal differences between baseline and 1 year. An

  12. Three-month evaluation of vital tooth bleaching using light units-a randomized clinical study.

    Science.gov (United States)

    Polydorou, O; Wirsching, M; Wokewitz, M; Hahn, P

    2013-01-01

    The aim of this study was to evaluate the color stability of vital bleaching using a halogen unit, laser, or only chemical activation up to three months after treatment. A total of 60 patients were divided into three groups, and their teeth were bleached with 38% hydrogen peroxide using three methods: acceleration of the bleaching process with halogen (eight minutes), laser (30 seconds), or chemical activation only. All teeth were bleached a maximum of four times (4 × 15 minutes) until a change of six shade tabs took place. The color was evaluated both visually and with a spectrophotometer before bleaching, immediately after bleaching, and one and three months after bleaching. Directly after bleaching, the use of halogen showed better results than laser (p≤0.05). One and three months after bleaching, no significant difference was found between the tested methods relative to the shade change, independent of the method of shade evaluation (p>0.05). As far as the color stability is concerned, bleaching with halogen resulted in stable color throughout the three months (p>0.05), whereas the other two methods resulted in whiter teeth after one and three months compared with the color directly after bleaching (p≤0.05). Bleaching with laser needed more time than halogen for the desired shade change (p≤0.05). Although directly after treatment bleaching with halogen resulted in better results, one and three months after bleaching the kind of acceleration used in the bleaching process did not have any effect on the esthetic results.

  13. Relationship Between Bone Minerals Density and Some Characteristics of Postmenopausal Women who Were Visiting Orthopedics Clinics - Original Investigation

    Directory of Open Access Journals (Sweden)

    Gülendam Karadağ

    2007-12-01

    Full Text Available Aim: Frequency of osteoporosis that depending different factors in postmenopausal women is increase. So our study was done to determine the relationship between some habits of the postmenopausal women and bone mineral density. Material and Methods: The study was done as descriptive a hospital in Gaziantep between the dates 3 July - 8 August, 2006. The comprehension of the study is all patients who applied to orthopedics clinics, and sampling consists of 70 patients who wanted to join study, and postmenopausal, hadn’t taken steroid and calcitonin treatment more than last one year. Before study, informed approwal was taken from patients and institution. Data of the study were collected using questionnaire form. Density of bone minerals was grouped according to the standarts of WHO as normal (t>-1.0, osteopenic (t0.05. Conclusion: It was seen that majority of patients didn’t make sports regularly, and the risk of having osteoporosis was higher who were getting older. For this reason, it can be suggested that to prevent osteoporosis especially in postmenopausal women necessary education should be given. (From the World of Osteoporosis 2007;13:75-9

  14. Effect of exercise on serum estrogens in postmenopausal women: a 12-month randomized clinical trial.

    Science.gov (United States)

    McTiernan, Anne; Tworoger, Shelley S; Ulrich, Cornelia M; Yasui, Yutaka; Irwin, Melinda L; Rajan, Kumar B; Sorensen, Bess; Rudolph, Rebecca E; Bowen, Deborah; Stanczyk, Frank Z; Potter, John D; Schwartz, Robert S

    2004-04-15

    Elevated circulating estrogens and a sedentary lifestyle increase risk for breast cancer. The effect of exercise on circulating estrogens in sedentary postmenopausal women is unknown. The objective of this study was to examine the effects of a 12-month moderate-intensity exercise intervention on serum estrogens. We randomly assigned 173 sedentary, overweight (body mass index > 24.0 kg/m(2), body fat > 33%), postmenopausal women, ages 50-75 years, not using hormone therapy, living in the Seattle, Washington, area for the next year, and willing to be randomly assigned to an exercise intervention or stretching control group. The exercise intervention included facility and home-based exercise (45 min, 5 days/week moderate intensity sports/recreational exercise). A total of 170 (98.3%) women completed the study with exercisers averaging 171 min/week of exercise. After 3 months, exercisers experienced declines in estrone, estradiol, and free estradiol of 3.8, 7.7, and 8.2%, respectively, versus no change or increased concentrations in controls (P = 0.03, 0.07, and 0.02, respectively). At 12 months, the direction of effect remained the same, although the differences were no longer statistically significant. The effect was limited to women who lost body fat: women whose percentage of body fat [by dual energy x-ray absortiometry (DEXA)] decreased by >/==" BORDER="0">2% had statistically significant (comparing exercisers versus controls) decreases at 12 months of 11.9, 13.7, and 16.7% for serum estrone, estradiol, and free estradiol, respectively. We concluded that a 12-month moderate-intensity exercise intervention in postmenopausal women resulted in significant decreases in serum estrogens. The association between increased physical activity and reduced risk for postmenopausal breast cancer may be partly explained by effects on serum estrogens.

  15. 42 CFR 405.2463 - What constitutes a visit.

    Science.gov (United States)

    2010-10-01

    ... self-management training services as defined in part 410, subpart H of this chapter. (2) Medical visit... practitioner, nurse midwife, visiting nurse, clinical psychologist, or clinical social worker. (ii) For FQHCs... visit also includes a separately billable medical nutrition therapy visit or a diabetes outpatient...

  16. Sexual Health Outcomes at 24 Months for a Clinic-Linked Intervention to Prevent Pregnancy Risk Behaviors

    Science.gov (United States)

    Sieving, Renee E.; McRee, Annie-Laurie; McMorris, Barbara J.; Beckman, Kara J.; Pettingell, Sandra L.; Bearinger, Linda H.; Garwick, Ann W.; Oliphant, Jennifer A.; Plowman, Shari; Resnick, Michael D.; Secor-Turner, Molly

    2015-01-01

    Importance Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. Objective To evaluate sexual risk behaviors and related outcomes with a 24-month postbaseline survey, 6 months after the conclusion of the Prime Time intervention. Design Randomized controlled trial. Setting Community and school-based primary care clinics. Participants Of 253 sexually active 13- to 17-year-old girls meeting specified risk criteria, 236 (93.3%) completed the 24-month follow-up survey. Intervention Offered during an 18-month period, Prime Time includes case management and youth leadership programs. Main Outcome Measures Self-reported consistency of condom, hormonal, and dual-method contraceptive use with most recent male sex partner and number of male sex partners in the past 6 months. Results At 24-month follow-up, the intervention group reported significantly more consistent use of condoms, hormonal contraception, and dual-method contraception than the control group. Intervention participants also reported improvements in family connectedness and self-efficacy to refuse unwanted sex, and reductions in the perceived importance of having sex. No between-group differences were found in the number of recent male sex partners. Conclusions and Relevance This study contributes to what has been a dearth of evidence regarding youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful but few efforts have emphasized a dual approach of strengthening sexual and nonsexual protective factors while addressing risk. Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth. PMID:23440337

  17. Clinical manifestations of human cytomegalovirus (HCMV) infection in children in the first few months of life

    OpenAIRE

    Aziza Khodjaeva

    2012-01-01

    The research objective was to study frequency of antenatal infection and record probable clinical manifestations in 100 children with HCMV born from mother with HCMV in blood and mononuclear cells. The study identified poly-systemic internal organ damage in neonates due to prenatal HCMV. Research procedures involved study of 100 pairs of patients, Mother-Child tandem, using regular clinical assessment methods per algorithm and HCMV diagnostic methods: ELISA, affinity and avidity of HCMV antib...

  18. Clinical and Radiographic Success of Pulpotomy with MTA in Primary Molars: 30 Months Follow up

    OpenAIRE

    Haghgoo, Roza; Abbasi, Farid

    2010-01-01

    INTRODUCTION Pulpotomy of carious primary teeth with an exposed pulp is a common treatment option. Pulpotomy has been conducted with various medicaments over the years. The aim of this study was to evaluate clinical and radiographic success of primary vital pulpotomy with ProRoot and Root MTA. MATERIALS AND METHODS In this randomized clinical trial, children aged between 3-7 years who met the inclusion criteria were enrolled. A total of 70 teeth were deemed suitable under the inclusion criter...

  19. Six-Month Clinical and Angiographic Results of Paclitaxel Eluting Simpax Stent

    Directory of Open Access Journals (Sweden)

    Mehmet Muhsin Türkmen

    2012-08-01

    Full Text Available Introduction: We aimed to evaluate the safety and efficacy of the simpax stent in the treatmentof different patient groups.Patients and Methods: Forty-five patients were treated with the simpax stent. Of these patients,23 patients gave consent for six months of follow-up by quantitative coronary angiography (QSAand six patients were evaluated by exercise electrocardiographic test. Only the patients havinglesions with stenosis > 50% of diameter and lengths > 16 mm with reference diameters < 2.75mm were included.Results: The device success rate was 100% and procedure success rate was 97.7%. The meanstent length was 24.6 ± 7.3 mm and stent size was 2.54 ± 0.24 mm. The overall six months incidenceof major adverse cardiac events (MACE was 8.8%. MACE was consisted of two casesof non-Q wave myocardial infarction and two cases of repeated revascularization of the targetlesion. MACE rate was higher in chronic total occlusion (CTO group than non-CTO group (respectively33.3% and 5.1. Also when compared to stent size, MACE rate was 25% in < 2.5 mm,0% ≥ 2.5 mm. The QSA results at six months showed in-stent late lumen loss witha diameter of0.25 ± 0.15 mm in 17 patients.Conclusion: The six month results in this study demonsrated excellent procedural and devicesuccess. Simpax stent was associated with a low in-stent late lumen loss. Also this study showedsimpax stent was a safe and effective device in non-CTO group with stent size ≥ 2.5 mm.

  20. Knowledge and risk perception of late effects among childhood cancer survivors and parents before and after visiting a childhood cancer survivor clinic.

    Science.gov (United States)

    Cherven, Brooke; Mertens, Ann; Meacham, Lillian R; Williamson, Rebecca; Boring, Cathy; Wasilewski-Masker, Karen

    2014-01-01

    Survivors of childhood cancer are at risk for a variety of treatment-related late effects and require lifelong individualized surveillance for early detection of late effects. This study assessed knowledge and perceptions of late effects risk before and after a survivor clinic visit. Young adult survivors (≥ 16 years) and parents of child survivors (survivor program. Sixty-five participants completed a baseline survey and 50 completed both a baseline and follow-up survey. Participants were found to have a low perceived likelihood of developing a late effect of cancer therapy and many incorrect perceptions of risk for individual late effects. Low knowledge before clinic (odds ratio = 9.6; 95% confidence interval, 1.7-92.8; P = .02) and low perceived likelihood of developing a late effect (odds ratio = 18.7; 95% confidence interval, 2.7-242.3; P = .01) were found to predict low knowledge of late effect risk at follow-up. This suggests that perceived likelihood of developing a late effect is an important factor in the individuals' ability to learn about their risk and should be addressed before initiation of education.

  1. Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India

    Directory of Open Access Journals (Sweden)

    Nagarajan Sripriya

    2008-01-01

    Full Text Available Background: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. Materials and Methods: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth, which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. Conclusion: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in.

  2. Investigating the condition of medical counseling and some of clinical aspects for fasting in holy month of Ramadan from the perspective of diabetic and hypertensive patients

    Directory of Open Access Journals (Sweden)

    Ahmad Mahmoudian

    2015-06-01

    Full Text Available Introduction: Although fasting has many benefits for health, it can be dangerous for patients. So it is necessary that physicians have adequate information about clinical aspects of fasting and they should advice patients. Therefore in this study we analyses the condition of physicians counseling about fasting from the perspective of patients. Methods:In this descriptive analytical cross-sectional study, patients with diabetes and hypertension who were going to doctors in Isfahan in holy month of Ramadan of 2012 and 2013 completed the questionnaires. A valid self-regulation questionnaire including patient`s satisfaction from the quality of physicians counseling about fasting (In the area of education, evaluation of the patient condition, communication /relationship with patients, caring for diseases in holy Ramadan and the incidence of symptoms in fasting had been used with  = 0.76. The patients completed the questionnaire after visit. The data was analyzed by Independent t-test, chi-square, Regression, one-way ANOVA in the19 spss software. Results: 285 patients, 199(69.8% female and 86(30.2% male, were selected. The mean satisfaction score of counseling was 70.50 ±13.23. The highest score (75.36±14.16 was referred to counseling of physician, and the least score (66.09±18.84 to patient assessment by physician. Mean score of Patients' satisfaction of specialists was higher than of general practitioner (p-value

  3. Ferritin surplus in mouse spleen 14 months after intravenous injection of iron oxide nanoparticles at clinical dose

    Institute of Scientific and Technical Information of China (English)

    Alexandre Tamion; Matthias Hillenkamp; Arnaud Hillion; Valentin A.Maraloiu; Ioana D.Vlaicu; Mariana Stefan; Daniela Ghica

    2016-01-01

    In this study,we followed the biodegradation of ultra-small superparamagnetic iron oxide nanoparticles injected intravenously at clinical doses in mice.An advanced fitting procedure for magnetic susceptibility curves and lowtemperature hysteresis loops was used to fully characterize the magnetic size distribution as well as the magnetic anisotropy energy of the injected P904 nanoparticles (Guerbet Laboratory).Additional magnetometry measurements and transmission electronic microscopy observations were systematically performed to examine dehydrated samples from the spleen and liver of healthy C57B16 mice after nanoparticle injection,with sacrifice of the mice for up to 14 months.At 3 months after injection,the magnetic properties of the spleen and liver were dramatically different.While the liver showed no magnetic signals other than those also present in the reference species,the spleen showed an increased magnetic signal attributed to ferritin.This surplus of ferritin remained constant up to 14 months after injection.

  4. Clinical Characteristics of Rheumatoid Arthritis Patients Achieving Functional Remission with Six Months of Biological DMARDs Treatment.

    Science.gov (United States)

    Miwa, Yusuke; Takahashi, Ryo; Ikari, Yuzo; Maeoka, Airi; Nishimi, Shinichiro; Oguro, Nao; Hayashi, Tomoki; Hatano, Mika; Isojima, Sakiko; Yanai, Ryo; Kasama, Tsuyoshi; Toyoshima, Yoichi; Inagaki, Katsunori; Sanada, Kenji

    2017-01-01

    Objective Although previous studies have reported the prognostic factors for functional remission, no reports have cited the predictive factors. Our aim was to study the predictive factors for functional remission, which is a treatment goal in rheumatoid arthritis (RA), after receiving biological disease-modifying antirheumatic drugs (bDMARDs) treatment for six months. Methods The study consisted of 333 RA patients treated with bDMARDs for six months. The following patient characteristics were investigated: age, gender, disease duration, type of bDMARDs, baseline steroid and methotrexate dosage, and levels of serum rheumatoid factor, matrix metalloprotease, anti-cyclic citrullinated peptides antibody, tumor necrosis factor-α, and interleukin-6. In our evaluation, we used the Simplified Disease Activity Index (SDAI) for RA disease activity, health assessment questionnaire disability index (HAQ-DI) for activity of daily living, Short Form (SF)-36 for quality of life, and Hamilton Depression Rating Scale (HAM-D) or Self-rating Depression Scale (SDS) to determine the patients' depression status. The subjects were divided into two groups: patients with HAQ-DI≤0.5 and HAQ-DI>0.5 at 6 months. Results A univariate analysis comparing a group of RA patients without functional remission (n=68) showed that the patients with functional remission (n=164) had the following in common compared with those without remission: younger age, shorter disease duration, lower baseline steroid dosage, lower SDAI, lower HAQ-DI, higher SF-36, and lower HAM-D. Only lower HAQ-DI scores and "mental health" score on the SF-36 were detected using a logistic regression analysis. Conclusion These findings suggested that RA patients with lower HAQ-DI and lower depression scores at baseline were more likely to achieve functional remission using bDMARDs treatment than those without these variables.

  5. Evaluation of different treatment protocols for dentin hypersensitivity: an 18-month randomized clinical trial.

    Science.gov (United States)

    Lopes, Anely Oliveira; de Paula Eduardo, Carlos; Aranha, Ana Cecília Correa

    2017-07-01

    This randomized and longitudinal in vivo study aimed to assess different protocols for the treatment of dentin hypersensitivity with low-power laser (with different doses), high-power laser, and a desensitizing agent, for a period of 12 and 18 months. The lesions from 32 patients (117 lesions), who were submitted to the inclusion and exclusion criteria, were divided into nine groups (n = 13): G1: Gluma Desensitizer (Heraeus Kulzer), G2: low-power laser with low dose (three points of irradiation in vestibular portion and an apical point 30 mW, 10 J/cm(2), 9 s per point with the wavelength of 810 nm, with three sessions with an interval of 72 h), G3: low-power laser with high dose (one point in the cervical area, and one apical point 100 mW, 40 J/cm(2), 11 s per point with the wavelength of 810 nm in three sessions with an interval of 72 h), G4: low-power laser with low dose + Gluma Desensitizer, G5: low-power laser with high dose + Gluma Desensitizer, G6: Nd:YAG laser (Power Laser™ ST6, Research® in contact 1.0 W, 10 Hz and 100 mJ, ≈85 J/cm(2), with the wavelength of 1064 nm), G7: Nd:YAG laser + Gluma Desensitizer, G8: low-power laser with low dose + Nd:YAG laser, and G9: low-power laser with high dose + Nd:YAG laser. The level of sensitivity of each volunteer was assessed by visual analog scale of pain (VAS) with the aid of air from the triple syringe and exploration probe, 12 and 18 months after treatment. All analyses were performed separately for air and probe stimulus. The level of significance was considered for values of p < 0.05. After statistical analysis, all treatments were shown to be effective in reducing dentinal hypersensitivity, and the results were considered not statistically different from those at 12 months. Therefore, until the 18-month evaluation, it could be said that no statistical differences were observed in the sensitivity levels for all treatments.

  6. Transcrestal Sinus Lift Procedure Approaching Atrophic Maxillary Ridge: A 60-Month Clinical and Radiological Follow-Up Evaluation

    Directory of Open Access Journals (Sweden)

    G. Lo Giudice

    2015-01-01

    Full Text Available Aim. The aim of this study was to assess the success and the survival rate of dental implants placed in augmented bone after sinus lifting procedures. Material and Methods. 31 patients were mainly enrolled for a residual upper jaw crest thickness of 3 mm. CBCT scans were performed before and after the augmentation technique and at the follow-up appointments, at 3, 6, 12, 24, and up to 60 months. The follow-up examination included cumulative survival rate of implants, peri-implant marginal bone loss, and the height of sinus floor augmentation. Results. This retrospective study on 31 patients and 45 implants later inserted in a less than 3 mm crest showed excellent survival rates (99.5%, one implant was lost before loading due to an acute infection after 24 days, and two implants did not osteointegrate and were removed after 3 months. The radiological evaluation showed an average bone loss of 0.25 mm (±0.78 mm at the first follow-up appointment (3 months up to 0.30 mm (±1.28 mm after 60-month follow-up. Conclusion. In this study it was reported how even in less than 3 mm thick crest a transcrestal technique can predictably be used with a long-term clinical and radiological outcome, giving patients excellent stability of the grafted material and healthy clinical results.

  7. Evaluation of crestal bone resorption around cylindrical and conical implants following 6 months of loading: A randomized clinical trial.

    Science.gov (United States)

    Sargolzaie, Naser; Arab, Hamid Reza; Moghaddam, Marzieh Mohammadi

    2017-01-01

    The purpose of this clinical study was to evaluate the effect of implant body form (cylindrical and conical implants) on crestal bone levels during 6 months' follow-up after loading. A total of 32 SPI implants (19 conical implants/13 cylindrical implants) were randomly placed in 12 male patients using a submerged approach. None of the patients had compromising medical conditions or parafunctional habits. Periapical radiographs using the parallel technique were taken after clinical loading and 6 months later. Clinical indices including pocket depth and bleeding on probing (BOP) were recorded on 6-month follow-up. Data were analyzed by independent samples t-test and Chi-square test with a significance level of 0.05. Six months after loading, crestal bone loss was 0.84 (±0.29) mm around the cylindrical implants and 0.73 (±0.62) mm around the conical types, which was not significantly different (P = 0.54). Pocket depth around the cylindrical and conical implants was 2.61 (±0.45) mm and 2.36 (±0.44) mm, respectively (P = 0.13). BOP was observed among 53.8% and 47.4% of the cylindrical implants and conical (P = 0.13). Bone loss and pocket depth in the maxilla and mandible had no significant difference (P = 0.46 and P = 0.09, respectively). In this study, although bone loss and clinical parameters were slightly higher in the cylindrical implants, there was no significant difference between the conical- and cylindrical-shaped implants.

  8. Clinical manifestations of human cytomegalovirus (HCMV infection in children in the first few months of life

    Directory of Open Access Journals (Sweden)

    Aziza Khodjaeva

    2012-10-01

    Full Text Available The research objective was to study frequency of antenatal infection and record probable clinical manifestations in 100 children with HCMV born from mother with HCMV in blood and mononuclear cells. The study identified poly-systemic internal organ damage in neonates due to prenatal HCMV. Research procedures involved study of 100 pairs of patients, Mother-Child tandem, using regular clinical assessment methods per algorithm and HCMV diagnostic methods: ELISA, affinity and avidity of HCMV antibodies, and HCMV genome identification via PCR method in blood plasma and mononuclear cells. Initial clinical disease manifested in 71% of children during late neonatal period. Children who died of HCMV (5% were infected antenatal, and 39% were born prematurely. Embryonic stigma found in five cases. HCMV’s affinity to different tissues during the process of embryogenesis leads of poly-systemic damage and results in various clinical manifestations in the postnatal period. HCMV’s ability to invade mononuclear blood cells jeopardizes the antivirus defense system. The research is vital to deter the transmission of the virus and provide HCMV specific treatment to couples planning to have children.

  9. Efficiency of photodynamic therapy in the treatment of peri-implantitis: A three-month randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Rakašević Dragana

    2016-01-01

    Full Text Available Introduction. Peri-implantitis is an inflammatory lesion of peri-implant tissues. Eradication of the causative bacteria and decontamination of the implant surface is essential in achieving predictable and stabile clinical results. Photodynamic therapy (PDT is non-invasive adjuvant therapeutic method to surgery in the treatment of bacterial infection. Objective. The aim of this study was to evaluate early clinical and microbiological outcomes of periimplantitis after surgical therapy with adjuvant PDT. Methods. Fifty-two diagnosed peri-implantitis sites were divided into two groups. PDT was used for decontamination of implant surface in the study group; in the control group, chlorhexidine gel (CHX followed by saline irrigation was applied. Several clinical parameters were recorded before the treatment (baseline values and three months after surgical treatment. Samples for microbiological identification were collected before therapy, during the surgical therapy (before and after decontamination of implant surface, and three months thereafter, and analyzed with identification systems using biochemical analysis. Results. The use of PDT resulted in significant decrease of bleeding on probing in comparison to CHX (p < 0.001. It showed significant decontamination of implant surfaces with complete elimination of anaerobic bacteria immediately after surgical procedure and three months later. Conclusion. The results indicate that PDT can be used as an adjuvant therapy to surgery for decontamination of implant surface and surrounding peri-implant tissues within the treatment of peri-implantitis. [Projekat Ministarstva nauke Republike Srbije, br. 41008

  10. Anticalculus efficacy and safety of a novel whitening dentifrice containing sodium hexametaphosphate: a controlled six-month clinical trial.

    Science.gov (United States)

    Liu, Henry; Segreto, Vincent A; Baker, Robert A; Vastola, Kathleen A; Ramsey, Lorie L; Gerlach, Robert W

    2002-01-01

    This study was undertaken to establish the tartar control efficacy and long-term safety of a new dentifrice containing sodium hexametaphosphate. In a randomized, examiner blind, parallel group clinical trial, the experimental dentifrice with 7% sodium hexametaphosphate (5% hexametaphosphate anion), a non-abrasive cleaning agent that provides whitening and tartar control benefits, was compared to two currently marketed controls, a regular sodium fluoride dentifrice and a triclosan/copolymer dentifrice. The 8-month trial model included a 2-month pretest period to establish calculus formation after prophylaxis, and a 6-month test period to evaluate anti-calculus efficacy and safety. Following the pretest period, 551 subjects were allocated to one of the three treatment groups and then monitored for calculus accumulation and soft tissue tolerance. After 6 months, the sodium hexametaphosphate group exhibited superior calculus inhibition compared to the regular sodium fluoride dentifrice and triclosan/copolymer dentifrice (p < 0.01). Over the 6-month observation period, the sodium hexametaphosphate and the marketed control dentifrices were comparable in terms of adverse event type and severity, and no subject discontinued treatment due to an oral soft tissue adverse event.

  11. Validity of 12-Month Falls Recall in Community-Dwelling Older Women Participating in a Clinical Trial

    Directory of Open Access Journals (Sweden)

    Kerrie M. Sanders

    2015-01-01

    Full Text Available Objectives. To compare 12-month falls recall with falls reported prospectively on daily falls calendars in a clinical trial of women aged ≥70 years. Methods. 2,096 community-dwelling women at high risk of falls and/or fracture completed a daily falls calendar and standardised interviews when falls were recorded, for 12 months. Data were compared to a 12-month falls recall question that categorised falls status as “no falls,” “a few times,” “several,” and “regular” falls. Results. 898 (43% participants reported a fall on daily falls calendars of whom 692 (77% recalled fall(s at 12 months. Participants who did not recall a fall were older (median 79.3 years versus 77.8 years, P=0.028. Smaller proportions of fallers who sustained an injury or accessed health care failed to recall a fall (all P<0.04. Among participants who recalled “no fall,” 85% reported zero falls on daily calendars. Few women selected falls categories of “several times” or “regular” (4.1% and 0.4%, resp. and the sensitivity of these categories was low (30% to 33%. Simply categorising participants into fallers or nonfallers had 77% sensitivity and 94% specificity. Conclusion. For studies where intensive ascertainment of falls is not feasible, 12-month falls recall questions with fewer responses may be an acceptable alternative.

  12. Effect of intervention on clinic visiting rate of woman with gynecological diseases after disease census among retired or poverty-stricken women%退休及生活困难女性妇女病普查后就诊干预研究

    Institute of Scientific and Technical Information of China (English)

    徐丽玲; 沈晔; 何萍; 黄璧琨; 孙雄

    2011-01-01

    目的 评价社区医生督促就诊措施对上海市长宁区江苏社区退休及生活困难女性妇女病普查后就诊率的干预效果.方法 采用前瞻性干预研究设计和整群抽样方法,利用妇科普查和入户调查相结合的方法,收集714名退休及生活困难女性相关信息进行分析.结果 江苏社区2008年妇女病普查患病并接受基线随访的退休及生活困难女性共714例,普查后半年内就诊率为36.27%;社区医生上门督促后1年左右再次接受调查的共681例,就诊率为54.48%;生活困难女性基线就诊率(13.04%)低于退休女性(37.87%);受教育程度为大专及以上或初中者督促后就诊率较高,分别为48.84%和33.33%;自感疾病严重程度和基线就诊率、督促后就诊率均呈正相关(OR=2.45,95%CI=1.82~3.30;OR=5.10,95%CI=3.21~8.10).结论 退休及生活困难女性妇女病普查检出率高,就诊率低,社区医生督促就诊对于提高就诊率有一定效果.%Objective To evaluate the effect of intervention on improving chinic visiting rate of women with gynecolological diseases after disease census among retired or poverty-stricken women in a community of Shanghai.Methods The prospective intervention study was executed in 714 subjects selected with cluster sampling from all retired or poverty-stricken women registered in the community.Data were collected through a questionnaire survey and physical examination.Results Among the 714 women with at least one gynecological disease,36.27% sought medical treatment during six months after the disease survey.After a face-to-face intervention on clinic visit by community doctor,54.48% of the women sought medical treatment.A decreased clinic visiting baseline rate was detected in the poverty-stricken women( 13.04% ).An increased clinic visiting rate after the intervention of community doctor was observed in the women with education of college and above(48.84% ) and middle school (33.33%).There was a

  13. The arthropathy of systemic sclerosis: a 12 month prospective clinical and imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Montagna, Giovanni La; Malesci, Domenico; Valentini, Gabriele [Seconda Universita di Napoli, Dipartimento Medico-Chirurgico di Internistica, Clinica e Sperimentale ' ' F Magrassi e A Lanzara' ' , Unita Operativa di Reumatologia, Naples (Italy); Sodano, Antonio; Capurro, Vittorio [Universita ' ' Federico II' ' , Dipartimento di Diagnostica per Immagini e Radioterapia, Naples (Italy)

    2005-01-01

    To assess the clinical and radiological features of systemic sclerosis (SSc) joint involvement in a prospective cross-sectional study. Seventy-six consecutive patients with SSc divided into clinical and serological subsets were investigated. Clinical and radiological assessments of the hands and feet were carried out. Three radiological patterns of inflammatory, degenerative and fibrotic changes were predefined. The Health Assessment Questionnaire (HAQ) disability index (DI) and individual components of the HAQ-DI were also evaluated. The highest impairments on the HAQ-DI (median 0.44; range 0-2.87) were detected in subdimensions such as hygiene, grip and activity components. Clinically articular involvement, arthralgia and finger contractures were seen more frequently than arthritis, and a significantly higher prevalence of finger flexion was found in patients with diffuse cutaneous SSc (P=0.03) compared with the other SSc subtypes. Radiologically, distal interphalangeal joint space narrowing and flexion deformity indicating periarticular fibrosis were frequently detected. Juxta-articular osteoporosis, joint space narrowing and flexion contractures of the fingers were seen significantly more frequently in the hands. A significantly higher frequency of fibrotic pattern were found in the hands whereas a degenerative pattern was more frequent in the feet (P<0.05). Finally, significant correlations were detected between flexion contractures and a radiological fibrotic pattern (P<0.001), and the severity scores of peripheral vascular impairment (P=0.026) and skin (P=0.007). This cross-sectional prospective study confirms that an arthropathy is common in SSc patients and shows that it is a major determinant of disability. A classification of radiological alterations into three specific patterns is proposed. (orig.)

  14. Effects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in the Netherlands.

    NARCIS (Netherlands)

    Bouman, A.; Rossum, E. van; Evers, S.; Ambergen, T.; Kempen, G.; Knipschild, P.

    2008-01-01

    BACKGROUND: Home visiting programs have been developed to improve the functional abilities of older people and subsequently to reduce the use of institutional care services. The results of trials have been inconsistent and their cost-effectiveness uncertain. Home visits for a high-risk population ra

  15. Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics.

    Science.gov (United States)

    Stennis, Natalie L; Burzynski, Joseph N; Herbert, Cheryl; Nilsen, Diana; Macaraig, Michelle

    2016-01-01

    Completion of treatment for tuberculosis infection (TBI) with 9 months of self-administered daily isoniazid (9H) has historically been low (tuberculosis clinic patients. Treatment of TBI with 3 months of once-weekly isoniazid and rifapentine (3HP) administered under directly observed therapy (DOT) might increase treatment acceptance and completion. The study population included patients diagnosed with TBI at 2 NYC Health Department tuberculosis clinics from January 2013 through November 2013. Treatment acceptance and completion with 3HP were compared with historical estimates. Treatment outcomes, side effects, and reasons for refusing 3HP were described. Among 631 patients eligible for TBI treatment, 503 (80%) were offered 3HP; 302 (60%) accepted, 92 (18%) chose other treatment, and 109 (22%) refused treatment. The most common reason for refusing 3HP was the clinic-based DOT requirement. Forty (13%) patients treated with 3HP experienced side effects--9 were restarted on 3HP, 18 switched treatment regimens, and 13 discontinued. Although treatment acceptance did not differ from historical estimates (78% vs 79%, P = .75), treatment completion increased significantly (65% vs 34%, P tuberculosis clinics increased TBI treatment completion by 31 percentage points compared with historical estimates. More flexible DOT options may improve acceptance of 3HP. Wider use of 3HP may substantially improve TBI treatment completion in NYC and advance progress toward tuberculosis elimination. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  16. Comparison of clinical and laboratory characteristics of intestinal amebiasis with shigellosis among patients visiting a large urban diarrheal disease hospital in Bangladesh.

    Science.gov (United States)

    Das, Sumon Kumar; Chisti, Mohammod Jobayer; Malek, Mohammad Abdul; Salam, Mohammed Abdus; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Mondal, Dinesh

    2013-08-01

    Between 1993 and 2011, a total of 371 intestinal amebiasis (IA), caused by Entamoeba histolytica cases were compared with 1,113 shigellosis (randomly selected) patients of icddr,b, excluding co-infections (rotavirus and Vibrio cholerae) in two age stratums: 0-14 years of age and ≥ 15 years of age. The number of IA and shigellosis cases gradually reduced over the study period. In multivariate analysis, individuals 0-14 years of age, slum dwellers (odds ratio [OR] 3.51; 95% confidence interval [CI] 1.69-7.24; P < 0.001), red blood cell (0.44 [0.24-0.86] 0.016), fecal leukocytes (0.17 [0.07-0.33] < 0.001), and alkaline stool (0.16 [0.07-0.36] < 0.001) were independently associated with IA; and among individuals ≥ 15 years of age, living in the slum area (1.88 [1.12-3.14] 0.016), watery stool (2.21 [1.37-3.55] 0.001), use of antimicrobials before visiting hospital (0.67 [0.46-0.99] 0.047), red blood cell (0.45 [0.22-0.94] 0.036), and fecal leukocytes (0.21 [0.12-0.35] < 0.001) in stool were independently associated with IA. Socio-demographic and clinical characteristics of IA and shigellosis varied distantly from each other.

  17. The effect of systematic clinical interventions with cigarette smokers on quit status and the rates of smoking-related primary care office visits.

    Science.gov (United States)

    Land, Thomas G; Rigotti, Nancy A; Levy, Douglas E; Schilling, Thad; Warner, Donna; Li, Wenjun

    2012-01-01

    The United States Public Health Service (USPHS) Guideline for Treating Tobacco Use and Dependence includes ten key recommendations regarding the identification and the treatment of tobacco users seen in all health care settings. To our knowledge, the impact of system-wide brief interventions with cigarette smokers on smoking prevalence and health care utilization has not been examined using patient population-based data. Data on clinical interventions with cigarette smokers were examined for primary care office visits of 104,639 patients at 17 Harvard Vanguard Medical Associates (HVMA) sites. An operational definition of "systems change" was developed. It included thresholds for intervention frequency and sustainability. Twelve sites met the criteria. Five did not. Decreases in self-reported smoking prevalence were 40% greater at sites that achieved systems change (13.6% vs. 9.7%, pstrategies focus on the provider or the tobacco user, but these results argue that health systems should be included as an integral component of a comprehensive tobacco intervention strategy. The HVMA results also give us an indication of the potential health impacts when meaningful use core tobacco measures are widely adopted.

  18. Percutaneous Stabilization System Osseofix® for Treatment of Osteoporotic Vertebral Compression Fractures - Clinical and Radiological Results after 12 Months.

    Directory of Open Access Journals (Sweden)

    Stephan Albrecht Ender

    Full Text Available A prospective consecutive cohort study (follow-up study.Our study investigated whether implantation of an expandable titanium mesh cage (Osseofix® is a successful and safe minimally invasive therapy for osteoporotic vertebral compression fractures (VCF. Our experiences, clinical and radiological findings after 12 months follow-up are presented. Kypho- and vertebroplasty are well-established minimally invasive procedures for the treatment of osteoporotic VCF. The main complications associated with both procedures are uncontrolled bone cement leakage. Therefore a suitable alternative has been investigated.During June 2010 to May 2011 24 patients were included with 32 osteoporotic VCF (T6 to L4. All of them were stabilized with the Osseofix® system. Preinterventionally we performed X-ray, MRI, and bone density measurements (DXA. Clinical and radiological results were evaluated preop., postop. and after 12 months postop. based on the Oswestry Disability Index (ODI and the Visual Analogue Scale (VAS, X-ray (Beck Index, Cobb-angle and CT.There was a significant improvement in the mean ODI (70,6% to 30,1% as well as a significant reduction in pain intensity (VAS (7,7 to 1,4 after 12 month. The mean kyphotic angle according to Cobb showed significant improvements (11,7° to 10,4° after 12 months. Postinterventional imaging showed only one case of loss of height in a stabilized vertebral body (3.1%. We saw no changes in posterior vertebral wall or adjacent fractures. Except for one pronounced postoperative hematoma we saw no surgical complications including no cement leakage.Stabilization of symptomatic osteoporotic VCF with Osseofix® system is a safe and effective procedure, even in fractures with posterior wall involvement. The clinical mid-term results are good at a very low complication rate. The Osseofix® system is an interesting alternative to the established procedures of cement augmentation.

  19. [Clinical case of the month. Cerebral salt wasting syndrome: report of a case].

    Science.gov (United States)

    Llabres, V; Canivet, J L; Hennuy, V; Damas, P

    1999-11-01

    A 75 year old woman was found to have a posterior cerebellar lesion which after surgical removal was shown to be a meningioma. Her postoperative course was complicated by a MRSA meningitis and on day 23 after resection, a polyuria up to 11.7 1/24 h became apparent. The diagnosis of cerebral wasting syndrome (CSWS) was made based on biological and clinical features such as an excessive natriuresis (143 mmol/l) resulting in hyponatremia (130 mmol/l) and an osmolarity higher in urine than in blood. A low central venous pressure and a low wedge pressure confirming a volumic depletion indicated the diagnosis of CSWS. This syndrome has marked similarities with the Inappropriate Secretion of Antidiuretic Hormone Syndrome (SIADH) in terms of biological finding with regards to clinical context and presentation. Without an adequate assessment, a patient with CSWS may be misdiagnosed as SIADH. However recognition is important, as water restriction which is part of SIADH treatment, is detrimental to patients with CSWS and can possibly be lethal.

  20. Comparison of two strategies for the administration of injectable depot medroxyprogesterone acetate: among women who returned to a family planning clinic at three- or six-month intervals.

    Science.gov (United States)

    Ferreira, Jéssica M; Bottura, Bruna F; Gonçalves, Mayara P; Monteiro, Ilza; Bahamondes, Luis

    2016-10-01

    The aim of this study was to compare the clinical performance of depot medroxyprogesterone acetate (DMPA) in women who received injections every 3 months at the Family Planning Clinic, and those who received every other injection at a health care facility near their place of residence, only returning to the clinic every 6 months. The medical charts of DMPA users from 2 January 1980 through 31 December 2012 were evaluated for this study. Two cohorts of women were created and compared: those who regularly received DMPA injections every 3 months (3-month group) at the clinic and those who received alternating 3-month injections at a health care facility near their residence house, returning to the clinic every 6 months for an injection (6-month group). In addition, effectiveness rates, reasons for discontinuation, and continuation rates were evaluated. Overall, 2637 women received all injections at 3-month intervals at the clinic, and 1190 women received every other injection at a health care facility near their residence. The women in the 3-month group had higher pregnancy rates and higher discontinuation rates (with the exception of discontinuation due to the loss of libido). The women who received alternating injections near their homes were more likely to continue using DMPA as a contraception method and presented lower pregnancy and discontinuation rates (for the majority of reasons), when compared to those women who returned to the clinic every 3 months.

  1. Clinical and Psychosocial Predictors of Community Reintegration of Stroke Survivors Three Months Post In-Hospital Discharge.

    Science.gov (United States)

    Ekechukwu, Nelson; Olaleye, Olubukola; Hamzat, Talhatu

    2017-01-01

    There appears to be a dearth of published literature on the biopsychosocial predictors of community reintegration (CR) among stroke survivors. This study aims to investigate the clinical and psychosocial predictors of CR among stroke survivors three months post in-hospital discharge. Fifty-two stroke survivors took part in this prospective exploratory study. The participants' clinical attributes of motor function (MF), balance (Bal) and psychosocial characteristics of Fall Self-Efficacy (FSE), Balance Self-Efficacy (BSE), Self-Esteem (SEst) and Social Support (SS) were assessed pre-discharge and at three months post-discharge. CR was also assessed at three months post-discharge. Data were analyzed using paired t-test, Pearson's Moment correlation and multiple regressions. Level of significance was set at p = 0.05. The mean age of the participants was 61.21±11.25 years with mean hospital length of stay of 5.31±3.71weeks. There were significant differences in the mean MF, Bal, FSE, BSE, SEst and SS scores of the participants pre- and post-discharge (p reintegration among stroke survivors.

  2. A 12 month clinical audit of cervical spine imaging in multiply injured and intubated patients.

    Science.gov (United States)

    Ball, C; Watson, D

    2010-03-01

    Previous work has questioned how plain films should be used when imaging the cervical spine of trauma patients. The authors wanted to identify whether the National Institute for Clinical Excellence (NICE) guidelines were being followed with respect to the imaging of patients presenting with cervical spine injury over a 1 year period. Data retrieved from the Electronic Digital Information Service (EDIS) computerised database records of all patients presenting with a triage code 1 or 2 between 1 September 2007 and 31 August 2008 were used to conduct a retrospective audit that identified multiply injured and intubated patients who did not undergo CT of the cervical spine and to highlight the use of plain films when the patient was to undergo CT of the head and cervical spine. A clinical record search identified 52 patients with a mean age of 32 years, of whom 73% were males, who had been admitted with multiple traumas and had undergone imaging of the cervical spine. Although no patient was intubated without undergoing CT of the cervical spine or head, seven patients had plain films when it was clear that they were to undergo CT. In conclusion, the audit emphasised the excellent work of emergency department and radiology staff in identifying and imaging multiple trauma patients, as all patients requiring CT of the cervical spine received this investigation. However, careful thought should be given to ordering plain films before CT, as some patients who clearly required CT of the cervical spine underwent unnecessary lateral plain films in the emergency department, delaying their progression to definitive care.

  3. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures.Three months follow up in a clinical randomised study

    DEFF Research Database (Denmark)

    Rousing, Rikke

    2008-01-01

    ) were included from January 2001 until January 2008. Patients with acute (weeks) and subacute (between 2 and 8 weeks) osteoporotic fractures were included and randomised to either PVP or conservative treatment. Pain was assessed with a visual analogue scale and physical and mental outcome were...... assessed by validated questionnaires and tests. Tests, questionnaires, and plain radiographs were performed at the inclusion and after 3 months. Results. Reduction in pain from initial visit to 3 months follow up was comparable in the two groups (p=0.22) from approximate VAS 8.0 to VAS 2.0, intra group...... difference was significant (phours after the procedure (p

  4. Oral health students as reflective practitioners: changing patterns of student clinical reflections over a period of 12 months.

    Science.gov (United States)

    Tsang, Annetta K L

    2012-01-01

    The purpose of this study was to determine the levels of reflection shown by bachelor of oral health students in relation to their clinical and professional practice. Reflective learning was embedded as a topic in the oral health curriculum within the discipline of dental hygiene practice. Reflective journal writing was integrated with clinical practice and linked with assessment requirements. Students' reflective writing was analyzed thematically to elucidate levels of reflection based on Boud's 4 Rs of Reflection (review, react, relate and respond) over a period of 12 months. Differences in the levels of reflection at different time intervals were examined. Students' ability to critically reflect improved over the period of 12 months. The predominant level of reflection changed from primarily descriptive and superficial at the start of the academic year to primarily critical and relational by the end. As expected, the highest level of critical reflection (respond) occurred infrequently, although it became more frequent as the academic year progressed. Bachelor of oral health students do reflect critically. Regular reflective writing contributed to the development of critical reflective skills in the context of clinical and professional development.

  5. Incremental predictive value of red cell distribution width for 12-month clinical outcome after acute myocardial infarction.

    Science.gov (United States)

    Lee, Jang Hoon; Yang, Dong Heon; Jang, Se Yong; Choi, Won Suk; Kim, Kyun Hee; Lee, Won Kee; Bae, Myung Hwan; Park, Hun Sik; Cho, Yongkeun; Chae, Shung Chull

    2013-06-01

    The incremental predictive value of red cell distribution width (RDW) for major adverse cardiac events (MACEs) has not been fully investigated in patients with acute myocardial infarction (AMI). The aim of this study was to determine the incremental value of RDW to the established risk factors in predicting clinical outcomes after AMI. Between November 2005 and January 2010, 1596 patients with AMI (1070 male; mean age, 64.5 ± 11.9 years) were analyzed in this study. Baseline levels of RDW were measured at the time of admission. The 12-month MACEs were defined as death and nonfatal MI. The RDW levels were significantly higher in patients with 12-month MACEs (13.8 ± 1.3% vs 13.3 ± 1.2%, P Adding RDW to established risk factors and hemoglobin levels significantly improved prediction for 12-month MACEs, as shown by the net reclassification improvement (0.297; P = 0.012) and integrated discrimination improvement (0.0143; P = 0.042). The likelihood ratio test showed that RDW added incremental predictive value to the combination of hemoglobin and established risk factors (P = 0.005). Patients were categorized into 4 groups according to quartiles of RDW at baseline. Adjusted HRs for 12-month MACEs were 1 (RDW ≤12.6%, reference), 4.24 (RDW 12.7%-13.1%, P = 0.01), 4.36 (RDW 13.2%-13.9%, P = 0.008), and 6.18 (RDW 13.2%-13.9%, P = 0.001), respectively. In post-myocardial infarction patients, baseline RDW levels at admission could provide incremental predictive value to established risk factors for predicting 12-month MACEs. © 2013 Wiley Periodicals, Inc.

  6. Analysis on dental uncooperative behaviors of the first-visit children in clinic%初诊儿童牙科不合作行为分析

    Institute of Scientific and Technical Information of China (English)

    阳婵; 邹红梅; 邹静

    2011-01-01

    目的 探讨初次到牙科就诊的儿童其不合作行为与儿童气质、龋病严重程度等因素的相关性,以期制定个性化的牙科治疗方案,预防和应对初诊儿童的牙科不合作行为.方法 从2007年12月-2008年12月初次到儿童口腔科就诊的儿童中随机抽取195名3~7岁儿童为研究对象,对儿童进行口腔检查和实施相应的治疗措施,并对治疗过程中儿童的牙科行为进行评估分级.家长填写《NYLS 3~7岁儿童气质家长评定问卷》.结果 195名儿童中,牙科恐惧及焦虑(DFA)儿童114名(58.46%),牙科行为管理问题(DBMP)儿童66名(33.85%);随着年龄的增加,儿童DBMP逐渐下降;性别与儿童DFA/DBMP无关;龋病越严重的儿童越易发生DFA/DBMP.不同气质类型儿童的DFA/DBMP差异无统计学意义,但气质维度中,DFA儿童的反应阈高于非DFA儿童,DBMP儿童的节律性低于非DBMP儿童.结论 应将患龋严重的儿童作为重点人群,根据不同年龄、不同气质特点采取不同行为管理方法,降低初诊儿童DFA/DBMP的发生.%Objective To investigate the relationship between the uncooperative behaviors of first-visit-dental children and correlative factors that include children's temperament, severe of dental caries and so on in order to help dentists to make personal dentistry therapy plan for each child to prevent and deal with children's uncooperative behaviors. Methods From the pediatric dentistry clinic, 195 first-visit-dental children (aged 3-7 years) from Dec. 2007 to Dec. 2008 were randomly selected to accept dental examination and accepted corresponding treatment according to personal therapy plans. Children's clinic behavior was valued during treatment. The parents were asked to complete NYLS temperament parents scale questionnaires for 3-7 years old children. Results Among the 195 children, there were 114(58.46%) had dental fear and anxiety (DFA) and 66(33.85%) had dental behavior management problem (DBMP). As the

  7. Integration of Oral Health Into the Well-Child Visit at Federally Qualified Health Centers: Study of 6 Clinics, August 2014–March 2015

    Science.gov (United States)

    Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul I.; Tinanoff, Norman

    2016-01-01

    Introduction Early childhood caries, the most common chronic childhood disease, affects primary dentition and can impair eating, sleeping, and school performance. The disease is most prevalent among vulnerable populations with limited access to pediatric dental services. These same children generally receive well-child care at federally qualified health centers. The objective of this study was to identify facilitators and barriers to the integration of oral health into pediatric primary care at health centers to improve problem recognition, delivery of preventive measures, and referral to a dentist. Methods We collected and analyzed background data and data from structured observations and 39 interviews with administrators and staff at 6 clinics in 2 states, Maryland and Massachusetts. Results Participants valued oral health across professional roles but cited limited time, lack of training and expertise, low caregiver literacy, and lack of shared medical and dental electronic records as barriers to cooperation. Facilitators included an upper-level administration with the vision to see the value of integration, designated team leaders, and champions. An administration’s vision, not structural determinants, patient characteristics, or geographic location, predicted the level of integration. Interviewees generated multilevel recommendations to promote delivery of oral health preventive measures and services during a well-child visit. Conclusion Poor oral health contributes to health care disparities. Barriers to integrating dental care into pediatric medical practice at health centers must be overcome to improve oral health for children living in poverty, with a disability, at a rural address, or any combination of these. Implementation will require adapting delivery systems to support multidisciplinary collaboration. Strategies suggested here may point the way to enhancing children’s oral health. PMID:27126556

  8. Rapid response predicts 12-month post-treatment outcomes in binge-eating disorder: theoretical and clinical implications

    Science.gov (United States)

    Grilo, C. M.; White, M. A.; Wilson, G. T.; Gueorguieva, R.; Masheb, R. M.

    2011-01-01

    Background We examined rapid response in obese patients with binge-eating disorder (BED) in a clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL). Method Altogether, 90 participants were randomly assigned to CBT or BWL. Assessments were performed at baseline, throughout and post-treatment and at 6- and 12-month follow-ups. Rapid response, defined as ≥70% reduction in binge eating by week four, was determined by receiver operating characteristic curves and used to predict outcomes. Results Rapid response characterized 57% of participants (67% of CBT, 47% of BWL) and was unrelated to most baseline variables. Rapid response predicted greater improvements across outcomes but had different prognostic significance and distinct time courses for CBT versus BWL. Patients receiving CBT did comparably well regardless of rapid response in terms of reduced binge eating and eating disorder psychopathology but did not achieve weight loss. Among patients receiving BWL, those without rapid response failed to improve further. However, those with rapid response were significantly more likely to achieve binge-eating remission (62% v. 13%) and greater reductions in binge-eating frequency, eating disorder psychopathology and weight loss. Conclusions Rapid response to treatment in BED has prognostic significance through 12-month follow-up, provides evidence for treatment specificity and has clinical implications for stepped-care treatment models for BED. Rapid responders who receive BWL benefit in terms of both binge eating and short-term weight loss. Collectively, these findings suggest that BWL might be a candidate for initial intervention in stepped-care models with an evaluation of progress after 1 month to identify non-rapid responders who could be advised to consider a switch to a specialized treatment. PMID:21923964

  9. Prognostic Impact of 9-Month High-Sensitivity C-Reactive Protein Levels on Long-Term Clinical Outcomes and In-Stent Restenosis in Patients at 9 Months after Drug-Eluting Stent Implantation.

    Directory of Open Access Journals (Sweden)

    I-Chang Hsieh

    Full Text Available The level of 9-month high-sensitivity C-reactive protein (hsCRP in predicting cardiovascular outcomes is scanty in patients at 9 months after receiving drug-eluting stent (DES implantations. This study aims to evaluate the relationship between 9-month follow-up hsCRP levels and long-term clinical outcomes in patients at 9 months after receiving DES.A total of 1,763 patients who received 9-month follow-up angiography were enrolled and grouped according to hsCRP level 9 months after the DES implantation: group I (718 patients, hsCRP3.0 mg/L.Group III patients had a lower cardiovascular event-free survival rate than group I or II patients during a follow-up of 64 ± 45 months (64.5% vs. 71.6% vs. 72.8%, respectively, p = 0.012. Multivariate analysis showed that a follow-up hsCRP level <3.0 mg/L was an independent predictor of a major adverse cardiovascular event (cardiac death, reinfarction, target lesion revascularization, stenting in a new lesion, or coronary bypass surgery. Group III patients had a higher restenosis rate (11.3% vs. 5.8% vs. 6.6%, respectively, p = 0.002 and loss index (0.21 ± 0.32 vs. 0.16 ± 0.24 vs. 0.18 ± 0.28, respectively, p = 0.001 than group I or II patients in 9-month follow-up angiography.A high 9-month follow-up hsCRP level is an independent predictor of long-term clinical cardiovascular outcomes in patients at 9 months after DES implantation. It is also associated with a higher restenosis rate, larger late loss and loss index at 9 months after DES implantation.

  10. First tooth, first visit, zero cavities: a practical approach to the infant oral health visit

    LENUS (Irish Health Repository)

    Fitzgerald, Kirsten

    2017-04-01

    The IDA adopted a formal policy on children’s oral health in 2011. There is increasing evidence to support early dental visits for children. The background to the infant oral health visit is discussed and a systematic approach to the practicalities of the visit is offered. General dental practitioners are encouraged to offer the first oral health visit before the first birthday, and this paper aims to give them practical advice concerning this visit. The feature is accompanied by a companion paper that reviews the literature pertaining to the topic, and serves to complement the recent clinical feature published in the Journal of the Irish Dental Association.

  11. Effectiveness of a promotora home visitation program for underserved Hispanic children with asthma.

    Science.gov (United States)

    Rashid, Shumyla; Carcel, Consuelo; Morphew, Tricia; Amaro, Silvia; Galant, Stanley

    2015-06-01

    Retention in a mobile asthma clinic, the Breathmobile™, of ≥3 visits has previously been shown to be essential for attaining asthma control in underserved children. The objective of this study in primarily Hispanic-American children was to determine the difference in retention between those seen in the Breathmobile™ compared to those receiving an additional promotora-based home visit (HV). Children with asthma in the Breathmobile™ program were evaluated for asthma status and aeroallergen sensitivity. Indication for HV included poor asthma control, educational and environmental control needs. An initial visit consisted of environmental assessment as well as a 3-h interactive educational session covering asthma basics. A follow-up visit 1 month later assessed implementation. The primary outcome measure of retention was ≥6 months in the Breathmobile™ program. Of the 1007 asthmatic children seen between April 2002 and June of 2005, 136 received HV. These children showed significantly greater retention compared to those without HV with a median number of visits (5 visits versus 2 visits), ≥3 Breathmobile™ visits (86.0% versus 38.8%), median number of days in the program (299 versus 63 days) and percentage of patients in the program ≥6 months (67.8% versus 31.3%) p asthma severity were each independent predictors of retention. The addition of a promotora HV program proved effective in providing greater retention in the Breathmobile™ program essential for asthma control. Randomized clinical trials will be needed to show the impact on health care utilization and asthma control.

  12. A Significant Visit

    Institute of Scientific and Technical Information of China (English)

    SHI YONGMING

    2010-01-01

    @@ North Korean leader KimJong Ⅱ paid a visit to China from May 3-7. The trip was on the agenda as early as last January, when Wang Jiarui, head of the International Department of the Communist Party of China Central Committee visited North Korea and delivered Chinese President Hu Jintao's invitation to Kim.

  13. Berliner Philarmoniker ATLAS visit

    CERN Multimedia

    ATLAS Collaboration

    2017-01-01

    The Berliner Philarmoniker in on tour through Europe. They stopped on June 27th in Geneva, for a concert at the Victoria Hall. An ATLAS visit was organised the morning after, lead by the ATLAS spokesperson Karl Jakobs (welcome and overview talk) and two ATLAS guides (AVC visit and 3D movie).

  14. Clinical outcomes and immune reconstitution in 103 advanced AIDS patients undergoing 12-month highly active antiretroviral therapy

    Institute of Scientific and Technical Information of China (English)

    DAI Yi; QIU Zhi-feng; LI Tai-sheng; HAN Yang; ZUO Ling-yan; XIE Jing; MA Xiao-jun; LIU Zheng-yin; WANG Ai-xia

    2006-01-01

    Background Highly active antiretroviral therapy (HAART) roduces profound suppression of HIV replication, substantial increase in CD4+ T cells, and partial reconstitution of the immune system. However, the numbers of subjects were small in previous Chinese studies. This study evaluated the efficacy and side effects of HAART in Chinese advanced AIDS patients.Methods One hundred and three antiretroviral drug naive AIDS patients were enrolled in this study and were divided into two groups by their baseline CD4+ count: <100 cells/ μl or ≥ 100 cells/μl. Clinical, virological and immunological outcomes were monitored at baseline and at 1, 3, 6, 9 and 12 months during the course of treatment with HAART.Results One patient died and another was lost from the follow-up. For the remaining 101 HIV/AIDS patients at the 12th month during the HAART, the plasma viral load (VL) was reduced to (3.2±0.7) lg copies/ml, the CD4+ count increased to (168±51) cells/μl [among which the naive phenotype (CD45RA+CD62L+) increased to (49±27) cells/μl and the memory phenotype (CD45RA ̄) increased to (119±55) cells/μl], and the percentage of CD4+CD28+ cells increased. At the same time, there was a significant reduction of CD8+ T cell activation. In the 69 patients with the baseline CD4+ count <100 cells/μl, 37 had a VL <50 copies/ml; while in the 34 patients with the baseline CD4+ count ≥ 100 cells/μl, 25 had a VL <50 copies/ml, the difference between the two groups was statistically significant. The CD4+ T cell count showed a two-phase increase during HAART and a significant positive correlation was shown between the change of CD4+ count and plasma VL. Over 12 months of HAART,10 patients had gastrointestinal side effects, 13 peripheral neuritis, 7 hepatic lesions, 8 hematological side effects,8 skin rashes, 10 lipodystrophy and 1 renal calculus.Conclusions Immune reconstitution as well as the significantly improved clinical outcomes is observed in Chinese advanced AIDS

  15. Mid-Treatment Sleep Duration Predicts Clinically Significant Knee Osteoarthritis Pain reduction at 6 months: Effects From a Behavioral Sleep Medicine Clinical Trial.

    Science.gov (United States)

    Salwen, Jessica K; Smith, Michael T; Finan, Patrick H

    2017-02-01

    To determine the relative influence of sleep continuity (sleep efficiency, sleep onset latency, total sleep time [TST], and wake after sleep onset) on clinical pain outcomes within a trial of cognitive behavioral therapy for insomnia (CBT-I) for patients with comorbid knee osteoarthritis and insomnia. Secondary analyses were performed on data from 74 patients with comorbid insomnia and knee osteoarthritis who completed a randomized clinical trial of 8-session multicomponent CBT-I versus an active behavioral desensitization control condition (BD), including a 6-month follow-up assessment. Data used herein include daily diaries of sleep parameters, actigraphy data, and self-report questionnaires administered at specific time points. Patients who reported at least 30% improvement in self-reported pain from baseline to 6-month follow-up were considered responders (N = 31). Pain responders and nonresponders did not differ significantly at baseline across any sleep continuity measures. At mid-treatment, only TST predicted pain response via t tests and logistic regression, whereas other measures of sleep continuity were nonsignificant. Recursive partitioning analyses identified a minimum cut-point of 382 min of TST achieved at mid-treatment in order to best predict pain improvements 6-month posttreatment. Actigraphy results followed the same pattern as daily diary-based results. Clinically significant pain reductions in response to both CBT-I and BD were optimally predicted by achieving approximately 6.5 hr sleep duration by mid-treatment. Thus, tailoring interventions to increase TST early in treatment may be an effective strategy to promote long-term pain reductions. More comprehensive research on components of behavioral sleep medicine treatments that contribute to pain response is warranted.

  16. Etiological analysis of diarrhea patients visiting enteric disease clinics in Beijing%北京市肠道门诊腹泻患者病原谱分析

    Institute of Scientific and Technical Information of China (English)

    刘晓峰; 张扬; 张兰荣; 甄博珺; 李朝辉; 吴阳博; 高志勇

    2015-01-01

    目的:了解北京市肠道门诊腹泻患者的病原学特征。方法2013年7月至2014年6月在2家哨点医院肠道门诊收集腹泻患者的粪便标本595份。对沙门菌、志贺菌、副溶血性弧菌、O1和O139群霍乱弧菌、致泻大肠埃希菌进行分离培养,对轮状病毒、诺如病毒、星状病毒和肠道腺病毒进行核酸检测。采用描述性流行病学方法对病原的时间分布、人群分布、血清型别等特征进行分析。组间率的比较采用χ2检验。结果595份样本中,128份细菌检测阳性,检出率为21.5%,其中致泻大肠埃希菌检出率为11.4%(68/595),其次为副溶血性弧菌(6.9%,41/595)、沙门菌(2.4%,14/595)和志贺菌(2.2%,13/595),霍乱弧菌未检出。112份样本腹泻病毒核酸检测阳性,检出率为18.8%,其中诺如病毒检出率为9.1%(54/595),其次为轮状病毒(8.7%,52/138),星状病毒(1.8%,11/595)和肠道腺病毒(0.7%,4/595)。致泻大肠埃希菌以肠致病性大肠埃希菌、肠产毒素性大肠埃希菌、肠黏附性大肠埃希菌为主,副溶血性弧菌血清型别主要为O4∶K8。6~9月份为病原菌检出的高峰期,当年11月至次年3月为腹泻病毒检出的高峰期。结论诺如病毒、轮状病毒亦是肠道门诊腹泻患者的主要病原,应予以重视。%Objective To investigate the etiological characteristics of diarrhea patients visiting enteric disease clinics in Beijing .Methods A total of 595 stool samples were collected among outpatients with diarrhea vistiting enteric disease clinics at two sentinel hospitals from July 2013 to June 2014 . Diarrheagenic Escherichia coli (E . coli) , Vibrio parahemolyticus , O1 or O139 Vibrio cholerae , Salmonella and Shigella were isolated according to standard methods . And rotavirus , norovirus , astrovirus and enteric adenovirus were identified by

  17. Clinical usefulness and patient satisfaction with a musculoskeletal ultrasound clinic: results of a 6-month pilot service in a Rheumatology Unit.

    Science.gov (United States)

    Acebes, Carlos; Harvie, John P; Wilson, Alison; Duthie, Janet; Bowen, Fran; Steven, Malcolm

    2016-12-01

    There is no agreement among the rheumatology community in how to implement the musculoskeletal ultrasound (MSUS) technique in the Rheumatology Divisions. To test the perceived usefulness of the MSUS, under consensus indications, for referring colleagues for the clinical management of their patients with inflammatory arthritis (IA) and to score the satisfaction level of the patients with different aspects of the ultrasound (US) examination, after attend to the MSUS clinic. A written questionnaire-based survey regarding the usefulness and satisfaction with the implementation of a pilot MSUS clinic in a Rheumatology Unit. Over a 6-month period, 43 patients attended 10 MSUS clinics. Referral agreed indications were: US assisting in early/subclinical diagnosis (35 %), decision making with patient treatment (44 %), monitoring of disease activity/treatment response (39 %) and US-guided injection (11 %). Average scores of the referrers regarding usefulness of the information provided for the US for these indications were 8.0, 8.3, 8.7 and 8.6, respectively, with a high score of 9.0 regarding the valuable support of the US for the management of their patients with IA. Patient satisfaction scores in responders (44 %) were averaged 9.5 and higher for receiving an adequate explanation of the US procedure, indications, US findings and their significance, lack of discomfort and length of the appointment. The average score was slightly lower (8.5) for the waiting time frame for the appointment for the MSUS examination. The referrers expressed a perception of usefulness of our pilot US clinic, under previous consensus indications, for the clinical management of their patients with IA. In addition, this MSUS clinic seemed to show a good acceptability and a high satisfaction scores for the patients.

  18. Comparison of efficacy of an arginine-calcium carbonate-MFP toothpaste to a calcium carbonate-MFP toothpaste in controlling supragingival calculus formation and gingivitis: a 6-month clinical study.

    Science.gov (United States)

    Li, Yiming; Lee, Sean; Stephens, Joni; Mateo, Luis R; Zhang, Yun Po; DeVizio, William

    2012-02-01

    To investigate whether the long-term use (6 months) of an arginine-calcium carbonate-MFP toothpaste would affect calculus formation and/or gingivitis when compared to a calcium carbonate-MFP toothpaste. This was a double-blind clinical study. Eligible adult subjects (120) entered a 2-month pre-test phase of the study. After receiving an evaluation of oral tissue and a dental prophylaxis, the subjects were provided with a regular fluoride toothpaste, a soft-bristled adult toothbrush with instructions to brush their teeth for 1-minute twice daily (morning and evening) for 2 months. The subjects were then examined for baseline calculus using the Volpe-Manhold Calculus Index (VMI) and gingivitis using the Löe-Silness Gingival Index (GI), along with an oral tissue examination. Qualifying subjects were randomized to two treatment groups: (1) Colgate Sensitive Pro-Relief toothpaste containing 8.0% arginine, 1450 ppm MFP and calcium carbonate (Test group), or (2) Colgate Cavity Protection toothpaste containing 1450 ppm MFP and calcium carbonate (Control group). Subjects were stratified by the VMI score and gender. After a dental prophylaxis (VMI=0), the subjects entered a 6-month test phase. Each received the assigned toothpaste and a soft-bristled adult toothbrush for home use with instructions of brushing teeth for 1 minute twice daily (morning and evening). The examinations of VMI, Löe-Silness GI and oral tissues were conducted after 3 and 6 months. Prior to each study visit, subjects refrained from brushing their teeth as well as eating and drinking for 4 hours. 99 subjects complied with the study protocol and completed the 6-month test phase. No within-treatment comparison was performed for the VMI because it was brought down to zero after the prophylaxis at the baseline of the test phase. For the Löe-Silness GI, subjects of the Test group exhibited a significant difference from baseline at the 3- and 6-month examinations. The 3-month Löe-Silness GI of the Control

  19. Plasma Levels of Uric Acid, Urea and Creatinine in Diabetics Who Visit the Clinical Analysis Laboratory (CAn-Lab) at Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    OpenAIRE

    Amartey, N.A.A.; Nsiah, K.; Mensah, F.O.

    2015-01-01

    Introduction: Diabetes mellitus is one of the most common metabolic diseases worldwide. This metabolic disorder contributes greatly to the significant proportion of the burden of renal damage and dysfunction. The aim of the study was to investigate the renal function of the diabetic patients who visit the Clinical Analysis Laboratory (CAn-Lab) at the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.

  20. Visit-to-visit blood pressure variability and future functional decline in old age

    DEFF Research Database (Denmark)

    Ogliari, Giulia; Smit, Roelof A J; Westendorp, Rudi G J

    2016-01-01

    OBJECTIVE: Higher blood pressure variability (BPV), independent of mean blood pressure (BP), has been associated with adverse health outcomes. We investigated the association between visit-to-visit BPV and functional decline in older adults at high cardiovascular risk. METHODS: In PROspective Study...... of Pravastatin in the Elderly at Risk, 4745 participants with mean age of 75.2 years and high cardiovascular risk were followed for a mean of 3.2 years. BP was measured in every 3 months during the first 18 months. BPV was defined as the intraindividual SD of measurements across these visits. Functional status.......008) in IADL score. These associations were not modified by sex, hypertension or antihypertensives. These findings were independent of mean BP, cardiovascular risk factors and morbidities and cognition. CONCLUSION: Higher visit-to-visit SBPV but not DBPV was associated with steeper functional decline in older...

  1. Comparing common reasons for inpatient and outpatient visits between commercially-insured duloxetine or pregabalin initiators with fibromyalgia

    Directory of Open Access Journals (Sweden)

    Zhao Y

    2012-10-01

    Full Text Available Yang Zhao,1 Peter Sun,2 Mark Bernauer31Eli Lilly and Company, 2Kailo Research Group, 3OptumInsight, Indianapolis, IN, USABackground: The purpose of this study was to examine the main reasons for inpatient or outpatient visits after initiating duloxetine or pregabalin.Methods: Commercially insured patients with fibromyalgia and aged 18–64 years who initiated duloxetine or pregabalin in 2006 with 12-month continuous enrollment before and after initiation were identified. Duloxetine and pregabalin cohorts with similar demographics, pre-index clinical and economic characteristics, and pre-index treatment patterns were constructed via propensity scoring stratification. Reasons for inpatient admissions, physician office visits, outpatient hospital visits, emergency room visits, and primary or specialty care visits over the 12 months post-index period were examined and compared. Logistic regression was used to assess the contribution of duloxetine versus pregabalin initiation to the most common reasons for visits, controlling for cross-cohort differences.Results: Per the study design, the duloxetine (n = 3711 and pregabalin (n = 4111 cohorts had similar demographics (mean age 51 years, 83% female and health care costs over the 12-month pre-index period. Total health care costs during the 12-month post-index period were significantly lower for duloxetine patients than for pregabalin patients ($19,378 versus $27,045, P < 0.05. Eight of the 10 most common reasons for inpatient admissions and outpatient hospital (physician office, emergency room, primary or specialty care visits were the same for both groups. Controlling for cross-cohort differences, duloxetine patients were less likely to be hospitalized due to an intervertebral disc disorder or major depressive disorder, to have a physician office visit due to nonspecific backache/other back/neck pain (NB/OB/NP disorder, or to go to specialty care due to a soft tissue, NB/OP/NP, or intervertebral disc

  2. Protective efficacy of standard Edmonston-Zagreb measles vaccination in infants aged 4.5 months: interim analysis of a randomised clinical trial

    OpenAIRE

    Martins, Cesário L; Garly, May-Lill; Balé, Carlito; Rodrigues, Amabelia; Ravn, Henrik; Whittle, Hilton C.; Lisse, Ida M.; Aaby, Peter

    2008-01-01

    Objective To examine the protective efficacy of measles vaccination in infants in a low income country before 9 months of age. Design Randomised clinical trial. Participants 1333 infants aged 4.5 months: 441 in treatment group and 892 in control group. Setting Urban area in Guinea-Bissau. Intervention Measles vaccination using standard titre Edmonston-Zagreb vaccine at 4.5 months of age. Main outcome measures Vaccine efficacy against measles infection, admission to hospital for measles, and m...

  3. CPAFFC Delegation Visits Ukraine

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    <正>A3-member delegation led by Su Guang, vice president of the CPAFFC and the China-Ukraine Friendship Association (CUFA), paid a goodwill working visit to Kiev, capital of Ukraine, and Yalta from June 20 to 27.

  4. CPAFFC Delegation Visits Ukraine

    Institute of Scientific and Technical Information of China (English)

    NiuYingli

    2004-01-01

    A3-member delegation led by Su Guang, vice president of the CPAFFC and the ChinaUkraine Friendship Association (CUFA), paid a goodwill working visit to Kiev, capital of Ukraine,and Yalta from June 20 to 27.

  5. Visits from two ministers

    CERN Multimedia

    2005-01-01

    Two ministers have recently paid visits to CERN. On 30 June, Mosibudi Mangena, South Africa's Minister for Science and Technology, was welcomed by CERN's Chief Scientific Officer, Jos Engelen. He also visited the ALICE experiment down at Point 2, accompanied by the ALICE spokesman, Jürgen Schukraft. Physicists from the University of Cape Town are members of the ALICE collaboration. Jürgen Schukraft, ALICE spokesman, accompanies Mosibudi Mangena, South Africa's Minister for Science and Technology. The Vice-Minister-President of the Flemish Government, Fientje Moerman, visited the CMS cavern and assembly hall, followed by Building SM18, where the LHC superconducting magnets are being tested. After lunch with the CERN Management, her visit ended with a tour of the ISOLDE facilities. Fientje Moerman, Flemish Vice-Minister-President, with members of her delegation and the CMS collaboration in front of the CMS detector.

  6. Visit by two Ministers

    CERN Document Server

    2008-01-01

    Last December CERN received visits from two Ministers. Bulgaria’s Deputy Prime Minister and Minister of Science and Education, Daniel Vylchev, visited the CMS experiment in the company of the CMS Spokesman, T. Virdee, and several Bulgarian physicists. From left to right: J. Stamenov, M. Mateev, S. Stavrev, T. Virdee, V. Genchev, the Minister Daniel Vylchev, A. Hristova Vutsova, L. Litov and G. Soultanov. CERN Director-General, Robert Aymar, and Montenegro’s Minister of Education and Science, Slobodan Backović. On 18 December, Robert Aymar welcomed Bulgaria’s Deputy Prime Minister and Minister of Science and Education, Daniel Vylchev. A particular highlight of his visit was a tour of the CMS site, during which he met the many Bulgarian physicists working on the experiment. He also attended a presentation of the LHC Computing Grid and visited the Computer Centre. Bulgaria has been a CERN ...

  7. Visit-to-visit variability of blood pressure and renal function decline in patients with diabetic chronic kidney disease.

    Science.gov (United States)

    Yokota, Kei; Fukuda, Masamichi; Matsui, Yoshio; Kario, Kazuomi; Kimura, Kenjiro

    2014-05-01

    The authors previously reported that the visit-to-visit variability of blood pressure is correlated with renal function decline in nondiabetic chronic kidney disease. Little is known about the association between visit-to-visit variability and renal function decline in patients with diabetic chronic kidney disease. The authors retrospectively studied 69 patients with diabetic chronic kidney disease stage 3a, 3b, or 4. The standard deviation and coefficient of variation of blood pressure in 12 consecutive visits were defined as visit-to-visit variability of blood pressure. The median observation period was 32 months. In univariate correlation, the standard deviation and coefficient of variation of blood pressure were not significantly associated with the slope of estimated glomerular filtration rate. There was no significant association between the visit-to-visit variability of blood pressure and renal function decline in patients with diabetic chronic kidney disease, in contrast with our previous study of nondiabetic patients with chronic kidney disease.

  8. A Successful Visit

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    A state visit to China during the first year in office is unprecedented for a U. S.president, but Barack Obama has made it. Moreover, the fact that President Obama spent four days and three nights of his seven-day visit to four Asian nations in Beijing and Shanghai has demonstrated the importance his administration attaches to China and to Sino-U.S. relations in its global strategy.

  9. Challenges to providing pre-travel care for travellers visiting friends and relatives: an audit of a specialist travel medicine clinic.

    Science.gov (United States)

    Rowe, Kate; Chaves, Nadia; Leder, Karin

    2017-09-01

    Travellers visiting friends and relatives (VFRs) often have complex pre-travel needs. We identified the characteristics, destinations, vaccinations and pre-travel advice provided to VFRs and compared these with non-VFR travellers. The significant differences we found suggest that future research should focus on improving the uptake of recommended interventions in VFR travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. A randomized comparison of home visits and hospital-based group follow-up visits after early postpartum discharge.

    Science.gov (United States)

    Escobar, G J; Braveman, P A; Ackerson, L; Odouli, R; Coleman-Phox, K; Capra, A M; Wong, C; Lieu, T A

    2001-09-01

    Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. We aimed to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed by means of telephone interviews at 2 weeks postpartum. During a 17-month period in 1998 to 1999, we enrolled and randomized 1014 mother-infant pairs (506 to the control group and 508 to the intervention group). There were no significant differences between the study groups with respect to maternal age, race, education, household income, parity, previous breastfeeding experience, early initiation of prenatal care, or postpartum LOS. There were no differences with respect to neonatal LOS or Apgar scores. In the control group, 264 mother-infant pairs had an individual visit only, 157 had a group visit only, 64 had both a group and an individual visit, 4 had a home health and a hospital-based follow-up, 13 had no follow-up within 72 hours, and 4 were lost to follow-up. With respect to outcomes within 2 weeks after discharge, there were no significant differences in newborn or maternal hospitalizations or urgent care visits, breastfeeding discontinuation, maternal depressive symptoms, or a combined clinical outcome measure indicating whether a mother-infant pair had any of the above outcomes. However, mothers in the home visit group were more likely than those in the control group to rate multiple aspects of their care as excellent or very good. These included the preventive advice delivered (76% vs 59%) and the skills and abilities of the provider (84% vs 73%). Mothers in the home visit group also gave higher ratings on overall satisfaction with the newborn's posthospital care (71% vs 59

  11. Retention of fissure sealants in young permanent molars affected by dental fluorosis: a 12-month clinical study.

    Science.gov (United States)

    Hasanuddin, S; Reddy, E R; Manjula, M; Srilaxmi, N; Rani, S T; Rajesh, A

    2014-10-01

    To evaluate and compare retention and caries occurance following placement of Clinpro and FUJI VII fissure sealants, by two different techniques simultaneously in unsealed, contralateral young permanent molars of 7- to 10-year-old children affected by mild to moderate dental fluorosis at various recall intervals of 1 week, 1, 3, 6 and 12 months. 80 schoolchildren with mild to moderate dental fluorosis were assigned to Group A and Group B with 40 children in each group. In Group A Clinpro fissure sealant and in Group B Fuji VII fissure sealant was used. In both the groups fissure sealants were applied by conventional fissure sealant technique (CST) on one side and enameloplasty sealant technique (EST) on the other side of the same arch. The applied fissure sealants were evaluated clinically for retention and caries incidence. Clinpro fissure sealant showed a retention rate of 95% when compared with Fuji VII (57.5%) at the end of 12 months, which was statistically significant. Regarding techniques, EST showed better results than CST in both the groups. Comparison of groups with respect to retention and techniques at different time periods was performed using Mann-Whitney U test (p < 0.05). Comparison of different time periods with respect to retention and technique in all the groups was performed using Wilcoxon matched pairs test by ranks (p < 0.05). Clinpro fissure sealant showed better retention at all treatment intervals, when compared with Fuji VII. Further follow-up is required to study the efficacy of the fissure sealant placement techniques.

  12. Clinical evaluation of different adhesives used in the restoration of non-carious cervical lesions: 24-month results.

    Science.gov (United States)

    Tuncer, D; Yazici, A R; Özgünaltay, G; Dayangac, B

    2013-03-01

    The aim of this study was to compare after 24 months the clinical performance of cervical restorations placed with the use of an etch-and-rinse and an all-in-one adhesive. Twenty-four patients with at least one pair of non-carious cervical lesions participated in this study. One hundred and twenty-three cervical lesions were restored (62 etch-and-rinse adhesive, Solobond M; 61 all-in-one adhesive, Futurabond NR). A nanohybrid resin composite, Grandio, was used as the restorative material. Restorations were evaluated according to modified USPHS criteria by two independent examiners. The survival rates of the restorations were calculated by the Kaplan-Meier estimator and log-rank test. The restorations in each category were compared using the Pearson chi-square test, while the performance of restorations at the baseline and at each recall time was evaluated by McNemar's test (p adhesives (p > 0.05). None of the restorations had secondary caries, loss of anatomical form, or surface texture changes. Cervical restorations placed with an etch-and-rinse adhesive showed higher retention than an all-in-one adhesive. © 2013 Australian Dental Association.

  13. 门诊支气管哮喘患者就诊情况分析%Investigation on the visit clinic of outpatients with bronchial asthma in respiratory department

    Institute of Scientific and Technical Information of China (English)

    左震华; 管希周

    2014-01-01

    [ABSTRACT]Objective: To investigate regularity of medical visit and medication of the outpatients with bronchial asthma, in order to provide reference for improving work quality in clinic.Methods: A total of 132 outpatients with bronchial asthma collected from our hospital during January 25, 2013 and May 31, 2013 were investigated. According to the history inquiry and outpatient medical records review, the patients were divided into two groups, regular visit group and intermittent visit group. The education background, frequencies of medical visit, treatment, asthma knowledge education, and pulmonary function test of the patients with bronchial asthma were investigated.Results:There were 76 patients in intermittent visit group, and 56 patients in regular visit group. The main visit reason for irregular visit group was asthma exacerbation. Only 24.2% of the patients regularly received pulmonary function test. The number of patients receiving the asthma education accounted for 42.0%, the numbers of patients with bachelor degree or above in intermittent visit group and regular visit group accounted for 38.1%, 73.2%, respectively. Conclusion: Delayed diagnosis, irregular treatment, and under application of pulmonary function test are common defects in management of asthma. It is important to strengthen the education of asthma for patients and doctor-patient communication to better control the disease.%目的:了解门诊支气管哮喘患者的就诊规律及用药情况等,以期为临床工作质量提高提供参考。方法:对我院呼吸科军人门诊2013年1月25日–5月31日期间就诊的132例支气管哮喘患者进行调查,采用询问病史和复习门诊病历的方法,将调查病例分为两组,一组为规律就诊组,另一组为非规律就诊组。调查内容包括:教育背景、就诊规律、治疗情况、哮喘知识教育、肺功能定期复查情况等。结果:76例患者不规律就诊,56例患者为规律就诊

  14. NOTE FROM VISITS SERVICE

    CERN Multimedia

    ETT Division; Division ETT; Service des visites

    2000-01-01

    The Visit Service noticed that for many years countries such as Great Britain, Germany, Spain, Portugal, the Netherlands and the Scandinavian countries visit CERN less than other member countries and that is due to the high price of the trip for the students. To improve the situation the Visit Service plans to create a network of 'Family-Accommodation' ('Famille-Accueil') in Geneva and in France nearbywith the aim to facilitate the trip to foreign students especially from the more distant member countries and to encourage them to visit our unique laboratory. We expect this exchange to be an interesting experience for both the students and the welcoming family ('famille d'accueil'). If you are interested in participating in this family network, please fill in the questionnaire below. The questionnaire is to be returned to the Visit Service, Mrs Christine Fromm, e-mail Christine.Fromm@cern.ch.Name: First name: CERN address: E-mail: Portable phone number: Home address...

  15. ATLAS Virtual Visits

    CERN Document Server

    Goldfarb, Steven; The ATLAS collaboration

    2015-01-01

    ATLAS Virtual Visits is a project initiated in 2011 for the Education & Outreach program of the ATLAS Experiment at CERN. Its goal is to promote public appreciation of the LHC physics program and particle physics, in general, through direct dialogue between ATLAS physicists and remote audiences. A Virtual Visit is an IP-based videoconference, coupled with a public webcast and video recording, between ATLAS physicists and remote locations around the world, that typically include high school or university classrooms, Masterclasses, science fairs, or other special events, usually hosted by collaboration members. Over the past two years, more than 10,000 people, from all of the world’s continents, have actively participated in ATLAS Virtual Visits, with many more enjoying the experience from the publicly available webcasts and recordings. We present an overview of our experience and discuss potential development for the future.

  16. Dutch ministerial visit

    CERN Multimedia

    2007-01-01

    Dutch Minister of Education, Culture and Science R. Plasterk (third from left) in the ATLAS cavern with NIKHEF Director F. Linde, CERN Chief Scientific Officer J. Engelen, Ambassador J. van Eenennaam, ATLAS Collaboration Spokesperson P. Jenni, Mission Representative G. Vrielink and ATLAS Magnet Project Leader H. ten Kate.Minister of Education, Culture and Science from the Kingdom of the Netherlands, Ronald Plasterk, visited CERN on 25th October. With Jos Engelen, CERN Scientific Director, as his guide he visited Point 1 of the LHC tunnel and ATLAS, where Nikhef (the national institute for subatomic physics, a Dutch government and university collaboration) constructed all 96 of the largest muon drift chambers in the barrel as well as parts of the magnet system, the inner detector, the DAQ and triggering. Overall the Netherlands contribute 4.5% to the annual CERN budget and the minister’s visit celebrated the contributions of the 79 ...

  17. Visit by two Ministers

    CERN Multimedia

    2007-01-01

    Two European ministers have recently paid visits to CERN. On 11 June, the Austrian Minister for Science and Research, Johannes Hahn, visited the CMS cavern and assembly hall, before being given a tour of the CERN Control Centre. Following a lunch with the Ambassador, he was shown the LHC Computing Grid. His visit was rounded off with meetings with Robert Aymar and with Austrian students working at CERN. The Austrian Minister for Science and Research, Johannes Hahn, and Felicitas Pauss, Deputy Chair of the CMS Collaboration Committee, in front of one of the sections of the CMS detector. Jos Engelen, CERN’s Chief Scientific Officer, Jens Jorgen Gaardhoje, a physicist from the Niels Bohr Institute and a member of the ALICE collaboration, and the Danish Employment Minister, Claus Hjort Frederiksen, in front of the ALICE detector. On 12 June, Claus Hjort Frederiksen, the Danish Employment Minister,...

  18. Nortriptyline versus fluoxetine in the treatment of major depressive disorder: a six-month, double-blind clinical trial

    Directory of Open Access Journals (Sweden)

    Hashemi SN

    2012-01-01

    Full Text Available SN Hashemi1, HR Ghafarian Shirazi2,3, A Mohamadi4, GH Zadeh-Bagheri5, KH Noorian5, M Malekzadeh21Department of Psychiatry, Faculty of Medicine, 2Research Center of Social Factors Affecting Health, Yasuj University of Medical Sciences, Yasuj, 3School of Public Health, Tehran University of Medical Sciences, Tehran, 4Department of Psychiatry, 5School of Medicine, Yasuj University of Medical Sciences, Yasuj, IranBackground: Depression is a common psychiatric disorder worldwide, including in Iran, and is estimated to affect 10%–15% of the population. Antidepressant drugs can have multiple side effects, so a good choice of drug is important for successful treatment. This study compared the efficacy of nortriptyline with that of fluoxetine in the treatment of patients with major depressive disorder and assessed related factors, including age, gender, and level of education.Methods: The study was a double-blind, randomized clinical trial with a six-month follow-up period. Participants were 120 patients aged 15–60 years with a diagnosis of major depressive disorder based on a psychiatry interview and the Beck depression rating scale, which were performed at the beginning, middle, and end of the study. The patients were treated with nortriptyline or fluoxetine. The paired t-test, independent t-test, and the k chi-square test were used to analyze the data.Results: Twenty-three patients dropped out and 97 remained in the trial. Before intervention, the mean depression score was 32.85 ± 6.23 in the nortriptyline group and 33.12 ± 6.50 in the fluoxetine group. The results of the independent t-test showed a significant difference between depression score means before and after treatment in both groups. Changes at the end of the trial compared with baseline scores were 13.4 ± 4.68 and 16.96 ± 4.96 for nortriptyline and fluoxetine, respectively. Paired t-testing showed a significant difference in the mean depression score for both the nortriptyline and

  19. Protective efficacy of standard Edmonston-Zagreb measles vaccination in infants aged 4.5 months: interim analysis of a randomised clinical trial

    DEFF Research Database (Denmark)

    Martins, C.L.; Garly, May-Lill; Bale, C.

    2008-01-01

    Objective To examine the protective efficacy of measles vaccination in infants in a low income country before 9 months of age. Design Randomised clinical trial. Participants 1333 infants aged 4.5 months: 441 in treatment group and 892 in control group. Setting Urban area in Guinea-Bissau. Interve......Objective To examine the protective efficacy of measles vaccination in infants in a low income country before 9 months of age. Design Randomised clinical trial. Participants 1333 infants aged 4.5 months: 441 in treatment group and 892 in control group. Setting Urban area in Guinea......-Bissau. Intervention Measles vaccination using standard titre Edmonston-Zagreb vaccine at 4.5 months of age. Main outcome measures Vaccine efficacy against measles infection, admission to hospital for measles, and measles mortality before standard vaccination at 9 months of age. Results 28% of the children tested at 4.......5 months of age had protective levels of maternal antibodies against measles at enrolment. After early vaccination against measles 92% had measles antibodies at 9 months of age. A measles outbreak offered a unique situation for testing the efficacy of early measles vaccination. During the outbreak, 96...

  20. A cluster randomised controlled effectiveness trial evaluating perinatal home visiting among South African mothers/infants.

    Directory of Open Access Journals (Sweden)

    Mary Jane Rotheram-Borus

    Full Text Available Interventions are needed to reduce poor perinatal health. We trained community health workers (CHWs as home visitors to address maternal/infant risks.In a cluster randomised controlled trial in Cape Town townships, neighbourhoods were randomised within matched pairs to 1 the control, healthcare at clinics (n = 12 neighbourhoods; n = 594 women, or 2 a home visiting intervention by CBW trained in cognitive-behavioural strategies to address health risks (by the Philani Maternal, Child Health and Nutrition Programme, in addition to clinic care (n = 12 neighbourhoods; n = 644 women. Participants were assessed during pregnancy (2% refusal and 92% were reassessed at two weeks post-birth, 88% at six months and 84% at 18 months later. We analysed 32 measures of maternal/infant well-being over the 18 month follow-up period using longitudinal random effects regressions. A binomial test for correlated outcomes evaluated overall effectiveness over time. The 18 month post-birth assessment outcomes also were examined alone and as a function of the number of home visits received.Benefits were found on 7 of 32 measures of outcomes, resulting in significant overall benefits for the intervention compared to the control when using the binomial test (p = 0.008; nevertheless, no effects were observed when only the 18 month outcomes were analyzed. Benefits on individual outcomes were related to the number of home visits received. Among women living with HIV, intervention mothers were more likely to implement the PMTCT regimens, use condoms during all sexual episodes (OR = 1.25; p = 0.014, have infants with healthy weight-for-age measurements (OR = 1.42; p = 0.045, height-for-age measurements (OR = 1.13, p<0.001, breastfeed exclusively for six months (OR = 3.59; p<0.001, and breastfeed longer (OR = 3.08; p<0.001. Number of visits was positively associated with infant birth weight ≥2500 grams (OR = 1.07; p = 0

  1. Health-related quality of life following a clinical weight loss intervention among overweight and obese adults: intervention and 24 month follow-up effects

    Directory of Open Access Journals (Sweden)

    Ruggiero Laurie

    2006-07-01

    Full Text Available Abstract Background Despite a growing literature on the efficacy of behavioral weight loss interventions, we still know relatively little about the long terms effects they have on HRQL. Therefore, we conducted a study to investigate the immediate post-intervention (6 months and long-term (12 and 24 months effects of clinically based weight management programs on HRQL. Methods We conducted a randomized clinical trial in which all participants completed a 6 month clinical weight loss program and were randomized into two 6-month extended care groups. Participants then returned at 12 and 24 months for follow-up assessments. A total of 144 individuals (78% women, M age = 50.2 (9.2 yrs, M BMI = 32.5 (3.8 kg/m2 completed the 6 month intervention and 104 returned at 24 months. Primary outcomes of weight and HRQL using the SF-36 were analyzed using multivariate repeated measures analyses. Results There was complete data on 91 participants through the 24 months of the study. At baseline the participants scored lower than U.S. age-specific population norms for bodily pain, vitality, and mental health. At the completion of the 6 month clinical intervention there were increases in the physical and mental composite measures as well as physical functioning, general health, vitality, and mental health subscales of the SF-36. Despite some weight regain, the improvements in the mental composite scale as well as the physical functioning, vitality, and mental health subscales were maintained at 24 months. There were no significant main effects or interactions by extended care treatment group or weight loss group (whether or not they maintained 5% loss at 24 months. Conclusion A clinical weight management program focused on behavior change was successful in improving several factors of HRQL at the completion of the program and many of those improvements were maintained at 24 months. Maintaining a significant weight loss (> 5% was not necessary to have and maintain

  2. Patients' purpose for clinical gynecologic visits and their level of contraceptive knowledge%妇科门诊患者就诊目的与避孕知识知晓现状的关系

    Institute of Scientific and Technical Information of China (English)

    张秀芬; 田园; 崔娜; 孙金豹; 陈玲; 张静

    2013-01-01

    Objectives:To help to give reproductive health instructions to patients with different purposes for gynecologic clinical visits.Methods:Questionnaires were used to evaluate the knowledge level of patients with different visiting purposes.Results:Reproduction group and general gynecologic group,reproduction group and birth control group all suggested significant difference(P =0.000).Conclusion:Patients' visit for general gynecologic problem should be provided with more reproductive health instructions.%目的:指导妇科门诊患者不同就医人群的生殖健康教育.方法:问卷调查法分析不同就诊目的患者生殖健康知识知晓情况.结果:生殖问题组与普通妇科问题组、生殖问题组与计划生育组有明显的差别(P值均为0.000).结论:普通妇科问题就诊的患者更应该注重生殖健康教育.

  3. Changes in actual and perceived physical abilities in clinically obese children: a 9-month multi-component intervention study.

    Directory of Open Access Journals (Sweden)

    Milena Morano

    Full Text Available OBJECTIVES: (1 To examine relationships among changes in physical activity, physical fitness and some psychosocial determinants of activity behavior in a clinical sample of obese children involved in a multi-component program; (2 to investigate the causal relationship over time between physical activity and one of its strongest correlates (i.e. perceived physical ability. METHODS: Self-reported physical activity and health-related fitness tests were administered before and after a 9-month intervention in 24 boys and 20 girls aged 8 to 11 years. Individuals' perceptions of strength, speed and agility were assessed using the Perceived Physical Ability Scale, while body image was measured using Collins' Child Figure Drawings. RESULTS: Findings showed that body mass index, physical activity, performances on throwing and weight-bearing tasks, perceived physical ability and body image significantly improved after treatment among obese children. Gender differences were found in the correlational analyses, showing a link between actual and perceived physical abilities in boys, but not in girls. For the specific measurement interval of this study, perception of physical ability was an antecedent and not a potential consequence of physical activity. CONCLUSIONS: Results indicate that a multi-component activity program not based merely on a dose-effect approach enhances adherence of the participants and has the potential to increase the lifelong exercise skills of obese children. Rather than focusing entirely on diet and weight loss, findings support the inclusion of interventions directed toward improving perceived physical ability that is predictive of subsequent physical activity.

  4. A six-month double-blind, placebo-controlled, randomized clinical trial of duloxetine for the treatment of fibromyalgia

    Directory of Open Access Journals (Sweden)

    Amy S Chappell

    2008-12-01

    Full Text Available Amy S Chappell1, Laurence A Bradley2, Curtis Wiltse1, Michael J Detke1,3,4, Deborah N D’Souza1, Michael Spaeth51Lilly Research Laboratories, Indianapolis, IN, USA; 2University of Alabama at Birmingham, Birmingham, Alabama, USA; 3Indiana University School of Medicine, Indianapolis, IN, USA; 4Harvard Medical School, Boston, MA, USA; 5Practice for Internal Medicine/Rheumatology, Graefelfing, GermanyObjective: Assess the efficacy of duloxetine 60/120 mg (N = 162 once daily compared with placebo (N = 168 in the treatment of patients with fibromyalgia, during six months of treatment.Methods: This was a phase-III, randomized, double-blind, placebo-controlled, parallel-group study assessing the efficacy and safety of duloxetine.Results: There were no significant differences between treatment groups on the co-primary efficacy outcome measures, change in the Brief Pain Inventory (BPI average pain severity from baseline to endpoint (P = 0.053 and the Patient’s Global Impressions of Improvement (PGI-I at endpoint (P = 0.073. Duloxetine-treated patients improved significantly more than placebo-treated patients on the Fibromyalgia Impact Questionnaire pain score, BPI least pain score and average interference score, Clinical Global Impressions of Severity scale, area under the curve of pain relief, Multidimensional Fatigue Inventory mental fatigue dimension, Beck Depression Inventory-II total score, and 36-item Short Form Health Survey mental component summary and mental health score. Nausea was the most common treatment-emergent adverse event in the duloxetine group. Overall discontinuation rates were similar between groups.Conclusions: Although duloxetine 60/120 mg/day failed to demonstrate significant improvement over placebo on the co-primary outcome measures, in this supportive study, duloxetine demonstrated significant improvement compared with placebo on numerous secondary measures.Keywords: fibromyalgia, duloxetine, placebo, double-blind, trial

  5. Auger Physicists visit CMS

    CERN Multimedia

    Hoch, Michael

    2012-01-01

    Visit at CERN P5 CMS in the experimental cavern Alan Watson, Auger Spokesperson Emeritus, University of Leeds; Jim Cronin, Nobel Laureate, Auger Spokesperson Emeritus, University of Chicago; Jim Virdee, CMS Former Spokesperson, Imperial College; Jim Matthews, Auger Co-Spokesperson, Louisiana State University

  6. Albert Einstein visits Argentina

    CERN Document Server

    Gangui, A; Gangui, Alejandro; Ortiz, Eduardo L.

    2005-01-01

    This is a detailed, day by day, account of Albert Einstein's activities, both social and scientific, during his 30-day stay in Argentina in 1925, including his lectures on relativity at the various local universities and his visit to the National Academy of Sciences, as follows from his personal Diary of the trip to South-America and other contemporary documents.

  7. CPAFFC Delegation Visits Gabon

    Institute of Scientific and Technical Information of China (English)

    Tang; Ruimin

    2013-01-01

    <正>In March, when warm spring had come and flowers were in bloom, a CPAFFC delegation visited Gabon. It was accorded warm welcome from the Gabon-China Friendship Association (GCFA), with Ms. Pierrette Djouassa, former Procurator General of Gabon and President of the GCFA, leading all her members to greet the delegation at

  8. Pakistan Guest Visit HRC

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Companied by CMEC Beijing representative, Dr. Eng. S.M.Bhutta,a technical advisor of Alternative Energy Development Board (AEDB) in Pakistan, paid a visit to HRC during June 3-5, 2005. Both sides exchanged ideas on micro & small hydropower development, and intended to further strengthen the cooperation in micro & small hydropower fields as to push forward the rural electrification program in Pakistan.

  9. Thomas Kibble visits CERN

    CERN Multimedia

    Rosaria Marraffino

    2014-01-01

    Emeritus Professor Sir Thomas W.B. Kibble, from Imperial College London visited LHC for the first time last week and delivered a colloquium on the genesis of electroweak unification and the Brout-Englert-Higgs mechanism.   From left to right: Jim Virdee, Tiziano Camporesi, Tom Kibble and Austin Ball on the visit to CMS. On his way back from Trieste, where he received the Abdus Salam International Centre for Theoretical Physics' Dirac Medal, Tom Kibble stopped by CERN for his first visit to the LHC. Kibble had a standing invitation from Jim Virdee, former CMS spokesperson, who is also a researcher from Imperial College London. Peter Jenni (left) and Tom Kibble tour the ATLAS detector. (Image: Erwan Bertrand) Kibble made the trip to CERN a family outing and brought along 14 relatives,  including his children and grandchildren. He visited the ATLAS detector with Peter Jenni, its former spokesperson, on Friday 10 October. In the afternoon, Kibble delivered a colloquium in the...

  10. Italian Minister visits CERN

    CERN Multimedia

    2002-01-01

    Passing through Geneva, the Italian Deputy Minister for Productive Activities, Dr. Adolfo Urso, came to visit the SM18 hall where LHC magnets are tested. From left to right: Adolfo Urso, Deputy Minister for Productive Activities, CERN's Roberto Saban, Director General Luciano Maiani, Mario Gerbino, Director General of the Ministry and Lucio Rossi, LHC Main Magnet and Superconductors Group Leader.

  11. [Nurse home visits in France].

    Science.gov (United States)

    Monguillon, Dominique; Gracia, Pierre-Benjamin

    2011-10-01

    Nurse home visits in France. More and more nurses carry out home visits, either as freelance nurses or employees of a nurse home visits service, a home hospital care structure or a nursing care centre. These home visits are both demanded by patients and encouraged by the health authorities. As a consequence, the service is expanding every year.

  12. Veterinarian satisfaction with companion animal visits.

    Science.gov (United States)

    Shaw, Jane R; Adams, Cindy L; Bonnett, Brenda N; Larson, Susan; Roter, Debra L

    2012-04-01

    To measure veterinarian satisfaction with companion animal visits through an adaptation of a previously validated physician visit satisfaction scale and to identify demographic, personality, appointment, and communication factors that contribute to veterinarian visit satisfaction. Cross-sectional descriptive study. Random sample of 50 companion animal practitioners in southern Ontario, Canada, and convenience sample of 300 clients and their pets. For each practitioner, 6 clinical appointments were videotaped, and the resulting 300 videotapes were analyzed by use of the Roter interaction analysis system. The physician satisfaction scale, Rosenberg self-esteem scale, and interpersonal reactivity index were used to measure veterinarian visit satisfaction, self-esteem, and empathy, respectively. Linear regression analysis was conducted to study the relationship between factors and veterinarian visit satisfaction. Veterinarian visit satisfaction ranged from 1 to 5 (mean ± SD, 3.97 ± 0.99) and differed significantly between wellness appointments (mean scale score, 4.13) and problem appointments (mean scale score, 3.81). Various elements of client and veterinarian communication as well as personality measures of veterinarian self-esteem and empathy were associated with veterinarian satisfaction. The specific factors differed depending on the nature of the appointment. Results suggested that veterinarian visit-specific satisfaction is enhanced through the use of communication that builds relationships with clients and is associated with degrees of veterinarian empathetic concern and veterinarian self-esteem. The implications extend to overall job satisfaction and its potential link to the health and well-being of individual veterinarians.

  13. Child Maltreatment History and Response to CBT Treatment in Depressed Mothers Participating in Home Visiting.

    Science.gov (United States)

    Ammerman, Robert T; Peugh, James L; Teeters, Angelique R; Putnam, Frank W; Van Ginkel, Judith B

    2016-03-01

    Child maltreatment contributes to depression in adults. Evidence indicates that such experiences are associated with poorer outcomes in treatment. Mothers in home visiting programs display high rates of depression and child maltreatment histories. In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat maternal depression in home visiting. The purpose of this study was to examine the moderating effects of child maltreatment history on depression, social functioning, and parenting in mothers participating in a clinical trial of IH-CBT. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and then confirmation of major depressive disorder diagnosis. Measures of child maltreatment history, depression, social functioning, and parenting were administered at pre-treatment, post-treatment, and 3-month follow-up. Results indicated high rates of maltreatment in both conditions relative to the general population. Mixed model analyses found a number of main effects in which experiences of different types of trauma were associated with poorer functioning regardless of treatment condition. Evidence of a moderating effect of maltreatment on treatment outcomes was found for physical abuse and parenting and emotional abuse and social network size. Future research should focus on increasing the effectiveness of IH-CBT with depressed mothers who have experienced child maltreatment. © The Author(s) 2014.

  14. Research on tiered management in specialist clinic visiting in general hospital%综合医院专家门诊层级就诊管理的探讨

    Institute of Scientific and Technical Information of China (English)

    姚峥; 安凤梅; 刘德海; 刘凤华; 曹红英; 马志娟; 吉训明

    2011-01-01

    According to the supply and demand of specialist clinic visiting in Xuanwu Hospital, tiered management mode was implemented.The conception, objective and scope of tier management were introduced. Measures such as application, approval and putting on records, building management chain and tier management process, real name reservation, sub-period visit, monitoring specialist clinic service rate, feedback and recommending, propagandizing and training were discussed. Suggestions such as rational using expert resources to exerting the advantages of disciplines, maximum matching patient ' s demand to smooth conflicts between hospital and patient and changing conceptions of hospital and patient to build a more harmonious outpatient visiting environment.%首都医科大学宣武医院根据医院专家门诊供需现状,对专家门诊实施层级就诊的管理模式.介绍了层级就诊的概念、目的和适用范围.并从申请、审批和备案、建立管理"链"和层级就诊流程、实名制层级就诊预约登记、分时段就诊、监测专家出诊率、反馈意见建议、宣传和培训等方面阐述了层级就诊的管理措施.提出合理利用现有专家资源,发挥各学科优势;最大程度满足广大群众就医需求,缓解专家门诊供需矛盾;转变医患双方观念,使门诊医疗活动更加文明有序.

  15. A royal visit

    CERN Multimedia

    Katarina Anthony

    2014-01-01

    On Wednesday, 21 May, CERN received His Majesty Philippe, King of the Belgians, for a full-day visit of the Laboratory.   From left to right: Tiziano Camporesi, CMS Spokesperson; François Englert, Nobel Prize in Physics 2013; Rolf Heuer, CERN Director-General; His Majesty Philippe, King of the Belgians; Philippe Courard, Belgium's State Secretary for Scientific Policy and Walter Van Doninck, CERN Council Vice-President. Director-General Rolf Heuer welcomed King Philippe to CERN at Point 5 (Cessy). This was to be no small visit, with His Majesty accompanied by a host of diplomats, prominent Belgian physicists - including François Englert - and even members of Belgium's press corps. After quick introductions, the morning began with a tour of the CMS underground experimental area and the LHC tunnel at Point 5, guided by the CMS Collaboration Spokesperson, Tiziano Camporesi, and the Director for Accelerators and Technology, Frédérick Bord...

  16. Belgian Firms Visit CERN

    CERN Document Server

    2001-01-01

    Fifteen Belgian firms visited CERN last 2 and 3 April to present their know-how. Industrial sectors ranging from precision machining to electrical engineering and electronics were represented. And for the first time, companies from the Flemish and Brussels regions of the country joined their Walloon compatriots, who have come to CERN before. The visit was organised by Mr J.-M. Warêgne, economic and commercial attaché at the Belgian permanent mission for the French-speaking region, Mr J. Van de Vondel, his opposite number for the Flemish region, and Mrs E. Solowianiuk, economic and commercial counsellor at the Belgian permanent mission for the Brussels-Capital region.

  17. Romanian President Visits CERN

    CERN Multimedia

    2001-01-01

    Director General Luciano Maiani watches as Romanian President Ion Iliescu signs the CERN guest book. On Friday the 12th of October, Romanian President Ion Iliescu arrived at CERN and was warmly greeted by Director General Luciano Maiani at the steps of building 500. After initial greetings and a general presentation of the laboratory, President Iliescu and his entourage embarked on a whistle stop tour of the CERN facilities. They visited the CMS magnet assembly hall and civil engineering work where presentations were made by CMS spokesperson Michel Della Negra and the ATLAS Tile Calorimeter where the president was introduced to Romanian physicists working here at CERN. Michel Della Negra explains some of the general principles behind CMS to President Iliescu during his visit last week. The Romanian teams working on CERN projects make very visible contributions, for example to the construction of the ATLAS experiment and to the preparation of its eventual scientific exploitation. 'Those of us on the ATLAS ...

  18. Indian President visits CERN

    CERN Multimedia

    Katarina Anthony

    2011-01-01

    On 1 October, her Excellency Mrs Pratibha Devisingh Patil, President of India, picked CERN as the first stop on her official state visit to Switzerland. Accompanied by a host of Indian journalists, a security team, and a group of presidential delegates, the president left quite an impression when she visited CERN’s Point 2!   Upon arrival, Pratibha Patil was greeted by CERN Director General Rolf Heuer, as well as senior Indian scientists working at CERN, and various department directors. After a quick overview of the Organization, Rolf Heuer and the President addressed India’s future collaboration with CERN. India is currently an Observer State of the Organization, and is considering becoming an Associate Member State. A short stop in LHC operations gave Steve Myers and the Accelerator team the opportunity to take the President on a tour through the LHC tunnel. From there, ALICE’s Tapan Nayak and Spokesperson Paolo Giubellino took Pratibha Patil to the experiment&am...

  19. Kandinsky College Visits CERN

    CERN Multimedia

    CERN Video productions; Angelos Alexopoulos

    2012-01-01

    This video documents the visit of nine senior high school students of the Kandinsky College in Nijmegen (Netherelands) to CERN. The students visited many of CERN's experimental facilities, took part in a Cloud Chamber workshop, attended talks and roundtable discussions of SpacePart12 and worked on the evaluation of the Microcosm exhibition as part of a school inquiry-based research project. The students and their teacher, Paul de Haas (a participant of the High School Teachers 2012 Programme at CERN) were connected with Prof. Christine Kourkoumelis and George Vasileiadis at the University of Athens and learned hands-on how to analyse real physics events, including Higgs-like ones, from the ATLAS experiment at the LHC using the HYPATIA Applet.

  20. German visits to CERN

    CERN Multimedia

    2007-01-01

    State secretary to Germany's Federal Ministry of Education and Research, Frieder Meyer-Krahmer, with CERN's Director-General Robert Aymar.On 21 February, Professor Frieder Meyer-Krahmer, State Secretary to Germany's Federal Ministry of Education and Research, came to CERN. He visited the ALICE and ATLAS experiments and the computing centre before meeting the CERN's Director-General, some German physicists and members of the top management. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Peter Frankenberg, and CERN's Director-General, Robert Aymar, signing an agreement on education. In the background: Sigurd Lettow, CERN's Director of Finance and Human Resources, and Karl-Heinz Meisel, Rector of the Fachhochschule Karlsruhe. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Prof. Peter Frankenberg, visited CERN on 23 February. He was accompanied by the Rector of the Fachhochschule Karlsruhe, Prof. Karl-Heinz Meisel, and b...

  1. Putin's Visit Bears Fruit

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The Russian President's trip to China marks progress in overall cooperation between the two countries If one word could be used to describe Russian President Vladimir Putin's recent visit to China, it would be "fruitful." During his brief two-day stay, which began March 21, Putin had a compact agenda-he met with his Chinese counterpart, President Hu Jintao, Chinese Premier Wen Jiabao and China's top legis-

  2. On Visiting Our Dead

    Directory of Open Access Journals (Sweden)

    Joanna Clapps Herman

    2013-08-01

    Full Text Available A redefining of the meaning of death and grief: this essay explores a rejection of conventional ideas about mourning and describes the experiences of two daughters after they have lost their beloved father. In the one case, it is an evocation of his spirit that feels like a conversation and, in the other, visits by the father to the daughter through palpable signs.

  3. Spanish Visit to CERN

    CERN Multimedia

    2002-01-01

    Last week CERN was visited by the Spanish Minister of Science and Technology, Josep Piqué i Camps. While here, he was able to visit the ATLAS assembly hall where many items of equipment are being built in collaboration with Spanish academic institutions or firms. These include the vacuum vessels for the ATLAS barrel toroid magnets supplied by the Spanish firm Felguera Construcciones Mechanics. Similarly, the Universidad Autónoma de Madrid is participating in the manufacture of the electromagnetic calorimeter endcaps, while the Barcelona Institute for High Energy Physics and the Valencia IFIC (Instituto de Física Corpuscular) are highly involved in the production of barrel modules for the tile calorimeter. The delegation, accompanied by Spanish scientists at CERN, also visited the LHC superconducting magnet test hall (photo). From left to right: Felix Rodriguez Mateos of CERN LHC Division, Josep Piqué i Camps, Spanish Minister of Science and Technology, César Dopazo, Director-General of CIEMAT (Spanish ...

  4. EUCYS prizewinner visits CERN

    CERN Multimedia

    Jennifer Toes

    2016-01-01

    Young Turkish student Baris Volkan Gürses visited CERN from 4 to 8 July after winning the prize in the 2015 European Contest for Young Scientists (EUCYS).    Baris Volkan Gürses, EUCYS prizewinner, visiting the Microcosm. After winning both regional and national competitions in Turkey, 18-year-old student Baris Volkan Gürses competed against 169 young scientists and was awarded a visit to CERN by EIROforum for his physics project in EUCYS 2015. His project, entitled “Generation of artificial gravity by using electrostatic force for prevention of muscle atrophy and osteoporosis occurring in gravity-free environments”, focused on the design of a mechanism to help with the impact of spaceflight on the human body. “My objective was to eliminate the negative effects of a gravity-free environment on astronauts who stay in space for longer periods of time, like in the International Space Station,” explained Volkan. &...

  5. EU Commissioner visits CERN

    CERN Multimedia

    2005-01-01

    European Commissioner Viviane Reding in front of one of the computers showing how the Grid works and, from left to right, Robert Aymar, CERN's Director-General, Wolfgang von Rüden, Head of the Information Technology Department, and Bob Jones, the newly appointed director of the EGEE project since 1st November. Viviane Reding, European Commissioner for Information Society and Media, visited CERN on 28 October. Accompanied throughout by CERN's Director-General, Robert Aymar, and the Head of the Information Technology Department, Wolfgang von Rüden, the Commissioner visited the ATLAS cavern before going on to the Information Technology Department, where she was given a complete overview of CERN's activities in the strategic field of Grid computing. Viviane Reding's visit coincided with the end of the EGEE (Enabling Grids for E-sciencE) conference, which took place in Pisa in Italy. Co-ordinated by CERN and funded by the European Commission, the EGEE project aims to set up a worldwide grid infrastructure for sc...

  6. A boost to visits

    CERN Multimedia

    2005-01-01

    Several guides were rewarded by CERN's Director-General and Secretary-General for their contributions in 2004. Left to right: Géraldine Chuste, the Director-General Robert Aymar, Klaus Batzner, Philippe Moret, Joanna Weng, Alberto Ribon, Head of the Visits Service, Emma Sanders, and the Secretary-General, Maximilian Metzger. Three other guides not in the photograph, Antonio Francano, Christoph Ilgner and Tzanko Spassoff, were also rewarded for their contributions. As every year, the CERN Visits Service has paid tribute to its guides, all of whom are volunteers and devote some of their time to showing people around their Laboratory. The guides were invited to a get-together in Microcosm during which the Director-General, Robert Aymar, expressed his special gratitude for their efforts and presented awards to the most dedicated among them. He encouraged members of the Laboratory to become guides and underlined that 2004 had been an exceptional year for visits, which had risen by 15% to almost 22,000. Including ...

  7. Serbian President visits CERN

    CERN Document Server

    Katarina Anthony

    2012-01-01

    On Tuesday 10 January, Serbian President Boris Tadić visited the Laboratory to sign the Agreement of granting the status of Associate Membership as the pre-stage to full Membership of CERN.    Before the signing ceremony, the President, welcomed by Director-General Rolf Heuer at CERN’s Point 5, took the opportunity to visit CERN. After a general introduction, the President took advantage of the shutdown to visit the LHC’s underground caverns. Leading the President through their respective experiments were spokespersons Fabiola Gianotti (ATLAS) and Joe Incandela (CMS).  After a morning of tours, President Tadić and Rolf Heuer signed the Agreement. Serbia’s status as an Associate Member as pre-stage to full Membership is expected to come into force following ratification by the Serbian Parliament. After a maximum period of five years, the CERN Council will decide on the admission of Serbia to full Membership. This new agreement continues Serbia&a...

  8. Clinical outcomes of long-acting injectable risperidone in patients with schizophrenia: six-month follow-up from the Electronic Schizophrenia Treatment Adherence Registry in Latin America

    Science.gov (United States)

    Apiquian, Rogelio; Córdoba, Rodrigo; Louzã, Mario

    2011-01-01

    Background Risperidone long-acting injection (RLAI) has been shown to be efficacious, improve compliance, and increase long-term retention rate on therapy. The aim of this work was to determine the effect of RLAI on clinical outcome and hospitalization rate in patients with schizophrenia or schizoaffective disorder enrolled in the electronic Schizophrenia Treatment Adherence Registry in Latin America. Methods Data were collected at baseline, retrospectively for the 12 months prior to baseline, and prospectively every three months for 24 months. Hospitalization prior to therapy was assessed by a retrospective chart review. Efficacy and functioning were evaluated using Clinical Global Impression of Illness Severity (CGI-S), Personal and Social Performance (PSP), and Global Assessment of Functioning (GAF) scores. Relapse and treatment were also registered. Results Patients were recruited in Mexico (n = 53), Brazil (n = 11), and Colombia (n = 15). Sixty-five percent (n = 52) were male, and mean age was 32.9 years. Patients were classified as having schizophrenia (n = 73) or schizoaffective disorder (n = 6). The mean dose of RLAI at six months was 34.1 mg (standard deviation = 10.2 mg). The percentage of hospitalized patients before treatment was 28.2% and 5.1% at six months after initiating RLAI (P < 0.001). Significant changes were registered on CGI-S, GAF, and PSP scores. Conclusions RLAI was associated with an improvement in clinical symptoms and functioning, and a greater reduction in hospitalization. PMID:21326651

  9. Safety and efficacy of a novel tartar control dentifrice containing 3.3% pyrophosphate: a controlled six-month clinical trial.

    Science.gov (United States)

    Segreto, V A; Stevens, D P; Schulte, M C; Fortna, R H; Gerlach, R W

    1998-01-01

    This study was undertaken to establish the tartar control efficacy and long-term safety of a new tartar control dentifrice that was formulated to enhance aesthetics and consumer acceptability. In a partially randomized, examiner-blind clinical trial, the experimental dentifrice, Crest MultiCare with 3.3% pyrophosphate, was compared to two currently marketed control dentifrices, Crest Regular Paste or Crest Tartar Protection Paste with 5.0% pyrophosphate. The eight-month trial model included a two-month pretest period to establish calculus formation after prophylaxis, followed by a six-month test period to evaluate efficacy and safety. Following the pretest period, 456 subjects were allocated to one of the three treatment groups and then monitored for calculus accumulation. After three and six months' test product use, the Crest MultiCare group experienced reductions in calculus accumulation of 28.9% and 32.3%, respectively compared to the regular control dentifrice. Over the six-month observation period, the experimental tartar control and the marketed tartar control dentifrices were comparable on adverse event frequency, type or severity, and no subject discontinued treatment due to an oral soft tissue adverse event. In this partially randomized and controlled six-month clinical trial, this new dentifrice exhibited tartar control efficacy, with a comparable overall safety profile to a marketed tartar control dentifrice.

  10. Clinical evaluation of the ability of a proprietary scoliosis traction chair to de-rotate the spine: 6-month results of Cobb angle and rotational measurements

    Directory of Open Access Journals (Sweden)

    Clayton J. Stitzel

    2014-10-01

    Full Text Available The aim of this study was to investigate the immediate and 6-month effects of a scoliosis traction chair on scoliosis rotation and Cobb angle. The scoliosis traction chair has been used clinically for 10 years and has been part of previous studies, but has not been the focus of any previous study. Our goal was to test the scoliosis traction chair’s ability to de-rotate the spine to create scoliosis correction. Fifteen patient files were retrospectively selected for study. Patients were radiographically studied in a proprietary traction chair to evaluate impact on Cobb angle and apical vertebral rotation. Six-month follow-up results were recorded. Six-month results showed an average overall Cobb angle increase of about 7°. Patients with in-chair apical de-rotation showed 9° of Cobb angle improvement, while those with increased in-chair apical rotation showed an average 16° progression. Scoliotic curves whose apical rotation worsened on stress radiography showed deterioration of the curve at 6 months. Those with improved apical rotation showed Cobb angle corrections at 6 months. Since progression of scoliotic curvatures was observed in our cohort of patients after 6 months of home and clinical use, it is imperative that further studies attempt to qualify which patients and scoliosis curve patterns are best suited for the scoliosis traction chair.

  11. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up.

    NARCIS (Netherlands)

    Luijsterburg, P.A.; Verhagen, A.P.; Ostelo, R.W.J.G.; Hoogen, H.J.M. van den; Peul, W.C.; Avezaat, C.J.; Koes, B.W.

    2008-01-01

    A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2)

  12. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: A randomised clinical trial with a 12-month follow-up

    NARCIS (Netherlands)

    P.A.J. Luijsterburg (Pim); A.P. Verhagen (Arianne); R.W.J.G. Ostelo (Raymond); H.J. van den Hoogen (Hans); W.C. Peul (Wilco); C.J.J. Avezaat (Cees); B.W. Koes (Bart)

    2008-01-01

    textabstractA randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' ca

  13. Randomized controlled clinical trial of the 24-months survival of composite resin restorations after one-step incomplete and complete excavation on primary teeth

    NARCIS (Netherlands)

    Franzon, R.; Opdam, N.J.; Guimaraes, L.F.; Demarco, F.F.; Casagrande, L.; Haas, A.N de; Araujo, F.B.

    2015-01-01

    OBJECTIVE: This randomized clinical trial aimed to compare the 24-months survival of composite restorations in primary molars after partial caries removal (PCR) and total caries removal (TCR). METHODS: Forty-eight children aged 3-8 years with at least one molar with a deep carious lesion were includ

  14. Monthly continuous erythropoietin receptor activator treatment maintains stable hemoglobin levels in routine clinical management of hemodialysis patients.

    Science.gov (United States)

    Weinreich, Thomas; Leistikow, Frank; Hartmann, Hagen-Georg; Vollgraf, Günter; Dellanna, Frank

    2012-01-01

    Once-monthly administration of CERA, a continuous erythropoietin receptor activator, has shown equivalent efficacy to shorter-acting erythropoiesis-stimulating agents (ESAs) that require more frequent dosing, but data on routine use of once-monthly CERA in hemodialysis patients are lacking. Study on Efficacy, Safety and Applicability of Mircera (SESAM) was a prospective, multicenter, noninterventional trial with a duration of up to 9 months (month 0-5 "titration phase"; month 6-8 "evaluation phase") to test the stability of Hb control in hemodialysis patients under routine conditions. Patient selection, Hb targets and CERA dosing were at the discretion of the local nephrologist. 918 patients from 92 German nephrology centers were included. Ninety-three percent were on ESA treatment prior to study entry. The mean number of CERA dose changes during the study was 1.9 ± 1.9 per patient. Mean Hb level was 11.4 ± 1.2 g/dL at baseline and 11.7 ± 1.4 g/dL at the end of the 8-month study. During the evaluation phase (months 6-8), 15.6%, 40.3%, and 66.0% of patients had stable Hb (i.e., at least two values) in the ranges 11-12, 10-12, and 10-13 g/dL, respectively. The mean intra-individual fluctuation in Hb was 1.4 ± 0.7 g/dL during the study (0.5 ± 0.4 g/dL during the 3-month evaluation phase). More than 90% of patients, and > 80% of physicians, rated CERA therapy as "very good" or "good" throughout the study. Four patients (0.4%) discontinued prematurely due to adverse drug reactions. Once-monthly CERA therapy maintains stable Hb values with low intra-individual variability and few dose adaptations in hemodialysis patients when administered entirely according to local practice, and the regimen was well-tolerated.

  15. A Clinical Study of the Effectiveness of Two Different 10% Carbamide Peroxide Bleaching Products: A 6-Month Followup

    Directory of Open Access Journals (Sweden)

    S. R. Grobler

    2011-01-01

    Full Text Available The purpose of this study was to evaluate the efficacy of two different 10% carbamide peroxide bleaching products just after treatment and after a 6-month follow-up period. Methods. Two 10% carbamide peroxide products (Opalescence PF and Nite White ACP were applied nightly for 14 days, according to the manufacturers' instructions. The color of teeth 11 and 21 of thirty-four subjects having A2 or darker teeth were measured with a spectrophotometer (L∗;a∗;b∗ before treatment, just after treatment (14 days and after 6 months. Results and Conclusions. Both products produced significant whitening of teeth with total color change (ΔEab∗ of approximately 5.20 units. There was a significant improvement in all 3 color coordinates (L*,a*, and b∗ for up to 6 months postbleaching (P<.05. Nite White showed a higher degree of relapse (27% than Opalescence (18% over the 6-month period. It is suggested that rebleaching after 6 months is not necessary.

  16. Clinical and radiological results of fixation of acromioclavicular joint dislocation by hook plates retained for more than five months.

    Science.gov (United States)

    Jafary, Dawood; Keihan Shokouh, Hassan; Najd Mazhar, Farid; Shariat Zadeh, Human; Mochtary, Tahmineh

    2014-04-01

    Hook plates are used to treat acromioclavicular joint dislocations. Our study took into consideration the patients' outcome following treatment with clavicular hook plates retained for more than five months. Our aim was to assess the response to treatment of acromioclavicular joint dislocation by clavicular hook plate when retained for more than five months. We treated 24 patients who had acromioclavicular joint dislocation with a clavicular hook plate between 2008 and 2012 at our hospital. We did not repair the coracoclavicular ligament. In all patients, the plate remained more than five months because they did not come back at the recommended time for removal of their plates. The follow-up period ranged from five to thirty three months with a mean of nineteen months. The main complication was osteolysis that was seen in two patients. The mean constant score was 94.5 ± 8.77 out of 100 with a range between 70 and 100. Our study showed that the use of clavicular hook plates was a good treatment option for acromioclavicular joint dislocation. However, scores were lower in case of prolonged presence of plates.

  17. Randomized clinical trial of thrice-weekly 4-month moxifloxacin or gatifloxacin containing regimens in the treatment of new sputum positive pulmonary tuberculosis patients.

    Directory of Open Access Journals (Sweden)

    Mohideen S Jawahar

    Full Text Available BACKGROUND: Shortening tuberculosis (TB treatment duration is a research priority. This paper presents data from a prematurely terminated randomized clinical trial, of 4-month moxifloxacin or gatifloxacin regimens, in South India. METHODS: Newly diagnosed, sputum-positive HIV-negative pulmonary TB patients were randomly allocated to receive gatifloxacin or moxifloxacin, along with isoniazid and rifampicin for 4 months with pyrazinamide for first 2 months (G or M or isoniazid and rifampicin for 6 months with ethambutol and pyrazinamide for first 2 months (C. All regimens were administered thrice-weekly. Clinical and bacteriological assessments were done monthly during treatment and for 24 months post-treatment. The Data and Safety Monitoring Board recommended termination of the trial due to high TB recurrence rates in the G and M regimens. RESULTS: Of 416 patients in intent-to-treat analysis, 6 (5% of 124, 2 (2% of 110 and 2 (2% of 137 patients with drug-susceptible TB in the G, M and C arms respectively had unfavorable response at the end of treatment; during the next 24 months, 17 (15% of 115, 11 (11% of 104 and 8 (6% of 132 patients respectively, had TB recurrence. Of 38 drug-resistant patients 1 of 8 and 3 of 26 in the G and C arms respectively had unfavourable response at the end of treatment; and TB recurrence occurred in 2 of 7 and 2 of 23 patients, respectively. The differences in TB recurrence rates between the G and C arms was statistically significant (p = 0.02. Gastro-intestinal symptoms occurred in 23%, 22% and 9% of patients in the G, M and C arms respectively, but most reactions were mild and manageable with symptomatic measures; 1% required regimen modification. CONCLUSIONS: 4-month thrice-weekly regimens of gatifloxacin or moxifloxacin with isoniazid, rifampicin and pyrazinamide, were inferior to standard 6-month treatment, in patients with newly diagnosed sputum positive pulmonary TB. TRIAL REGISTRATION: Clinical Trials Registry

  18. What Do the Parents of Children Who Have Chronic Pain Expect from Their First Visit to a Pediatric Chronic Pain Clinic?

    Directory of Open Access Journals (Sweden)

    Kathy Reid

    2010-01-01

    Full Text Available BACKGROUND: Chronic pain in childhood is increasingly recognized as a significant clinical problem. Best-practice management of pediatric chronic pain in a multidisciplinary pain clinic involves a variety of treatment modalities. It is important that parents of children treated in these settings understand the different treatment options available for their children. By involving parents more effectively, care providers may more efficiently address unmet treatment needs and improve tailoring of treatment programs aimed at increasing function, reducing pain-related disability and improving quality of life.

  19. Patterns of Family Visitation During Immigration Detention

    Directory of Open Access Journals (Sweden)

    Caitlin Patler

    2017-07-01

    Full Text Available The population detained by Immigration and Customs Enforcement more than doubled between 2001 and 2013, swelling to over 477,000 individuals. Despite this growth, few studies analyze the experiences of detained immigrants. We draw from one of the first studies of detention in the United States, analyzing survey data from 565 noncitizens detained for six months or longer in California. Criminal incarceration literature finds that family visitation helps maintain social ties but is not evenly distributed. We analyze the predictors of contact and visitation with children during immigration detention. Results indicate that demographic background, the type of detention facility, and children’s legal status substantially affect contact and visitation experiences. Findings suggest that immigration detention replicates experiences of criminal incarceration and is perpetuating inequality in immigrant communities.

  20. Rethinking emergency department visits.

    Science.gov (United States)

    Resar, Roger K; Griffin, Frances A

    2010-01-01

    Efforts to date have been unable to reverse the trend of increased emergency department utilization. The Institute for Healthcare Improvement has developed a framework for reducing avoidable emergency department visits on the basis of the formation of local coalitions. These coalitions include interested partners approaching improvement by integrating community resources and nonmedical solutions. Targeted patient populations are identified via homogeneous characteristics. Open-ended interview questions are used to identify possible community and nonmedical solutions to complement medical strategies. This article describes the framework and process of testing. If validated, this approach will have significant policy implications.

  1. CPAFFC Delegation Visits India

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>A CPAFFC delegation headed by Wang Wenyuan,former vice chairman of the National Committee of the Chinese Peo-ple’s Political Consultative Conference and adviser to the CPAFFC,paid a goodwill visit to India from December 19 to 28,2007 at the invitation of the Indian Council for Cultural Relations(ICCR).Also on the delegation were CPAFFC President Chen Haosu and Vice President Feng Zuoku.It was the highest-level delegation the CPAFFC has sent to India over the last decade.

  2. ACDF Using the Solis Cage with Iliac Bone Graft in Single Level: Clinical and Radiological Outcomes in Average 36 months Follow-up.

    Science.gov (United States)

    Oh, Si-Hyuck; Yoon, Kyeong-Wook; Kim, Young-Jin; Lee, Sang-Koo

    2013-06-01

    To evaluate the utility of anterior cervical discectomy and fusion (ACDF) with polyetheretherketone (PEEK) cage and autograft through long term(average 36 months) follow-up. Thirty selected patients (male:20/female:10) who suffered from cervical radiculopathy, myelopathy or radiculomyelopathy underwent a single level ACDF with PEEK cage and autograft from iliac crest from March 2006 to July 2008 in single institute. We followed patients for an average 36.4±8.1 months (ranged from 23 to 49 months). The Japanese Orthopedic Association (JOA) score for evaluation of myelopathy and visual analogue scale (VAS) for radiating pain was used to estimate postoperative clinical outcome. Plain x-ray on true lateral standing flexion, extension and neutral position view and 3D CT scan were used every 6 months after surgery during follow-up period. The mean VAS and JOA scoring improved significantly after the surgery and radiological fusion rate was accomplished by 100% 36 months after the surgery. We had no complication related with the surgery except one case of osteomyelitis. There was one case of Grade I fusion, four cases of grade II, and 25 cases of grade III by radiologic evaluation. This long term follow-up study for ACDF with PEEK cage shows that this surgical method is comparable with other anterior cervical fusion methods in terms of clinical outcomes and radiologic fusion rate.

  3. Piloting a Statewide Home Visiting Quality Improvement Learning Collaborative.

    Science.gov (United States)

    Goyal, Neera K; Rome, Martha G; Massie, Julie A; Mangeot, Colleen; Ammerman, Robert T; Breckenridge, Jye; Lannon, Carole M

    2017-02-01

    Objective To pilot test a statewide quality improvement (QI) collaborative learning network of home visiting agencies. Methods Project timeline was June 2014-May 2015. Overall objectives of this 8-month initiative were to assess the use of collaborative QI to engage local home visiting agencies and to test the use of statewide home visiting data for QI. Outcome measures were mean time from referral to first home visit, percentage of families with at least three home visits per month, mean duration of participation, and exit rate among infants learning. A statewide data system was used to generate monthly run charts. Results Mean time from referral to first home visit was 16.7 days, and 9.4% of families received ≥3 visits per month. Mean participation was 11.7 months, and the exit rate among infants learning network, agencies tested and measured changes using statewide and internal data. Potential next steps are to develop and test new metrics with current pilot sites and a larger collaborative.

  4. Emergency presurgical visit

    Directory of Open Access Journals (Sweden)

    Alfredo Castro Díaz

    2009-07-01

    Full Text Available The objective has been to create a Protocol of Structured Presurgical Visit applicable to the patients who are undergoing an emergency surgery, to provide the user and his family all the necessary cares on the basis of those nursing diagnosis that prevail in all the cases of surgical emergency interventions. The used method has been an analysis of the emergency surgical interventions more prevalent from February 2007 until October 2008 in our area (a regional hospital, and statistic of those nursing diagnosis that more frequently appeared in these interventions, the previous moment to the intervention and in addition common to all of them. The results were the following ones: the more frequent emergency operations were: Caesarean, ginecological curettage, laparotomy, help in risk childbirth, orthopaedic surgery and appendectomy. The more frequent nursing diagnosis in all the emergency operations at the previous moment of the intervention were: risk of falls, pain, anxiety, deficit of knowledge, risk of infection, movement stress syndrome, risk of hemorrhage, cutaneous integrity deterioration. The conclusion is that users present at the previous moment to an emergency operation several problems, which force to the emergency surgical ward nurse to the introduction of the nursing methodology, in order to identify the problems, to mark results and to indicate the interventions to achieve those results, besides in a humanitarian way and with quality. This can be obtained by performing a Structured Emergency Presurgical Visit.

  5. Steven Weinberg visits CERN

    CERN Multimedia

    2009-01-01

    Steven Weinberg visiting the ATLAS cavern accompanied by Peter JenniIt was no surprise that the CERN audience arrived early in the Globe of Science and Innovation for the colloquium on 7 July. Nobel laureate Steven Weinberg is one of the major contributors to the Standard Model of particle physics. He received the Nobel Prize for Physics in 1979 for his work on the unified theory of the electromagnetic and weak interactions, one of the essential pillars of the Standard Model. After lunch at CERN and a visit to ATLAS, Weinberg gave a colloquium on "The Quantum Theory of Fields: Effective or Fundamental" to a packed audience. In his talk, he looked at how the use of quantum field theory in particle physics has fluctuated in popularity since Paul Dirac first introduced the approach to describe the interaction of particles with electromagnetic fields in the late 1920s. In particular, he posed the question: Is quantum field theory fundamental or does it a...

  6. Kofi Annan visits CERN

    CERN Document Server

    Katarina Anthony

    2011-01-01

    On Tuesday 13 September, former Secretary-General of the United Nations and Nobel Peace Laureate Kofi Annan paid a visit to CERN.   Arriving in the early afternoon, Kofi Annan and his family were greeted by Director-General Rolf Heuer on the steps of Building 500. After a quick introduction to the Laboratory, they were whisked off to SM18 for a tour of the LHC’s superconducting magnet test hall, guided by Technology Department Head Frédérick Bordry. After a light lunch in Restaurant 2, Kofi Annan added his signature to CERN’s Guest Book. He is the second UN Secretary-General to add their name to CERN’s roster; his successor Ban Ki-Moon’s visited CERN in 2008.  Kofi Annan was then guided by spokesperson Fabiola Gianotti on a tour of ATLAS’s Visitor Centre. This was an opportunity for some of the younger members of the ATLAS collaboration to meet the former Secretary-General and to answer his questions about the exper...

  7. Factors predicting suicidal ideation in the preceding 12 months among patients attending a community psychiatric outpatient clinic.

    LENUS (Irish Health Repository)

    Anyansi, Tochukwu E

    2013-06-01

    Predictive factors are used to alert the clinician to the necessity of carrying out a suicide risk assessment in those patients whose demographic and clinical characteristics suggest the possibility of suicide.

  8. k-visit Attribute Grammars

    DEFF Research Database (Denmark)

    Nielson, Hanne Riis; Skyum, S.

    1981-01-01

    It is shown that any well-defined attribute grammar is k-visit for some k. Furthermore, it is shown that given a well-defined grammar G and an integer k, it is decidable whether G is k-visit. Finally it is shown that the k-visit grammars specify a proper hierarchy with respect to translations...

  9. Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness): a pragmatic 6-month trial of lithium versus quetiapine for bipolar disorder.

    Science.gov (United States)

    Nierenberg, Andrew A; McElroy, Susan L; Friedman, Edward S; Ketter, Terence A; Shelton, Richard C; Deckersbach, Thilo; McInnis, Melvin G; Bowden, Charles L; Tohen, Mauricio; Kocsis, James H; Calabrese, Joseph R; Kinrys, Gustavo; Bobo, William V; Singh, Vivek; Kamali, Masoud; Kemp, David; Brody, Benjamin; Reilly-Harrington, Noreen A; Sylvia, Louisa G; Shesler, Leah W; Bernstein, Emily E; Schoenfeld, David; Rabideau, Dustin J; Leon, Andrew C; Faraone, Stephen; Thase, Michael E

    2016-01-01

    Bipolar disorder is among the 10 most disabling medical conditions worldwide. While lithium has been used extensively for bipolar disorder since the 1970s, second-generation antipsychotics (SGAs) have supplanted lithium since 1998. To date, no randomized comparative-effectiveness study has compared lithium and any SGA. Within the duration of the study (September 2010-September 2013), participants with bipolar I or II disorder (DSM-IV-TR) were randomized for 6 months to receive lithium (n = 240) or quetiapine (n = 242). Lithium and quetiapine were combined with other medications for bipolar disorder consistent with typical clinical practice (adjunctive personalized treatment [APT], excluding any SGA for the lithium + APT group and excluding lithium or any other SGA for the quetiapine + APT group). Coprimary outcome measures included Clinical Global Impressions-Efficacy Index (CGI-EI) and necessary clinical adjustments, which measured number of changes in adjunctive personalized treatment. Secondary measures included a full range of symptoms, cardiovascular risk, functioning, quality of life, suicidal ideation and behavior, and adverse events. Participants improved across all measures, and over 20% had a sustained response. Primary (CGI-EI, P = .59; necessary clinical adjustments, P = .15) and secondary outcome changes were not statistically significantly different between the 2 groups. For participants with greater manic/hypomanic symptoms, CGI-EI changes were significantly more favorable with quetiapine + APT (P = .02). Among those with anxiety, the lithium + APT group had fewer necessary clinical adjustments per month (P = .02). Lithium was better tolerated than quetiapine in terms of the burden of side effects frequency (P = .05), intensity (P = .01), and impairment (P = .01). Despite adequate power to detect clinically meaningful differences, we found outcomes with lithium + APT and quetiapine + APT were not significantly different across 6 months of treatment

  10. ESAT and M-CHAT as screening instruments for autism spectrum disorders at 18 months in the general population: issues of overlap and association with clinical referrals.

    Science.gov (United States)

    Beuker, Karin T; Schjølberg, Synnve; Lie, Kari Kveim; Swinkels, Sophie; Rommelse, Nanda N J; Buitelaar, Jan K

    2014-11-01

    The Modified Checklist for Autism in Toddlers (M-CHAT) and the Early Screening of Autistic Traits (ESAT) were designed to screen for autism spectrum disorders in very young children. The aim of this study was to explore proportions of children that screened positive on the ESAT or the M-CHAT and to investigate if screening positive on the ESAT and M-CHAT is associated with clinical referral by 18 months and other aspects of children's development, health, and behavior. In this study, the mothers of 12,948 18-month-old children returned a questionnaire consisting of items from the ESAT and M-CHAT, plus questions about clinical and developmental characteristics. The M-CHAT identified more screen-positive children than the ESAT, but the ESAT was associated with more clinical referrals and tended to identify more children with medical, language, and behavioral problems. A post hoc analysis of combining the two instruments found this to be more effective than the individual instruments alone in identifying children referred to clinical services at 18 months. Further analysis at the level of single items is warranted to improve these screening instruments.

  11. Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study

    DEFF Research Database (Denmark)

    Skau, Maren; Sander, Birgit; Milea, Dan

    2011-01-01

    , fast RNFL 3.4 protocol), and Humphrey visual field testing were evaluated at regular intervals. Repeat lumbar puncture was performed at final visit (n = 13). The diagnostic delay was 3 months and initial symptoms were headache (94%), visual blurring (82%) and pulsatile tinnitus (65%). Complete clinical...

  12. High-intensity Statin Treatments in Clinically Stable Patients on Aspirin Monotherapy 12 Months After Drug-eluting Stent Implantation: A Randomized Study.

    Science.gov (United States)

    Im, Eui; Cho, Yun-Hyeong; Suh, Yongsung; Cho, Deok-Kyu; Her, Ae-Young; Kim, Yong Hoon; Lee, Kyounghoon; Kang, Woong Chol; Yun, Kyeong Ho; Yoo, Sang-Yong; Cheong, Sang-Sig; Shin, Dong-Ho; Ahn, Chul-Min; Kim, Jung-Sun; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeong-Ki

    2017-07-14

    Current guidelines on the treatment of blood cholesterol recommend continuous maintenance of high-intensity statin treatment in drug-eluting stent (DES)-treated patients. However, high-intensity statin treatment is frequently underused in clinical practice after stabilization of DES-treated patients. Currently, the impact of continuous high-intensity statin treatment on the incidence of late adverse events in these patients is unknown. We investigated whether high-intensity statin treatment reduces late adverse events in clinically stable patients on aspirin monotherapy 12 months after DES implantation. Clinically stable patients who underwent DES implantation 12 months previously and received aspirin monotherapy were randomly assigned to receive either high-intensity (40mg atorvastatin, n = 1000) or low-intensity (20mg pravastatin, n = 1000) statin treatment. The primary endpoint was adverse clinical events at 12-month follow-up (a composite of all death, myocardial infarction, revascularization, stent thrombosis, stroke, renal deterioration, intervention for peripheral artery disease, and admission for cardiac events). The primary endpoint at 12-month follow-up occurred in 25 patients (2.5%) receiving high-intensity statin treatment and in 40 patients (4.1%) receiving low-intensity statin treatment (HR, 0.58; 95%CI, 0.36-0.92; P = .018). This difference was mainly driven by a lower rate of cardiac death (0 vs 0.4%, P = .025) and nontarget vessel myocardial infarction (0.1 vs 0.7%, P = .033) in the high-intensity statin treatment group. Among clinically stable DES-treated patients on aspirin monotherapy, high-intensity statin treatment significantly reduced late adverse events compared with low-intensity statin treatment. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01557075. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  13. "One-step" bone marrow-derived cells transplantation and joint debridement for osteochondral lesions of the talus in ankle osteoarthritis: clinical and radiological outcomes at 36 months.

    Science.gov (United States)

    Buda, Roberto; Castagnini, Francesco; Cavallo, Marco; Ramponi, Laura; Vannini, Francesca; Giannini, Sandro

    2016-01-01

    Ankle osteoarthritis (OA) is a challenging pathology, often requiring surgical treatments. In young patients, joint sparing, biologic procedures would be desirable. Recently, a few reports have described the efficacy of bone marrow stem cells in OA. Considering the good outcomes of one-step bone marrow derived cells transplantation (BMDCT) for osteochondral lesions of the talus (OLT), we applied this procedure for OLT in concomitant ankle OA. 56 patients, with a mean age of 35.6 years (range 16–50), who suffered from OLT and ankle OA, were treated using BMDCT. All patients were clinically checked using AOFAS score, in the pre-operative setting until the final follow-up of 36 months. Weight-bearing radiographs and MRI evaluation using Mocart score were performed, preoperatively and postoperatively. The whole clinical outcome had a remarkable improvement at 12 months, a further amelioration at 24 months and a lowering trend at 36 months (77.8 ± 18.3). Early OA had better outcomes. 16 patients required another treatment and they were considered failures. Clinical outcome significantly correlates with OA degree, BMI, associate procedures. Radiographs were in line with clinical results. MRI evaluation showed signs of osteochondral repair. BMDCT showed encouraging clinical and radiological outcomes at short-term follow-up. This procedure should be applied in young and selected patients, excluding severe ankle degeneration, where the results are critical. Longer follow-ups and larger case series are needed to confirm these results and if this treatment could be effective in postponing end-stage procedures. IV.

  14. Light-Speed LSX系统一次法和两次法治疗慢性根尖周炎的临床研究%Randomized controlled clinical studies of Light-Speed LSX system in single-visit and two-visit root canal treatment of chronic apical periodontitis

    Institute of Scientific and Technical Information of China (English)

    吴志国; 杜红保; 李斌; 吴翠柳

    2015-01-01

    目的:采用Light-Speed LSX根管预备系统对慢性根尖周炎患者采用一次法根管治疗和两次法根管治疗,评估术后2年随访结果,比较二者治疗成功率。方法300例上下颌慢性根尖周炎患牙随机分为2组,A组为一次性完成根管治疗, B组分次完成根管预备和根管充填,所有组内患牙均使用Light-Speed LSX根管预备器械进行根管预备,评价患牙术后2年的临床和影像学表现。结果采用Light-Speed LSX根管预备系统进行根管预备,一次法组138例(93.88%)治愈,两次法组122例(89.05%)治愈;疗效不确定的一次法组5例(3.40%),两次法组9例(6.57%);治疗失败的一次法组4例(2.72%),两次法组6例(4.38%)。两组治疗成功率的比较采用卡方检验,结果显示两组治疗成功率无统计学差异(P>0.05)。结论采用Light-Speed LSX根管预备系统对慢性根尖周炎患者采用一次法根管治疗和两次法根管治疗成功率无差异。%Objective To evaluate and compare the outcomes of Light-Speed LSX systems in single-visit and two-visit root canal treatment of patients with chronic apical periodontitis after a 2-year follow-up. Methods 300 maxillary and mandibular teeth with chro-nic apical periodontitis were randomly assigned into two groups. While the teeth of patients in group A were obturated,those in group B were temporarily sealed and obturated one week later. All canals were enlarged with Light-speedLSX root canal instruments. The healing results were clinically and radiographically evaluated 2 years after the operation. Results Of the 300 treated teeth,138 of 147 teeth (93. 88%) in the A group were healed compared with 122 of 137 teeth (89. 05%) in the B group,curative effects of 5 cases (3. 40%) in the A group were classified as uncertain compared with 9 cases (6. 57%) in the B group;4 cases (2. 72%) in the A group and 6 cases (4. 38%) in the B group were classified as not healed. Chi-square test was used to compare the

  15. Health visiting in rural Gambia.

    Science.gov (United States)

    Hoare, K

    1991-01-01

    A British nurse was the 1st health visitor in the village of Keneba in the Gambia. She was at a nutritional research center which provided basic medical services. In addition to visiting mothers in their homes to talk about health education, such as oral rehydration and advice on hand washing, she would also encourage them to bring their children to the infant welfare clinic for immunizations. She told the mothers that the health staff would check the growth and nutritional status of their children and why these activities were important. Staff at the clinic aimed to see all the children 2 years 9 times the 1st year and 4 times the 2nd year. All anthropometric data were forwarded to Cambridge, England to be included in a continuing study on the growth of the population. The clinic referred children with serious illnesses to the pediatrician or, if necessary, took them to a hospital on the coast. Children that came to the clinic with a fever 37.4 degrees Celsius during the wet season had a blood film taken to check for malaria parasites. Indeed cerebral malaria contributed greatly to child deaths in the Gambia. If malaria was present, children received their 1st dose of chloroquine immediately so the staff could determine tolerance. 3 doses followed this dose. The health visitor also organized the health education component of the clinic. The clinic dresser interpreted the British nurse's presentations to eventually conduct them alone. The nurse divided the mothers and fathers into 2 groups. In the future, she would evaluate the 2 groups to determine if weekly education on hand washing and skin hygiene would reduce diarrheal and cutaneous disease incidence in children 3 years old. The other group learned about family planning. Both groups learned about immunization, detection of illness, safety, sanitation, nutritional advice, dental care, and food preparation.

  16. Visit-to-Visit Variability in Blood Pressure and Kidney and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Nephropathy : A Post Hoc Analysis From the RENAAL Study and the Irbesartan Diabetic Nephropathy Trial

    NARCIS (Netherlands)

    McMullan, Ciaran J.; Lambers Heerspink, Hiddo J.; Parving, Hans-Henrik; Dwyer, Jamie P.; Forman, John P.; de Zeeuw, Dick

    2014-01-01

    Background: Increased systolic blood pressure variability between outpatient visits is associated with increased incidence of cardiovascular end points. However, few studies have examined the association of visit-to-visit variability in systolic blood pressure with clinically relevant kidney disease

  17. Longer Weekly Sleep Duration Predicts Greater 3-Month BMI Reduction among Obese Adolescents Attending a Clinical Multidisciplinary Weight Management Program

    Directory of Open Access Journals (Sweden)

    Bethany J. Sallinen

    2013-05-01

    Full Text Available Aims: To determine whether baseline levels of self-reported sleep and sleep problems among obese adolescents referred to an outpatient multidisciplinary family-based weight management program predict reduction in BMI 3 months later. Methods: A retrospective medical chart review was conducted for 83 obese adolescents. The following baseline variables were extracted: self-reported sleep duration (weekdays and weekends, and presence of snoring, daytime fatigue, suspected sleep apnea, and physician-diagnosed sleep apnea. Anthropometric data at baseline and 3 months were also collected. Results: On average, adolescents reported significantly less sleeping on weeknights (7.7 ± 1.3 h compared to weekend nights (10.0 ± 1.8 h, t(82 = 10.5, p = 0.0001. Reduction in BMI after 3 months of treatment was predicted by more weekly sleep at baseline (R2 = 0.113, F(1, 80 = 10.2, p = 0.002. Adolescents who reduced their BMI by ≥1 kg/m2 reported greater weekly sleep at baseline compared to adolescents who experienced 2 reduction (60.7 ± 7.5 h vs. 56.4 ± 8.6 h; F(1, 80 = 5.7, p = 0.02. Conclusion: Findings from this study, though correlational, raise the possibility that increased duration of sleep may be associated with weight loss among obese adolescents enrolled in a weight management program. Evidence-based behavioral techniques to improve sleep hygiene and increase sleep duration should be explored in pediatric weight management settings.

  18. Real clinical practice of catheter therapy for deep venous thrombosis: periprocedural and 6-month outcomes from the EDO registry.

    Science.gov (United States)

    Mizuno, Atsushi; Anzai, Hitoshi; Utsunomiya, Makoto; Yajima, Junji; Ohta, Hiroshi; Ando, Hiroshi; Umemoto, Tomoyuki; Higashitani, Michiaki; Ozaki, Shunsuke; Sakamoto, Hiroshi; Nakao, Masashi; Yuzawa, Yasufumi; Kaneko, Hidehiro; Nakamura, Masato

    2015-07-01

    A recent national study in Japan indicated that 5.8 % of deep venous thrombosis (DVT) patients were treated using endovascular procedures, 83 % of which included catheter-directed thrombolysis (CDT). However, the details of these endovascular procedures and their outcomes have not yet been fully evaluated. Using DVT data from the EDO registry (EnDOvascular treatment registry) database, a total of 35 symptomatic iliac or femoral DVT patients who received endovascular treatment (54.3 % male, age 64.7 ± 15.1) were analyzed. The dominant patient risks were being bedridden (22.9 %) and May-Thurner syndrome (25.7 %). Approximately 77.1 % of patients were treated using an antegrade approach, and CDT and other endovascular procedures were performed in 82.9 and 57.1 % of patients, respectively. A periprocedural inferior vena cava (IVC) filter was used in 94.1 % of patients, which remained implanted in 37.1 and 20.0 % of patients after discharge and 6 months after hospitalization, respectively. After 6 months of treatment, 2.9 % of patients experienced a recurrence of DVT and 5.7 % suffered revascularization, but no patient had a recurrence of pulmonary embolism. Subjective symptoms improved in 80.0 % of patients, while 2.9 % of patients felt worse at 6 months after treatment. Postthrombotic syndrome-related symptoms were observed in seven patients (19.4 %), and edema was most frequently observed (71.4 %). The details of CDT procedures, such as approach site and the removal of the IVC filter, varied among hospitals. Despite improved symptoms, further procedural standardization and data collection should be conducted to reduce complications and improve outcomes.

  19. Identification of relapse predictors in IgG4-related disease using multivariate analysis of clinical data at the first visit and initial treatment.

    Science.gov (United States)

    Yamamoto, Motohisa; Nojima, Masanori; Takahashi, Hiroki; Yokoyama, Yoshihiro; Ishigami, Keisuke; Yajima, Hidetaka; Shimizu, Yui; Tabeya, Tetsuya; Matsui, Mikiko; Suzuki, Chisako; Naishiro, Yasuyoshi; Takano, Ken-ichi; Himi, Tetsuo; Imai, Kohzoh; Shinomura, Yasuhisa

    2015-01-01

    Inducting clinical remission by glucocorticoid treatment is relatively easy in IgG4-related disease (IgG4-RD), but relapse also occurs easily with tapering of the steroid dose. The present study tried to analyse the cases to extract predictors of relapse present at the diagnosis of IgG4-RD. Subjects comprised 79 patients with IgG4-related dacryoadenitis and sialadenitis, known as Mikulicz's disease, who were diagnosed between April 1997 and October 2013 and followed-up for >2 years from the initial induction treatment. They were applied to Cox proportional hazard modelling, based on the outcome of interval to relapse. We performed multivariate analysis for the clinical factors of these cases and identified predictors of relapse. Identified factors were male sex and younger onset in cases without organ involvement at diagnosis and low levels of serum IgG4 in cases with organ dysfunction at diagnosis. Complication with autoimmune pancreatitis and low steroid dose at initial treatment also tended to be associated with recurrence. Follow-up is important in cases with recognized risk factors for relapse, including male sex and younger onset in cases without organ damage. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Clinical outcomes of long-acting injectable risperidone in patients with schizophrenia: six-month follow-up from the Electronic Schizophrenia Treatment Adherence Registry in Latin America

    Directory of Open Access Journals (Sweden)

    Mario Louzã

    2010-12-01

    Full Text Available Rogelio Apiquian1, Rodrigo Córdoba2, Mario Louzã31Americas University, Behavior and Development Sciences Division, Mexico City, Mexico; 2Nervous System Research Center-CISNE, Bogota, Colombia; 3Schizophrenia Research Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, BrazilBackground: Risperidone long-acting injection (RLAI has been shown to be efficacious, improve compliance, and increase long-term retention rate on therapy. The aim of this work was to determine the effect of RLAI on clinical outcome and hospitalization rate in patients with schizophrenia or schizoaffective disorder enrolled in the electronic Schizophrenia Treatment Adherence Registry in Latin America.Methods: Data were collected at baseline, retrospectively for the 12 months prior to baseline, and prospectively every three months for 24 months. Hospitalization prior to therapy was assessed by a retrospective chart review. Efficacy and functioning were evaluated using Clinical Global Impression of Illness Severity (CGI-S, Personal and Social Performance (PSP, and Global Assessment of Functioning (GAF scores. Relapse and treatment were also registered.Results: Patients were recruited in Mexico (n = 53, Brazil (n = 11, and Colombia (n = 15. Sixty-five percent (n = 52 were male, and mean age was 32.9 years. Patients were classified as having schizophrenia (n = 73 or schizoaffective disorder (n = 6. The mean dose of RLAI at six months was 34.1 mg (standard deviation = 10.2 mg. The percentage of hospitalized patients before treatment was 28.2% and 5.1% at six months after initiating RLAI (P < 0.001. Significant changes were registered on CGI-S, GAF, and PSP scores.Conclusions: RLAI was associated with an improvement in clinical symptoms and functioning, and a greater reduction in hospitalization.Keywords: long-acting, risperidone, schizophrenia, schizoaffective disorder, Latin America

  1. Immediate occlusal loading of Tapered Internal Laser-Lok® implants in partial arch rehabilitations: a 24-months clinical and radiographic study

    Directory of Open Access Journals (Sweden)

    M. Grande

    2013-10-01

    Full Text Available Aim The purpose of this 2 year prospective clinical study was to clinically and radiographically evaluate an implant with laser microtextured collar surface placed for immediate loading of fixed prostheses in cases of partial posterior maxillary and/or mandibular edentulism.Materials and methods Thirty-five partially edentulous patients who needed implant treatment and met inclusion criterias were consecutively enrolled at different study-centers in Italy. A total of 107 Tapered Internal Laser-Lok® implants (49 maxillary and 58 mandibular were placed and immediately loaded. All provisional constructions were delivered within 1 hour, and the final constructions placed after 4 months. A total of 107 Tapered Internal Laser-Lok implants (49 maxillary and 58 mandibular were placed and immediately loaded. All provisional restorations were delivered within 1 hour, and the final prosthesis placed after 4 months. A total of 32 prosthetic restorations, consisting of 10 two- units, 12 three-units, and 10 four-units fixed partial dentures were evaluated. Clinical and radiographic outcomes were monitored at follow-up examinations scheduled 6, 12, 24 months after implants placement.Results Five implants were lost after loading (3 implants in a two-unit maxillary restorations, 1 implant in a two-unit mandibular restorations, and 1 implant in three-unit maxillary restorationsgiving a survival rate of 95.4% after 24 months. Mean crestal bone loss at 6, 12, and 24 months after implant insertion was 0.42 +/- 1.1 mm, 0.52 +/- 0.9 mm, and 0.66 +/- 1.3 mm, respectively.Conclusion Although limited bytheshort follow-up, immediate function with Tapered Internal Laser-Lok® implants seems to be a viable option to treat partially edentulous patients.

  2. Transcrestal Sinus Lift Procedure Approaching Atrophic Maxillary Ridge: A 60-Month Clinical and Radiological Follow-Up Evaluation

    OpenAIRE

    Lo Giudice, G.; G. Iannello; Terranova, A.; Lo Giudice, R.; Pantaleo, G; Cicciù, M.

    2015-01-01

    Aim. The aim of this study was to assess the success and the survival rate of dental implants placed in augmented bone after sinus lifting procedures. Material and Methods. 31 patients were mainly enrolled for a residual upper jaw crest thickness of 3 mm. CBCT scans were performed before and after the augmentation technique and at the follow-up appointments, at 3, 6, 12, 24, and up to 60 months. The follow-up examination included cumulative survival rate of implants, peri-implant marginal bon...

  3. Root coverage stability of the subepithelial connective tissue graft and guided tissue regeneration: A 30-month follow-up clinical trial

    OpenAIRE

    Rosetti, Elizabeth P. [UNESP; Marcantonio Júnior, Elcio [UNESP; Zuza, Elizangela P. [UNESP; Marcantonio, Rosemary Adriana Chierici [UNESP

    2013-01-01

    Objectives: The aim of this study was to compare the long-term clinical effects produced by subepithelial connective tissue graft (SCTG) and guided tissue regeneration combined with demineralized freeze-dried bone allograft (GTR-DFDBA) in the treatment of gingival recessions in a 30-month follow-up clinical trial. Methods: Twenty-four defects were treated in 12 patients who presented canine or pre-molar Miller class I and/or II bilateral gingival recessions. GTR-DFDBA and SCTG treatments were...

  4. Preliminary study into the components of the fear-avoidance model of LBP: change after an initial chiropractic visit and influence on outcome

    Directory of Open Access Journals (Sweden)

    Newell Dave

    2010-07-01

    Full Text Available Abstract Background In the last decade the sub grouping of low back pain (LBP patients according to their likely response to treatment has been identified as a research priority. As with other patient groups, researchers have found few if any factors from the case history or physical examination that are helpful in predicting the outcome of chiropractic care. However, in the wider LBP population psychosocial factors have been identified that are significantly prognostic. This study investigated changes in the components of the LBP fear-avoidance beliefs model in patients pre- and post- their initial visit with a chiropractor to determine if there was a relationship with outcomes at 1 month. Methods Seventy one new patients with lower back pain as their primary complaint presenting for chiropractic care to one of five clinics (nine chiropractors completed questionnaires before their initial visit (pre-visit and again just before their second appointment (post-visit. One month after the initial consultation, patient global impression of change (PGIC scores were collected. Pre visit and post visit psychological domain scores were analysed for any association with outcomes at 1 month. Results Group mean scores for Fear Avoidance Beliefs (FAB, catastrophisation and self-efficacy were all improved significantly within a few days of a patient's initial chiropractic consultation. Pre-visit catastrophisation as well as post-visit scores for catastrophisation, back beliefs (inevitability and self-efficacy were weakly correlated with patient's global impression of change (PGIC at 1 month. However when the four assessed psychological variables were dichotomised about pre-visit group medians those individuals with 2 or more high variables post-visit had a substantially increased risk (OR 36.4 (95% CI 6.2-213.0 of poor recovery at 1 month. Seven percent of patients with 1 or fewer adverse psychological variables described poor benefit compared to 73% of those

  5. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up

    OpenAIRE

    Luijsterburg, Pim; Verhagen, Arianne; Ostelo, Raymond; Hoogen, Hans; Peul, Wilco; Avezaat, Cees; Koes, Bart

    2008-01-01

    textabstractA randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2) the control group with general practitioners' care only. To assess the effectiveness of PT additional to general practitioners' care compared to general practitioners' care alone, in pa...

  6. Changes in Lipid Profiles of HIV+ Adults over Nine Months at a Harare HIV Clinic: A Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Danai Tavonga Zhou

    2016-01-01

    Full Text Available HIV infection, together with ART, is associated with changes in biochemical, metabolic parameters and lipid profiles. The aim of this study was to compare changes in lipid profiles among HIV positive outpatients over nine months. 171 patients were investigated, 79% were ART experienced, and 82% of ART experienced patients were on NVP/EFV first line at baseline, but some patients changed ART groups over follow-up and classification was based on intent to treat. More than 60% ART naïve and ART experienced patients had some form of dyslipidemia either at baseline or at follow-up, but mean lipid values for the two groups were within normal limits. At baseline and follow-up, mean levels of TC and HDL were slightly higher in the ART experienced group. Interestingly, there was higher increase in HDL over time in the ART negative group compared to the ART positive group. There was a decrease in TC/HDL ratio in both groups over time, suggesting a reduction in calculated risk of CHD over time. HIV positive patients frequently show various forms of dyslipidemia, but there are no changes in average atherogenic lipid levels and results suggest reduced risk of CHD, mainly due to increases in HDL, after nine months of observation time.

  7. Postanesthesia care unit visitation decreases family member anxiety.

    Science.gov (United States)

    Carter, Amy J; Deselms, JoAnn; Ruyle, Shelley; Morrissey-Lucas, Marcella; Kollar, Suzie; Cannon, Shelly; Schick, Lois

    2012-02-01

    Despite advocacy by professional nursing organizations, no randomized controlled trials (RCTs) have evaluated the response of family members to a visit with an adult patient during a postanesthesia care unit (PACU) stay. Therefore, the purpose of this RCT was to evaluate the impact of a brief PACU visitation on the anxiety of family members. The study was conducted in a phase I PACU of a large community-based hospital. Subjects were designated adult family members or significant others of an adult PACU patient who had undergone general anesthesia. A pretest-posttest RCT design was used. The dependent variable was the change in anxiety scores of the visitor after seeing his or her family member in the PACU. Student t test (unpaired, two tailed) was used to determine if changes in anxiety scores (posttest score-pretest score) were different for the PACU visit and no visit groups. A total of 45 participants were studied over a 3-month period, with N=24 randomly assigned to a PACU visit and N=21 assigned to usual care (no PACU visit). Participants in the PACU visit group had a statistically significant (P=.0001) decrease in anxiety after the visitation period (-4.11±6.4); participants in the usual care group (no PACU visit) had an increase in anxiety (+4.47±6.6). The results from this study support the value and importance of PACU visitation for family members.

  8. Collaborative relationship in preventive home visits to older people

    DEFF Research Database (Denmark)

    Yamada, Yukari; Vass, Mikkel; Hvas, Lotte

    2011-01-01

    To describe what characterizes preventive home visits with collaborative relationships among non-disabled home-dwelling older people in Japan. Background. Preventive home visits have the potential to result in improved health outcomes among older people. Collaboration, mutual understanding...... communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non-disabled home-dwelling older people in Japan. Relevance to clinical practice. Education should be emphasized, because preventive home visitor...

  9. Hospital Readmission Following Emergency Room Visit for Cholelithiasis

    Science.gov (United States)

    Williams, Taylor P.; Dimou, Francesca M.; Adhikari, Deepak; Kimbrough, Thomas D.; Riall, Taylor S.

    2015-01-01

    Background For patients presenting with symptomatic cholelithiasis, cholecystectomy is the definitive treatment modality. Our goal was to evaluate the surgical follow-up and outcomes in patients seen in the Emergency Department (ED) for an episode of symptomatic cholelithiasis and discharged home for elective follow-up. Methods We performed a retrospective review of consecutive patients seen in the ED for cholelithiasis and discharged without hospital admission between August 2009 and May 2014. All patients were followed for two years from the date of initial ED visit. We evaluated outpatient surgeon visits, elective and emergent cholecystectomy rates, and additional ED visits. Cumulative incidence and Kaplan-Meier curves were used to examine the time from the initial ED visit to outpatient surgeon evaluation and the time from initial ED visit to ED readmission. Results Seventy-one patients were discharged from the ED with a diagnosis of symptomatic gallstones. 12.6% of patients had an elective cholecystectomy in the two years after the initial visit. In this group, the mean time from the initial ED visit to outpatient surgeon follow-up was 7.7 days and all elective cholecystectomies occurred within one month of the initial visit. Of the 62 patients who did not have an elective cholecystectomy, only 14.5% of patients in this group had outpatient surgeon follow-up at mean time of 137 days from the initial ED visit for symptomatic gallstones. In addition, 37.1% of patients in this group had additional ED visits for gallstone-related symptoms, with 17.7 % of patients having two or more additional ED visits, and 12.9% required emergent/urgent cholecystectomy. 43.5% of additional ED visits occurred within one month and 60.9% within three months of their initial ED visit. In patients with additional ED visits for symptomatic cholelithiasis, 60.9% had more than one abdominal Ultrasound (US) or Computed Tomography (CT) scan during the course of multiple visits. Conclusion

  10. Hemiconvulsion-hemiplegia-epilepsy syndrome: clinical course and neuroradiological features in a 20-month-old girl.

    Science.gov (United States)

    Bhat, Ramesh Y; Kakkar, Shruti; Prakashini, Koteshwara

    2014-03-10

    Hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome involves initial sudden and prolonged unilateral convulsive seizures, followed by transient or permanent hemiplegia and epilepsy during infancy or early childhood. Seizures are prolonged, difficult to control and sometimes may require surgery. Hemiplegia varies in intensity, differs from Todd paralysis and disappears in about 20% of cases. Neuroimaging characteristically shows brain atrophy more pronounced on the hemisphere contralateral to the side of hemiplegia with dilation of the ventricular system. A 20-month-old girl presented with left hemiconvulsions and left hemiplegia lasting for a prolonged period. Seizures failed to resolve with various anticonvulsants even after many physician contacts. Characteristic neuroimaging findings, seizure control with carbamazepine and valproate, subsequent recovery of hemiplegia and attainment of developmental milestones observed on follow-up confirmed HHE syndrome. The case highlights the need for good seizure control in this syndrome.

  11. The relationships between visit-to-visit blood pressure variability and renal and endothelial function in chronic kidney disease.

    Science.gov (United States)

    Nakano, Chikara; Morimoto, Satoshi; Nakahigashi, Mitsutaka; Kusabe, Makiko; Ueda, Hiroko; Someya, Kazunori; Ichihara, Atsuhiro; Iwasaka, Toshiji; Shiojima, Ichiro

    2015-03-01

    Visit-to-visit blood pressure variability has been shown to be an independent risk factor for cardiovascular diseases. High visit-to-visit blood pressure variability and endothelial dysfunction are observed in patients with chronic kidney disease. It is therefore assumed that high variability in visit-to-visit blood pressure measurements may be associated with endothelial dysfunction in these patients. The present study investigated the associations between visit-to-visit blood pressure variability and renal and endothelial function in patients with chronic kidney disease. We analyzed 150 consecutive patients with predialysis chronic kidney disease who visited our outpatient clinic from January 2006 to December 2010. The study examined the relationships between variability in visit-to-visit systolic blood pressure levels or mean systolic blood pressure (M SBP) and estimated glomerular filtration rate (eGFR) and flow-mediated dilation, an index of endothelial function. Variability in visit-to-visit systolic blood pressure showed a significant negative association with eGFR, independent of age, hemoglobin A1c, low-density lipoprotein (LDL) cholesterol and uric acid, whereas M SBP did not. Similarly, variability in SBP showed a significant negative association with flow-mediated dilation, independent of age, eGFR, HbA1c, LDL cholesterol and M SBP. These data indicate that variability in visit-to-visit blood pressure measurements is associated with impaired renal and endothelial function in patients with chronic kidney disease. This finding suggests that reducing blood pressure fluctuations might have beneficial effects in patients with chronic kidney disease, although this point needs to be addressed by future studies.

  12. Factors Associated With Emergency Department Visits

    Directory of Open Access Journals (Sweden)

    Parul Agarwal

    2016-05-01

    Full Text Available Objective: The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED visits among adult fee-for-service (FFS Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. Methods: A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file. Results: In adjusted analyses, the following patient-level factors were associated with higher number of ED visits: African Americans (incidence rate ratios [IRR] = 1.47, Hispanics (IRR = 1.63, polypharmacy (IRR = 1.89, and tobacco use (IRR = 2.23. Patients with complex chronic illness had a higher number of ED visits (IRR = 3.33. The county-level factors associated with ED visits were unemployment rate (IRR = 0.94 and number of urgent care clinics (IRR = 0.96. Conclusion: Patients with complex healthcare needs had a higher number of ED visits as compared to those without complex healthcare needs. The study results provide important baseline context for future policy analysis studies around Medicaid expansion options.

  13. Commercial Television Exposure, Fast Food Toy Collecting, and Family Visits to Fast Food Restaurants among Families Living in Rural Communities.

    Science.gov (United States)

    Emond, Jennifer A; Bernhardt, Amy M; Gilbert-Diamond, Diane; Li, Zhigang; Sargent, James D

    2016-01-01

    To assess the associations between children's exposure to television (TV) networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants. One hundred parents of children 3-7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's TV viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association. Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (aOR 2.84 for each 1-unit increase in the child's commercial TV viewing scale, P < .001); toy collecting partially mediated that positive association. Higher exposure among children to commercial TV networks that aired child-directed ads for children's fast food meals was associated with more frequent family visits to those fast food restaurants. Child desire for toy premiums may be a mediating factor. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Visit Patterns for Severe Mental Illness with Implementation of Integrated Care: A Pilot Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Meghan Fondow

    2015-12-01

    Full Text Available There is increasing interest in models that integrate behavioral health services into primary care. For patients with severe mental illness (SMI, a population with disproportionate morbidity and mortality, little is known about the impact of such models on primary care clinic utilization, and provider panels. We performed a retrospective cohort pilot study examining visit patterns for 1,105 patients with SMI overall, by provider, before, and after the implementation of a primary care behavioral health model which had a ramp up period from May 2006-August 2007. We used 2003-2012 electronic health record data from two clinics of a Federally Qualified Health Center and conducted interrupted time series and chi-square analyses. During the intervention period there was a significant increase in the proportion of visits per month to the clinic for patient with SMI relative to overall visits (0.27; 95% CI 0.22-0.32. After the intervention period, this rate declined (-0.23; -0.19-0.28 but remained above the pre-intervention period. After integration of behavioral health into our primary care clinics, there was a sharp increase in the number of patients with SMI, suggesting patient willingness to explore receiving care under this model. Clinics looking to adopt the model should be mindful of potential changes in patient subpopulations and proactively manage this transition.

  15. Good rate of clinical response to cholinesterase inhibitors in mild and moderate Alzheimer's disease after three months of treatment: An open-label study

    Directory of Open Access Journals (Sweden)

    Luis Felipe José Ravic de Miranda

    Full Text Available ABSTRACT Life expectancy in Brazil has increased markedly over the last 30 years. Hence, age-related disorders, such as Alzheimer's disease (AD, warrant special attention due to their high prevalence in the elderly. Pharmacologic treatment of AD is based on cholinesterase inhibitors (ChEI and memantine, leading to modest clinical benefits both in the short and long-term. However, clinical response is heterogeneous and needs further investigation. Objective: To investigate the rate of response to ChEI in AD after three months of treatment. Methods: Patients with mild or moderate dementia due to probable AD or to AD associated with cerebrovascular disease were included in the study. The subjects were assessed at baseline and again after three months of ChEI treatment. Subjects were submitted to the Mini-Mental State Examination (MMSE, Mattis Dementia Rating Scale, Katz Basic Activities of Daily Living, Pfeffer Functional Activities Questionnaire, Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Good response was defined by a gain of ≥2 points on the MMSE after three months of treatment in relation to baseline. Results: Seventy-one patients, 66 (93% with probable AD and five (7% with AD associated with cerebrovascular disease, were evaluated. The good response rate at three months was 31.0%, being 37.2% and 21.4% in mild and moderate dementia, respectively. There were no significant differences on most tests, except for improvement in hallucinations, agitation and dysphoria in moderate dementia patients. Conclusion: The rate of good clinical response to ChEI was higher than usually reported. Specific behavioral features significantly improved in the subgroup of moderate dementia.

  16. Commissaire Moulin visits CERN

    CERN Multimedia

    CERN Bulletin

    2014-01-01

    The French actor and film-maker Yves Rénier was shown around the Laboratory on Friday 6 June by friends at CERN.   Yves Rénier at LEIR. (Photo: Ludwig Pregernig) A keen diver and star of the long-running French television police drama Commissaire Moulin, Yves Rénier took advantage of a stopover in Geneva on his way to the Red Sea to meet up with his friends from the CERN Diving Club, who were only too pleased to take him on a tour of the Laboratory. In the morning, Yves Rénier visited the CERN Control Centre (CCC), Linac2 and LEIR. After lunch at the brasserie in Restaurant No. 2, the actor continued his tour with the CERN Computer Centre, the SM18 superconducting magnet test facility, and lastly the ATLAS experiment. “Thank you so much for showing me around and introducing me to a world I knew so little about,” confided Yves Rénier. “It’s fascinating to see so many scientists of different cultures,...

  17. Spaceflight participant visits CERN!

    CERN Document Server

    Kathryn Coldham

    2016-01-01

    On 15 July, CERN welcomed spaceflight participant Anousheh Ansari.   Anousheh Ansari’s grin stretches from ear to ear, during an intriguing conversation with Nobel laureate Samuel C.C. Ting at AMS POCC. (Image: Maximilien Brice/CERN) Iranian-American Anousheh Ansari was the first-ever female spaceflight participant, spending eight days on the International Space Station (ISS) in 2006. She now has a new addition to her list of extraordinary sights ­– the home of the world’s largest particle accelerator: CERN.   On 15 July, Anousheh Ansari came to CERN and, unsurprisingly, visited the control room of the experiment attached to the ISS: the AMS. At the AMS Payload Operations Control Centre (AMS POCC) on CERN’s Prévessin site, she met the Nobel laureate Samuel Ting, spokesperson of the AMS experiment. Ansari and her accompanying guests were thrilled to expand their knowledge about CERN, its research and its...

  18. A royal visit

    CERN Multimedia

    2009-01-01

    On 19 February Albert II, King of the Belgians, visited CERN. He took a very active interest during his tour of the tunnel and the CMS cavern, in particular the pixel detector, which was made in Belgium. var flash_video_player=get_video_player_path(); insert_player_for_external('Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-0753-kbps-640x360-25-fps-audio-64-kbps-44-kHz-stereo', 'mms://mediastream.cern.ch/MediaArchive/Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-Multirate-200-to-753-kbps-640x360-25-fps.wmv', 'false', 533, 300, 'https://mediastream.cern.ch/MediaArchive/Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-posterframe-640x360-at-10-percent.jpg', '1164771', true, 'Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-0600-kbps-maxH-360-25-fps-audio-128-kbps-48-kHz-stereo.mp4'); Watch the video! Albert II, King of the Belgians receiving a souvenir from Sergio Bertolucci, Director for Research and...

  19. Claude Nicollier visits CERN

    CERN Multimedia

    Jordan Juras

    2011-01-01

    Switzerland’s first astronaut, Claude Nicollier, paid a short visit to CERN on Thursday 22 June, to lead a colloquium about the Hubble Space Telescope. With the Shuttle programme soon coming to an end. Nicollier recalled the enriching experience he had at NASA and gave us a preview of the futuristic project that he is currently involved in.   The colloquium, Hubble, the astronomer, the telescope, the results, surveyed the three themes suggested by its title: the fundamental discoveries made by Edwin Hubble in the early 20th century, servicing the telescope in orbit and the main results recently obtained relating to the structure and history of our universe. Nicollier spoke from the rare perspective of an astronaut who has had real contact with Hubble in orbit and included some of his own photography from the missions. Nicollier has an intimate relationship with the telescope that very few astrophysicists share. “I had the opportunity to service Hubble twice, both from the comf...

  20. 上海世博会试运行期间园区内就诊情况回顾性分析%Retrospective Analysis on Clinic Visit Data within Expo Sites during Trial Run of Expo 2010 Shanghai China

    Institute of Scientific and Technical Information of China (English)

    何懿; 何永超; 毛智盛; 潘浩; 孙晓冬

    2011-01-01

    [目的]分析中国2010年上海世博会(简称"上海世博会")试运行期间的园区就诊情况,探讨上海世博会医疗服务特点,为更好地开展大型活动的保障工作积累经验. [方法]收集2010年4月20日至21日、23日至26日上海世博会试运行期间园区内所有5个医疗站的就诊数据,应用描述流行病学方法对上述资料进行统计分析. [结果]6场试运行期间园区5个医疗站累计接诊777例就诊患者,转诊患者58人;平均就诊率为0.71%o,平均转诊率为7.46%.就诊人数居前三位的诊断病种分别是伤害、上呼吸道感染和急性肠胃炎.就诊患者主要集中在浦东片区,以C片区最多.[结论]世博会试运行期间就诊率和转诊率低于国外有关文献报道的大型活动.试运行期间伤害病例占多数,因此开园初期应加强伤害的预防.世博会期间浦东片区尤其是C片区将面临较大的就诊压力,应做好充分的医疗资源配备.%[ Objective ] To analyze the clinic visits in the Expo sites during trial run to identify the characteristics of Expo medical care service and to accumulate experience for future mass gathering security work. [ Methods ] Data were collected from 5 medical stations within the Expo sites during the trail run period, namely April 20th to 21st and 23rd to 26th.Descriptive epidemiological methods were used to analyze the data. [ Results ] There were 777 patient-visits in 5 medical stations during 6 trial runs and 58 patients were tranfered to designated hospitals. The patient presentation rate( PPR )was 0.71%and the transfer to hospital rate was 7.46%. The most common diagnosis were injury, upper respiratory tract infection and acute gastroenteritis. Most of patients visited to Pudong area, especially in C zone. [ Conclusion ] The PPR and transfer rate were lower comparing with other reported mass gatherings events. Injury accounted for most of the clinic visits during trial runs and the injury

  1. Monthly errors

    Data.gov (United States)

    U.S. Environmental Protection Agency — The 2006 monthly average statistical metrics for 2m Q (g kg-1) domain-wide for the base and MODIS WRF simulations against MADIS observations. This dataset is...

  2. Robotic-assisted gait training in Parkinson's disease: a three-month follow-up randomized clinical trial.

    Science.gov (United States)

    Furnari, Anna; Calabrò, Rocco Salvatore; De Cola, Maria Cristina; Bartolo, Michelangelo; Castelli, Alberto; Mapelli, Alessia; Buttacchio, Giampiero; Farini, Elena; Bramanti, Placido; Casale, Roberto

    2017-11-01

    The aim of this study was to evaluate the efficacy of a robotic-assisted gait training (RAGT), together with a conventional exercise program (CEP), to improve PD ambulation, as compared to standard gait training. Thirty-eight patients with mild PD stage (H&Y 2-2.5) were randomly assigned to an experimental group (EG) or a control group. The 19 patients in EG received 30 min RAGT (using Lokomat device), whereas the 19 controls received a conventional gait training; both groups received 30 min of CEP. Participants were evaluated before (T0), immediately after (T1), and 12 weeks after the end of treatment (T2), by using 10-MWT, Tinetti Test and the motor score of the UPDRS-III. We found that Tinetti Walking (TW) (X(2)(3) = 31.75; p Tinetti Balance (X(2)(3) = 74.07; p scores were affected by the type of the rehabilitative treatment. At T2, we found a significant difference between the two groups for TW (t = 2.62; p < 0.02, d = 0.85). Concerning all the study outcomes, a significant improvement was observed from T0 to T1 in both groups. However, the functional motor gain at T2 was maintained only in the EG. RAGT may significantly improve walking ability, motor function and for a maximum period of three months. Thus, our findings support the importance of a RAGT as a valid rehabilitative tool for PD.

  3. Factors associated with patient visits to the emergency department for asthma therapy

    Directory of Open Access Journals (Sweden)

    AL-Jahdali Hamdan

    2012-12-01

    Full Text Available Abstract Background Acute asthma attacks remain a frequent cause of emergency department (ED visits and hospital admission. Many factors encourage patients to seek asthma treatment at the emergency department. These factors may be related to the patient himself or to a health system that hinders asthma control. The aim of this study was to identify the main factors that lead to the frequent admission of asthmatic patients to the ED. Methods A cross-sectional survey of all the patients who visited the emergency room with bronchial asthma attacks over a 9-month period was undertaken at two major academic hospitals. The following data were collected: demographic data, asthma control in the preceding month, where and by whom the patients were treated, whether the patient received education about asthma or its medication and the patients’ reasons for visiting the ED. Result Four hundred fifty (N = 450 patients were recruited, 39.1% of whom were males with a mean age of 42.3 ± 16.7. The mean duration of asthma was 155.90 ± 127.13 weeks. Approximately half of the patients did not receive any information about bronchial asthma as a disease, and 40.7% did not receive any education regarding how to use asthma medication. Asthma was not controlled or partially controlled in the majority (97.7% of the patients preceding the admission to ED. The majority of the patients visited the ED to receive a bronchodilator by nebuliser (86.7% and to obtain oxygen (75.1%. Moreover, 20.9% of the patients believed that the ED managed them faster than the clinic, and 21.1% claimed that their symptoms were severe enough that they could not wait for a clinic visit. No education about asthma and uncontrolled asthma are the major factors leading to frequent ED visits (three or more visits/year, p-value = 0.0145 and p-value = 0.0003, respectively. Asthma control also exhibited a significant relationship with inhaled corticosteroid ICS use (p-value =0

  4. Treatment and outcomes of an Australian cohort of outpatients with bipolar I or schizoaffective disorder over twenty-four months: implications for clinical practice

    Directory of Open Access Journals (Sweden)

    Kulkarni Jayashri

    2012-12-01

    Full Text Available Abstract Background The Bipolar Comprehensive Outcomes Study (BCOS is a 2-year, prospective, non-interventional, observational study designed to explore the clinical and functional outcomes associated with ‘real-world’ treatment of participants with bipolar I or schizoaffective disorder. All participants received treatment as usual. There was no study medication. Methods Participants prescribed either conventional mood stabilizers (CMS; n = 155 alone, or olanzapine with, or without, CMS (olanzapine ± CMS; n = 84 were assessed every 3 months using several measures, including the Young Mania Rating Scale, 21-item Hamilton Depression Rating Scale, Clinical Global Impressions Scale – Bipolar Version, and the EuroQol Instrument. This paper reports 24-month longitudinal clinical, pharmacological, functional, and socioeconomic data. Results On average, participants were 42 (range 18 to 79 years of age, 58%; were female, and 73%; had a diagnosis of bipolar I. Polypharmacy was the usual approach to pharmacological treatment; participants took a median of 5 different psychotropic medications over the course of the study, and spent a median proportion of time of 100%; of the study on mood stabilizers, 90%; on antipsychotics, 9%; on antidepressants, and 5%; on benzodiazepines/hypnotics. By 24 months, the majority of participants had achieved both symptomatic and syndromal remission of both mania and depression. Symptomatic relapse rates were similar for both the CMS alone (65%; and the olanzapine ± CMS (61%; cohorts. Conclusions Participants with bipolar I or schizoaffective disorder in this study were receiving complex medication treatments that were often discordant with recommendations made in contemporary major treatment guidelines. The majority of study participants demonstrated some clinical and functional improvements, but not all achieved remission of symptoms or syndrome.

  5. Effects of Contemplative Dyads on Engagement and Perceived Social Connectedness Over 9 Months of Mental Training: A Randomized Clinical Trial.

    Science.gov (United States)

    Kok, Bethany E; Singer, Tania

    2017-02-01

    Loneliness is a risk factor for depression and other illnesses and may be caused and reinforced by maladaptive social cognition. Secularized classical meditation training programs address social cognition, but practice typically occurs alone. Little is known about the effectiveness of contemplative practice performed in dyads. To introduce and assess the effectiveness of contemplative dyadic practices relative to classical-solitary meditation with regard to engagement and perceived social connectedness. The ReSource Project was a 9-month open-label efficacy trial of three, 3-month secularized mental training modules. Replacement randomization was used to assign 362 healthy participants in Leipzig and Berlin, Germany. Eligible participants were recruited between November 11, 2012, and February 13, 2013, and between November 13, 2013, and April 30, 2014. Intention-to-treat analyses were conducted. Breathing meditation and body scan (the presence module), loving-kindness meditation and affect dyad (the affect module), and observing-thoughts meditation and perspective dyad (the perspective module). Primary outcomes were self-disclosure and social closeness. Engagement measures included compliance (ie, the mean [95% margin of error] number of meditation sessions that a participant engaged in per week), liking, and motivation to practice. Thirty participants dropped out after assignment to 3 experimental groups; 90 participants were assigned to a retest control that did not complete the main outcome measures; 16 participants provided no state-change data for the affect and perspective modules (226 remaining participants; mean age of 41.15 years; 59.3% female). Results are aggregated across training cohorts. Compliance was similar across the modules: loving-kindness meditation (3.78 [0.18] sessions), affect dyad (3.59 [0.14] sessions), observing-thoughts meditation (3.63 [0.20] sessions), and perspective dyad (3.24 [0.18] sessions). Motivation was higher for meditation

  6. Effect of kangaroo mother care on growth and development of low birthweight babies up to 12 months of age: a controlled clinical trial.

    Science.gov (United States)

    Bera, Alpanamayi; Ghosh, Jagabandhu; Singh, Arun K; Hazra, Avijit; Mukherjee, Suchandra; Mukherjee, Ranajit

    2014-06-01

    Kangaroo mother care (KMC) is a nonconventional low-cost method of newborn care. Our aim was to assess the effect of sustained KMC on the growth and development of low birthweight Indian babies up to the age of 12 months. We enrolled 500 mother and baby pairs, in groups of five, in a parallel group controlled clinical trial. The three infants with the lowest birthweight in each group received KMC, while the other two received conventional care. All babies were exclusively breastfed for 6 months. Babies in the intervention group were provided KMC until the infant was 40 weeks of corrected gestation or weighed 2500 g. Weight, length and head, chest and arm circumferences were evaluated at birth and at the corrected ages of 0, 3, 6, 9 and 12 months. Development was assessed using the Developmental Assessment Scales for Indian Infants (DASII) at 12 months. The KMC babies rapidly achieved physical growth parameters similar to the control babies at 40 weeks of corrected age. But after that, they surpassed them, despite being smaller at birth. DASII motor and mental development quotients were also significantly better for KMC babies. The infants in the KMC group showed better physical growth and development than the conventional control group. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  7. Occupational therapy predischarge home visits for patients with a stroke (HOVIS): results of a feasibility randomized controlled trial.

    Science.gov (United States)

    Drummond, A E R; Whitehead, P; Fellows, K; Sprigg, N; Sampson, C J; Edwards, C; Lincoln, N B

    2013-05-01

    To assess the feasibility of conducting a randomized controlled trial of occupational therapy predischarge home visits for people after stroke. Randomized controlled trial and cohort study. We randomized eligible patients for whom there was clinical uncertainty about the need to conduct a home visit to a randomized controlled trial; patients for whom a visit was judged 'essential' were enrolled into a cohort study. Stroke rehabilitation unit of teaching hospital. One hundred and twenty-six participants hospitalized following recent stroke. Predischarge home visit or structured, hospital-based interview. The primary objective was to collect information on the feasibility of a randomized controlled trial, including eligibility, control intervention and outcome assessments. The primary outcome measure was the Nottingham Extended Activities of Daily Living Scale at one month after discharge from hospital. Secondary outcomes included mood, quality of life and costs at one week and one month following discharge. Ninety-three people were allocated to the randomized controlled trial; 47 were randomized to intervention and 46 to control. Thirty-three were enrolled into the cohort study. More people were allocated to the randomized controlled trial as the study progressed. One hundred and thirteen people (90%) received the proposed intervention, although there was a need for stricter protocol adherence. Follow-up was good: at one month 114 (90%) were assessed. There were no significant differences between the groups in the randomized controlled trial for the primary outcome measure at one month. The average cost of a home visit was £208. A trial is feasible and warranted given the resource implications of predischarge occupational therapy home visits.

  8. Differential Effects of Acetylcholinesterase Inhibitors on Clinical Responses and Cerebral Blood Flow Changes in Patients with Alzheimer's Disease: A 12-Month, Randomized, and Open-Label Trial

    Directory of Open Access Journals (Sweden)

    Soichiro Shimizu

    2015-04-01

    Full Text Available Background/Aims: The present study evaluated the differences in treatment outcomes and brain perfusion changes among 3 types of acetylcholinesterase inhibitors (AchEIs, i.e. donepezil, rivastigmine, and galantamine. Methods: This was a prospective, longitudinal, randomized, open-label, 3-arm (donepezil, rivastigmine, or galantamine, parallel-group, 12-month clinical trial carried out in 55 patients with AD. Results: At 6 months, the results of the Mini-Mental State Examination (MMSE and the Trail Making Test (TMT-Part A showed an improvement versus baseline in the donepezil treatment group. All groups showed a significant increase in regional cerebral blood flow (rCBF, mainly in the frontal lobe. Significant rCBF reduction was observed in the temporal lobe and cingulate gyrus in all 3 groups. Conclusion: AchEI treatment prevents the progression of cognitive impairment and increases the relative rCBF in the frontal lobe.

  9. The effect of a dentifrice containing Magnolia extract on established plaque and gingivitis in man: a six-month clinical study.

    Science.gov (United States)

    Hellström, M-K; Ramberg, P

    2014-05-01

    The aim was to evaluate the clinical effect of a dentifrice containing 0.3% Magnolia extract on dental plaque and gingivitis. The trial was a 6-month double-blind, stratified, randomized and 2-armed parallel group study. Forty-six subjects in the test group brushed their teeth with a dentifrice containing 0.3% Magnolia extract and 48 subjects in the control group brushed with a placebo dentifrice. Plaque and gingivitis were assessed at baseline, 3 and 6 months. There was a significantly larger gingivitis reduction in the Magnolia group than in the control group (0.26 ± 0.11 versus 0.11 ± 0.12) (P dentifrice containing 0.3% Magnolia extract resulted in significantly greater gingivitis reduction than a corresponding control dentifrice. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Impact of comorbidity on three month follow-up outcome of children with ADHD in a child guidance clinic: Preliminary report

    Directory of Open Access Journals (Sweden)

    Rangan Srinivasaraghavan

    2013-01-01

    Full Text Available Context: Attention deficit hyperactivity disorder (ADHD is one of the common neurodevelopmental disorders. Aims: Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic. Settings and Design: This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children. Materials and Methods: Children attending pediatric department with behavioral problems or poor scholastic performance were screened for ADHD and further confirmation of diagnosis was done by semistructured interview of the child and parent. Children functional assessment and ADHD symptom profile was compared at baseline and at follow-up. We screened for and excluded those showing autistic spectrum disorder and having worse than mild mental retardation. Baseline variables were compared between improved and not improved subgroups and impact of these variables on outcome at 3-month follow-up was analyzed. Statistical Analysis: Descriptive statistics. Results: Of the 25 children completing the study, at the end of 3 months, 15 improved (not fulfilling criteria for ADHD and 10 did not improve. Applying Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS for diagnosis of psychiatric comorbidities, six had associated psychiatric comorbidities. This was significantly higher in those who did not improve. Conclusions: Presence of comorbidities at baseline was found to affect outcome at 3 month assessment in this preliminary study. Future studies with larger sample and longer follow-up are needed for finding the predictors of outcome in ADHD children in developing nations.

  11. Effect of Bone Marrow-Derived Mononuclear Cell Treatment, Early or Late After Acute Myocardial Infarction: Twelve Months CMR and Long-Term Clinical Results.

    Science.gov (United States)

    Sürder, Daniel; Manka, Robert; Moccetti, Tiziano; Lo Cicero, Viviana; Emmert, Maximilian Y; Klersy, Catherine; Soncin, Sabrina; Turchetto, Lucia; Radrizzani, Marina; Zuber, Michel; Windecker, Stephan; Moschovitis, Aris; Bühler, Ines; Kozerke, Sebastian; Erne, Paul; Lüscher, Thomas F; Corti, Roberto

    2016-07-22

    Intracoronary delivery of autologous bone marrow-derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction (AMI). To demonstrate long-term efficacy of BM-MNC treatment after AMI. In a multicenter study, we randomized 200 patients with large AMI in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were either administered 5 to 7 days (early) or 3 to 4 weeks (late) after AMI. Cardiac magnetic resonance imaging was performed at baseline and after 12 months. The current analysis investigates the change from baseline to 12 months in global LV ejection fraction, LV volumes, scar size, and N-terminal pro-brain natriuretic peptide values comparing the 2 treatment groups with control in a linear regression model. Besides the complete case analysis, multiple imputation analysis was performed to address for missing data. Furthermore, the long-term clinical event rate was computed. The absolute change in LV ejection fraction from baseline to 12 months was -1.9±9.8% for control (mean±SD), -0.9±10.5% for the early treatment group, and -0.7±10.1% for the late treatment group. The difference between the groups was not significant, both for complete case analysis and multiple imputation analysis. A combined clinical end point occurred equally in all the groups. Overall, 1-year mortality was low (2.25%). Among patients with AMI and LV dysfunction, treatment with BM-MNC either 5 to 7 days or 3 to 4 weeks after AMI did not improve LV function at 12 months, compared with control. The results are limited by an important drop out rate. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186. © 2016 American Heart Association, Inc.

  12. Hanford Laboratories monthly activities report, August 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-09-16

    This is the monthly report for the Hanford Laboratories Operation, August 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  13. Hanford Laboratories monthly activities report, July 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-08-15

    This is the monthly report for the Hanford Laboratories Operation, July 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  14. Hanford Laboratories monthly activities report, June 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-07-15

    This is the monthly report for the Hanford Laboratories Operation, June 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  15. Hanford Laboratories monthly activities report, September 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-10-15

    This is the monthly report for the Hanford Laboratories Operation, September 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  16. Hanford Laboratories monthly activities report, October 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-11-15

    This is the monthly report for the Hanford Laboratories Operation, October 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  17. Hanford Laboratories monthly activities report, November 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-12-16

    This is the monthly report for the Hanford Laboratories Operation, November 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  18. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as <\\/=53 nmol\\/l and severe deficiency as <\\/=25 nmol\\/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged >\\/=65 and 78% of patients aged <\\/=30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases\\/connective tissue diseases (IJD\\/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD\\/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD\\/CTD warrants further attention.

  19. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    Science.gov (United States)

    Haroon, Muhammad; Bond, Ursula; Quillinan, Niamh; Phelan, Mark J; Regan, Michael J

    2011-06-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as ≤53 nmol/l and severe deficiency as ≤25 nmol/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged ≥65 and 78% of patients aged ≤30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases/connective tissue diseases (IJD/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD/CTD warrants further attention.

  20. Home Visiting in Two Cultures

    Science.gov (United States)

    Lamorey, Suzanne

    2017-01-01

    The home visiting component of early childhood education programs provides an important portal through which to observe family interactions as well as gain insights about the ethnotheories of the home visitor. Home visits were videotaped in the United States and in Turkey to analyze training and program effectiveness. One striking feature of this…

  1. Effectiveness of Comprehensive Geriatric Assessment-Based Intervention to Reduce Frequent Emergency Department Visits: A Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Mei-Chen Liao

    2012-06-01

    Full Text Available A small number of clustered visits by emergency department frequent users (EDFUs may over-consume emergency care resources. We report the effectiveness of comprehensive geriatric assessment (CGA-based multidisciplinary team (MDT care for four EDFUs, in reducing ED visits. Case 1 had visited the ED twice/month due to chest discomfort. Her ED visits were significantly reduced to 0.2 visits/month following CGA-based MDT care. Case 2 had failed back surgery syndrome and bipolar disorder. His ED visit was reduced from 2.8 visits to 0.8 visits/month following CGA-based MDT intervention. Case 3 had chronic obstructive pulmonary disease, heart failure, and urinary incontinence, with a urinary catheter in place. He made 31 ED visits (5.1 visits/month before his lung cancer and depression were discovered by CGA. He died 2 months later. Case 4 made 27 ED visits (2.7 visits/month due to dizziness. His problems of early dementia and neglect were identified by CGA, and he visited the ED only once following MDT intervention. In conclusion, CGA-based MDT intervention successfully reduced ED visits among these EDFUs, but further investigation is needed to evaluate the effectiveness of geriatric services in the ED.

  2. Arthritis as a hypersensitivity reaction in a case of sporotrichosis transmitted by a sick cat: clinical and serological follow up of 13 months.

    Science.gov (United States)

    Orofino-Costa, R; Bóia, M N; Magalhães, G A P; Damasco, P S; Bernardes-Engemann, A R; Benvenuto, F; Silva, I C; Lopes-Bezerra, L M

    2010-01-01

    Sporotrichosis is a subacute or chronic fungal infection caused by Sporothrix schenckii, which is commonly acquired by traumatic inoculation of the fungus carried in a contaminated material into the skin. Joint involvement is the most frequent extracutaneous manifestation in immunosuppressed patients. We report the case of an immunocompetent woman who acquired sporotrichosis through the scratch of a sick cat. She presented skin lesions and arthritis possibly because of a hypersensitivity reaction. Treatment resulted in complete cure up to 13 months of clinical and serological follow-up.

  3. Possibly enhanced Gd-excretion in dialysate, but no clinical benefit of 3-5 months treatment with sodium thiosulfate in nephrogenic systemic fibrosis

    DEFF Research Database (Denmark)

    Marckmann, P.; Nielsen, A.H.; Sloth, Jens Jørgen

    2008-01-01

    -5 months. Symptoms and patients' experiences were investigated. The dialysate Gd content was monitored. Results. We observed no major clinical improvements in any patient. In one patient, we found slightly improved joint motion. Two patients had a subjective impression of slight improvements of joint...... motion and skin abnormalities. The dialysate Gd content was raised by the treatment, up to fivefold. Conclusions. We could not confirm that sodium thiosulfate treatment results in marked and rapid improvement in late stages of Gd-related nephrogenic systemic fibrosis. However, dialysate contents of Gd...

  4. Possibly enhanced Gd excretion in dialysate, but no major clinical benefit of 3-5 months of treatment with sodium thiosulfate in late stages of nephrogenic systemic fibrosis

    DEFF Research Database (Denmark)

    Marckmann, P.; Sloth, J.J.; Nielsen, Arne Høj

    2008-01-01

    -5 months. Symptoms and patients' experiences were investigated. The dialysate Gd content was monitored. Results. We observed no major clinical improvements in any patient. In one patient, we found slightly improved joint motion. Two patients had a subjective impression of slight improvements of joint...... motion and skin abnormalities. The dialysate Gd content was raised by the treatment, up to fivefold. Conclusions. We could not confirm that sodium thiosulfate treatment results in marked and rapid improvement in late stages of Gd-related nephrogenic systemic fibrosis. However, dialysate contents of Gd...

  5. 150 Bulgarian students visit CERN

    CERN Multimedia

    Alizée Dauvergne

    2010-01-01

    Between 27 March and 8 April 2010, 150 Bulgarian students from the Astronomical Observatory in Varna visited CERN as part of the “From Galileo to CERN” programme. Bulgarian students participating in the "From Galileo to CERN" educational programme. “It’s interesting to combine astronomy and particle physics”, explains Svejina Dimitrova, organiser of the programme and Director of Varna Astronomical Observatory. The three groups, each one comprising 50 students, first visited Pisa, Padua and other places in Italy  related to Galileo’s life. “Thanks to the visit, students understood telescopes and why Galileo is such an important scientist”, says Svejina. After Italy, they came to CERN for three days and visited several sites: Linac, the Computer Centre CCC, etc. Another group of Bulgarian students in their visit to CERN. “They became aware that particle physics is not only the...

  6. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study.

    Science.gov (United States)

    Sawant, Ajinkya; Chunawalla, Yusuf; Morawala, Abdul; S Kanchan, Nupur; Jain, Kapil; Talathi, Rohan

    2017-01-01

    Early childhood caries discloses a distinct clinical pattern, and the teeth most often involved are the maxillary central incisors, lateral incisors, and the maxillary and man-dibular first molars. The maxillary incisors are most severely affected, with deep carious lesions usually involving the pulp. Teeth that have been endodontically treated often have little coronal tooth tissue remaining and as such require a post to retain the core and restoration .This study evaluated and compared the efficacy of EverStick glass fiber-reinforced composite post with ParaPost Taper Lux in primary maxillary anterior teeth. An in vivo study was conducted to evaluate and compare the longevity and failures of two fiber post systems in primary maxillary anterior teeth. A total of 60 severely mutilated primary maxillary anterior teeth from children aged 3 to 5 years were selected according to the inclusion criteria. These teeth were treated endodontically and were randomly assigned into two groups with 30 samples in each group, group I: EverStick glass fiber-reinforced composite post, group II: ParaPost Taper Lux post. The evaluation of dislodgment of posts, secondary caries, root fracture, and post fracture was carried out clinically and radiographically during every follow-up at 3, 6, 9, and 12 months interval. Statistical tests (Chi-square test, Fisher's exact probability test) suggested that dislodgment of the posts was significant between the two groups at 6, 9, and 12 months follow-ups. But within the group during subsequent follow-up intervals, dislodgment of posts as a mode of failure was not statistically significant. However, clinically failures were seen in both the study groups. Fiber post system has proved to be successful clinically in both primary and permanent teeth due to the mono-block effect with luting agent, post system, core material, and bonding to dentin. Thus, today the EverStick glass fiber post system provides a novel way of fabricating cost-effective and

  7. The clinical efficacy of Colgate Total Plus Whitening Toothpaste containing a special grade of silica and Colgate Total Fresh Stripe Toothpaste in the control of plaque and gingivitis: a six-month clinical study.

    Science.gov (United States)

    Allen, Donald R; Battista, Guido W; Petrone, Dolores M; Petrone, Margaret E; Chaknis, Patricia; DeVizio, William; Volpe, Anthony R

    2002-01-01

    The objective of this six-month, placebo-controlled, double-blind clinical study, conducted in harmony with American Dental Association guidelines, was to provide an assessment of the effectiveness of a new dentifrice formulation of Colgate Total Toothpaste containing a special grade of silica (Colgate Total Plus Whitening Toothpaste), vs. Colgate Total Fresh Stripe Toothpaste as a control, and a placebo dentifrice without triclosan and the copolymer, for the control of supragingival dental plaque and gingivitis. Adult male and female subjects from the state of New Jersey were entered into the study, and stratified into three treatment groups which were balanced for baseline Quigley-Hein Plaque Index scores and baseline Löe-Silness Gingival Index scores. Subjects received an oral prophylaxis, and were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice, using a soft-bristled toothbrush. Examinations for supragingival plaque and gingivitis were conducted after three-months' and again after six-months' participation in the study. One-hundred ten (110) subjects complied with the protocol and completed the entire six-month clinical study. At both the three- and six-month study examinations, the Colgate Total Plus Whitening Toothpaste group and the Colgate Total Fresh Stripe Toothpaste group exhibited statistically significantly less supragingival plaque and gingivitis than did the placebo toothpaste group. At the six-month examination, the magnitude of these differences exceeded 23.0% for all four parameters measured in the Colgate Total Plus Whitening Toothpaste group (29.9% for Plaque Index, 59.2% for Plaque Severity Index, 23.2% for Gingival Index, and 75.1% for Gingivitis Severity Index). Also, at the six-month examination, the magnitude of these differences exceeded 21.0% for each of the four parameters measured in the Colgate Total Fresh Stripe Toothpaste group (27.9% for Plaque Index, 54.9% for Plaque

  8. Six months of daily high-dose xylitol in high-risk schoolchildren: a randomized clinical trial on plaque pH and salivary mutans streptococci.

    Science.gov (United States)

    Campus, G; Cagetti, M G; Sacco, G; Solinas, G; Mastroberardino, S; Lingström, P

    2009-01-01

    A randomized clinical trial was designed to evaluate the effect of daily high-dose xylitol chewing gum on plaque pH and salivary mutans streptococci (MS) in a sample of schoolchildren at high risk of caries. The study was performed on 204 subjects (acceptance rate 88.3%). Inclusion criteria were: >1 and salivary MS concentration >10(5) CFU/ml. Subjects were randomly assigned to the xylitol or control group. Study design included one examination at baseline (t(0)), one after 3 months of chewing (t(1)), one after 6 months of chewing (t(2)) and the last 3 months after the end of chewing period (t(3)). Plaque pH was assessed using the MicroTouch technique, following a sucrose challenge. The area under the curve (AUC(5.7) and AUC(6.2)) was recorded. Whole saliva was collected in sterile vials and MS CFU/ml were counted. Data were analysed using repeated-measures ANOVA. The main result was that plaque acidogenicity was reduced in both groups. The differences between treatments were statistically significant both for plaque pH and MS concentration; the interaction term for treatment and time was statistically significant (p salivary MS concentration >10(5) and those with pH, and that this effect was statistically greater when using xylitol chewing gums, both on plaque pH and MS salivary concentration.

  9. Effects of Delayed Umbilical Cord Clamping vs Early Clamping on Anemia in Infants at 8 and 12 Months: A Randomized Clinical Trial.

    Science.gov (United States)

    Kc, Ashish; Rana, Nisha; Målqvist, Mats; Jarawka Ranneberg, Linda; Subedi, Kalpana; Andersson, Ola

    2017-03-01

    Delayed umbilical cord clamping has been shown to improve iron stores in infants to 6 months of age. However, delayed cord clamping has not been shown to prevent iron deficiency or anemia after 6 months of age. To investigate the effects of delayed umbilical cord clamping, compared with early clamping, on hemoglobin and ferritin levels at 8 and 12 months of age in infants at high risk for iron deficiency anemia. This randomized clinical trial included 540 late preterm and term infants born vaginally at a tertiary hospital in Kathmandu, Nepal, from October 2 to November 21, 2014. Follow-up included blood levels of hemoglobin and ferritin at 8 and 12 months of age. Follow-up was completed on December 11, 2015. Analysis was based on intention to treat. Infants were randomized to delayed umbilical cord clamping (≥180 seconds after delivery) or early clamping (≤60 seconds after delivery). Main outcomes included hemoglobin and anemia levels at 8 months of age with the power estimate based on the prevalence of anemia. Secondary outcomes included hemoglobin and anemia levels at 12 months of age and ferritin level, iron deficiency, and iron deficiency anemia at 8 and 12 months of age. In this study of 540 infants (281 boys [52.0%] and 259 girls [48.0%]; mean [SD] gestational age, 39.2 [1.1] weeks), 270 each were randomized to the delayed and early clamping groups. At 8 months of age, 212 infants (78.5%) from the delayed group and 188 (69.6%) from the early clamping group returned for blood sampling. After multiple imputation analysis, infants undergoing delayed clamping had higher levels of hemoglobin (10.4 vs 10.2 g/dL; difference, 0.2 g/dL; 95% CI, 0.1 to 0.4 g/dL). Delayed cord clamping also reduced the prevalence of anemia (hemoglobin level clamping group in 60 (22.2%) vs 103 (38.1%) patients (relative risk, 0.58; 95% CI, 0.44-0.77; NNT, 6; 95% CI, 4-13). At 12 months, delayed cord clamping still resulted in a hemoglobin level of 0.3 (95% CI, 0.04-0.5) g/dL higher

  10. Protected Area Tourism in a Changing Climate: Will Visitation at US National Parks Warm Up or Overheat?

    Directory of Open Access Journals (Sweden)

    Nicholas A Fisichelli

    Full Text Available Climate change will affect not only natural and cultural resources within protected areas but also tourism and visitation patterns. The U.S. National Park Service systematically collects data regarding its 270+ million annual recreation visits, and therefore provides an opportunity to examine how human visitation may respond to climate change from the tropics to the polar regions. To assess the relationship between climate and park visitation, we evaluated historical monthly mean air temperature and visitation data (1979-2013 at 340 parks and projected potential future visitation (2041-2060 based on two warming-climate scenarios and two visitation-growth scenarios. For the entire park system a third-order polynomial temperature model explained 69% of the variation in historical visitation trends. Visitation generally increased with increasing average monthly temperature, but decreased strongly with temperatures > 25°C. Linear to polynomial monthly temperature models also explained historical visitation at individual parks (R2 0.12-0.99, mean = 0.79, median = 0.87. Future visitation at almost all parks (95% may change based on historical temperature, historical visitation, and future temperature projections. Warming-mediated increases in potential visitation are projected for most months in most parks (67-77% of months; range across future scenarios, resulting in future increases in total annual visits across the park system (8-23% and expansion of the visitation season at individual parks (13-31 days. Although very warm months at some parks may see decreases in future visitation, this potential change represents a relatively small proportion of visitation across the national park system. A changing climate is likely to have cascading and complex effects on protected area visitation, management, and local economies. Results suggest that protected areas and neighboring communities that develop adaptation strategies for these changes may be able

  11. Protected Area Tourism in a Changing Climate: Will Visitation at US National Parks Warm Up or Overheat?

    Science.gov (United States)

    Fisichelli, Nicholas A; Schuurman, Gregor W; Monahan, William B; Ziesler, Pamela S

    2015-01-01

    Climate change will affect not only natural and cultural resources within protected areas but also tourism and visitation patterns. The U.S. National Park Service systematically collects data regarding its 270+ million annual recreation visits, and therefore provides an opportunity to examine how human visitation may respond to climate change from the tropics to the polar regions. To assess the relationship between climate and park visitation, we evaluated historical monthly mean air temperature and visitation data (1979-2013) at 340 parks and projected potential future visitation (2041-2060) based on two warming-climate scenarios and two visitation-growth scenarios. For the entire park system a third-order polynomial temperature model explained 69% of the variation in historical visitation trends. Visitation generally increased with increasing average monthly temperature, but decreased strongly with temperatures > 25°C. Linear to polynomial monthly temperature models also explained historical visitation at individual parks (R2 0.12-0.99, mean = 0.79, median = 0.87). Future visitation at almost all parks (95%) may change based on historical temperature, historical visitation, and future temperature projections. Warming-mediated increases in potential visitation are projected for most months in most parks (67-77% of months; range across future scenarios), resulting in future increases in total annual visits across the park system (8-23%) and expansion of the visitation season at individual parks (13-31 days). Although very warm months at some parks may see decreases in future visitation, this potential change represents a relatively small proportion of visitation across the national park system. A changing climate is likely to have cascading and complex effects on protected area visitation, management, and local economies. Results suggest that protected areas and neighboring communities that develop adaptation strategies for these changes may be able to both

  12. Six-month clinical outcomes of Firebird 2TM sirolimus-eluting stent implantation in real-world patients with coronary artery diseases

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo; ZHANG Feng; QIAN Ju-ying; GE Lei; LIU Xue-bo; ZHOU Jun

    2011-01-01

    Background The Firebird 2TM sirolimus-eluting stent (Firebird 2 stent) is a second-generation sirolimus-eluting stent which has a cobalt-chromium alloy stent platform, a brand new bracket structure, and two layers of styrene-butylenes-styrene polymer coatings with better biocompatibility. The Firebird 2TM cObalt-Chromium alloy sirolimus-elUting Stent registry (FOCUS registry) aimed to evaluate the safety and efficacy of the Firebird 2 stent in patients with coronary artery disease in daily practice.Methods The FOCUS registry is a prospective, non-randomized, international multi-center, single-arm clinical registry.Between March 2009 and February 2010, 5084 patients receiving at least 1 Firebird 2 stent during daily clinical practice at 83 medical centers were enrolled.Results Of the 5084 patients enrolled in the registry, 5077 and 5058 were respectively available for 30 days and 6 months follow-up. The 30-day rate of major adverse cardiac events (MACE) was 1.20%, including 13 cardiac deaths, 46 non-fatal myocardial infarction (MI), and 6 target vessel revascularization (TVR). At 6 months follow-up, the rate of MACE was 1.80%. There were 32 cardiac deaths, 48 non-fatal MI, and 15 TVR. According to the Academic Research Consortium definition, definite/probable stent thrombosis (ST) occurred in 0.43% (22/5058) of patients, including 8 cases of acute ST, 11 subacute ST, and 3 late ST.Conclusion The Firebird 2 stent showed the promising efficacy and safety at 30 days and 6 months in a real-world population of patients with coronary artery diseases.

  13. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up.

    Science.gov (United States)

    Luijsterburg, Pim A J; Verhagen, Arianne P; Ostelo, Raymond W J G; van den Hoogen, Hans J M M; Peul, Wilco C; Avezaat, Cees J J; Koes, Bart W

    2008-04-01

    A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2) the control group with general practitioners' care only. To assess the effectiveness of PT additional to general practitioners' care compared to general practitioners' care alone, in patients with acute sciatica. There is a lack of knowledge concerning the effectiveness of PT in patients with sciatica. The primary outcome was patients' global perceived effect (GPE). Secondary outcomes were severity of leg and back pain, severity of disability, general health and absence from work. The outcomes were measured at 3, 6, 12 and 52 weeks after randomisation. At 3 months follow-up, 70% of the intervention group and 62% of the control group reported improvement (RR 1.1; 95% CI 0.9-1.5). At 12 months follow-up, 79% of the intervention group and 56% of the control group reported improvement (RR 1.4; 95% CI 1.1; 1.8). No significant differences regarding leg pain, functional status, fear of movement and health status were found at short-term or long-term follow-up. At 12 months follow-up, evidence was found that PT added to general practitioners' care is only more effective regarding GPE, and not more cost-effective in the treatment of patients with acute sciatica than general practitioners' care alone. There are indications that PT is especially effective regarding GPE in patients reporting severe disability at presentation.

  14. Effect of delayed vs early umbilical cord clamping on iron status and neurodevelopment at age 12 months: a randomized clinical trial.

    Science.gov (United States)

    Andersson, Ola; Domellöf, Magnus; Andersson, Dan; Hellström-Westas, Lena

    2014-06-01

    Prevention of iron deficiency in infancy may promote neurodevelopment. Delayed cord clamping (DCC) can prevent iron deficiency during the first 6 months of life. However, no data are available on long-term effects on infant outcomes in relation to time for umbilical cord clamping. To investigate effects of DCC, as compared with early cord clamping (ECC), on infant iron status and neurodevelopment at age 12 months in a European setting. Randomized clinical trial of 382 full-term infants born after a low-risk pregnancy at a Swedish county hospital. Follow-up at 12 months included evaluation of iron status (ferritin level, transferrin saturation, transferrin receptor level, reticulocyte hemoglobin level, and mean cell volume) and parental assessment of neurodevelopment by the Ages and Stages Questionnaire, second edition (ASQ). Infants were randomized to DCC (≥180 seconds after delivery) or ECC (≤10 seconds after delivery). The main outcome was iron status at age 12 months; the secondary outcome was ASQ score. In total, 347 of 382 infants (90.8%) were assessed. The DCC and ECC groups did not differ in iron status (mean ferritin level, 35.4 vs 33.6 ng/mL, respectively; P = .40) or neurodevelopment (mean ASQ total score, 229.6 vs 233.1, respectively; P = .42) at age 12 months. Predictors of ferritin levels were infant sex and ferritin in umbilical cord blood. Predictors of ASQ score were infant sex and breastfeeding within 1 hour after birth. For both outcomes, being a boy was associated with lower results. Interaction analysis showed that DCC was associated with an ASQ score 5 points higher among boys (mean [SD] score, 229 [43] for DCC vs 224 [39] for ECC) but 12 points lower among girls (mean [SD] score, 230 [39] for DCC vs 242 [36] for ECC), out of a maximum of 300 points (P = .04 for the interaction term). Delayed cord clamping did not affect iron status or neurodevelopment at age 12 months in a selected population of healthy term-born infants

  15. SM18 Visits and Access

    CERN Multimedia

    2012-01-01

      VISITS The rules and conditions to be followed for visits in the SM18 Hall are laid out in the EDMS 1205328 document. No visit is allowed without prior reservation.   ACCESS Special access right is needed ONLY from 7 p.m. to 7 a.m. and during week-ends. From 1 December, the current SM18 access database will be closed and a new one “SM18-OWH outside normal hours” started from scratch. Requests, via EDH SM18-OWH, will have to be duly justified.   For further information, please contact Evelyne Delucinge.

  16. Cost-utility of a visiting service for older widowed individuals: Randomised trial

    Directory of Open Access Journals (Sweden)

    Willemse Godelief

    2008-06-01

    Full Text Available Abstract Background Despite a growing understanding of the effectiveness of bereavement interventions and the groups that benefit most from them, we know little about the cost-effectiveness of bereavement interventions. Methods We conducted a cost-utility analysis alongside a randomized clinical trial on a visiting service for older widowed individuals (n = 110 versus care as usual (CAU; n = 106. The visiting service is a selective bereavement intervention that offers social support to lonely widows and widowers by a trained volunteer. Participants were contacted 6–9 months post-loss. Eleven percent of all contacted persons responded and eight percent participated in the trial. The primary outcome measure was quality adjusted life years (QALYs gained (assessed with the EQ-5D, which is a generic measure of health status. Costs were calculated from a societal perspective excluding costs arising from productivity losses. Using the bootstrap method, we obtained the incremental cost utility ratio (ICUR, projected these on a cost-utility plane and presented as an acceptability curve. Results Overall, the experimental group demonstrated slightly better results against slightly higher costs. Whether the visiting service is acceptable depends on the willingness to pay: at a willingness to pay equal to zero per QALY gained, the visiting service has a probability of 31% of being acceptable; beyond €20,000, the visiting service has a probability of 70% of being more acceptable than CAU. Conclusion Selective bereavement interventions like the visiting service will not produce large benefits from the health economic point of view, when targeted towards the entire population of all widowed individuals. We recommend that in depth analyses are conducted to identify who benefits most from this kind of interventions, and in what subgroups the incremental cost-utility is best. In the future bereavement interventions are then best directed to these groups. Trial

  17. Home visits: why do rates vary so much?

    LENUS (Irish Health Repository)

    Stewart, P

    2012-03-01

    Data including information on patient age, gender, who initiated the visit and call classification was collected during office hours from 12 G.P. rural teaching practices with a combined GMS patient population of 24,720, over a 2 month period. There were a total of 603 home visits, giving an annual visiting rate of 143\\/1000. Visiting rates varied between practices from 45 to 305\\/1000 per year. When high visiting practices (>210\\/1000\\/year) were compared to low visiting rate practices (>90\\/1000\\/year), patients tended to be older (79.7 v. 74.5 years) and calls were 12 times more likely to be doctor initiated (16.6% v. 1.4%) or classified as routine( 50.7% v. 44.9%). The variation between practices was related in part to patient age but appears largely due to differences in doctor home visiting behaviour. There are no recent figures on home visiting in Ireland.

  18. Skylab mission report, third visit

    Science.gov (United States)

    1974-01-01

    An evaluation is presented of the operational and engineering aspects of the third Skylab visit, including information on the performance of the command and service module and the experiment hardware, the crew's evaluation of the visit, and other visit-related areas of interest such as biomedical observations. The specific areas discussed are contained in the following: (1) solar physics and astrophysics investigations; (2) Comet Kohoutek experiments; (3) medical experiments; (4) earth observations, including data for the multispectral photographic facility, the earth terrain camera, and the microwave radiometer/scattermometer and altimeter; (5) engineering and technology experiments; (6) food and medical operational equipment; (7) hardware and experiment anomalies; and (8) mission support, mission objectives, flight planning, and launch phase summary. Conclusions discussed as a result of the third visit to Skylab involve the advancement of the sciences, practical applications, the durability of man and systems in space, and spaceflight effectiveness and economy.

  19. Tests and visits before surgery

    Science.gov (United States)

    Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

  20. 75 FR 54447 - National Alcohol and Drug Addiction Recovery Month, 2010

    Science.gov (United States)

    2010-09-07

    ... Cancer Awareness Month, 2010 Proclamation 8552--National Prostate Cancer Awareness Month, 2010..., failure in school, job loss, child abuse, crimes, and death. I encourage all Americans to visit...

  1. A six-month crossover chemoprevention clinical trial of tea in smokers and non-smokers: methodological issues in a feasibility study

    Directory of Open Access Journals (Sweden)

    Dash Chiranjeev

    2012-07-01

    Full Text Available Abstract Background Chemoprevention crossover trials of tea can be more efficient than parallel designs but the attrition and compliance rates with such trials are unknown. Methods Attrition (dropouts and compliance with treatment were assessed in a 25-week randomized, placebo controlled, crossover, feasibility clinical trial of four tea treatments to investigate the effect of tea on oral cancer biomarkers. Each treatment lasted 4 weeks with 2 weeks of washout in between. Participants were 32 smokers and 33 non-smokers without any evidence of premalignant oral lesions. The interventions consisted of packets of green tea, black tea, caffeinated water, or placebo. Participants were assigned to each treatment for four weeks, and were instructed to drink five packets per day while on the treatment. Dropout from the trial and compliance (consumption of ≥ 85% of the prescribed treatment packets are the main outcome measures reported. Results There was a high rate of dropout (51% from the study, and the rates were significantly higher among smokers (64% than non-smokers (36%. Among participants who completed the study the rate of compliance was 72%. The highest rates of dropouts occurred between the first and second treatment visits in both smokers (38% dropout and non-smokers (18% dropout. Throughout the study smokers were more likely to dropout than non-smokers. Black tea treatment was associated with the highest rates of dropout among smokers (37%, but was associated with the lowest rate of dropout among non-smokers (4%. Conclusions In a study conducted to test the feasibility of a four-treatment crossover tea trial, a high rate of dropout among smokers and non-smokers was observed. Multi-arm crossover tea trials might pose a higher burden on participants and research is needed to improve adherence and treatment compliance in such trials. Trial registration number ISRCTN70410203

  2. [Three-year follow-up of 12 patients with prostate cancer treated with monthly degarelix in a phase II clinical trial].

    Science.gov (United States)

    Hoshi, Senji; Hayashi, Natsuho; Yagi, Mayu; Ookubo, Teppei; Muto, Akinori; Sugano, Osamu; Numahata, Kenji; Bilim, Vladimir; Hoshi, Kiyotugu; Sasagawa, Isoji

    2014-01-01

    The efficacy and safety of degarelix, a luteinizing hormone-releasing hormone(LH-RH)antagonist, in patients with prostate cancer(PCa)were evaluated in a phase II, open-label, multicenter clinical trial. In this trial, a total of 13 patients were accrued at the Yamagata Prefectural Central Hospital from 2007 to 2008. The median age was 80 years(range, 65-85 years), and clinical stages were T1c, T2, T3, and T4 in 1, 4, 6, and 2 patients, respectively. Nodal(N)status was N0 in 9 patients and N1 in 4 patients. Distant metastases were absent(M0)in 12 patients and present(M1b)in 1 patient. The median prostate- specific antigen(PSA)level was 29.1 ng/mL(range, 6.3-427 ng/mL). All but one patient, who died of an unrelated cause, received a monthly dose(80 or 160mg)of degarelix for 12 months and were followed-up for 3 years. The PSA level declined in all patients. One patient died of an unrelated cause during the phase II trial. After completion of the phase II trial, 5 patients were treated with combined and rogen blockade(CAB)(leuprolide plus anti-androgen therapy), 2 patients were treated with single-agent leuprolide, 2 patients received single-agent bicalutamide, and 1 patient was followed-up without additional treatment. Radical prostatectomy was performed in 2 patients. Among the 5 patients treated with CAB, 2 died of metastatic cancer. CAB was effective in suppressing PSA levels in 3 patients. In 1 patient with T3aN1M1b PCa, colon cancer with lung metastases was detected during the follow-up period. Treatment with chemotherapy for colon cancer was effective in suppressing PSA levels for 12 months. In 1 patient with cT3aN1M0 PCa, the PSA level declined to size of the prostate gland and metastatic lymph nodes was observed. This effect persisted for 3.5 years after the completion of the 12-month degarelix regimen, and no additional treatment was required.

  3. Visit of Spanish Government delegation

    CERN Multimedia

    CERN PhotoLab

    1982-01-01

    A Spanish Government delegation visited CERN before Spain rejoined CERN as a Member State(in 1983). Delegates interested in advanced technologies visited the ISR workshop clean room, where Romeo Perin explained fabrication and properties of stainless steel, titanium and inconel components of vacuum chambers for experiments at the ISR. Left to right: Technical Director Giorgio Brianti, the Spanish Minister of Industry and Energy Mr.Ignacio Bayon Marine , Romeo Perin, a delegate and Director-General Herwig Schopper. See also 8202369.

  4. WILL I AM visits CERN

    CERN Multimedia

    Noemi Caraban

    2013-01-01

    Will.i.am visited CERN in December 2013, fulfilling a wish he made in a video-link appearance at TEDxCERN earlier that year http://tedxcern.web.cern.ch/video/choral-performance-reach-stars-william. During his visit, he was shown the Antimatter Decelerator, the underground ATLAS experiment cavern and the CERN Control Centre. He also took the opportunity to promote CERN’s beam line for schools competition.

  5. Sexuality Talk During Adolescent Health Maintenance Visits

    Science.gov (United States)

    Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Bravender, Terrill; Davis, J. Kelly; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Shields, Cleveland G.

    2015-01-01

    Importance Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. Objective To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Design, Setting, and Participants Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Main Outcomes and Measures Total time per visit during which sexuality issues were discussed. Results One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant

  6. Sexuality talk during adolescent health maintenance visits.

    Science.gov (United States)

    Alexander, Stewart C; Fortenberry, J Dennis; Pollak, Kathryn I; Bravender, Terrill; Davis, J Kelly; Ostbye, Truls; Tulsky, James A; Dolor, Rowena J; Shields, Cleveland G

    2014-02-01

    Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Total time per visit during which sexuality issues were discussed. RESULTS One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥ 36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥ 36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant associations between adolescent, physician, and visit characteristics were

  7. Periapical healing outcome following single visit endodontic treatment in patients with type 2 diabetes mellitus

    Science.gov (United States)

    Nayak, Moksha; Babshet, Medha

    2016-01-01

    Background The prevalence of apical periodontitis in diabetes mellitus patients is high. The altered immunity in diabetes affects the healing process of periapical tissue. Single visit endodontic treatment has shown to increase the periapical healing rate with better patient compliance. Hence the present study aims at evaluating the clinical and radiographic healing outcome of single visit endodontic treatment, in type 2 diabetes mellitus patients with periapical disease. Material and Methods Eighty patients with periapical disease were divided into 2 groups of 40 each: Group I, Control subjects and Group II, Type 2 diabetics. Glycosylated hemoglobin levels were assessed preoperatively and at follow up intervals in diabetics. Pre-operative assessment of periapical status was done using CPDR (Clinical periapical diagnosis of root), QLDR (Qualitative radiographic diagnosis of tooth) and QTDR (Quantitative radiographic diagnosis of tooth) criteria. Postoperative healing was evaluated following single-visit endodontic treatment by Strindberg criteria. Results Group 2 subjects had chronic and exacerbating lesions with significantly larger lesions (p=0.029). 100 % clinical healing outcome in diabetic group was seen in two months. Group 2 showed 85% success in one year on radiographic evaluation. Poor controlled diabetics showed failure compared to fair and good controlled. Conclusions Type 2 diabetics had chronic and larger sized lesions when compared to control subjects. The periapical lesions in patients with poor diabetic control showed failure. The clinical and radiographic healing outcome of single visit endodontic therapy was delayed in diabetic patients. Key words:Apical periodontitis, diabetes mellitus type 2, endodontics, periapical lesion, strindberg criteria. PMID:27957260

  8. Effect of home visit training program on growth and development of preterm infants: a double blind randomized controlled trial.

    Science.gov (United States)

    Edraki, Mitra; Moravej, Hossian; Rambod, Masoume

    2015-01-01

    Home visit program can be effective in infants' growth and development. The present study aimed to investigate the effect of home visit program on preterm infants' growth and development within 6 months. It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital's routine care. Then, the infants' growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants' mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting,  producing "Agha" sound, and taking objects by hand (Pdevelopment indexes at the sixth month. Considering the importance of infants' growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants' health. IRCT2014082013690N3 

  9. Replacement of Anterior Composite Resin Restorations Using Conservative Ceramics for Occlusal and Periodontal Rehabilitation: An 18-Month Clinical Follow-Up

    Directory of Open Access Journals (Sweden)

    Leonardo Fernandes da Cunha

    2016-01-01

    Full Text Available This case report describes a patient with discolored and fractured composite resin restorations on the anterior teeth in whom substitution was indicated. After wax-up and mock-up, the composite was removed and replaced with minimally invasive ceramic laminates. An established and predictable protocol was performed using resin cement. Minimally invasive ceramic restorations are increasingly being used to replace composite restorations. This treatment improves the occlusal and periodontal aspects during the planning and restorative phases, such as anterior guides, and laterality can be restored easily with ceramic laminates. In addition, the surface smoothness and contour of ceramic restorations do not affect the health of the surrounding periodontal tissues. Here we present the outcome after 18 months of clinical follow-up in a patient in whom composite resin restorations in the anterior teeth were replaced with minimally invasive ceramic laminates.

  10. Rational emotive behavior therapy, cognitive therapy, and medication in the treatment of major depressive disorder: a randomized clinical trial, posttreatment outcomes, and six-month follow-up.

    Science.gov (United States)

    David, Daniel; Szentagotai, Aurora; Lupu, Viorel; Cosman, Doina

    2008-06-01

    A randomized clinical trial was undertaken to investigate the relative efficacy of rational-emotive behavior therapy (REBT), cognitive therapy (CT), and pharmacotherapy in the treatment of 170 outpatients with nonpsychotic major depressive disorder. The patients were randomly assigned to one of the following: 14 weeks of REBT, 14 weeks of CT, or 14 weeks of pharmacotherapy (fluoxetine). The outcome measures used were the Hamilton Rating Scale for Depression and the Beck Depression Inventory. No differences among treatment conditions at posttest were observed. A larger effect of REBT (significant) and CT (nonsignificant) over pharmacotherapy at 6 months follow-up was noted on the Hamilton Rating Scale for Depression only. (c) 2008 Wiley Periodicals, Inc.

  11. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.

    Science.gov (United States)

    Masiero, Stefano; Poli, Patrizia; Bonaldo, Lara; Pigatto, Maurizia; Ramonda, Roberta; Lubrano, Ennio; Punzi, Leonardo; Maffulli, Nicola

    2014-06-01

    To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy. Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up. Patients' homes. A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23). Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control. Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer. At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001). In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis. © The Author(s) 2013.

  12. Application of a dental adhesive using the self-etch and etch-and-rinse approaches: an 18-month clinical evaluation.

    Science.gov (United States)

    Loguercio, Alessandro D; Reis, Alessandra

    2008-01-01

    Laboratory investigations have demonstrated that the application of multiple adhesive coats can increase adhesive infiltration, thereby increasing bond strength values. The authors conducted an 18-month, randomized, controlled prospective study to evaluate the clinical performance of a self-etch and an etch-and-rinse adhesive in noncarious cervical lesions. Twenty-nine patients with at least two pairs of similarly sized lesions participated in this study. The authors placed 116 restorations in one of four groups: OS2 (phosphoric acid and dental adhesive [One-Step Plus, Bisco, Schaumburg, Ill.], following the manufacturer's recommendation [two coats]); OS4 (phosphoric acid and One-Step Plus, with four coats); TY2 (Tyrian SPE [Bisco] and One-Step Plus, following the manufacturer's recommendation [two coats]); and TY4 (Tyrian SPE and One-Step Plus, with four coats). The authors evaluated the restorations at baseline and at six, 12 and 18 months, according to modified U.S. Public Health Service criteria. (Eight of the 116 restorations were unavailable for follow-up.) The retention rate for the TY2 group (55.5 percent) was statistically lower than that for the TY4 (77.8 percent) and OS4 (88.9 percent) groups. Only teeth in OS4 exhibited a retention rate at 18 months that was similar to that observed at baseline. Marginal discoloration occurred in all groups, and it was statistically significantly worse in TY2. Multiple adhesive coats significantly improved retention rates. Applying multiple coats of adhesive with the etch-and-rinse or self-etch approach can improve retention rates of Class V resin-based composite restorations, although not to the level of the American Dental Association's guidelines for dentin and adhesive materials.

  13. Pulp and Periodontal Regeneration of an Avulsed Permanent Mature Incisor Using Platelet-rich Plasma after Delayed Replantation: A 12-month Clinical Case Study.

    Science.gov (United States)

    Priya M, Harini; Tambakad, Pavan B; Naidu, Jaya

    2016-01-01

    Numerous publications have reported revascularization of necrotic immature permanent teeth, but the regenerative potential of pulp in mature teeth has rarely been considered. Platelet-rich plasma (PRP) meets many requirements of a scaffold for regenerative endodontics. To the best of our knowledge, no clinical study has evaluated PRP for endodontic regeneration in a mature avulsed tooth. The present case evaluated PRP for pulpal regeneration in an avulsed mature incisor (>8 hours extraoral dry time) of an 11-year-old boy after delayed replantation. The canal was disinfected after extraoral access cavity preparation and pulp extirpation. The root apex was enlarged, and the tooth was placed in doxycycline solution for 20 minutes. After tooth replantation and splinting, PRP was injected up to the level of the cementoenamel junction and sealed with glass ionomer cement. The 6-month follow-up revealed evidence of internal and external root resorption with periapical radiolucency and an apparent periodontal ligament space. Access was reopened; slurry of 2 antibiotics (minocycline and metronidazole) was inserted into the canal and sealed. Nine- and 12-month radiographs revealed resolution of periapical radiolucency with no further progression of internal resorption. The tooth showed a positive response to thermal and electric pulp tests. The findings observed in this case warrant further research under controlled conditions to evaluate endodontic and periodontal regeneration in a tooth that would otherwise be expected to have an unfavorable prognosis. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  14. Use of Implant-Derived Minimally Invasive Sinus Floor Elevation: A Multicenter Clinical Observational Study With 12- to 65-Month Follow-Up.

    Science.gov (United States)

    Mijiritsky, Eitan; Barbu, Horia; Lorean, Adi; Shohat, Izhar; Danza, Matteo; Levin, Liran

    2016-08-01

    The aim of this study is to evaluate the performance of implant-derived minimally invasive sinus floor elevation. A multicenter retrospective study was performed in 5 dental clinics. Patients requiring sinus augmentation for single implant placement were recorded and followed up. The dental implant used in this trial was a self-tapping endosseous dental implant that contains an internal channel to allow the introduction of liquids through the implant body into the maxillary sinus; those liquids include saline and a flowable bone grafting material. Overall, 37 implants were installed in 37 patients. The age range of the patients was 37-75 years (mean: 51.2 years). The average residual bone height prior to the procedure was 5.24 ± 1 mm. Of all cases, 25 implants replaced the maxillary first molar and 12 replaced the maxillary second premolar. All surgeries were uneventful with no apparent perforation of the sinus membrane. The mean follow-up time was 24.81 ± 13 months ranging from 12 to 65 months. All implants integrated and showed stable marginal bone level. No adverse events were recorded during the follow-up period. The presented method for transcrestal sinus floor elevation procedure can be accomplished using a specially designed dental implant. Further long-term studies are warranted to reaffirm the results of this study.

  15. Non-clinical immuno-toxicological evaluation of HER1 cancer vaccine in non-human primates: a 12-month study.

    Science.gov (United States)

    Barro, Ana M Bada; Rivero, Arianna Iglesias; Goñi, Avelina León; Navarro, Bárbara O González; Angarica, Meilis Mesa; Ramírez, Belinda Sánchez; Bedoya, Darel Martínez; Triana, Consuelo González; Rodríguez, Axel Mancebo; Parada, Ángel Casacó

    2012-12-17

    Human epidermal growth factor receptor (HER1) constitutes a tumor associated antigen. Its overexpression in many epithelial tumors has been associated with bad prognosis and poor survival. Cancer vaccine based on the extracellular domain (ECD) of HER1 and adjuvated in very small sized proteoliposomes (VSSP) and Montanide ISA 51-VG is a new and complementary approach for the treatment of epithelial tumors. The present study deals with the immunogenicity of this vaccine in Macaca fascicularis monkeys and evaluation of its toxicity during 12 months. Twelve monkeys were randomized into two groups of 3 animals per sex: control and vaccinated. Treated monkeys received 9 doses of vaccination and were daily inspected for clinical signs. Body weight, rectal temperature, cardiac and respiratory rates were measured during the study. Humoral immune response, clinical pathology parameters and delayed type hypensensitivity were analyzed. Skin biopsy was performed at the end of the study in all animals. Animal's survival in the study was 100% (n=12). Local reactions were observed at the administration site of four treated animals (n=6), with two showing slight inflammatory cutaneous damage. Clinical pathology parameters were not affected. HER1 vaccine induced high IgG antibodies titers in the treated animals even when DTH was not observed. The induced antibodies recognized HER1+ tumor cell lines, decreased HER1 phosphorylation and showed anti-proliferative and pro-apoptotic effects in H125 cells. In general the present study showed that HER1 vaccine induced specific immune response in M. fascicularis monkeys and was well tolerated, suggesting it could be safely used in clinical studies in epithelial cancer patients.

  16. Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

    Science.gov (United States)

    Tousignant, Michel; Corriveau, Hélène; Kairy, Dahlia; Berg, Katherine; Dubois, Marie-France; Gosselin, Sylvie; Swartz, Richard H; Boulanger, Jean-Martin; Danells, Cynthia

    2014-01-30

    The incidence of strokes in industrialized nations is on the rise, particularly in the older population. In Canada, a minority of individuals who have had a stroke actually receive intensive rehabilitation because most stroke patients do not have access to services or because their motor recovery was judged adequate to return home. Thus, there is a considerable need to organize home-based rehabilitation services for everyone who has had a stroke. To meet this demand, telerehabilitation, particularly from a service center to the patient's home, is a promising alternative approach that can help improve access to rehabilitation services once patients are discharged home. This non-inferiority study will include patients who have returned home post-stroke without requiring intensive rehabilitation. To be included in the study, participants will: 1) not be referred to an Intensive Functional Rehabilitation Unit, 2) have a Rankin score of 2 or 3, and 3) have a balance problem (Berg Balance Scale score between 46 and 54). Participants will be randomly assigned to either the teletreatment group or the home visits group. Except for the delivery mode, the intervention will be the same for both groups, that is, a personalized Tai Chi-based exercise program conducted by a trained physiotherapist (45-minute session twice a week for eight consecutive weeks). The main objective of this research is to test the non-inferiority of a Tai Chi-based exercise program provided via telerehabilitation compared to the same program provided in person at home in terms of effectiveness for retraining balance in individuals who have had a stroke but do not require intensive functional rehabilitation. The main outcome of this study is balance and mobility measured with the Community Balance and Mobility Scale. Secondary outcomes include physical and psychological capacities related to balance and mobility, participants' quality of life, satisfaction with services received, and cost

  17. Clinical profiles of patients colonized or infected with extended-spectrum beta-lactamase producing Enterobacteriaceae isolates: a 20 month retrospective study at a Belgian University Hospital

    Directory of Open Access Journals (Sweden)

    Jamart Jacques

    2011-01-01

    Full Text Available Abstract Background Description of the clinical pictures of patients colonized or infected by ESBL-producing Enterobacteriaceae isolates and admitted to hospital are rather scarce in Europe. However, a better delineation of the clinical patterns associated with the carriage of ESBL-producing isolates may allow healthcare providers to identify more rapidly at risk patients. This matter is of particular concern because of the growing proportion of ESBL-producing Enterobacteriaceae species isolates worldwide. Methods We undertook a descriptive analysis of 114 consecutive patients in whom ESBL-producing Enterobacteriaceae isolates were collected from clinical specimens over a 20-month period. Clinical data were obtained through retrospective analysis of medical record charts. Microbiological cultures were carried out by standard laboratory methods. Results The proportion of ESBL-producing Enterobacteriaceae strains after exclusion of duplicate isolates was 4.5% and the incidence rate was 4.3 cases/1000 patients admitted. Healthcare-associated acquisition was important (n = 104 while community-acquisition was less frequently found (n = 10. Among the former group, two-thirds of the patients were aged over 65 years and 24% of these were living in nursing homes. Sixty-eight (65% of the patients with healthcare-associated ESBL, were considered clinically infected. In this group, the number and severity of co-morbidities was high, particularly including diabetes mellitus and chronic renal insufficiency. Other known risk factors for ESBL colonization or infection such as prior antibiotic exposure, urinary catheter or previous hospitalisation were also often found. The four main diagnostic categories were: urinary tract infections, lower respiratory tract infections, septicaemia and intra-abdominal infections. For hospitalized patients, the median hospital length of stay was 23 days and the average mortality rate during hospitalization was 13% (Confidence

  18. HIV care visits and time to viral suppression, 19 U.S. jurisdictions, and implications for treatment, prevention and the national HIV/AIDS strategy.

    Directory of Open Access Journals (Sweden)

    H Irene Hall

    Full Text Available OBJECTIVE: Early and regular care and treatment for human immunodeficiency virus (HIV infection are associated with viral suppression, reductions in transmission risk and improved health outcomes for persons with HIV. We determined, on a population level, the association of care visits with time from HIV diagnosis to viral suppression. METHODS: Using data from 19 areas reporting HIV-related tests to national HIV surveillance, we determined time from diagnosis to viral suppression among 17,028 persons diagnosed with HIV during 2009, followed through December 2011, using data reported through December 2012. Using Cox proportional hazards models, we assessed factors associated with viral suppression, including linkage to care within 3 months of diagnosis, a goal set forth by the National HIV/AIDS Strategy, and number of HIV care visits as determined by CD4 and viral load test results, while controlling for demographic, clinical, and risk characteristics. RESULTS: Of 17,028 persons diagnosed with HIV during 2009 in the 19 areas, 76.6% were linked to care within 3 months of diagnosis and 57.0% had a suppressed viral load during the observation period. Median time from diagnosis to viral suppression was 19 months overall, and 8 months among persons with an initial CD4 count ≤ 350 cells/µL. During the first 12 months after diagnosis, persons linked to care within 3 months experienced shorter times to viral suppression (higher rate of viral suppression per unit time, hazard ratio [HR] = 4.84 versus not linked within 3 months; 95% confidence interval [CI] 4.27, 5.48. Persons with a higher number of time-updated care visits also experienced a shorter time to viral suppression (HR = 1.51 per additional visit, 95% CI 1.49, 1.52. CONCLUSIONS: Timely linkage to care and greater frequency of care visits were associated with faster time to viral suppression with implications for individual health outcomes and for secondary prevention.

  19. UN Secretary General visits CERN

    CERN Multimedia

    2008-01-01

    UN Secretary General praises CERN in recent visit. Ban Ki-moon, Robert Aymar, CERN Director-General, and Sergei Ordzhonikidze, Director-General of the United Nations Office in Geneva at the CMS site.On Sunday 31 August, Ban Ki-moon, the UN Secretary General, made an important visit to CERN. Arriving in the late afternoon, he was warmly greeted at Point 5 by Robert Aymar, the Director-General, and the Sous-préfet of Gex, Olivier Laurens-Bernard. Accompanied by a UN delegation, Ban Ki-moon was also introduced to Jos Engelen, the Chief Scientific Officer, and Jim Virdee, the CMS spokesperson. He then took the opportunity to visit CMS and the machine tunnel. At the end of his short trip, Ban Ki-moon signed the Guest Book in the tradition of important dignitaries visiting CERN. Expressing his admiration for CERN’s spirit of collaboration, Ban Ki-moon said, "I am very honored to visit CERN, an invaluable scientific institution a...

  20. Analysis of 24 cases of HIV/AIDS with oral lesion as the reason for the first clinical visit%以口腔损害为HIV/AIDS首诊症状24例分析

    Institute of Scientific and Technical Information of China (English)

    汪玲; 赵纯; 陈珊; 刘燕; 汤博钰; 葛素荣; 柳志文

    2015-01-01

    目的:分析艾滋病患者的口腔损害特征,加强口腔医生对于艾滋病相关口腔病损的认识,提高早期识别和诊断的准确性。方法:收集2012~2014年就诊于中南大学湘雅二医院口腔科,首诊症状表现为口腔损害的24例HIV/AIDS患者,分析其临床特征。结果:24例患者中16例口腔念珠菌病,10例单纯疱疹性口炎,4例复发性阿弗他溃疡,5例口干症,4例口腔毛状白斑,3例卡波济肉瘤,1例颌面部淋巴结炎和1例艾滋病相关性牙周炎,部分患者有两项或两项以上的口腔表征。结论:口腔念珠菌病、单纯疱疹性口炎是该组病例中最常见的口腔损害。%Objective:To investigate the oral features of patients with HIV/AIDS,reinforce the clinical dentists'knowledge of HIV/AIDS related oral lesions, and improve the earlier recognition and accurate diagnosis of HIV/AIDS. Method:All patients attending Department of Stomatology of The Second Xiangya Hospital between Year 2012 and 2014 with oral lesions as the reason of clinical visit and diagnosed as HIV/AIDS were analysed. A total of 24 cases were includ-ed. A cross-sectional study was conducted between them. Result:Among the total of 24 HIV/AIDS patient included in the study,there were 16 oral candidiasis,4 aphtha ulcer,10 herpetic stomatitis,5 xerostomia,4 oral hairy leukoplakia and 3 Ka-posi's sarcoma,1 HIV related periodontitis and 1 lymphadentits. Some patients have 2 or more symptoms. Conclusion:Oral candidiasis,herpetic stomatitis are the most common oral lesion among this group of patients.

  1. Clinical outcomes at 12 months and risk of inflammatory bowel disease in patients with an intermediate raised fecal calprotectin: a ‘real-world’ view

    Science.gov (United States)

    Chambers, Samantha; Malik, Ahmad; Lee, Bee; Sung, Edmond; Nwokolo, Chuka; Arasaradnam, Ramesh

    2016-01-01

    Objectives A recent systematic review confirmed the usefulness of fecal calprotectin (FC) in distinguishing organic (inflammatory bowel disease (IBD)) from non-organic gastrointestinal disease (irritable bowel syndrome (IBS)). FC levels 92% to exclude organic gastrointestinal (GI) disease. Levels >250 μg/g correlate with endoscopic IBD disease activity; sensitivity 90%. We aimed to determine clinical outcomes in intermediate raised FC results (50–250 μg/g). Setting Primary care general practices in Coventry and Warwickshire, and 3 secondary care hospitals. Participants 443 FC results in adults (>16 years old) were reviewed from July 2012 to October 2013. Clinical data was collected from hospital databases and general practitioners. Long-term clinical data was available in 41 patients (out of 48). Primary and secondary outcome measures The number of new diagnoses of IBD, IBS and other diagnoses for the intermediate group. The number referred and discharged from secondary care. Results A new IBD diagnosis was made in 19% (n=8) of intermediate results (1% of normal and 38% of raised results). 5% (n=2) of intermediate results had known IBD in remission. A new IBS diagnosis was made in 27% (n=11) of intermediate results, while 34% (n=14) remained undiagnosed, although 8 of these were not referred to secondary care. Conclusions FC testing remains useful in aiding diagnosis of organic GI conditions. However, unlike negative and strongly positive FC results, intermediate FC results lead to a mixture of diagnoses. The OR of a new diagnosis of IBD for an intermediate result compared to normal FC result was 26.6, while an intermediate FC result gave an OR of 0.54 for a new IBS diagnosis compared to normal FC. For intermediate FC results, 1 in 3 patients remained in secondary care after 12 months with an OR of 3.6 compared to a normal FC result. PMID:27266773

  2. Visits from Croatia and Belarus

    CERN Multimedia

    2003-01-01

    On 23 September, CERN was visited by two Ministers, Anatoly Rusetsky, Chairman of the Committee on Science and Technology of the Republic of Belarus, and Professor Gvozden Flego, Croatian Minister of Science and Technology. Mr Rusetsky met with Roger Cashmore, Research Director for Collider Programmes, and Michel Della Negra, spokesperson of the CMS experiment, and visited the CMS detector assembly hall. Professor Flego also met Mr Cashmore and visited the NA49 and CAST experiments, the LHC superconducting magnet test hall, the ALICE experiment cavern, and the assembly hall for the CMS experiment. From left to right: Nikola Godinovic, working at CMS, Jürgen Schukraft, ALICE spokesperson, Gordan Markotic, Ambassador and Permanent Representative of Croatia to the United Nations and other international organisations in Geneva, Professor Gvozden Flego, Minister of Science and Technology, Republic of Croatia.

  3. A Finnish delegation visits CERN

    CERN Multimedia

    2001-01-01

    Minister Maija Rask (front, centre) led a Finnish delegation on a visit to CERN last week. Here the delegation inspects CMS preparations with the collaboration's spokesman Michel Della Negra (front, left). On 19 February Finnish Minister of Education, Mrs Maija Rask, visited CERN. She led a delegation composed of Mr. Pekka Huttaniemi, Permanent Representative of Finland to the United Nations, Mrs Pirjo Välinoro, Ministerial Counsellor (Economic affairs), Mr Markku Linna, Director General of the Ministry of Education, and Mr Tapio Kosunen, Special Adviser at the Ministry. Accompanied by Director General Luciano Maiani, the delegation visited CMS experiment and the LHC superconducting magnet test hall, and met Finnish students and scientists at CERN.

  4. Visit of the Italian President

    CERN Document Server

    2003-01-01

    "CERN stands as the demonstration of the great results that science can achieve [...] when it succeeds in getting all the main players in international scientific cooperation involved," stated the President of the Italian Republic, Carlo Azeglio Ciampi, in front of an overcrowded and enthusiastic Main Auditorium. The President visited CERN on 2nd December, and met the CERN directorate as well as the Italians at CERN. With about 1500 Italians working at CERN, which is one sixth of the total personnel, they are the second largest nationality at CERN. The Italian President visited the CMS assembly hall and the LHC superconducting magnet test hall before meeting the CERN community, in particular Italian personnel, in the main auditorium. There he emphasised the role of CERN as a transnational model for research which not only achieved great results in science but is also a powerful vehicle for progress in other fields. President Ciampi visits the LHC superconducting test hall together with Luciano Maiani and Lu...

  5. Italy's Prime Minister visits CERN

    CERN Document Server

    Stefania Pandolfi

    2015-01-01

    On Tuesday, 7 July 2015, the Prime Minister of the Italian Republic, Matteo Renzi, visited CERN. He was accompanied by a delegation that included Italy's Minister for Education, University and Research, Stefania Giannini.   From left to right: Fernando Ferroni, President of the Istituto Nazionale di Fisica Nucleare (INFN); Sergio Bertolucci, CERN Director for Research and Scientific Computing; Stefania Giannini, Italy's Minister of Education, University and Research; Matteo Renzi, Prime Minister of the Italian Republic; Fabiola Gianotti, CERN Director-General Designate; Rolf Heuer, CERN Director-General.   The Prime Minister was welcomed by members of the CERN Management together with former CERN Director-General and Senator for Life of the Italian Republic, Carlo Rubbia. After a brief general introduction to CERN’s activities by Rolf Heuer, the Italian delegation visited LHC Point 1. After a tour of the ATLAS control room, they donned helmets to visit th...

  6. Hospitalization and emergency department visits among seniors receiving homecare: a pilot study

    Directory of Open Access Journals (Sweden)

    Abernathy Tom

    2005-07-01

    Full Text Available Abstract Background Despite the recent growth in home health services, data on clinical outcomes and acute health care utilization among older adults receiving homecare services are sparse. Obtaining such data is particularly relevant in Ontario where an increasing number of frail seniors receiving homecare are awaiting placement in long-term care facilities. In order to determine the feasibility of a large-scale study, we conducted a pilot study to assess utilization of acute health care services among seniors receiving homecare to determine associated clinical outcomes. Methods This prospective cohort study followed forty-seven seniors admitted to homecare by two homecare agencies in Hamilton, Ontario over a 12-month period. Demographic information and medical history were collected at baseline, and patients were followed until either termination of homecare services, death, or end of study. The primary outcome was hospitalization. Secondary outcomes included emergency department visits that did not result in hospitalization and death. Rates of hospitalization and emergency department visits without admission were calculated, and univariate analyses were performed to test for potential risk factors. Survival curves for accumulative rates of hospitalization and emergency department visits were created. Results 312 seniors were eligible for the study, of which 123 (39% agreed to participate initially. After communicating with the research nurse, of the 123 who agreed to participate initially, 47 (38% were enrolled in the study. Eleven seniors were hospitalized during 3,660 days of follow-up for a rate of 3.0 incident hospitalizations per 1,000 homecare-days. Eleven seniors had emergency department visits that did not result in hospitalization, for a rate of 3.3 incident emergency department visits per 1,000 homecare-days. There were no factors significantly associated with hospitalization or emergency department visits when adjustment was made

  7. Sirolimus-eluting cobalt alloyed stents in treating patients with coronary artery disease: six-month angiographic and one-year clinical follow-up result A prospective, historically controlled, multi-center clinical study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; HONG Tao; CHEN Ji-lin; HUO Yong; SHEN Wei-feng; GAO Run-lin; XU Bo; YANG Yue-jin; ZHANG Rui-yan; LI Jian-ping; QIAO Shu-bin; ZHANG Jian-sheng; HU Jian; QIN Xue-wen

    2007-01-01

    Background The emergence of drug-eluting stents (DES) has dramatically reduced the incidence of in-stent restenosis.This study was conducted to evaluate the safetyand efficacy of sirolimus-eluting cobalt-chrome stents (Firebird 2) for treating patients with coronary artery disease.Methods Sixty-seven patients with de novo or non-stented restenostic coronary lesions were chosen to receive the Firebird 2 stent as the final treatment (Firebird 2 group). Another 49 consecutive patients were implanted with bare cobalt alloyed stents (Driver, Medtronic) withit the previous six months and served as historical controls (control group).Baseline clinical characteristics, angiographic features, procedural results, 30-day, 6-month and 12-month clinical follow-up regarding the occurrence of major adverse cardiac events (MACE), as well as the primary endpoint of late lumen loss at 6-month angiographic follow-up were compared between the two groups.Results The demographic characteristics were similar between the two groups despite more patients in the Firebird 2group who underwent previous percutaneous coronary intervention (22.4% vs 8.2%, P=0.0418) and who had diabetes mellitus (29.9% vs 12.2%, P=0.0253). In the Firebird 2 group, the mean diameter of the reference vessel was smaller((2.79±0.46) mm vs (2.98±0.49) mm, P=0.0175) and more stents were implanted for each lesion (1.28±0.52 vs 1.10±0.30, P=0.0060). Other angiographic, procedural results and the device success rate were similar between the two groups. The MACE rate at 30-day and 3-month was the same, but significantly fewer MACE occurred in the Firebird 2group at 6- and 12-month follow-up (1.5% vs 12.2% at 6 month, P=0.0168; 1.5% vs 26.5% at 12 month, P<0.0001). The primary endpoint of late lumen loss at 6-month angiographic follow-up was significantly reduced in the Firebird 2 group (in-stent: (0.05±0.09) mm vs (0.98±0.61) mm; in-segment: (0.05±0.18) mm vs (0.72±0.59) mm; P<0.0001) than the control group

  8. Clinical analysis of 61 cases of progressive muscular dystrophy visiting as transaminase elevation%转氨酶升高的进行性肌营养不良61例

    Institute of Scientific and Technical Information of China (English)

    吉英杰; 何卫平

    2012-01-01

    myogenic disease, and liver biopsy had obviously specific damage. Conclusion The clinical manifestation of PMD is not typical or easy to be neglected in the early stage. Lots of patients visit the doctor for elevated transaminase. However it is easy to be misdiagnosed as viral hepatitis. As a genetic disease, the diagnosis of PMP could be made with clinical manifestations, family history, serum enzymology, electromyogram, muscle biopsy and so on comprehensively.

  9. Commercial TV exposure, fast-food toy collecting and family visits to fast food restaurants among families living in rural communities

    Science.gov (United States)

    Emond, Jennifer A.; Bernhardt, Amy M.; Gilbert-Diamond, Diane; Li, Zhigang; Sargent, James D.

    2015-01-01

    Objective To assess the associations between children's exposure to TV networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants. Study design One hundred parents of children 3–7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's television viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association. Results Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (adjusted odds ratio 2.84 for each one-unit increase in the child's commercial TV viewing scale, p<0.001); toy collecting partially mediated that positive association. Conclusions Higher exposure among children to commercial TV networks that aired child-directed ads for children's fast food meals was associated with more frequent family visits to those fast food restaurants. Child desire for toy premiums may be a mediating factor. PMID:26526362

  10. Clinical course of ophthalmic findings and potential influence factors of herpesvirus infections: 18 month follow-up of a closed herd of lipizzaners.

    Directory of Open Access Journals (Sweden)

    James O Rushton

    Full Text Available BACKGROUND: To date the influence of herpesviruses on the development of equine ocular diseases has not been clearly determined. OBJECTIVE: The purpose of this study was to illustrate the course of equine ocular findings over a period of 18 months at 6 month intervals, in correlation with the results of herpesvirus detection. METHODS: 266 Lipizzaners in 3 federal states of Austria underwent complete ophthalmologic examination 4 times. Blood samples, nasal- and conjunctival swabs were obtained at the same time and used for the detection of the equid gammaherpesviruses EHV-2 and EHV-5 using consensus herpesvirus PCR and type-specific qPCRs. Ophthalmic findings and results of herpesvirus PCRs were recorded and statistically analysed using one-way ANOVA, and multiple logistic regression analysis to determine the influence of herpesvirus infections and other contributing factors on the presence of ophthalmic findings. RESULTS: In the first, second, third and fourth examination period 266, 261, 249 and 230 horses were included, respectively. Ophthalmic findings consistent with herpesvirus infections included conjunctival- and corneal pathologies. Statistical analysis revealed that the probability of positive herpesvirus PCR results decreased with progressing age; however the presence of corneal findings increased over time. At the time of each examination 45.1%, 41.8%, 43.0%, and 57.0% of horses with conjunctival or corneal findings, respectively, were positive for EHV-2 and/or EHV-5. However, 31.6%, 17.6%, 20.1%, and 13.0% of clinically sound horses were positive for these herpesviruses at each examination period, too. CONCLUSION: Based on the results of our study there is a significant influence of young age on EHV-2 and/or EHV-5 infection. Corneal pathologies increased over time and with progressing age. Whether the identified findings were caused by herpesviruses could not be unequivocally determined.

  11. Randomised trial of coronary intervention with antibody against platelet IIb/IIIa integrin for reduction of clinical restenosis: results at six months. The EPIC Investigators.

    Science.gov (United States)

    Topol, E J; Califf, R M; Weisman, H F; Ellis, S G; Tcheng, J E; Worley, S; Ivanhoe, R; George, B S; Fintel, D; Weston, M

    1994-04-09

    Restenosis after coronary angioplasty occurs in at least 30% of patients in the first six months and, as yet, there is no known treatment to decrease this event. We tested a monoclonal antibody Fab fragment (c7E3) directed against the platelet glycoprotein IIb/IIIa integrin, the receptor mediating the final common pathway of platelet aggregation, to see whether it reduced the frequency of clinical restenosis. Patients who had unstable angina, recent or evolving myocardial infarction, or high-risk angiographic morphology, were randomised to receive c7E3 bolus and a 12 hour infusion of c7E3 (708 patients), c7E3 bolus and placebo infusion (695 patients), or placebo bolus and placebo infusion (696 patients). With maintenance of the double-blind state, patients were followed-up for at least 6 months to determine the need for repeat angioplasty or surgical coronary revascularisation and the occurrence of ischaemic events. By 30 days, 12.8% of placebo bolus/placebo infusion patients had had a major ischaemic event (death, myocardial infarction, urgent revascularisation), compared with 8.3% of c7E3 bolus/c7E3 infusion patients, yielding a 4.5% difference (35% reduction, p = 0.008). At 6 months, the absolute difference in patients with major ischaemic event or elective revascularisation was 8.1% between placebo bolus/placebo infusion and c7E3 bolus/c7E3 infusion patients (35.1% vs 27.0%; 23% reduction p = 0.001). The favourable long-term effect was mainly due to less need for bypass surgery or repeat angioplasty in patients with an initial successful procedure, since need for repeat target vessel revascularisation was 26% less for c7E3 bolus/c7E3 infusion than for placebo treatment (16.5% vs 22.3%; p = 0.007). The c7E3 bolus/placebo infusion group had an intermediate outcome which was not significantly better than that of the placebo bolus/placebo infusion group. These results extend the benefit of c7E3 bolus/c7E3 infusion from reducing abrupt closure and acute

  12. Outcome and clinical changes in patients 3, 6, 12 months after a severe or major hand injury - can sense of coherence be an indicator for rehabilitation focus?

    Directory of Open Access Journals (Sweden)

    Rosberg Hans-Eric

    2010-12-01

    Full Text Available Abstract Background Our objective was to explore outcome and clinical changes in hand function, satisfaction in daily occupations, sleep disturbances, health and quality of life in consecutive patients after a severe or major hand injury. Our objective was also to investigate possible differences between groups according to severity of injury, presence of peripheral nerve injury and the patients' sense of coherence. Methods A postal questionnaire, including demographic data, disabilities of the arm, shoulder and hand (DASH, QoL (SF-36, EuroQol (EQ-5D VAS, hand function (VAS, satisfaction in daily occupation (SDO, was sent out 3, 6 and 12 months after injury to 45 consecutive patients with a severe or major hand injury. Sense of coherence (SOC was evaluated at 6 months. For the descriptive study, non-parametric tests were used since almost all results were measured with ordinal scales, the study sample was small, and most variables not normally distributed. Results Almost all self-assessed aspects of hand function, satisfaction in daily occupations, health (DASH, and physical QoL (SF-36 improved statistically for the whole group over time. Large clinical improvement was seen for physical QoL and health, while a low or no improvement was observed for mental QoL, and cold sensitivity. Few differences were found between participants with a severe or major of hand injury or with or without a major nerve injury. No significant differences in demographic data were observed between participants with high or low SOC, but participants with low SOC showed significantly lower satisfaction in daily occupations, higher DASH scores, lower mental QoL, more sleep disturbances, and bodily pain. Correlation was found between SOC, and QoL, health and satisfaction in daily occupations. Conclusions SOC had a significant influence on patients with a severe or major traumatic hand injury. Patients with lower SOC would probably benefit from extra support and help to

  13. Visit of the Austrian Ambassador

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    The Austrian Ambassador Wolfgang Petritsch (light raincoat) learns about superconducting magnets at the LHC magnet test facility in building SM18 during a visit to CERN. The blue pipe-like structure in the left background is String 2: the 120-m long full-scale model of an LHC cell, which is used to test LHC systems.

  14. ATLAS Visit of Indian President

    CERN Multimedia

    2005-01-01

    Welcomed by CERN's Director General, Robert Aymar, the President of India Dr. A.P.J. Abdul Kalam visited the LHC tunnel, the ATLAS experimental cavern and the test facility for the LHC magnets. There the President had the chance to meet Indian scientists working at CERN.

  15. CPAFFC Delegation Visits New Zealand

    Institute of Scientific and Technical Information of China (English)

    Xu; Fenghua

    2016-01-01

    In early December 2015,a CPAFFC delegation,with representatives from six departments,visited New Zealand at the host’s invitation.Members conducted work exchanges with the New Zealand-China Maori Friendship Trust and held talks with the

  16. Dr. John Marburger visits DESY

    CERN Multimedia

    2003-01-01

    Dr. John Marburger, Director of the United States Office of Science and Technology Policy, visited the research center DESY in Hamburg. The American physicist wanted to inform himself about the status of the TESLA X-ray laser and the TESLA linear collider as well as the international collaboration at DESY (1/2 page).

  17. Visit of UK Prime Minister

    CERN Multimedia

    1982-01-01

    Wolfgang Schnell shows a prototype LEP r.f. accelerating cavity with a superposed storage cavity to U.K. Head of Government Mrs.Margareth Thatcher during her visit to CERN. Behind Mrs.Thatcher one can see CERN Director General Herwig Schopper.

  18. A Modern Visit to Galileo

    Science.gov (United States)

    Freilich, Florence G.

    1970-01-01

    Describes the author's visit to the Italian cities where Galileo lived. Discusses the legendary swinging Cathedral lamp and the Leaning Tower of Pisa. Describes the science apparatus used by Galileo and other men of science which appear in the Museum of the History of Science in Florence. Presents six pictures of items viewed within the museum.…

  19. “VICO”, Visiting Colleagues

    CERN Multimedia

    Staff Association

    2017-01-01

    “Hello, I am your delegate” – have you heard this line? Maybe you have already had the pleasure of receiving a visit from a Staff Association delegate – then you know what this is all about. As for those of you, who have not yet heard these words, it’s time to get curious. The Staff Association has decided to embark upon an adventure called “VICO”, Visiting Colleagues. From past experience, we have understood the value of personal, direct contact with the people we represent. We believe that the best way to achieve this is to knock on your office door and pay you a short visit.  We do not want to make you fill in yet another online questionnaire and would much rather collect your feedback in a short conversation face to face. Of course, we have prepared ourselves thoroughly for these visit rounds, because we do not want to waste your time. We welcome criticism because it can make us aware of our shortcomings, tell us about how y...

  20. Gall's visit to The Netherlands

    NARCIS (Netherlands)

    Eling, Paul; Draaisma, Douwe; Conradi, Matthijs

    2011-01-01

    In March 1805, Franz Joseph Gall left Vienna to start what has become known as his cranioscopic tour. He traveled through Germany, Denmark, and The Netherlands. In this article, we will describe his visit to The Netherlands in greater detail, as it has not yet received due attention. Gall was eager

  1. Gall's Visit to The Netherlands

    NARCIS (Netherlands)

    Eling, P.A.T.M.; Draaisma, D.; Conradi, M.

    2011-01-01

    In March 1805, Franz Joseph Gall left Vienna to start what has become known as his cranioscopic tour. He traveled through Germany, Denmark, and The Netherlands. In this article, we will describe his visit to The Netherlands in greater detail, as it has not yet received due attention. Gall was eager

  2. Should Care Visits Be Enforced?

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The China National Committee on Ageing recently announced the revision of the law which protects the rights of elderly people was completed. Among the revised sections,a provision that grown-up children will have to visit society’s elderly seniors more often was included in the draft law.

  3. President of Ecuador visits CERN

    CERN Multimedia

    Rosaria Marraffino

    2014-01-01

    On Friday, 24 October, Dr. Rafael Correa Delgado, President of the Republic of Ecuador, visited CERN.   Visiting Geneva to deliver a lecture at the UN, Ecuadorian President Rafael Correa Delgado seized the chance to have a short but intense visit of the Laboratory. The President was met at LHC Point 1 by the Director for Research and Scientific Computing Sergio Bertolucci, who gave him an introduction to CERN’s activities.He was also introduced to the Director for Accelerators and Technology, Frédérick Bordry, and Department Heads José Miguel Jiménez (TE), Livio Mapelli (PH) and Roberto Saban (EN). President Correa Delgado also met with Martijn Mulders, co-organiser of the CERN Latin America School of High-Energy Physics, which will be held in Ecuador from 4 to 17 March 2015. Shortly after that, he visited the ATLAS experimental cavern which he toured with ATLAS Collaboration Spokesperson David Charlton and Fernando Monticelli of t...

  4. 镍钛机动器械联合不同超声冲洗液对慢性根尖周炎进行一次性根管治疗的临床研究%Clinical one-visit root treatment with nickel-titanium rotary instrument and ultrasonic irrigation unit for chronic apical periodontitis

    Institute of Scientific and Technical Information of China (English)

    唐震宇; 蒋士勇; 王辉; 蓝碧峰

    2014-01-01

    fil ing. Six and twelve months after root canal fil ing, the therapeutic effect was determined with X-ray examination and clinical assessment. RESULTS AND CONCLUSION:The degree of pain and occurrence rate of acute reactions in groups A and B were significantly lower than those in group C (P0.05). Six months after root canal fil ing, the cure rate was not significantly different between three groups (P>0.05). But after 12 months, the cure rate in the group C was significantly lower than that in groups A and B (P<0.05). By using of nickel-titanium rotary instruments and ultrasonic irrigation unit in treatment of chronic apical periodontitis, the short-and long-term effects of one-visit root treatment have been achieved clinical y.

  5. 28 CFR 540.41 - Visiting facilities.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visiting facilities. 540.41 Section 540... WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.41 Visiting facilities. The Warden shall have... have a portion of the visiting room equipped and set up to provide facilities for the children of...

  6. Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

    Directory of Open Access Journals (Sweden)

    Vordermark Dirk

    2011-09-01

    Full Text Available Abstract Background The aim of the present study was to evaluate the recovery potential of the parotid glands after using either 3D-conformal-radiotherapy (3D-CRT or intensity-modulated radiotherapy (IMRT by sparing one single parotid gland. Methods Between 06/2002 and 10/2008, 117 patients with head and neck cancer were included in this prospective, non-randomised clinical study. All patients were treated with curative intent. Salivary gland function was assessed by measuring stimulated salivary flow at the beginning, during and at the end of radiotherapy as well as 1, 6, 12, 24, and 36 months after treatment. Measurements were converted to flow rates and normalized relative to rates before treatment. Mean doses (Dmean were calculated from dose-volume histograms based on computed tomographies of the parotid glands. Results Patients were grouped according to the Dmean of the spared parotid gland having the lowest radiation exposure: Group I - Dmean mean 26-40 Gy (n = 45, and group III - Dmean > 40 Gy (n = 36. 15/117 (13% patients received IMRT. By using IMRT as compared to 3D-CRT the Dmean of the spared parotid gland could be significantly reduced (Dmean IMRT vs. 3D-CRT: 21.7 vs. 34.4 Gy, p Conclusions If a Dmean mean of the parotids, and thus on the saliva flow and recovery of parotid gland.

  7. Clinical evaluation of a novel dental implant system as single implants under immediate loading conditions - 4-month post-loading results from a multicentre randomised controlled trial.

    Science.gov (United States)

    Esposito, Marco; Trullenque-Eriksson, Anna; Blasone, Rodolfo; Malaguti, Giuliano; Gaffuri, Cristiano; Caneva, Marco; Minciarelli, Armando; Luongo, Giuseppe

    To evaluate the safety and clinical effectiveness of a novel dental implant system (GENESIS Implant System, Keystone Dental, Massachusetts, USA) using another dental implant system by the same manufacturer as a control (PRIMA Implant System, Keystone Dental). A total of 53 patients requiring at least two single crowns had their sites randomised according to a split-mouth design to receive both implant systems at six centres. If implants could be placed with a torque superior to 40 Ncm they were to be loaded immediately with provisional crowns, otherwise after 3 months of submerged healing. Provisional crowns were replaced by definitive crowns 4 months after initial loading, when the follow-up period for the initial part of this study was completed. Outcome measures were crown/implant failures, complications, pink esthetic score (PES), peri-implant marginal bone level changes, plaque score, marginal bleeding, patients and preference of the clinician. In total 53 PRIMA and 53 GENESIS implants were placed. Three patients dropped out but all of the remaining patients were followed up to 4-months post-loading. No PRIMA implant failed whereas four GENESIS implants failed. Only two complications were reported for PRIMA implants. There were no statistically significant differences for crown/implant failures (difference in proportions = 0.080; P (McNemar test) = 0.125) and complications (difference in proportions = -0.04; P (McNemar test) = 0.500) between the implant systems. There were no differences at 4-months post-loading for plaque (difference = -0.54, 95% CI: -3.01 to 1.93; P (Paired t-test) = 0.660), marginal bleeding (difference = -3.8, 95% CI: -7.63 to 0.019; P (Paired t-test) = 0.051), PES (difference = 0.47, 95% CI: -0.56 to 1.50; P (Paired t-test) = 0.365) and marginal bone level changes (difference in mm = -0.04, 95% CI: -0.33 to 0.26; P (Paired t-test) = 0.795). The majority of the patients (46) had no

  8. Modern scleral lenses part I: clinical features.

    NARCIS (Netherlands)

    Visser, E.S.; Visser, R.; Lier, H.J.J. van; Otten, H.M.

    2007-01-01

    PURPOSE: To evaluate the indications for modern scleral lenses and their clinical performance in patients who were fitted with scleral lenses at the authors' practices. METHODS: In this cross-sectional survey, all the necessary data were obtained at the first follow-up visit during the 5-month study

  9. Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study.

    Science.gov (United States)

    Verkerk, Karin; Luijsterburg, Pim A J; Heymans, Martijn W; Ronchetti, Inge; Miedema, Harald S; Koes, Bart W; Pool-Goudzwaard, Annelies

    2015-02-01

    This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic non-specific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n = 1760) of a rehabilitation center were used, where patients followed a 2-months cognitive behavior treatment. The outcome 'improvement in quality of life (SF-36)' was defined as a 10% increase in score on the SF-36 at follow-up compared with baseline. On the GPE scale, patients who indicated to be 'much improved' were coded as 'clinically improved'. Multivariable logistic regression analysis included 23 baseline characteristics. At 5-months follow-up, scores on the SF-36 Mental Component Scale (SF-36; MCS) and the Physical Component Scale (SF-36; PCS) had increased from 46.6 (SD 10.3) to 50.4 (SD 9.8) and from 31.9 (SD 7.1) to 46.6 (SD 10.3), respectively. At 5-months follow-up, 53.0% of the patients reported clinical improvement (GPE) which increased to 60.3% at 12-months follow-up. The 10% improvement in quality of life (SF-36 MCS) at 5-months follow-up was associated with patient characteristics and psychological factors. At 5-months follow-up, the 10% improvement in quality of life (SF-36 PCS) and GPE was associated with patient characteristics, physical examination, work-related factors and psychological factors; for GPE, an association was also found with clinical status. At 12-months follow-up GPE was associated with patient characteristics, clinical status, physical examination and work-related factors. The next phase in this prognostic research is external validation of these results.

  10. Two pioneering artists visit CERN

    CERN Multimedia

    CERN Bulletin

    2015-01-01

    On Monday, 19 January, CERN physicists welcomed musician Tim Blake - progressive rock keyboard and theremin player - and architectural lighting designer Patrice Warrener - inventor of the Chromolithe Polychromatic Illumination system, used in Lyon’s “Fête des Lumières”. Together, they make up the musical duo "Crystal Machine".   The artists visit the Antiproton Decelerator. (Image: Django Manglunki.)   Their visit began with an introduction to CERN by their friend Django Manglunki, project leader for the ion injector chain, and an improvised discussion on the LHC extraction system with Roger Barlow, kicker magnet controls expert and progressive rock fan. This was followed by a quick trip to the CCC, the server room and the SPS RF amplifiers in BA3. Next on the itinerary was a tour of the AD and anti-hydrogen experiments led by Michael Doser, AEgIS Spokesperson. A leisurely lunch followed, in the company ...

  11. An Algerian Minister visits CERN

    CERN Multimedia

    2006-01-01

    The Algerian Minister of Higher Education and Scientific Research, Rachid Haraoubia, visited CERN on 14 November. His party included the Rector of the University of Blida and the Director of the Algerian Ecole Nationale Polytechnique. Welcomed by CERN's Director-General, Robert Aymar, and Secretary-General, Maximilien Metzger, he signed the VIP Visitors' Book before going on to visit the ATLAS experiment and the LHC tunnel. He then had the opportunity to meet Algerian scientists working at CERN. Some fifteen Algerian physicists attached to European and US institutes are participating in the LHC experiments, in particular ATLAS. A formal collaboration agreement between Algeria and CERN is expected to be drawn up in the near future.

  12. CPAFFC Delegation Visits French Polynesia

    Institute of Scientific and Technical Information of China (English)

    YinShenglun

    2004-01-01

    At the invitation of Gaston Flosse, president of the Government of French Polynesia, a CPAFFC delegation headed by CPAFFC President Chen Haosu and Vice President Su Guang paid a goodwill visit to French Polynesia in September 2003. The Government of French Polynesia attached great importance to the visit. During their stay there, the delegation exchanged views with President Flosse many times on promoting friendship and cooperation between the Chinese and French Polynesian peoples. Both sides unanimously held that to promote friendship and strengthen cooperation are the common aspiration of the Chinese and French Polynesian people, which is conducive to the prosperity and development of the two sides and world peace. The delegation had extensive contacts with highranking officials and personages of various circles, and achieved its purpose of strengthening understanding, enhancing friendship and promoting cooperation.

  13. Young EIROforum prizewinner visits CERN

    CERN Multimedia

    CERN Bulletin

    2015-01-01

    On 27 to 31 July, CERN welcomed Paul Clarke, an 18-year-old Irish mathematician who won a CERN EIROforum prize (second place) at EUCYS 2014 (European Union Contest for Young Scientists).   Paul Clarke, visiting the new Microcosm exhibit. In addition to a €5000 prize, Paul visited the Laboratory and its experiments, meeting and speaking with CERN physicists and computer scientists. Paul's winning project is entitled "Contributions to cyclic graph theory." As the summary of the project suggests, graph theory is an area of pure mathematics which studies properties of linkages and networks. It has applications in several areas including computing, molecular structure, neuroscience, search engines, engineering etc. This project makes a profound contribution to the study of graphs. It identifies key concepts and provides the methodology to apply them to some long-standing major problems in the subject with great success. Paul has just finished high sc...

  14. A Croatian delegation visits CERN

    CERN Multimedia

    2001-01-01

    Professor Hrvoje Kraljeviç signing the Golden book with Professor Roger Cashmore. A Croatian delegation composed of the Minister of Science and Technology, Professor Hrvoje Kraljeviç, his deputy for international collaboration Prof. Davor Butkovic have visited CERN on the 12 and 13th of February and held talks with the CERN authorities, ALICE and CMS spokespersons on the possibilities to increase the participation of Croatia to the LHC related activities.

  15. NGO Work Committee Visits Beijing

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    ON June 27, 19 members of the Work Committee of the UN FWCW’s 1995 NGO Forum on Women arrived in Beijing. During their five-day visit in the capital they talked with representatives from the host country about preparations for the forum, the meeting place, facilities and other relevant matters. Huang Qizao, Vice-Chairperson of the FWCW’s China Organizing Committee, Committee Director of the NGO Forum and

  16. A Visit to the CPAFFC

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    <正>The participants of the China International Friendship Conference in Commemoration of the 60th Anniversary of the CPAFFC took part in the Open House activities—visiting the exhibitions on the history and the collection of paintings and art works of the CPAFFC,watching the documentary on 60 years of people-to-people diplomacy,getting together with Chinese friends old and new—at the CPAFFC compound on the afternoon of May 14.

  17. US Cub Scouts visit CERN

    CERN Multimedia

    2001-01-01

    A group of young American Cub Scouts from Den 10, Pack 130 (based in Geneva) at the Microcosm last Saturday. On their trip to CERN, which included the first Visits Service tour of the ATLAS construction site, the scouts were able to satisfy most of the requirements for the Cub Scout engineering badge. From left to right: Edouard Vincent, Ariel Litke, Alexander Richter, Antoine Vidal de Saint Phalle, Jason Iredale and Daniel Reghelini.

  18. Prospective Multicenter Study of Bronchiolitis: Predictors of an Unscheduled Visit After Discharge From the Emergency Department

    Science.gov (United States)

    Norwood, Agatha; Mansbach, Jonathan M.; Clark, Sunday; Waseem, Muhammad; Camargo, Carlos A.

    2012-01-01

    Objectives There is little evidence about which children with bronchiolitis will have worsened disease after discharge from the emergency department (ED). The objective of this study was to determine predictors of post-ED unscheduled visits. Methods The authors conducted a prospective cohort study of patients discharged from 2004 to 2006 at 30 EDs in 15 U.S. states. Inclusion criteria were diagnosis of bronchiolitis, age bronchiolitis within 2 weeks. Results Of 722 patients eligible for the current analysis, 717 (99%) had unscheduled visit data, of whom 121 (17%; 95% confidence interval [CI] = 14% to 20%) had unscheduled visits. Unscheduled visits were more likely for children age 0.10). Using multivariable logistic regression, independent predictors of unscheduled visits were age bronchiolitis, one of six children had unscheduled visits within 2 weeks of ED discharge. The three predictors of unscheduled visits were age under 2 months, male sex, and previous hospitalization. PMID:20370776

  19. [Effectiveness of an integrated treatment for severe personality disorders. A 36-month pragmatic follow-up].

    Science.gov (United States)

    Lana, Fernando; Sánchez-Gil, Carmen; Ferrer, Laia; López-Patón, Nuria; Litvan, Lia; Marcos, Susana; Sierra, Ana C; Soldevilla, Joan M; Feixas, Guillem; Pérez, Víctor

    2015-01-01

    Over the past 25 years, several studies have shown the efficacy of a number of psychological interventions for severe personality disorders. However, the generalizability of these positive results from long traditional research settings to more ordinary ones has been questioned, requiring a need for replication in pragmatic studies. This pragmatic study compares hospitalizations and Emergency Room visits before and during a 6-month therapeutic program for severe personality disorders, and at 36 months after starting it. The therapeutic program, which integrates several specific interventions within a coherent framework, was carried out in an ordinary clinical setting. Fifty-one patients, evaluated according DSM-IV criteria by using the Spanish version of the Structured Clinical Interview for Personality Disorders (SCID-II), were included. The clinical characteristics showed a group of severely disturbed patients, of which 78.4% met criteria for borderline personality disorder. The percentage of patients hospitalized and visiting the Emergency Room, as well as the number of days of hospitalization and Emergency Room visits was significantly reduced during the treatment, and this improvement was maintained throughout. An integrated treatment for severe personality disorders could be effective in preventing reliance on readmissions, or prolonged hospital stays, when it is implemented by clinicians in ordinary clinical settings. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  20. Comparative clinical and radiographic evaluation of mineralized cancellous bone allograft (puros®) and autogenous bone in the treatment of human periodontal intraosseous defects: 6-months follow-up study

    Science.gov (United States)

    Reddy, B. Ravinder; Sudhakar, J.; Rajesh, Nichenametla; Sandeep, V.; Reddy, Y. Muralidhar; Gnana Sagar, W. R.

    2016-01-01

    Aims: Several materials have been introduced as bone grafts, i.e., autografts, allograft, xenografts, and alloplastic grafts, and studies have shown them to produce greater clinical bone defect fill than open flap debridement alone. The aim of this clinical and radiological 6-month study was to compare and evaluate the clinical outcome of deep intraosseous defects following reconstructive surgery with the use of mineralized cancellous bone allograft (Puros®) or autogenous bone. Materials and Methods: Ten patients with 12 sites exhibiting signs of moderate generalized chronic periodontitis were enrolled in the study. The investigations were confined to two and three-walled intra bony defects with a preoperative probing depth of ≥5 mm. Six of these defects were treated with Puros® (group A) the remaining six were treated with autogenous bone graft (group B). Allocation to the two groups was randomized. The clinical parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and bone fill, were recorded at different time intervals at the baseline, 1 month, 3 months, and 6 months. Intraoral radiographs were taken using standardized paralleling cone technique at baseline, 1, 3, and 6 months. Statistical analysis was done by using the one-way analysis of variance (ANOVA) followed by Tukey highly significant difference. Results: Both groups resulted in decrease in probing depth (group A, 3.0 mm; group B, 2.83 mm) and gain in clinical attachment level (group A, 3.33 mm; group B, 3.0 mm) over a period of 6 months, which was statistically insignificant. Conclusion: Within the limitations of the present study, it can be concluded that both mineralized cancellous bone allograft (Puros®) or autogenous bone result in significant clinical improvements. PMID:28217545

  1. Effects of home visiting on adolescent mothers' parenting attitudes.

    Science.gov (United States)

    McKelvey, Lorraine M; Burrow, Nicola A; Balamurugan, Appathurai; Whiteside-Mansell, Leanne; Plummer, Pamela

    2012-10-01

    We examined the impact of a home visiting intervention on 227 adolescent mothers' parenting attitudes. At enrollment, half of mothers were at risk for child maltreatment. Mothers assigned to intervention (n = 161) received home visits and case management. Intervention and comparison mothers (n = 66) participated in monthly peer group meetings. Regression analyses controlling for enrollment differences indicated that intervention group mothers had significant improvements in 3 of 5 subscales and in total Adult-Adolescent Parenting Inventory-2 scores relative to the comparison group.

  2. Partial left ventriculectomy in a child: 70-month clinical follow up Ventriculectomia parcial esquerda em criança: acompanhamento clínico por 70 meses

    Directory of Open Access Journals (Sweden)

    Eduardo Coelho de Souza

    2003-10-01

    Full Text Available We describe the 70- month follow up of a child with idiopathic dilated cardiomyopathy and end-stage congestive heart failure (NYHA III/IV who underwent partial left ventriculectomy - the Batista operation when he was two and half years old. The clinical follow up was performed in the outpatient clinic by electrocardiography, echocardiography and radionuclide ventriculography to better analyse the left ventricular ejection fraction. The left ventricular diameter increased. Echocardiograms showed enlargement mainly in the systolic left ventricular diameter and slow decrease in fractional shortening (delta D. The child was in class I (NYHA during the follow-up. His exercise endurance was better than before surgery and hospitalization was not necessary. For these reasons, we believe that this procedure can be considered as a therapeutic option in children with severe dilated cardiomiopathy who are waiting for heart transplantation, as the shortage of donors is a fact.Relatamos a evolução durante 70 meses de uma criança submetida a ventriculectomia parcial esquerda, pela técnica de Batista aos 2 anos e 6 meses de idade, em classe funcional III/IV em decorrência de cardiomiopatia dilatada idiopática, com seguimento clínico ambulatorial. Realizamos eletrocardiogramas, ecocardiogramas seriados e ventriculografia radioisotópica para melhor analisar a fração de ejeção do ventrículo esquerdo. Houve progressivo aumento deste. O ecocardiograma mostrou aumento principalmente do diâmetro sistólico do ventrículo esquerdo com queda progressiva, porém lenta, da fração de ejeção. Apesar da progressão da disfunção miocárdica, a criança manteve-se em classe funcional I durante todo o seguimento, com melhora da tolerância ao exercício e não necessitou de internações. Por isso, achamos que o método pode ser considerado opção terapêutica em crianças com cardiomiopatia dilatada avançada, aguardando a indicação mais tardia de

  3. Survival analysis of banding and bonding molar tubes in adult patients over a 12-month period: a split-mouth randomized clinical trial.

    Science.gov (United States)

    Oeiras, Valéria Jacques; Silva, Valéria Assis Almeida E; Azevedo, Leidiana Aguiar; Lobato, Vanessa Soares; Normando, David

    2016-12-22

    This split-mouth randomized clinical trial aimed to compare the survival rate of bonding and banding molar tubes in adult orthodontic patients. Eligibility criteria included adults (aged >18 years), no active caries, restorations, or fractures in the upper and lower molars. The main outcome was any type of first-time failure in molar tubes. A computer-generated randomization scheme was used in a 1:1 ratio. The survival rate was estimated for 32 adult patients, in whom a tube was bonded to a molar tooth using composite resin on one side and a band was cemented with glass ionomer onto the same tooth in the contralateral arch. A total of 59 banded and 59 bonded molars were followed up for 12 months. Blinding was not applicable. Survival analysis including Cox regression was used at p < 0.05. The survival rate of bonded molars was not statistically different from that of banded molars (log-rank test, p = 0.97). Hazard ratio (HR) was 0.72 (95%CI, 0.38-1.31). Bonded upper molars yielded a survival rate of 81.25% (26 out of 32) compared to 71.87% (23 out of 32) for banded upper molars. The survival rate was 66.66% (18 out of 27) for banded lower molars and 59.25% for bonded lower molars (16 out of 27). The HR for lower vs. upper arch was 2.16 (95%CI, 1.18-3.98). No serious problem was observed other than gingivitis associated with plaque accumulation. In contrast to previous studies in young patients, in adults, bonding orthodontic tubes to molars is similar to molar banding. However, both procedures had a high failure rate in the lower arch.

  4. Safety data on 19 vehicles for use in 1 month oral rodent pre-clinical studies: administration of hydroxypropyl-ß-cyclodextrin causes renal toxicity.

    Science.gov (United States)

    Healing, Guy; Sulemann, Tabassum; Cotton, Peter; Harris, Jayne; Hargreaves, Adam; Finney, Rowena; Kirk, Sarah; Schramm, Carolin; Garner, Clare; Pivette, Perrine; Burdett, Lisa

    2016-01-01

    Potential new drugs are assessed in pre-clinical in vivo studies to determine their safety profiles. The drugs are formulated in vehicles suitable for the route of administration and the physicochemical properties of the drug, aiming to achieve optimal exposure in the test species. The availability of safety data on vehicles is often limited (incomplete data, access restricted/private databases). Nineteen potentially useful vehicles that contained new and/or increased concentrations of excipients and for which little safety data have been published were tested. Vehicles were dosed orally once daily to HanWistar rats for a minimum of 28 days and a wide range of toxicological parameters were assessed. Only 30% (w/v) hydroxypropyl-ß-cyclodextrin was found unsuitable owing to effects on liver enzymes (AST, ALT and GLDH), urinary volume and the kidneys (tubular vacuolation and tubular pigment). 20% (v/v) oleic acid caused increased salivation and hence this vehicle should be used with caution. As 40% (v/v) tetraethylene glycol affected urinary parameters, its use should be carefully considered, particularly for compounds suspected to impact the renal system and studies longer than 1 month. There were no toxicologically significant findings with 10% (v/v) dimethyl sulphoxide, 20% (v/v) propylene glycol, 33% (v/v) Miglyol®812, 20% (w/v) Kolliphor®RH40, 10% (w/v) Poloxamer 407, 5% (w/v) polyvinylpyrrolidone K30 or 10% (v/v) Labrafil®M1944. All other vehicles tested caused isolated or low magnitude effects which would not prevent their use. The aim of sharing these data, including adverse findings, is to provide meaningful information for vehicle selection, thereby avoiding repetition of animal experimentation.

  5. Rapid-growing juvenile xanthogranuloma on the scalp in 18-month-old girl.

    Science.gov (United States)

    Park, Young Woo; Koh, Eun Jeong; Choi, Ha Young

    2011-09-01

    Juvenile xanthogranuloma (JXG) is an uncommon histiocytic cutaneous lesion. An 18-month-old girl visited our clinic due to rapid growing orange-yellowish lesion on scalp. Enlarging time from 1 mm to 12 mm was just 8 weeks. We excised the tumor and adjacent normal tissue. Histopathological study showed numerous eosinophils and Touton giant cells within the lesion. Immunohistochemical study revealed positive immunoreactivity for CD68 in most areas. No recurrence was seen during 12 months after resection. We report a case with rapidly growing JXG on scalp with peculiar histopathologic findings.

  6. Immunization in the Well Baby Clinic of Dr. Pirngadi Hospital Medan.

    Science.gov (United States)

    Dalimunthe, S; Tjipta, G D; Lubis, I Z; Manoeroeng, S M; Lubis, C P

    1990-01-01

    A retrospective study on an immunization programme was carried out in the Well Baby Clinic, Child Health Department, School of Medicine, University of North Sumatera, Dr. Pirngadi Hospital, Medan from January to December 1986. Of the 5951 total visits (an average of 495 visits each month) 3960 were primary and 1991 secondary visits. Most were first children in the family (39.9%) of which 37.6% were from one child families. Of 3275 live births 57.6% were immunized with BCG immediately after birth. The average BCG immunization visits to the Well Baby Clinic was 17 visits/day. When compared with DPT I and polio I visits we recorded a decrease of 27.1% for DPT II; 47.9% DPT III; 27.4% polio II; and 49.1% polio III respectively. Daily coverage of measles immunization visits was 4.6%. Complete immunization among the under-one-year-old children was 5.7% of which 44.9% were of the 9-12 months old group. The simultaneous immunization (BCG, DPT, polio, measles) comprised 0.5% of all visits. 4.1% of all visits were not immunized of which 36.5% was because they were beyond the immunization schedule.

  7. Sentinel surveillance of AIDS in male outpatients visiting STD clinics in Huzhou, Zhejiang, 2010%2010年浙江省湖州市性病门诊男性就诊者艾滋病哨点监测分析

    Institute of Scientific and Technical Information of China (English)

    董正全; 金玫华; 杨中荣

    2012-01-01

    commercial sex in past three months, 28. 9% had sex behavior with temporary sexual partners in past three months, 0.4% experienced injecting drug use, 3.5% had anal sex with men and 23.4% suffered from STDs. The rate of awareness of AIDS related knowledge in the subjects was 67. 7%. Conclusion The prevalence rates of HTV and STDs in the male outpatients in STD clinics were high in Huzhou. It is necessary to strengthen the health education and behavior intervention in male outpatients visiting STD clinics to effectively control the spread of AIDS and STDs.

  8. A Cross-Sectional Study on Quality of Life of Outpatients Visiting Methadone Clinics in Guangxi%广西美沙酮门诊患者生命质量现况研究

    Institute of Scientific and Technical Information of China (English)

    卢海艳; 罗红叶; 冯启明; 黎燕宁; 陈欢欢; 张宇星; 王勇

    2014-01-01

    Objective To explore the quality of life of patients receiving methadone maintenance treatment and its related influencing factors .Methods A self-administered questionnaire and the quality of life scale for drug addicts were used in the field investigation on the subjects′demographic characteristics and quality of life among 670 patients .Results The total scores of physiological function ,withdrawal syndrome ,quality of life showed no significant difference between the male and the female ( P>0 .05 ) , and the scores of psychological and social functions of the female were significantly higher than those of the male (P0.05).The total scores of physiological ,psychological and social functions ,withdrawal syndrome ,quality of life of employment patients were significantly lower than those of unemployment patients (P<0.05),which were significantly lower in the unmarried patients in contrast with those in the married patients (P<0.05).The total scores of physiological , psychological and social functions,withdrawal syndrome,quality of life were significantly lower in patients with monthly earnings(Yuan)<100 or ranged from 100 to 499 in contrast with those in patients with monthly earnings (Yuan) ranged from 500 to 999 or≥1 000(P<0.05).Conclusion Nationality,marital status,employment and monthly earnings might be the influencing factors for quality of life of patients receiving methadone maintenance treatment in clinics .%目的:了解美沙酮维持治疗患者的生命质量现状和探讨相关的影响因素。方法采用自填式调查问卷方式,运用《药物成瘾者生命质量测定量表》,对670例患者的一般情况及生命质量进行调查。结果男女身体功能、戒断症状、生命质量总分比较,差异无统计学意义( P>0.05);女性心理功能、社会功能评分均明显高于男性(P<0.05);汉族患者身体功能、戒断症状、生命质量总分明显低于少数民族(P<0.05);两

  9. Research on return visit and investigation of the relapse rate of children allergic purpura after treatment.

    Science.gov (United States)

    Yang, Weihong; Zhou, Yudong; Zhang, Sisen; Yang, Fang; Zhuang, Tanyue; Wu, Xinyan

    2015-01-01

    This paper aimed to research on return visit and investigation of the relapse rate of children allergic purpura after treatment. Children with allergic purpura were divided into two groups. The treatment group was treated with the adrenocorticotrophic hormone while the control group did not. We tracked and observed two groups of discharged children in the first month and the second month. It can be found that, at the first month, 5 cases recurred in the treatment group with 20 cases, the relapse rate was 25%, 1 case recurred in control group, the relapse rate was 5%; at the second month, 2 cases recurred in treatment group, the relapse rate was 10%, no case recurred in the control group. There were 8 cases recurred in the past two months, and there were no replace after the second time treatment. In contrast, the children, who treated with adrenocorticotrophic hormone, had higher relapse rate, while the control group had lower relapse rate. Then we can get the conclusion that, the application of adrenocorticotrophic hormone may be one of the main reasons to induce the allergic purpura and we should notice and discuss this conclusion in the clinical practice.

  10. Follow-Up Visit Patterns in an Antiretroviral Therapy (ART programme in Zomba, Malawi.

    Directory of Open Access Journals (Sweden)

    Beth Rachlis

    Full Text Available Identifying follow-up (FU visit patterns, and exploring which factors influence them are likely to be useful in determining which patients on antiretroviral therapy (ART may become Lost to Follow-Up (LTFU. Using an operation and implementation research approach, we sought 1 to describe the timing of FU visits amongst patients who have been on ART for shorter and longer periods of time; and 2 to determine the median time to late visits, and 3 to identify specific factors that may be associated with these patterns in Zomba, Malawi.Using routinely collected programme monitoring data from Zomba District, we performed descriptive analyses on all ART visits among patients who initiated ART between Jan. 1, 2007-June 30, 2010. Based on an expected FU date, each FU visit was classified as early (≥4 day before an expected FU date, on time (3 days before an expected FU date/up to 6 days after an expected FU date, or late (≥7 days after an expected FU date. In total, 7,815 patients with 76417 FU visits were included. Ninety-two percent of patients had ≥2 FU visits. At the majority of visits, patients were either on time or late. The median time to a first late visit among those with 2 or more visits was 216 days (IQR: 128-359. Various patient- and visit-level factors differed significantly across Early, On Time, and Late visit groups including ART adherence and frequency of, and type of side effects.The majority of patients do not demonstrate consistent FU visit patterns. Individuals were generally on ART for at least 6 months before experiencing their first late visit. Our findings have implications for the development of effective interventions that meet patient needs when they present early and can reduce patient losses to follow-up when they are late. In particular, time-varying visit characteristics need further research.

  11. Hospital-based inter-professional strategy to reduce in-patient admissions and emergency department visits for pediatric asthma.

    Science.gov (United States)

    Fleming, Karen; Kuzik, Brian; Chen, Chee

    2011-01-01

    Pediatric asthma is a common reason for emergency department (ED) visits and in-patient hospital admissions. Evidence demonstrates that asthma management initiated in the ED has limited benefit unless followed by ongoing coordinated inter-professional care (IPC). The Royal Victoria Hospital (RVH) of Barrie, Ontario, has developed a best practice model of care for pediatric asthma. Primary care providers and ED physicians are actively encouraged to refer children with any recurrent respiratory problems consistent with asthma to the Paediatric Asthma Clinic (PAC). Quarterly PAC visits with a certified asthma educator and a pediatrician include lung function measurement, written action plans and primary care provider communication. Ongoing outcome monitoring of patients receiving IPC has revealed that, compared with 12 months prior to enrolment in the PAC, patients show a two-thirds decrease in asthma-related ED visits and an 85% decrease in admissions. The PAC has contributed to an ongoing decline in the rates of pediatric asthma-related ED visits and admissions at RVH, which are currently less than half the rates seen at our peer hospitals. IPC for chronic diseases is best practice, and our model of care for pediatric asthma continues to provide critical data demonstrating and supporting the advantages of IPC in chronic disease management. RVH modifies practice and policy to meet best practices, optimizing the care provided to children with pediatric asthma.

  12. Parental Language and Return Visits to the Emergency Department After Discharge.

    Science.gov (United States)

    Samuels-Kalow, Margaret E; Stack, Anne M; Amico, Kendra; Porter, Stephen C

    2017-06-01

    Return visits to the emergency department (ED) are used as a marker of quality of care. Limited English proficiency, along with other demographic and disease-specific factors, has been associated with increased risk of return visit, but the relationship between language, short-term return visits, and overall ED use has not been well characterized. This is a planned secondary analysis of a prospective cohort examining the ED discharge process for English- or Spanish-speaking parents of children aged 2 months to 2 years with fever and/or respiratory illness. At 1 year after the index visit, a standardized chart review was performed. The primary outcome was the number of ED visits within 72 hours of the index visit. Multivariable logistic regression was used to examine the relative importance of predictor variables and adjust for confounders. There were 202 parents eligible for inclusion, of whom 23% were Spanish speaking. In addition, 6.9% of the sample had a return visit within 72 hours. After adjustment for confounders, Spanish language was associated with return visit within 72 hours (odds ratio, 3.49; 95% confidence interval, 1.02-11.90) but decreased risk of a second visit within the year (odds ratio, 0.28; 95% confidence interval, 0.12-0.66). Spanish-speaking parents are at an increased risk of 72-hour return ED visit but do not seem to be at increased risk of ED use during the year after their ED visit.

  13. Association between painful physical symptoms and clinical outcomes in Chinese patients with major depressive disorder:a three-month observational study

    Institute of Scientific and Technical Information of China (English)

    LI Hui-chun; WU Wen-yuan; Pritibha Singh; Renee Elizabeth Granger; Joel Raskin; ANG Qiu-qing; ZHANG Ming-yuan; WANG Gang; ZHANG Hong-geng; ZHANG Hong-yan; LIU Ying; LI Ming; ZHANG Cong-pei; TANG Ji-sheng

    2010-01-01

    Background Painful physical symptoms (PPS) may present as a component of major depressive disorder (MDD).Their effect in Chinese patients has not been investigated.This analysis reports the changes in disease severity,treatment patterns, quality of life and outcomes in a Chinese cohort according to the presence (PPS+) or absence (PPS-)of painful physical symptoms.Methods A subgroup of Chinese patients from a large observational 3-month study of patients from Asian countries and regions of China were classified using the modified Somatic Symptom Inventory (SSI) as PPS+(mean score≥2) or PPS(mean score <2).Depression severity was assessed with the Clinical Global Impression of Severity (CGI-S) scale and 17-item Hamilton depression rating scale (HAMD17).Pain severity was measured using a visual analogue scale (VAS),while the EuroQoL (EQ-5D) assessed patient well-being.Antidepressants were compared with regard to their efficacy.Results Of the 299 Chinese patients enrolled in the study, 105 were classified as PPS+ (73/105, 70% women).At baseline, PPS+ patients reported greater pain severity (VAS, mean (SD): 49.56 (26.49) vs.16.60 (20.99) for PPS-, P <0.01), were more depressed (HAMD17, mean (SD): 25.32 (5.47) vs.23.33 (5.24) for PPS-, P=0.002) and had poorer quality of life (EQ-5D Health State, mean (SD): 38.48 (22.38) vs.49.57 (18.54) for PPS-, P <0.001).PPS+ patients showed less overall improvement in depressive symptom severity (HAMD17, change from baseline (95% CI):-17.38(-18.65, -16.12) vs.-19.20 (-20.05,-18.35) for PPS-,P=-0.032; CGI-S, change from baseline (95% CI): -2.85(-3.11, -2.58) vs.-3.20 (-3.38, -3.02) for PPS-, P=0.044).Conclusions PPS were less frequent than expected compared with previous studies of Asian populations.PPS+were associated with greater MDD severity and less improvement than PPS- when antidepressants were given.

  14. In Alzheimer’s Disease, 6-Month Treatment with GLP-1 Analog Prevents Decline of Brain Glucose Metabolism: Randomized, Placebo-Controlled, Double-Blind Clinical Trial

    Science.gov (United States)

    Gejl, Michael; Gjedde, Albert; Egefjord, Lærke; Møller, Arne; Hansen, Søren B.; Vang, Kim; Rodell, Anders; Brændgaard, Hans; Gottrup, Hanne; Schacht, Anna; Møller, Niels; Brock, Birgitte; Rungby, Jørgen

    2016-01-01

    In animal models, the incretin hormone GLP-1 affects Alzheimer’s disease (AD). We hypothesized that treatment with GLP-1 or an analog of GLP-1 would prevent accumulation of Aβ and raise, or prevent decline of, glucose metabolism (CMRglc) in AD. In this 26-week trial, we randomized 38 patients with AD to treatment with the GLP-1 analog liraglutide (n = 18), or placebo (n = 20). We measured Aβ load in brain with tracer [11C]PIB (PIB), CMRglc with [18F]FDG (FDG), and cognition with the WMS-IV scale (ClinicalTrials.gov NCT01469351). The PIB binding increased significantly in temporal lobe in placebo and treatment patients (both P = 0.04), and in occipital lobe in treatment patients (P = 0.04). Regional and global increases of PIB retention did not differ between the groups (P ≥ 0.38). In placebo treated patients CMRglc declined in all regions, significantly so by the following means in precuneus (P = 0.009, 3.2 μmol/hg/min, 95% CI: 5.45; 0.92), and in parietal (P = 0.04, 2.1 μmol/hg/min, 95% CI: 4.21; 0.081), temporal (P = 0.046, 1.54 μmol/hg/min, 95% CI: 3.05; 0.030), and occipital (P = 0.009, 2.10 μmol/hg/min, 95% CI: 3.61; 0.59) lobes, and in cerebellum (P = 0.04, 1.54 μmol/hg/min, 95% CI: 3.01; 0.064). In contrast, the GLP-1 analog treatment caused a numerical but insignificant increase of CMRglc after 6 months. Cognitive scores did not change. We conclude that the GLP-1 analog treatment prevented the decline of CMRglc that signifies cognitive impairment, synaptic dysfunction, and disease evolution. We draw no firm conclusions from the Aβ load or cognition measures, for which the study was underpowered. PMID:27252647

  15. Efficacy of baby-CIMT: study protocol for a randomised controlled trial on infants below age 12 months, with clinical signs of unilateral CP.

    Science.gov (United States)

    Eliasson, Ann-Christin; Sjöstrand, Lena; Ek, Linda; Krumlinde-Sundholm, Lena; Tedroff, Kristina

    2014-06-05

    Infants with unilateral brain lesions are at high risk of developing unilateral cerebral palsy (CP). Given the great plasticity of the young brain, possible interventions for infants at risk of unilateral CP deserve exploration. Constraint-induced movement therapy (CIMT) is known to be effective for older children with unilateral CP but is not systematically used for infants. The development of CIMT for infants (baby-CIMT) is described here, as is the methodology of an RCT comparing the effects on manual ability development of baby-CIMT versus baby-massage. The main hypothesis is that infants receiving baby-CIMT will develop manual ability in the involved hand faster than will infants receiving baby-massage in the first year of life. The study will be a randomised, controlled, prospective parallel-group trial. Invited infants will be to be randomised to either the baby-CIMT or the baby-massage group if they: 1) are at risk of developing unilateral CP due to a known neonatal event affecting the brain or 2) have been referred to Astrid Lindgren Children's Hospital due to asymmetric hand function. The inclusion criteria are age 3-8 months and established asymmetric hand use. Infants in both groups will receive two 6-weeks training periods separated by a 6-week pause, for 12 weeks in total of treatment. The primary outcome measure will be the new Hand Assessment for Infants (HAI) for evaluating manual ability. In addition, the Parenting Sense of Competence scale and Alberta Infant Motor Scale will be used. Clinical neuroimaging will be utilized to characterise the brain lesion type. To compare outcomes between treatment groups generalised linear models will be used. The model of early intensive intervention for hand function, baby-CIMT evaluated by the Hand Assessment for Infants (HAI) will have the potential to significantly increase our understanding of how early intervention of upper limb function in infants at risk of developing unilateral CP can be performed and

  16. Women's Awareness of Periconceptional Use of Folic Acid Before and After Their Antenatal Visits.

    Science.gov (United States)

    Maher, Mark; Keriakos, Remon

    2014-01-01

    The aim of this study is to assess women's awareness of the benefit and use of folic acid during pregnancy and to assess whether their knowledge has improved following hospital visits. This is a prospective survey conducted in a large teaching hospital in the UK. The survey questionnaire consisted of 28 questions about demographic variables, behavioral variables, and knowledge about folic acid and neural tube defects (NTDs). A total of 603 women participated in this study. Some of them attended for the first time and others had more than one visit, either in their current or previous pregnancies. In about 25% of cases, the pregnancy was not planned. Between 14 and 19% of the women of First and Two+ Visit groups consulted their doctor or other healthcare professional before conception. Nearly 98% of the women stated that they had heard of folic acid, but only 42-52% knew the medical condition it protects against. The main sources of information for women who were aware of folic acid were midwives and general practitioners. Nearly 90% of women who attended their first antenatal visit were taking folic acid. However, only 40% of women knew that they should take it before pregnancy, and only between 36 and 46% knew the dietary sources of folic acid, although about 84% know the foods that should be avoided during pregnancy. This study found that attending antenatal clinic has not increased women's awareness about folic acid. There is still a high proportion of women who do not know that folic acid should be taken before pregnancy and continued for the first three months of pregnancy. School education, primary care team, and family planning service should take the lead in providing information to women about folic acid.

  17. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Directory of Open Access Journals (Sweden)

    Steven Hawken

    Full Text Available OBJECTIVE: We investigated the association between a child's birth order and emergency room (ER visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. METHODS: We included all children born in Ontario between April 1(st, 2006 and March 31(st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI of events among 1(st-born and later-born children using relative incidence ratios (RIR. RESULTS: For the 2-month vaccination, the RIR for 1(st-borns versus later-born children was 1.37 (95% CI: 1.19-1.57, which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99, representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st vs. later-borns was 1.27 (95% CI: 1.09-1.48, or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21, or 249 excess events/100,000 vaccinated. CONCLUSIONS: Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st-born children had significantly higher relative incidence of events compared to later-born children.

  18. Post-extraction mesio-distal gap reduction assessment by confocal laser scanning microscopy - a clinical 3-month follow-up study.

    Science.gov (United States)

    García-Herraiz, Ariadna; Silvestre, Francisco Javier; Leiva-García, Rafael; Crespo-Abril, Fortunato; García-Antón, José

    2017-05-01

    The aim of this 3-month follow-up study is to quantify the reduction in the mesio-distal gap dimension (MDGD) that occurs after tooth extraction through image analysis of three-dimensional images obtained with the confocal laser scanning microscopy (CLSM) technique. Following tooth extraction, impressions of 79 patients 1 month and 72 patients 3 months after tooth extraction were obtained. Cast models were processed by CLSM, and MDGD changes between time points were measured. The mean mesio-distal gap reduction 1 month after tooth extraction was 343.4 μm and 3 months after tooth extraction was 672.3 μm. The daily mean gap reduction rate during the first term (between baseline and 1 month post-extraction measurements) was 10.3 μm/day and during the second term (between 1 and 3 months) was 5.4 μm/day. The mesio-distal gap reduction is higher during the first month following the extraction and continues in time, but to a lesser extent. When the inter-dental contacts were absent, the mesio-distal gap reduction is lower. When a molar tooth is extracted or the distal tooth to the edentulous space does not occlude with an antagonist, the mesio-distal gap reduction is larger. The consideration of mesio-distal gap dimension changes can help improve dental treatment planning. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Detection of acute deterioration in health status visit among COPD patients by monitoring COPD assessment test score

    Directory of Open Access Journals (Sweden)

    Pothirat C

    2015-02-01

    Full Text Available Chaicharn Pothirat, Warawut Chaiwong, Atikun Limsukon, Athavudh Deesomchok, Chalerm Liwsrisakun, Chaiwat Bumroongkit, Theerakorn Theerakittikul, Nittaya PhetsukDivision of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandBackground: The Chronic Obstructive Pulmonary Disease Assessment Test (CAT could play a role in detecting acute deterioration in health status during monitoring visits in routine clinical practice.Objective: To evaluate the discriminative property of a change in CAT score from a stable baseline visit for detecting acute deterioration in health status visits of chronic obstructive pulmonary disease (COPD patients.Methods: The CAT questionnaire was administered to stable COPD patients routinely attending the chest clinic of Chiang Mai University Hospital who were monitored using the CAT score every 1–3 months for 15 months. Acute deterioration in health status was defined as worsening or exacerbation. CAT scores at baseline, and subsequent visits with acute deterioration in health status were analyzed using the t-test. The receiver operating characteristic curve was performed to evaluate the discriminative property of change in CAT score for detecting acute deterioration during a health status visit.Results: A total of 354 follow-up visits were made by 140 patients, aged 71.1±8.4 years, with a forced expiratory volume in 1 second of 47.49%±18.2% predicted, who were monitored for 15 months. The mean CAT score change between stable baseline visits, by patients’ and physicians’ global assessments, were 0.05 (95% confidence interval [CI], -0.37–0.46 and 0.18 (95% CI, -0.23–0.60, respectively. At worsening visits, as assessed by patients, there was significant increase in CAT score (6.07; 95% CI, 4.95–7.19. There were also significant increases in CAT scores at visits with mild and moderate exacerbation (5.51 [95% CI, 4.39–6

  20. Job Candidates' Views of Site Visits.

    Science.gov (United States)

    Fink, Laurence S.; And Others

    1994-01-01

    Followed 62 Master of Business Administration students through job search involving 97 site visits to determine whether site visits changed perceptions of visited companies, attitudes toward those firms, and intentions to accept job offers. Findings suggest that organizations can improve recruitment success by paying attention to how site visits…

  1. Case Study of Home-School Visits

    Science.gov (United States)

    Aguerrebere, Yolanda

    2009-01-01

    This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten…

  2. C4-1: As the Clock Ticks… Are Questions the Answer? Audio-Recordings of Primary Care Visits Among Patients with Mental Health Needs Show Room for Improvement in Physician Communication

    Science.gov (United States)

    Tai-Seale, Ming; Foo, Patricia; Stults, Cheryl

    2013-01-01

    Background/Aims Encouraging patients to ask questions in clinical visits is seen as a key to engaging patients. Multiple interventions have focused on activating patients to ask questions when visiting physicians. We know little about whether patients with mental illness ask questions in primary care visits, how their question-asking behavior is associated with physicians’ relational communication and the length of visit. Methods We conducted in-depth mixed method analyses of 322 audio-recordings of periodic health exams (PHE) made by patients 50–80 years of age. Patients included those with mental health (MH) needs, based on 2-item Personal Health Questionnaire (PHQ2) scores (2 or greater), on having filled or been prescribed a psychotropic medication, on having a MH diagnosis or visited a MH provider in prior 12 months, or on having a MH discussion in the visit. Using transcribed recordings, each conversation was categorized into “topics,” which were grouped into three categories: biomedical, MH, or other. Multivariate models were estimated using generalized estimating equations. Results About 99% of patients (319 of 322) asked at least one question. Patients asked questions throughout the visit, averaging 18 per visit. Half of them asked their first question within the first 1.4 minutes. Patients were more likely to ask a question if a topic discussed a medication (OR = 1.57, P <.01) and less likely if the topic was about MH issues compared to biomedical issues (OR = .51, P <.01). PHQ2 score was not a significant factor. The number of patient questions was negatively correlated with ratings of their physicians’ relational communication. Each additional question was associated with a 12-second increase in visit length (P <.01). Conclusions Patients ask many questions, and they ask them early and often. The number of patient questions was associated with unfavorable views of physician relational communication and with slightly longer visits. Patient

  3. Impact of Ramadan on emergency department visits and on medical emergencies.

    Science.gov (United States)

    Al Assaad, Reem G; Bachir, Rana; El Sayed, Mazen J

    2017-07-12

    Fasting during Ramadan is important to Muslims. This study describes changes in emergency department (ED) visits and in frequencies of emergency conditions and impact on clinical outcomes during Ramadan in a tertiary care center in Beirut, Lebanon. Patients presenting to ED during Ramadan 1 month before and 1 month after Ramadan over a 3-year period with specific conditions (acute coronary syndrome, stroke, seizure, diabetes, renal colic, headache or hypertension) were included. Clinical and sociodemographic characteristics, ED volume, diagnoses, and outcomes were examined during two periods (Ramadan vs. non-Ramadan). Multiple logistic regressions were performed to identify the impact of Ramadan on ED bounce-back and mortality at ED discharge. A total of 3536 patients were included. The daily average ED volume was higher during non-Ramadan months (145.65±22.14) compared with Ramadan (128.85±14.52). The average ED length of stay was higher during Ramadan (5.42±14.86 vs. 3.96±4.29 h; P=0.006). Frequencies and admission rates for the selected diseases were comparable during the two periods, except for patients with acute coronary syndrome or stroke who had lower admission rates during Ramadan.ED bounce-back rates and mortality at ED discharge were higher during Ramadan (odds=1.34, 95% confidence interval: 1.03-1.74 and odds ratio=2.88, 95% confidence interval: 1.01-8.27, respectively). EDs might experience a decreased in volumes, higher length of stay, and potentially worse outcomes during Ramadan. Changes in the frequencies of ED visits related to common conditions are not expected. Prospective studies documenting fasting status would clarify further the impact of Ramadan.

  4. Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study

    NARCIS (Netherlands)

    Verkerk, K.; Luijsterburg, P.A.J.; Heymans, M.W.; Ronchetti, I.; Miedema, H.S.; Koes, B.W.; Pool-Goudzwaard, A.

    2015-01-01

    This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic nonspecific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n ¼ 1760) of

  5. 76 FR 25517 - Jewish American Heritage Month, 2011

    Science.gov (United States)

    2011-05-05

    ...#0;#0; ] Proclamation 8660 of April 29, 2011 Jewish American Heritage Month, 2011 By the President of... laws of the United States, do hereby proclaim May 2011 as Jewish American Heritage Month. I call upon all Americans to visit ] www.JewishHeritageMonth.gov to learn more about the heritage...

  6. Virtual Visits for Acute, Nonurgent Care: A Claims Analysis of Episode-Level Utilization.

    Science.gov (United States)

    Gordon, Aliza S; Adamson, Wallace C; DeVries, Andrea R

    2017-02-17

    Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions. A cross-sectional, retrospective analysis of claims from a large commercial health insurer was performed to compare care and cost of patients receiving care via virtual visits for a condition of interest (sinusitis, upper respiratory infection, urinary tract infection, conjunctivitis, bronchitis, pharyngitis, influenza, cough, dermatitis, digestive symptom, or ear pain) matched to those receiving care for similar conditions in other settings. An episode was defined as the index visit plus 3 weeks following. Patients were children and adults younger than 65 years of age without serious chronic conditions. Visits were classified according to the setting where the visit occurred. Care provided was assessed by follow-up outpatient visits, ED visits, or hospitalizations; laboratory tests or imaging performed; and antibiotic use after the initial visit. Episode costs included the cost of the initial visit, subsequent medical care, and pharmacy. A total of 59,945 visits were included in the analysis (4635 virtual visits and 55,310 nonvirtual visits). Virtual visit episodes had similar follow-up outpatient visit rates (28.09%) as PCP (28.10%, P=.99) and RHC visits (28.59%, P=.51). During the episode, lab rates for virtual visits (12.56%) were lower than in-person locations (RHC: 36.79%, Pvirtual visits (6.62%) were typically lower than in-person locations (RHC: 5.97%, P=.11; UCC: 8.77%, Pvirtual visit episodes, respectively, including medical and pharmacy costs. Virtual care appears to

  7. Hanford Laboratories Operation monthly activities report, August 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-09-15

    This is the monthly report for the Hanford Laboratories Operation, August, 1959. Reactor fuels, chemistry, dosimetry, separation processes, reactor technology financial activities, visits, biology operation, physics and instrumentation research, employee relations, and operations research and synthesis operation are discussed.

  8. Hanford Laboratories Operation monthly activities report, June 1957

    Energy Technology Data Exchange (ETDEWEB)

    1957-07-15

    This is the monthly report for the Hanford Laboratories Operation, July 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  9. Hanford Laboratories Operation monthly activities report, July 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-08-15

    This is the monthly report for the Hanford Laboratories Operation, July 1969. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  10. Hanford Laboratories Operation monthly activities report, November 1962

    Energy Technology Data Exchange (ETDEWEB)

    1962-12-14

    This is the monthly report for the Hanford Laboratories Operation, November 1962. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  11. Hanford Laboratories Operation monthly activities report, November 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-12-15

    This is the monthly report for the Hanford Laboratories Operation, November 1959. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  12. Hanford Laboratories Operation monthly activities report, December 1962

    Energy Technology Data Exchange (ETDEWEB)

    1963-01-15

    This is the monthly report for the Hanford Laboratories Operation, December 1962. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  13. Hanford Laboratories Operation monthly activities report, August 1957

    Energy Technology Data Exchange (ETDEWEB)

    1957-09-15

    This is the monthly report for the Hanford Laboratories Operation, September 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  14. Hanford Atomic Products Operation monthly report for February 1956

    Energy Technology Data Exchange (ETDEWEB)

    1956-02-21

    This is the monthly report for the Hanford Laboratories Operation, February, 1956. Metallurgy, reactors fuels, chemistry, dosimetry, separation processes, reactor technology financial activities, visits, biology operation, physics and instrumentation research, employee relations are discussed.

  15. Hanford Laboratories Operation monthly activities report, March 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-04-15

    This is the monthly report for the Hanford Laboratories Operation, April 1961. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  16. Hanford Laboratories Operation monthly activities report, May 1957

    Energy Technology Data Exchange (ETDEWEB)

    1957-06-15

    This is the monthly report for the Hanford Laboratories Operation, May, 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  17. Hanford Laboratories Operation monthly activities report, July 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-08-15

    This is the monthly report for the Hanford Laboratories Operation, July, 1959. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  18. Hanford Laboratories Operation monthly activities report, February 1960

    Energy Technology Data Exchange (ETDEWEB)

    1960-03-15

    This is the monthly report for the Hanford Laboratories Operation, February, 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  19. Hanford Laboratories Operation monthly activities report, March 1958

    Energy Technology Data Exchange (ETDEWEB)

    Parker, H.M.

    1958-04-15

    This is the monthly report for the Hanford Laboratories Operation, March, 1958. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  20. Hanford Laboratories Operation monthly activities report, April 1958

    Energy Technology Data Exchange (ETDEWEB)

    1958-05-15

    This is the monthly report for the Hanford Laboratories Operation, May, 1958. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  1. Hanford Laboratories Operation monthly activities report, September 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-10-15

    This is the monthly report for the Hanford Laboratories Operation, October 1959. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  2. Hanford Laboratories Operation monthly activities report, June 1960

    Energy Technology Data Exchange (ETDEWEB)

    1960-07-15

    This is the monthly report for the Hanford Laboratories Operation, July 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities,, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  3. Hanford Laboratories Operation monthly activities report, January 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-02-15

    This is the monthly report for the Hanford Laboratories Operation, January 1961. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  4. Hanford Laboratories Operation monthly activities report, December 1959

    Energy Technology Data Exchange (ETDEWEB)

    1960-01-15

    This is the monthly report for the Hanford Laboratories Operation, January 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  5. Hanford Laboratories Operation monthly activities report, April 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-05-15

    This is the monthly report for the Hanford Laboratories Operation, April 1961. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  6. Hanford Laboratories Operation monthly activities report, September 1960

    Energy Technology Data Exchange (ETDEWEB)

    1960-10-15

    This is the monthly report for the Hanford Laboratories Operation, October, 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  7. Hanford Laboratories Operation monthly activities report, November 1960

    Energy Technology Data Exchange (ETDEWEB)

    Sale, W.

    1960-12-15

    This is the monthly report for the Hanford Laboratories Operation, November 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  8. Hanford Laboratories Operation monthly activities report, October 1960

    Energy Technology Data Exchange (ETDEWEB)

    1960-11-15

    This is the monthly report for the Hanford Laboratories Operation, October 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  9. Hanford Laboratories Operation monthly activities report, March 1957

    Energy Technology Data Exchange (ETDEWEB)

    Albaugh, E.W.

    1957-04-15

    This is the monthly report of the Hanford Laboratories Operation, March, 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  10. Hanford Laboratories Operation monthly activities report, February 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-03-15

    This is the monthly report for the Hanford Laboratories Operation, February 1961. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  11. Hanford Atomic Products Operation monthly report for March 1956

    Energy Technology Data Exchange (ETDEWEB)

    1956-04-20

    This is the monthly report for the Hanford Laboratories Operation, March, 1956. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology; financial activities, visits, biology operation, physics and instrumentation research, employee relations, pile technology, safety and radiological sciences are discussed.

  12. Hanford Laboratories Operation monthly activities report, September 1957

    Energy Technology Data Exchange (ETDEWEB)

    1957-10-15

    This is the monthly report for the Hanford Laboratories Operation, September, 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  13. Hanford Atomic Products Operation monthly report, January 1956

    Energy Technology Data Exchange (ETDEWEB)

    1956-02-24

    This is the monthly report for the Hanford Atomic Laboratories Products Operation, February, 1956. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  14. Hanford Atomic Products Operation monthly report for June 1955

    Energy Technology Data Exchange (ETDEWEB)

    1955-07-28

    This is the monthly report for the Hanford Atomic Products Operation, June, 1955. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  15. [A new LH-RH agonist for treatment of prostate cancer, 3-month controlled-release formulation of goserelin acetate (Zoladex LA 10.8 mg depot)--outline of pre-clinical and clinical studies].

    Science.gov (United States)

    Tsukagoshi, Shigeru

    2002-09-01

    Goserelin acetate is a LH-RH agonist developed by AstraZeneca (formerly ICI, UK), and has been used clinically for the treatment of prostate cancer as a 4-week controlled-release formulation (Zoladex 3.6 mg depot). Recently, a new drug (Zoladex LA 10.8 mg depot) with 3-month controlled-release formulation was developed and became commercially available in Japan. In the randomized comparative phase III studies carried out with global bases, single administration of the new drug yielded almost equivalent anti-testosterone effect and the same serum level of the previous 3.6 mg depot formulation in 3-times continuous administration. In these studies, adverse drug reactions, which were mainly due to pharmacological effects of the new drug and minimal, were found in 52.6% (41/78) compared with 54.8% (46/84) with the previous 3.6 mg depot formulation. In the phase III studies, there were no significant differences in average serum testosterone levels between the two formulations at 12 and 13 weeks after administration. In the Japanese late phase II study with untreated patients, castration effect was observed in all 20 cases entered in the trial. In 20 cases in which treatment was switched from 3.6 mg depot to the new formulation, there were no significant changes in serum testosterone levels at castration level of the untreated patients, 90% (18/20) responded to the treatment, and normalization of PSA level was found in 75.0% (15/20). The adverse drug reactions were mainly increased triglyceride level and hot flushes. In the retrospective evaluation of untreated patients in this trial and the post-marketing clinical trial data for 3.6 mg depot, it was concluded that the new drug had almost the same efficacy and safety profile as 3.6 mg depot in Japanese people. These results indicate that Zoladex LA 10.8 mg depot has the same efficacy and safety as 3.6 mg depot with administration every three months, the burden of injection of LH-RH agonist can be reduced. This new

  16. Swiss State Secretary visits CERN

    CERN Multimedia

    2008-01-01

    The new Swiss State Secretary for Education and Research recently visited CERN. Peter Jenni, the spokesperson for ATLAS, gave Mauro Dell’Ambrogio, the new Swiss State Secretary for Education and Research, a tour of ATLAS and the LHC tunnel.On 2 April, the newly appointed Swiss State Secretary for Education and Research, Mauro Dell’Ambrogio, was welcomed to CERN by Director-General Robert Aymar. On arrival the Swiss minister was given a guided tour of ATLAS and the adjoining LHC tunnel by Peter Jenni, the ATLAS spokesperson. Dr Dell’Ambrogio was then greeted by Swiss scientists and attended presentations by young post doc physicists about Swiss contributions to CMS and LHCb, in particular their work concerning hardware contribution and data analysis. There are 120 physicists from Swiss universities working on CERN’s experiments, and many more Swiss people working at CERN in other departments due to Switzerland’s special position as a host state. Also before ...

  17. Steven Hawking to visit Texas A&M in spring

    CERN Multimedia

    Xavier, D

    2002-01-01

    Stephen Hawking will visit Texas A&M University from Feb. 24 to March 21 2003 to participate in the inaugural meeting of the George P. and Cynthia W. Mitchell Institute for Fundamental Physics. This institute will bring several of the world's top physicists to A&M for a month-long exploration of the latest ideas on topics ranging from superstrings to M-theory and supergravity (1/2 page).

  18. The impact of systematic dietary counseling during the first year of life on prevalence rates of anemia and iron deficiency at 12-16 months.

    Science.gov (United States)

    Bortolini, Gisele Ane; Vitolo, Márcia Regina

    2012-01-01

    To evaluate the impact that a program based on maternal dietary counseling covering breastfeeding and healthy complementary feeding had on the prevalence of iron deficiency, anemia and iron deficiency anemia in children aged 12 to 16 months. Newborn infants were randomized at birth to an intervention or a control group. Mothers in the intervention group received home visits during the children's first year of life on a monthly basis up to 6 months, and at 8, 10 and 12 months. The mothers in the control group received visits for data collection when children reached 6 and 12 months. All children were visited at ages between 12 and 16 months and 24-hour dietary recalls and hemoglobin and ferritin tests were conducted. There was no evidence that the intervention had an effect on anemia incidence, which was 66.5% in the intervention group and 61.8% in the control group. There was also no evidence of any difference between the groups in the prevalence of iron deficiency anemia or of iron deficiency. However, a higher percentage of children in the intervention group were exclusively breastfed at 4 and 6 months, and breastfed at 6 and 12 months. Intervention group children also consumed more meat and were fed diets with better iron bioavailability and consumed less cow's milk and calcium than children from the control group. This intervention had no effect on the prevalence of anemia, iron deficiency or iron deficiency anemia. Clinical trial registry identification number: NCT00629629.

  19. A Rural-Urban Comparison in Emergency Department Visits for U.S. Children with Autism Spectrum Disorder

    Science.gov (United States)

    Zhang, Wanqing; Mason, Ashley E.; Boyd, Brian; Sikich, Linmarie; Baranek, Grace

    2017-01-01

    We examined rural-urban differences in emergency department visits, and child and clinical characteristics associated with visits for U.S. children aged 3-17 years with autism spectrum disorder (ASD). Rural children with ASD were twice more likely to have emergency department visits in urban hospitals than rural children without ASD. The children…

  20. Determinants of the number of antenatal visits in a metropolitan region

    Directory of Open Access Journals (Sweden)

    Beeckman Katrien

    2010-09-01

    Full Text Available Abstract Background Antenatal care has a positive effect on pregnancy, both clinically and psychologically, but consensus about the optimal number of antenatal visits is lacking. This study aims to provide insight into the dynamics of the number of antenatal visits a woman receives. Independent effects of predisposing, enabling and pregnancy-related determinants are examined. Methods Women were recruited in nine clinical centres in the Brussels Metropolitan region. Antenatal care use was measured prospectively. A Poisson regression model was applied to measure the independent effect of individual determinants on the number of antenatal visits. Results Data on antenatal care trajectories in 333 women were collected. The multivariate analyses showed that women with a Maghreb or Turkish origin had 14% fewer visits compared with European (EU15 women. More highly educated women had 22% more visits compared with those with a low education. Women with a high income had 14% more antenatal visits compared with those with a low income. Fewer antenatal visits were observed in multiparae (15%, women initiating care after 14 weeks of gestation (31%, women without medical risks during the pregnancy (12% and in women with a continuity of care index of 50% or more (12%. More visits were observed in delivering after week 37 (22% increase. Conclusions Predisposing and enabling factors have to be considered when antenatal care programmes are evaluated in a metropolitan area. Variations in the number of antenatal visits show that socially vulnerable women are more at risk of having fewer visits.

  1. Determinants of the number of antenatal visits in a metropolitan region.

    Science.gov (United States)

    Beeckman, Katrien; Louckx, Fred; Putman, Koen

    2010-09-01

    Antenatal care has a positive effect on pregnancy, both clinically and psychologically, but consensus about the optimal number of antenatal visits is lacking. This study aims to provide insight into the dynamics of the number of antenatal visits a woman receives. Independent effects of predisposing, enabling and pregnancy-related determinants are examined. Women were recruited in nine clinical centres in the Brussels Metropolitan region. Antenatal care use was measured prospectively. A Poisson regression model was applied to measure the independent effect of individual determinants on the number of antenatal visits. Data on antenatal care trajectories in 333 women were collected. The multivariate analyses showed that women with a Maghreb or Turkish origin had 14% fewer visits compared with European (EU15) women. More highly educated women had 22% more visits compared with those with a low education. Women with a high income had 14% more antenatal visits compared with those with a low income. Fewer antenatal visits were observed in multiparae (15%), women initiating care after 14 weeks of gestation (31%), women without medical risks during the pregnancy (12%) and in women with a continuity of care index of 50% or more (12%). More visits were observed in delivering after week 37 (22% increase). Predisposing and enabling factors have to be considered when antenatal care programmes are evaluated in a metropolitan area. Variations in the number of antenatal visits show that socially vulnerable women are more at risk of having fewer visits.

  2. Ambient Ozone and Emergency Department Visits for Cellulitis

    Directory of Open Access Journals (Sweden)

    Mieczysław Szyszkowicz

    2010-11-01

    Full Text Available Objectives were to assess and estimate an association between exposure to ground-level ozone and emergency department (ED visits for cellulitis. All ED visits for cellulitis in Edmonton, Canada, in the period April 1992–March 2002 (N = 69,547 were examined. Case-crossover design was applied to estimate odds ratio (OR, and 95% confidence interval per one interquartile range (IQR increase in ozone concentration (IQR = 14.0 ppb. Delay of ED visit relating to exposure was probed using 0- to 5-day exposure lags. For all patients in the all months (January–December and lags 0 to 2 days, OR = 1.05 (1.02, 1.07. For male patients during the cold months (October-March: OR = 1.05 (1.02, 1.09 for lags 0 and 2 and OR = 1.06 (1.02, 1.10 for lag 3. For female patients in the warm months (April-September: OR = 1.12 (1.06, 1.18 for lags 1 and 2. Cellulitis developing on uncovered (more exposed skin was analyzed separately, observed effects being stronger. Cellulitis may be associated with exposure to ambient ground level ozone; the exposure may facilitate cellulitis infection and aggravate acute symptoms.

  3. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months follow-up in a clinical randomized study

    DEFF Research Database (Denmark)

    Rousing, Rikke; Andersen, Mikkel O; Jespersen, Stig M

    2009-01-01

    STUDY DESIGN: Clinical randomized study. OBJECTIVE: The aim of this study is to compare percutaneous vertebroplasty (PVP) to conservative treatment of patients with osteoporotic vertebral fractures in a clinical randomized study with respect to pain, physical and mental outcome, and to asses the ...

  4. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures.Three months follow up in a clinical randomised study

    DEFF Research Database (Denmark)

    Rousing, Rikke

    2008-01-01

    Abstract Study design. Clinical randomised study.    Objective. The aim of this study is to compare PVP to conservative treatment of patients with osteoporotic vertebral fractures in a clinical randomised study with respect to pain, physical and mental outcome, and to asses the risk of adjacent f...

  5. Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis: a 6-month randomized, vehicle-controlled clinical trial

    NARCIS (Netherlands)

    van Leeuwen, M.P.C.; Rosema, N.A.M.; Versteeg, P.A.; Slot, D.E.; van Winkelhoff, A.J.; van der Weijden, G.A.

    2015-01-01

    Objective To evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. Materials & Methods Participants (n = 62) used their randomly assigned pro

  6. Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis : a 6-month randomized, vehicle-controlled clinical trial

    NARCIS (Netherlands)

    Van Leeuwen, M. P. C.; Rosema, N. A. M.; Versteeg, P. A.; Slot, D. E.; Van Winkelhoff, A. J.; Van der Weijden, G. A.

    2015-01-01

    ObjectiveTo evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. Materials & MethodsParticipants (n=62) used their randomly assigned product

  7. Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis : a 6-month randomized, vehicle-controlled clinical trial

    NARCIS (Netherlands)

    Van Leeuwen, M. P. C.; Rosema, N. A. M.; Versteeg, P. A.; Slot, D. E.; Van Winkelhoff, A. J.; Van der Weijden, G. A.

    ObjectiveTo evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. Materials & MethodsParticipants (n=62) used their randomly assigned product

  8. Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis: a 6-month randomized, vehicle-controlled clinical trial

    NARCIS (Netherlands)

    van Leeuwen, M.P.C.; Rosema, N.A.M.; Versteeg, P.A.; Slot, D.E.; van Winkelhoff, A.J.; van der Weijden, G.A.

    2015-01-01

    Objective To evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. Materials & Methods Participants (n = 62) used their randomly assigned pro

  9. Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis : a 6-month randomized, vehicle-controlled clinical trial

    NARCIS (Netherlands)

    Van Leeuwen, M. P. C.; Rosema, N. A. M.; Versteeg, P. A.; Slot, D. E.; Van Winkelhoff, A. J.; Van der Weijden, G. A.

    2015-01-01

    ObjectiveTo evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. Materials & MethodsParticipants (n=62) used their randomly assigned product

  10. Midazolam / ketamine induction and isoflurane maintenance of anaesthesia in a 2-month-old, hand-raised African buffalo (Syncerus caffer : clinical communication

    Directory of Open Access Journals (Sweden)

    G.F. Stegmann

    2004-06-01

    Full Text Available The use of a midazolam / ketamine combination for induction of anaesthesia in a 2-month-old, hand-raised buffalo calf (Syncerus caffer described to allow endotracheal intubation for the maintenance of anaesthesia with isoflurane and oxygen. Intraoperative complications were hypotension and hypothermia. For postoperative analgesia meloxicam and butorphanol was administered intramuscularly.

  11. Periodontal health status in patients treated with the Invisalign® system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation

    Science.gov (United States)

    Levrini, Luca; Mangano, Alessandro; Montanari, Paola; Margherini, Silvia; Caprioglio, Alberto; Abbate, Gian Marco

    2015-01-01

    Objective: The aim of this prospective study was to compare the periodontal health and the microbiological changes via real-time polymerase chain reaction (PCR) in patients treated with fixed orthodontic appliances and Invisalign® system (Align Technology, Santa Clara, California). Materials and Methods: Seventy-seven patients were enrolled in this study and divided into three groups (Invisalign® group, fixed orthodontic appliances group and control group). Plaque index, probing depth, bleeding on probing were assessed. Total biofilm mass and periodontal pathogens were analyzed and detected via real-time PCR. All these data were analyzed at the T0 (beginning of the treatment) T1 (1-month) and T2 (3 months); and statistically compared using the Mann–Whitney test for independent groups. Results: After 1-month and after 3 months of treatment there was only one sample with periodontopathic anaerobes found in patient treated using fixed orthodontic appliances. The Invisalign® group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group. A statistical significant difference (P Invisalign® System show a superior periodontal health in the short-term when compared to patients in treatment with fixed orthodontic appliances. Invisalign® should be considered as a first treatment option in patients with risk of developing periodontal disease. PMID:26430371

  12. Creating a national home visiting research network.

    Science.gov (United States)

    Duggan, Anne; Minkovitz, Cynthia S; Chaffin, Mark; Korfmacher, Jon; Brooks-Gunn, Jeanne; Crowne, Sarah; Filene, Jill; Gonsalves, Kay; Landsverk, John; Harwood, Robin

    2013-11-01

    Home visiting can play a key role in the early childhood system of services. For home visiting to achieve its potential, decision-makers must make informed choices regarding adoption, adaptation, coordination, scale-up, and sustainment. We need a coordinated, focused, and theory-based home visiting research infrastructure to inform such decisions. The transdisciplinary Home Visiting Research Network (HVRN) was established in July 2012 with funding from the Health Resources and Services Administration. Its goal is to promote the translation of research findings into policy and practice. Its objectives are to (1) develop a national home visiting research agenda, (2) advance the use of innovative research methods; and (3) provide a research environment that is supportive of the professional development of emerging researchers interested in home visiting. A Management Team designs and directs activities to achieve these objectives through Work Teams. A Steering Committee of national leaders representing stakeholder groups oversees progress. HVRN's Coordinating Center supports the Work Teams and HVRN's Home visiting Applied Research Collaborative, a practice-based research network of home visiting programs. This article describes HVRN's rationale, approach, and anticipated products. We use home visiting-primary care coordination as an illustration, noting potential roles for pediatric practices and pediatric researchers and research educators in HVRN activities. HVRN creates the infrastructure for a rigorous program of research to inform policy and practice on home visiting as part of the system of services to improve family functioning, parenting, and child outcomes.

  13. Does a multidisciplinary diabetes group education visit improve patient outcomes?

    Science.gov (United States)

    O'Dell, Kristi J; O'Dell, Michael L; Taylor, James L

    2009-12-01

    Diabetes is a significant and growing public health concern, and patient education is the primary approach for self-management. The objective of this study is to assess the impact of a single session diabetes group education intervention. The design is a one-group pretest/posttest evaluation. Participants were adult outpatients with diabetes who attended a single session group education visit and volunteered to participate in the study. Survey questions include the Single Item Literacy Screener and diabetes knowledge questions. The survey was mailed and collected before the group visit. Diabetes knowledge was collected immediately after the group visit and again by telephone one to four months later. Hemoglobin A1c (HbA1c), lipids, and blood pressure were collected from the patient electronic medical record before and, where available, three months after the group visit. Data analysis includes descriptive statistics and Students t-testing to determine pre- and posttest differences of diabetes knowledge and physiological markers. Thirty-eight adult outpatients participated in the study. Nearly half responded that they never needed to have someone help with written medical materials. There was a significant increase from pretest to immediate posttest diabetes knowledge scores (N = 3; M = 5.58 to M = 7.53 out of 10), t(38) = -5.217, p = education (M = 9.16 to M = 8.52), t(27) = 2.185, p = .038. A single session diabetes group education visit is effective in increasing patients' diabetes knowledge and decreasing HbA1c levels.

  14. Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study

    Directory of Open Access Journals (Sweden)

    Rakic JM

    2013-09-01

    Full Text Available Jean-Marie Rakic,1 Anita Leys,2 Heidi Brié,3 Kris Denhaerynck,4 Christy Pacheco,4 Stefaan Vancayzeele,3 Christine Hermans,3 Karen MacDonald,4 Ivo Abraham4,5 1Department of Ophthalmology, Centre Hospitalier Universitaire de Liège, Site du Sart Tilman, Liège, Belgium; 2Leuven University Eye Hospital, Leuven, Belgium; 3Novartis Pharma, Vilvoorde, Belgium; 4Matrix45, Tucson, AZ, USA; 5Center for Health Outcomes and Pharmacoeconomic Research, University of Arizona, Tucson, AZ, USA Introduction: The aim of this study was to examine ranibizumab treatment patterns in "real-world" practice and clinical settings, as well as to assess quality of life outcomes over a 24-month period. Materials and methods: This was a prospective, observational, multicenter, open-label study of 0.5 mg of ranibizumab administered intravitreally. Patients were followed over 24 ± 3 months with intermediate data points at 6 ± 2 months and 12 ± 2 months, and a limited data point at 2.5 ± 1 month that coincided with the end of the loading phase. Outcomes included visual acuity (Early Treatment Diabetic Retinopathy Study, visual function (National Eye Institute Visual Function Questionnaire-25 [NEI VFQ-25], quality of life (Health Utilities Index Mark III [HUI3], and safety. Results: A total of 267 patients with wet age-related macular degeneration (mean ± standard deviation [SD] age = 78.5 ± 7.3 years; 62.4% were female; 34.5% with dual eye involvement; 74.9% were treatment-naïve were treated (309 eyes were treated. The mean ± SD Early Treatment Diabetic Retinopathy Study score at baseline was 56.3 ± 14.3 letters. The mean ± SD number of injections over 24 months was 7.6 ± 4.1, including 2.5 ± 0.7 and 5.9 ± 3.6 during the loading and maintenance phases, respectively, with corresponding treatment intervals of 4.8 ± 1.4 weeks and 11.5 ± 9.5 weeks, respectively. Improvements in visual acuity over baseline were reached at 2.5 months and maintained at 6 months (both P

  15. The impact of paraprofessional home visitors on infants' growth and health at 18 months.

    Science.gov (United States)

    le Roux, Ingrid M; Rotheram-Borus, Mary Jane; Stein, Judith; Tomlinson, Mark

    2014-01-01

    Paraprofessional home visitors trained to improve multiple outcomes (HIV, alcohol, infant health, and malnutrition) have been shown to benefit mothers and children over 18 months in a cluster randomised controlled trial (RCT). These longitudinal analyses examine the mechanisms which influence child outcomes at 18 months post-birth in Cape Town, South Africa. The results were evaluated using structural equation modelling, specifically examining the mediating effects of prior maternal behaviours and a home visiting intervention post-birth. Twelve matched pairs of neighbourhoods were randomised within pairs to: 1) the control condition, receiving comprehensive healthcare at community primary health care clinics (n=12 neighbourhoods; n=594 pregnant women), or 2) the Philani Intervention Program, which provided home visits by trained, paraprofessional community health workers, here called Mentor Mothers, in addition to clinic care (n=12 neighbourhoods; n=644 pregnant women). Recruitment of all pregnant neighbourhood women was high (98%) with 88% reassessed at six months and 84% at 18 months. Infants' growth and diarrhoea episodes were examined at 18 months in response to the intervention condition, breastfeeding, alcohol use, social support, and low birth weight, controlling for HIV status and previous history of risk. We found that randomisation to the intervention was associated with a significantly lower number of recent diarrhoea episodes and increased rates and duration of breastfeeding. Across both the intervention and control conditions, mothers who used alcohol during pregnancy and had low birth weight infants were significantly less likely to have infants with normal growth patterns, whereas social support was associated with better growth. HIV-infection was significantly associated with poor growth and less breastfeeding. Women with more risk factors had significantly smaller social support networks. The relationships among initial and sustained maternal risk

  16. Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: analysis of outcome data at 12 months posttreatment.

    Science.gov (United States)

    Espie, C A; Inglis, S J; Harvey, L

    2001-02-01

    The clinical efficacy of cognitive behavior therapy (CBT) for chronic insomnia has been established, yet clinical effectiveness is less clear. This study presents data on 109 patients from general practice during a formal evaluation of clinical effectiveness. Two thirds achieved normative values of or =50%. Logistic regression revealed that initial severity did not contraindicate good outcome. Rather, greater sleep disturbance was positively associated with large symptom reduction, although lower endpoint scores were less likely. Similarly, symptoms of anxiety, depression, and thinking errors positively predicted good outcome. Hypnotic using patients responded equally well to CBT, and demographic factors were of no significant predictive value. It is concluded that CBT is clinically and durably effective for persistent insomnia in routine practice.

  17. Clinical evaluation of subepithelial connective tissue graft and guided tissue regeneration for treatment of Miller's class 1 gingival recession: comparative, split mouth, six months study

    OpenAIRE

    Trivedi, Sakshee R.; Bhavsar, Neeta V.; Dulani, Kirti; Trivedi, Rahul

    2014-01-01

    Objectives: The present study aims to clinically compare and evaluate subepithelial connective tissue graft and the GTR based root coverage in treatment of Miller’s Class I gingival recession. Study Design: 30 patients with at least one pair of Miller’s Class I gingival recession were treated either with Subepithelial connective tissue graft (Group A) or Guided tissue regeneration (Group B). Clinical parameters monitored included recession RD, width of keratinized gingiva (KG), probing depth ...

  18. Assessment of the effects of a stannous fluoride dentifrice on gingivitis in a two-month positive-controlled clinical study.

    Science.gov (United States)

    He, Tao; Barker, Matthew L; Biesbock, A R; Sharma, N C; Qaqish, J; Goyal, C R

    2012-01-01

    The purpose of this study was to evaluate the anti-gingivitis effectiveness of a 0.454% stannous fluoride test dentifrice relative to a marketed positive-control triclosan-containing dentifrice in adults with gingivitis. This was a two-month, randomized and controlled, double-blind, parallel group, single-center investigation involving 150 adults with existing mild to moderate gingivitis. Pre-treatment gingivitis levels were assessed at baseline using the Lobene Modified Gingival Index (MGI) and the Gingival Bleeding Index (GBI). Qualified subjects were randomly assigned to either a 0.454% stannous fluoride test dentifrice or a marketed, positive-control 0.30% triclosan/copolymer dentifrice. Subjects then brushed for two months unsupervised in the home setting with their assigned dentifrice per manufacturer's instructions. At Month 2, subjects were re-evaluated for gingivitis via MGI and GBI examinations. All 150 enrolled subjects completed the trial and were evaluable. Both the stannous fluoride test and triclosan/copolymer control dentifrices provided statistically significant reductions in average MGI, GBI, and number of bleeding sites relative to pre-treatment (p dentifrice group was 65% greater for number of bleeding sites, 62% greater for GBI, and 45% greater for MGI compared to the triclosan/copolymer positive-control group, with groups differing significantly (p dentifrices were well-tolerated. An advanced stannous fluoride test dentifrice provided superior reductions in gingival inflammation and gingival bleeding compared to a commercially available triclosan/copolymer positive-control dentifrice after two months of tooth brushing.

  19. Results from a 12 months, randomized, clinical trial comparing an olmesartan/amlodipine single pill combination to olmesartan and amlodipine monotherapies on blood pressure and inflammation.

    Science.gov (United States)

    Derosa, Giuseppe; Cicero, Arrigo F G; Carbone, Anna; Querci, Fabrizio; Fogari, Elena; D'Angelo, Angela; Maffioli, Pamela

    2014-01-23

    Hypertension affects nearly 1 in 3 adults in the United States, and it is an important modifiable risk factor for coronary artery disease, heart failure, renal failure, and stroke. The aim of this study was to evaluate the effects of a fixed-dose olmesartan/amlodipine combination on blood pressure control, lipid profile, insulin sensitivity, and inflammation compared to singles monotherapies. We randomized 276 hypertensive patients to olmesartan 20 mg, amlodipine 10mg or a single pill containing a fixed-dose olmesartan/amlodipine combination 20/5mg for 12 months. We evaluated: body weight, body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), fasting plasma glucose (FPG), fasting plasma insulin (FPI), lipid profile, omentin, chemerin, high sensitivity C-reactive protein (Hs-CRP). At baseline, and after 6 and 12 months, patients underwent an euglycemic, hyperinsulinemic clamp to assess insulin sensitivity (M value). Olmesartan/amlodipine combination was more effective than amlodipine or olmesartan in reducing blood pressure. Olmesartan/amlodipine combination, but not amlodipine, decreased FPG after 12 months. Olmesartan/amlodipine combination better decreased FPI and HOMA index and increased M value compared to olmesartan and amlodipine monotherapies. Olmesartan/amlodipine significantly decreased chemerin and omentin compared to olmesartan and amlodipine. Other than to be more effective in reducing blood pressure, olmesartan/amlodipine single pill combination gave also a major increase of insulin sensitivity and a decrease of inflammatory markers compared to single monotherapies. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. President Li Xiaolin Visits Saudi Arabia

    Institute of Scientific and Technical Information of China (English)

    Zhang; Min

    2016-01-01

    At the invitation of Prince Alwaleed,chairman of Kingdom Holding Company of Saudi Arabia,CPAFFC President Li Xiaolin led a delegation to visit Saudi Arabia from Feb 16 to 20.During the visit,Ms.Li met with the prince,visited Kingdom Hospital and Kingdom School and held working talks with Alwaleed Philanthropies.During the meeting with Prince Alwaleed,Ms.Li mentioned that Chi-

  1. American high school students visit CERN

    CERN Document Server

    Maximilien Brice

    2003-01-01

    Fifteen final-year students from Columbus High School, Mississippi, USA visited CERN recently with their physics teacher Ken Wester (left at rear). Mr Wester organized the trip after his participation in the 2002 edition of CERN's High School Teachers programme. The students visited the CMS construction site and the AD antimatter factory during their two-day visit. They are pictured here with Michel Della Negra, CMS spokesman (kneeling), in front of the model of the CMS detector in building 40.

  2. Home visit improves knowledge, self-care and adhesion in heart failure: randomized Clinical Trial HELEN-I Visita domiciliar mejora conocimiento, auto cuidado, adhesión en la insuficiencia cardíaca: Ensayo Clínico Aleatorizado HELEN - I Visita domiciliar melhora conhecimento, autocuidado e adesão na insuficiência cardíaca: ensaio clínico randomizado HELEN-I

    Directory of Open Access Journals (Sweden)

    Cláudia Motta Mussi

    2013-02-01

    Full Text Available OBJECTIVE: To verify the effect of an educative nursing intervention composed of home visits and phone calls on patients' knowledge about the disease, self-care and adhesion to the treatment. METHODS: Randomized clinical trial with patients with recent hospitalization caused by decompensated heart failure. There were two groups: the intervention group, which has received four home visits and four phone calls to reinforce the guidelines during six months of follow up; and the control group, which has received conventional follow up with no visits or phone calls. RESULTS: Two hundred patients were randomized (101 in the intervention group and 99 in the control group. After six months, a significant improvement was observed in self-care and knowledge about the disease in the intervention group (P=0.001 and POBJETIVO: Verificar el efecto de una intervención educativa de enfermería combinada de visita domiciliaria y contacto telefónico en pacientes con internación reciente por insuficiencia cardiaca descompensada, en el conocimiento de la enfermedad, las habilidades para el autocuidado y la adhesión al tratamiento comparado con el acompañamiento convencional de pacientes en el período de seis meses. MÉTODOS: Ensayo Clínico Aleatorizado en pacientes que fueron ingresados recientemente por insuficiencia cardiaca descompensada. El grupo intervención recibió cuatro visitas domiciliarias y cuatro contactos telefónicos para reforzar las orientaciones en seis meses de acompañamiento; el grupo control recibió acompañamiento convencional sin visitas y sin contactos telefónicos. RESULTADOS: Fueron aleatorizados doscientos pacientes (101: intervención y 99: control. Tras seis meses, se observó una mejoría significativa en el conocimiento y el autocuidado para el grupo intervención (P=0,001 y POBJETIVO: verificar o efeito de uma intervenção educativa de enfermagem combinada, caracterizada por visita domiciliar e contato telefônico, em

  3. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  4. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  5. STS-129 shuttle crew visits Stennis

    Science.gov (United States)

    2010-01-01

    Members of the STS-129 space shuttle crew visited NASA's John C. Stennis Space Center on Jan. 19 to share details of their November visit to the International Space Station. During their 11-day mission aboard shuttle Atlantis, crew members delivered equipment, supplies and spare parts to the ISS. Following their mission report, astronauts visited with Stennis employees during a brief reception. Astronauts visiting Stennis were Pilot Barry Wilmore, Mission Specialist Randy Bresnik, Commander Charles Hobaugh and Mission Specialists Mike Foreman and Robert Satcher.

  6. Palliative care team visits. Qualitative study through participant observation

    Directory of Open Access Journals (Sweden)

    María del Mar Alfaya Góngora

    2016-04-01

    Full Text Available Objectives:To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants.Methods:A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed.Results:The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources.Conclusion:Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources.

  7. Dental visits, oral hygiene behaviour, and orthodontic treatment in Switzerland.

    Science.gov (United States)

    Stadelmann, Pascale; Zemp, Elisabeth; Weiss, Carine; Weiger, Roland; Menghini, Giorgio; Zitzmann, Nicola U

    2012-01-01

    Since the first survey in 1992/93, the Swiss Health Survey (SHS) has been repeated every 5 years (1997, 2002 and 2007). In the present study, dental visits (dental care utilisation within the last 12 months), oral hygiene measures and the frequency of orthodontic treatments in the Swiss population in 2002 were examined and dental visits were compared with the years 1992/93, 1997 and 2007. Weighted data were analysed regarding different sociodemographic factors. From 1992 to 2002, dental visits among the 15-74-year-old declined continuously (1992/93: 70%, 1997: 66%, 2002: 63%), whereas in 2007 a slight increase (66%) was documented. In the survey from 2002, a large proportion (74%) of the population stated to clean their teeth or prostheses several times a day, predominantly with a manual toothbrush, whereas 28% applied an electric toothbrush and almost half of the respondents also used dental floss or toothpicks. Fewer visits and less intensive oral hygiene measures were observed among the elderly, men, weak social strata, smokers, persons with more than 8 missing teeth and in the group with removable dentures. Almost a quarter of the population had orthodontic treatment with the highest proportion among the 15-24-year-old (56%).

  8. Long-term Dental Visiting Patterns and Adult Oral Health

    Science.gov (United States)

    Thomson, W.M.; Williams, S.M.; Broadbent, J.M.; Poulton, R.; Locker, D.

    2010-01-01

    To date, the evidence supporting the benefits of dental visiting comes from cross-sectional studies. We investigated whether long-term routine dental visiting was associated with lower experience of dental caries and missing teeth, and better self-rated oral health, by age 32. A prospective cohort study in New Zealand examined 932 participants’ use of dentistry at ages 15, 18, 26, and 32. At each age, routine attenders (RAs) were identified as those who (a) usually visited for a check-up, and (b) had made a dental visit during the previous 12 months. Routine attending prevalence fell from 82% at age 15 to 28% by 32. At any given age, routine attenders had better-than-average oral health, fewer had teeth missing due to caries, and they had lower mean DS and DMFS scores. By age 32, routine attenders had better self-reported oral health and less tooth loss and caries. The longer routine attendance was maintained, the stronger the effect. Routine dental attendance is associated with better oral health. PMID:20093674

  9. Clinical investigation of visiting conditions of pediatric dental outpatients in Children's Hospital%儿童医院口腔门诊就诊情况临床调查

    Institute of Scientific and Technical Information of China (English)

    吴红

    2015-01-01

    目的::了解就诊儿童口腔科疾病的发生特点及就诊情况。方法:采用回顾性的调查研究,对8463例初诊病例的资料进行分析,按照年龄,疾病类型进行分类记录,并进行统计学分析。结果:初诊患者最多年龄组为4~7岁组。最常见的儿童口腔疾病依次是牙体牙髓疾病、黏膜病、深窝沟、乳牙滞留。结论:儿童口腔病疾较普遍,预防保健工作不足。%Objective: To investigate characteristics of oral diseases in children and their visiting conditions. Methods: The data of 8463 newly diagnosed cases were retrospectively investigated, recorded by age and type of diseases, and statistically analyzed. Results: The children of the newly diagnosed cases peaked at 4-7 years. The most common oral diseases in order were dental and pulp disease, mucosal disease, deep pit and fissure, and retained deciduous teeth. Conclusions: The children's oral diseases are common. It is urgent to strengthen the propaganda and education on the oral diseases of children.

  10. The effect of pulpotomy using a calcium-enriched mixture cement versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis: a randomized clinical trial.

    Science.gov (United States)

    Asgary, Saeed; Eghbal, Mohammad Jafar

    2010-07-01

    The purpose of this noninferiority trial was to compare postoperative pain relief after one-visit root canal therapy (ORCT) with a pulpotomy performed with a new endodontic calcium-enriched mixture cement (PCEM) in human permanent molars with irreversible pulpitis. A total of 407 selected patients were randomly allocated into the ORCT group (n = 202) or the PCEM group (n = 205). Numerical Rating Scale questionnaires were used to record pain intensity (PI) by the patients during the first 7 days after treatment. While there was no statistically significant difference in the mean PI at baseline between the two study groups (P = 0.45), changes in mean PI were significantly different between them (P < 0.001). In the ORCT group, pain relief was achieved after 36 h [95% confidence interval (CI), 27.00-45.00], compared to 18 h in the PCEM group (95% CI, 15.00-21.00), a significant difference (P < 0.01). Comparison of the mean PI sum recorded over 7 days showed that patients in the ORCT group experienced significantly more pain than those in the PCEM group (P < 0.001); a similar difference was observed for pain in response to percussion tests (P < 0.001). Treatment with PCEM thus had the better pain-reducing effects than ORCT in irreversible pulpitis cases.

  11. Improvement of large-joint ultrasonographic synovitis is delayed in patients with newly diagnosed rheumatoid arthritis: results of a 12-month clinical and ultrasonographic follow-up study of a local cohort.

    Science.gov (United States)

    Harman, Halil; Tekeoğlu, İbrahim; Takçı, Sibel; Kamanlı, Ayhan; Nas, Kemal; Harman, Sibel

    2015-08-01

    We analyzed the longitudinal changes in gray-scale ultrasonography (GSUS) and power Doppler ultrasonography (PDUS) parameters and correlated them with clinical, functional, and radiologic outcomes in patients with newly diagnosed rheumatoid arthritis (RA). GSUS and PDUS examinations, 44-joint disease activity score (DAS44) calculations, measurements of erythrocyte sedimentation rate, and C-reactive protein levels were performed in 68 RA patients at baseline and after 1, 3, 6, 9, and 12 months. Metacarpophalangeal joints, wrist, elbow, knee, ankle, metatarsophalangeal joints, and wrist and ankle tendons were examined by GSUS and PDUS. The laboratory and clinical findings began to decrease significantly at 1 month (P US) variables began at 3 months. After 6 months, all of the joint synovitis scores, except those of the knee, elbow, and ankle joints, showed a statistically significant reduction compared to baseline scores (P US synovitis at large joints such as the knee, elbow, and ankle tended to be delayed compared to that at small joints. PD synovitis that is persistent despite disease-modifying anti-rheumatic drug therapy may cause radiographic bone erosions.

  12. The use of weekly text messaging over 6 months was a feasible method for monitoring the clinical course of low back pain in patients seeking chiropractic care

    DEFF Research Database (Denmark)

    Axen, I.; Bodin, L.; Bergstrom, G.;

    2012-01-01

    Objective: This study critically evaluates a new method of collecting frequent data using mobile phones and text messages. Fluctuating conditions such as low back pain (LBP) need frequent monitoring to describe the clinical course in detail and to account for individual and subgroup variations. S...

  13. Repeated monthly epicutaneous challenges with diphenylcyclopropenone result in a clinically reproducible level of contact allergy in de novo sensitized individuals

    DEFF Research Database (Denmark)

    Mose, K F; Andersen, F; Skov, Lone

    2017-01-01

    Diphenylcyclopropenone (DPCP) has been used as an experimental contact allergen in humans and for topical immunotherapy of patients with alopecia areata. However, the efficacy is mostly based on case series. Randomized controlled clinical trials are lacking(1) , as is detailed descriptions of how...

  14. A 12-month clinical investigation with a 24-day regimen containing 15 microg ethinylestradiol plus 60 microg gestodene with respect to hemostasis and cycle control.

    Science.gov (United States)

    Fruzzetti, F; Genazzani, A R; Ricci, C; De Negri, F; Bersi, C; Carmassi, F

    2001-06-01

    The effects of a 24-day regimen containing 15 microg ethinyl estradiol (EE) plus 60 microg gestodene on cycle control and on hemostasis, were evaluated in 58 healthy women (age 19-47 years). All women received the pill for 12 months. Withdrawal bleeding at every cycle during the tablet-free interval was experienced by 84.5% of the women. The overall incidence of irregular bleedings was 19.3%. Hemostasis was evaluated in 20 women. No changes in plasma fibrinogen concentrations, nor in prothrombin fragment F1+2 were observed. A slight increase in thrombin-antithrombin III complexes was observed after 6 and 12 months of oral contraceptive use. Antithrombin III activity significantly increased after one-year of pill intake. The concentrations of tissue plasminogen activator and plasminogen activator inhibitor, both antigen and activity, did not change. These results show that very low doses of EE, such as 15 microg, do not impair hemostasis in healthy females. However, the reduction for the EE dose is responsible of some of the effects on cycle control.

  15. Monthly Meteorological Reports

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monthly forms that do not fit into any regular submission. Tabulation sheets and generic monthly forms designed to capture miscellaneous monthly observations.

  16. Assessing Quality in Home Visiting Programs

    Science.gov (United States)

    Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

    2013-01-01

    Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

  17. CPAFFC Agricultural Delegation Visits Germany and Austria

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    <正>At the invitation of the Germany-China Friendship Association-Stuttgart (GCFA-Stuttgart) and the Austrian-Chinese Friendship Association (ACFA),a delegation for studying agriculture composed of members from localities organized and sent by the CPAFFC paid a visit to Germany and Austria from June 11 to 23. The delegation visited farms and

  18. Notes on collecting flower-visiting insects

    NARCIS (Netherlands)

    Willemstein, S.C.

    1974-01-01

    Flower-visiting insects may play a role in the pollination of the flowers they visit. An important indication for this is the pollen they carry on their body. The transport of pollen does not prove pollination without observations of the behaviour of the insects on the flowers, but at least it offer

  19. Notes on collecting flower-visiting insects

    NARCIS (Netherlands)

    Willemstein, S.C.

    1974-01-01

    Flower-visiting insects may play a role in the pollination of the flowers they visit. An important indication for this is the pollen they carry on their body. The transport of pollen does not prove pollination without observations of the behaviour of the insects on the flowers, but at least it

  20. Four Outstanding Women Visit Hong Kong

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    ON March 2, four of the "Ten Outstanding Chinese Women" of 1995, joined the delegation of the All-China Women’s Federation (ACWF) on its visit to Hong Kong, and delivered speeches to more than 500 Hong Kong women. They visited Hong Kong with the ACWF delegation at the invitation of women’s organizations in Hong Kong.

  1. Clinical evaluation of autologous platelet-rich fibrin in the treatment of multiple adjacent gingival recession defects: a 12-month study.

    Science.gov (United States)

    Tunalι, Mustafa; Özdemir, Hakan; Arabacι, Taner; Gürbüzer, Bahadir; Pikdöken, Levent; Firatli, Erhan

    2015-01-01

    Leukocyte- and platelet-rich fibrin (L-PRF) belongs to a new generation of platelet concentrates. There are limited numbers of studies focused on the use of L-PRF in gingival recession defects. This study evaluated the safety and effectiveness of using L-PRF membranes as a substitute for free connective tissue grafts (CTGs) as a treatment method for gingival recession defects. A total of 44 Miller Class I/II gingival recessions that were bilateral, adjacent, and greater than 3 mm in size were selected. Each recession site was randomly assigned to the test group (L-PRF) or the control group (CTG). After 12 months, root coverage was 76.63% and 77.36% in the L-PRF and CTG groups, respectively. It is suggested that L-PRF membrane may be an alternative graft material for treating multiple adjacent recessions greater than 3 mm in size without a requirement for additional surgery.

  2. Aflibercept in branch retinal vein occlusion as second line therapy: clinical outcome 12 months after changing treatment from bevacizumab/ranibizumab—a pilot study

    OpenAIRE

    Wirth, Magdalena A.; Matthias D Becker; Graf, Nicole; Michels, Stephan

    2016-01-01

    Purpose To evaluate the effect of aflibercept (as second line therapy) on the clinical outcome in patients with chronic macular edema secondary to branch retinal vein occlusion (BRVO) insufficiently responding to prior treatment with bevacizumab and/or ranibizumab. Methods Ten eyes of ten patients (n = 10) with chronic macular edema secondary to BRVO were included in a retrospective analysis. These patients received aflibercept after an insufficient response to treatment with ranibizumab and/...

  3. Home Visits: Shortening the Path between Home and School.

    Science.gov (United States)

    Acosta, Dolores; Keith, Joe; Patin, Debra

    1997-01-01

    Describes the Home Visit Initiative at Socorro Middle School in Texas. Discusses the purpose of home visits; selection of families for teacher home visits; the visiting team; parents', students', and teachers' reactions to visits, and the results of an evaluation of the home visits, especially the impact on parent volunteerism and schooling,…

  4. Sirolimus-eluting stents for treatment of drug-eluting versus bare-metal stents restenosis: 42-month clinical outcomes from a Chinese single center

    Institute of Scientific and Technical Information of China (English)

    YAN Rong-qiang; LIU Hai-bo; WU Yong-jian; YUAN Jin-qing; CHEN Jue; YOU Shi-jie; DAI Jun; GAO Run-lin; CHEN Ji-lin; GAO Li-jian; YANG Yue-jin; LI Jian-jun; QIAO Shu-bin; XU Bo; YAO Min; QIN Xue-wen

    2012-01-01

    Background Restenosis of bare-metal stents (BMS) and drug-eluting stents (DES) has been increasingly treated with sirolimus-eluting stents (SES),but the long-term outcomes are unknown.Methods In our study,388 consecutive patients (144 DES restenosis and 244 BMS restenosis) with 400 lesions (147 DES restenosis and 253 BMS restenosis) treated with SES were included.The rates of target lesion revascularization (TLR) and major adverse cardiac events (MACE) at 42 months were analyzed.Results At the mean follow-up of 42 months,the rates of death (3.5% vs.3.3%,P=1.000) and myocardial infarction (2.8% vs.1.2%,P=0.431) in the DES group and BMS group were comparable.Compared with the BMS group,ischemia-driven TLR occurred with a higher frequency in the DES group (18.8% vs.10.7%,P=0.024).This translated into an increased rate of MACE in the DES group (22.2% vs.14.0%,P=0.034).Stent thrombosis occurred with a similar frequency in both groups (2.8% vs.1.6%,P=0.475).Multivariate analysis showed that DES restenosis (OR=1.907,95%Cl 1.108-3.285,P=0.020) and smoking (OR=2.069; 95% C/ 1.188-3.605; P=0.010) were independent predictors of MACE.Conclusions Although SES implantation appears to be safe and effective,it was associated with higher TLR recurrence for DES than BMS restenosis.

  5. Forecasting emergency department visits using internet data.

    Science.gov (United States)

    Ekström, Andreas; Kurland, Lisa; Farrokhnia, Nasim; Castrén, Maaret; Nordberg, Martin

    2015-04-01

    Using Internet data to forecast emergency department (ED) visits might enable a model that reflects behavioral trends and thereby be a valid tool for health care providers with which to allocate resources and prevent crowding. The aim of this study is to investigate whether Web site visits to a regional medical Web site, the Stockholm Health Care Guide, a proxy for the general public's concern of their health, could be used to predict the ED attendance for the coming day. In a retrospective, observational, cross-sectional study, a model for forecasting the daily number of ED visits was derived and validated. The model was derived through regression analysis, using visits to the Stockholm Health Care Guide Web site between 6 pm and midnight and day of the week as independent variables. Web site visits were measured with Google Analytics. The number of visits to the ED within the region was retrieved from the Stockholm County Council administrative database. All types of ED visits (including adult, pediatric, and gynecologic) were included. The period of August 13, 2011, to August 12, 2012, was used as a training set for the model. The hourly variation of visits was analyzed for both Web site and the ED visits to determine the interval of hours to be used for the prediction. The model was validated with mean absolute percentage error for August 13, 2012, to October 31, 2012. The correlation between the number of Web site visits between 6 pm and midnight and ED visits the coming day was significant (r=0.77; Pforecasting results for ED visits were achieved for the entire county, with a mean absolute percentage error of 4.8%. The result for the individual hospitals ranged between mean absolute percentage error 5.2% and 13.1%. Web site visits may be used in this fashion to predict attendance to the ED. The model works both for the entire region and for individual hospitals. The possibility of using Internet data to predict ED visits is promising. Copyright © 2014

  6. A profile of tourists visiting the Kruger National Park

    Directory of Open Access Journals (Sweden)

    M. Saayman

    2004-12-01

    Full Text Available Due to shrinking budgets for conservation and an increase in the number of government and privately owned parks, it has become very important for parks to determine who the tourists are who visit one of South Africa’s top tourist attractions. The reason for this is that park management and marketers need to focus their efforts to optimise their limited resources. This can only be done once there is a clear understanding of who the market is, where they come from and what they expect. The literature study clearly showed that market segmentation is essential for the effective marketing of a tourism product or destination. Two surveys were conducted, one in 2001 and a follow-up study in 2002, profiling tourists to the Kruger National Park. Different months were chosen to conduct the two surveys in order to get a more comprehensive profile of tourists visiting the park in different seasons.

  7. Lean implementation in primary care health visiting services in National Health Service UK.

    Science.gov (United States)

    Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K

    2010-10-01

    This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.

  8. Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study.

    Science.gov (United States)

    McGrail, Kimberlyn Marie; Ahuja, Megan Alyssa; Leaver, Chad Andrew

    2017-05-26

    Virtual visits are clinical interactions in health care that do not involve the patient and provider being in the same room at the same time. The use of virtual visits is growing rapidly in health care. Some health systems are integrating virtual visits into primary care as a complement to existing modes of care, in part reflecting a growing focus on patient-centered care. There is, however, limited empirical evidence about how patients view this new form of care and how it affects overall health system use. Descriptive objectives were to assess users and providers of virtual visits, including the reasons patients give for use. The analytic objective was to assess empirically the influence of virtual visits on overall primary care use and costs, including whether virtual care is with a known or a new primary care physician. The study took place in British Columbia, Canada, where virtual visits have been publicly funded since October 2012. A survey of patients who used virtual visits and an observational study of users and nonusers of virtual visits were conducted. Comparison groups included two groups: (1) all other BC residents, and (2) a group matched (3:1) to the cohort. The first virtual visit was used as the intervention and the main outcome measures were total primary care visits and costs. During 2013-2014, there were 7286 virtual visit encounters, involving 5441 patients and 144 physicians. Younger patients and physicians were more likely to use and provide virtual visits (Pvirtual visit patients indicated that virtual visits were liked by patients, with 372 (93.2%) of respondents saying their virtual visit was of high quality and 364 (91.2%) reporting their virtual visit was "very" or "somewhat" helpful to resolve their health issue. Segmented regression analysis and the corresponding regression parameter estimates suggested virtual visits appear to have the potential to decrease primary care costs by approximately Can $4 per quarter (Can -$3.79, P=.12

  9. Incorporating OASIS into the Visiting Nurses Association.

    Science.gov (United States)

    Clark, L L

    1998-01-01

    Beginning in 1994, the Visiting Nurses Association, Western Pennsylvania, began to investigate incorporating an outcome measurement system within its organization for the purposes of marketing quality results, benchmarking achievements, and defining quality of care for both internal and external review groups. In the fall of 1995, this agency was accepted into the Outcome Based Quality Improvement (OBQI) Demonstration Project, also known as the Medicare Quality Assurance Project, which the Health Care Financing Administration has funded for the purpose of measuring clinical and utilization outcomes in the home care arena. This article reviews the processes the agency used to develop and incorporate the entire OBQI process into its systems, including the incorporation of the Outcome Assessment Information Set (OASIS). The OASIS is a set of outcome measurement questions developed by Dr. Peter Shaughnessy at the Center for Health Policy Research in Denver. The process also includes training of staff and development of forms, point-of-care software with a vendor, and plans of action for improving outcomes that have been quantified through OBQI efforts.

  10. In Alzheimer's Disease, 6-Month Treatment with GLP-1 Analog Prevents Decline of Brain Glucose Metabolism: Randomized, Placebo-Controlled, Double-Blind Clinical Trial

    DEFF Research Database (Denmark)

    Jensen, Michael Gejl; Gjedde, Albert; Egefjord, Lærke

    2016-01-01

    with AD to treatment with the GLP-1 analog liraglutide (n = 18), or placebo (n = 20). We measured Aβ load in brain with tracer [(11)C]PIB (PIB), CMRglc with [(18)F]FDG (FDG), and cognition with the WMS-IV scale (ClinicalTrials.gov NCT01469351). The PIB binding increased significantly in temporal lobe...... in placebo and treatment patients (both P = 0.04), and in occipital lobe in treatment patients (P = 0.04). Regional and global increases of PIB retention did not differ between the groups (P ≥ 0.38). In placebo treated patients CMRglc declined in all regions, significantly so by the following means...

  11. The Knee Clinical Assessment Study – CAS(K. A prospective study of knee pain and knee osteoarthritis in the general population: baseline recruitment and retention at 18 months

    Directory of Open Access Journals (Sweden)

    Duncan Rachel

    2006-03-01

    Full Text Available Abstract Background Selective non-participation at baseline (due to non-response and non-consent and loss to follow-up are important concerns for longitudinal observational research. We investigated these matters in the context of baseline recruitment and retention at 18 months of participants for a prospective observational cohort study of knee pain and knee osteoarthritis in the general population. Methods Participants were recruited to the Knee Clinical Assessment Study – CAS(K – by a multi-stage process involving response to two postal questionnaires, consent to further contact and medical record review (optional, and attendance at a research clinic. Follow-up at 18-months was by postal questionnaire. The characteristics of responders/consenters were described for each stage in the recruitment process to identify patterns of selective non-participation and loss to follow-up. The external validity of findings from the clinic attenders was tested by comparing the distribution of WOMAC scores and the association between physical function and obesity with the same parameters measured directly in the target population as whole. Results 3106 adults aged 50 years and over reporting knee pain in the previous 12 months were identified from the first baseline questionnaire. Of these, 819 consented to further contact, responded to the second questionnaire, and attended the research clinics. 776 were successfully followed up at 18 months. There was evidence of selective non-participation during recruitment (aged 80 years and over, lower socioeconomic group, currently in employment, experiencing anxiety or depression, brief episode of knee pain within the previous year. This did not cause significant bias in either the distribution of WOMAC scores or the association between physical function and obesity. Conclusion Despite recruiting a minority of the target population to the research clinics and some evidence of selective non-participation, this

  12. Cognition and Visit-to-Visit Variability of Blood Pressure and Heart Rate in De Novo Patients with Parkinson’s Disease

    Science.gov (United States)

    Kwon, Kyum-Yil; Pyo, Seon Jong; Lee, Hye Mi; Seo, Woo-Keun; Koh, Seong-Beom

    2016-01-01

    Objective We sought to identify whether the characteristics of long-term visit-to-visit blood pressure (BP) and heart rate (HR) are related to baseline cognitive profiles in, Parkinson’s disease (PD). Methods We selected drug-naïve PD patients who visited our hospital at least 10 times with a baseline assessment of the Seoul neuropsychological battery. BP and HR were measured at each visit, and the variability of the systolic BP/diastolic BP (DBP) and HR was derived from the parameters of serial 10 office visits. Mild cognitive impairment (MCI) in PD patients was determined according to the proposed criteria with a cut-off value of z-score ≤ -2. Results Forty-seven patients with PD (mean follow-up duration = 22.3 months) were enrolled in the study. Compared with non-MCI PD patients, MCI PD patients revealed a significant increase in HR and/or variability in DBP. Conclusion This exploratory study showed that baseline cognition in drug-naïve PD patients might be related to the visit-to-visit variability of DBP and/or HR. PMID:27667186

  13. Diagnoses and visit length in complementary and mainstream medicine

    Directory of Open Access Journals (Sweden)

    de Groot Judith

    2010-01-01

    Full Text Available Abstract Background The demand for complementary medicine (CM is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate. Methods Three groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs participating in the second Dutch national study in general practice (DNSGP-2. Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis. Results The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs. Conclusions CM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to

  14. 1-6月龄婴儿重症肺炎合并呼吸衰竭的临床分析%Clinical analysis on 20 1- 6 months old infants who have severe pneumonia combine with respiratory failure

    Institute of Scientific and Technical Information of China (English)

    林正伦; 蔡杰荣; 程远; 孔卫乾

    2011-01-01

    目的 分析总结1~6月龄婴儿重症肺炎合并呼吸衰竭的临床表现和治疗方法.方法 回顾性分析广州市番禺区中心医院儿科2007-2010年3年间收治的1~6月龄婴儿重症肺炎合并呼吸衰竭20例临床资料.结果 1~6月龄婴儿重症肺炎合并呼吸衰竭临床表现严重,死亡率高.结论 1~6月龄婴儿重症肺炎合并呼吸衰竭是儿科临床危重急症,早期发现、早期干预、早插快拔是治疗关键.%Objective To analyze and summarize 1-6 month impact of severe pneumonia with respiratory failure in children clinical manifestations and treatment. Methods Retrospective analysis of Panyu District, Guangzhou City, Central Hospital of Pediatrics 3 years 2007-2010 1 ~ 6 shadow on children admitted with severe pneumonia with respiratory failure in 20 patients with clinical data. Results 1~6 month shadow children with severe pneumonia with respiratory failure severe clinical manifestations and high mortality. Conclusion 1-6 month impact of severe pneumonia with respiratory failure in children is a pediatric clinical critical illness, early detection, early intervention, early intubation is the treatment of rapid extubation in the key treatment strategies.

  15. Diabetic Macular Edema at the time of Cataract Surgery trial: a prospective, randomized clinical trial of intravitreous bevacizumab versus triamcinolone in patients with diabetic macular oedema at the time of cataract surgery - preliminary 6 month results.

    Science.gov (United States)

    Lim, Lyndell L; Morrison, Julie L; Constantinou, Marios; Rogers, Sophie; Sandhu, Sukhpal S; Wickremasinghe, Sanjeewa S; Kawasaki, Ryo; Al-Qureshi, Salmaan

    2016-05-01

    To compare visual and anatomical outcomes between intravitreous bevacizumab (BVB, Avastin) and triamcinolone (TA, Triesence) when administered at the time of cataract surgery in patients with diabetic macular oedema (DME). Prospective, single-masked, randomized clinical trial at The Royal Victorian Eye and Ear Hospital, Melbourne. Patients with clinically significant cataract and either centre-involving DME or DME treated within the previous 24 months. Participants were randomized 1:1 to receive intravitreous BVB 1.25 mg or TA 4 mg during cataract surgery, and at subsequent review if required over 6 months. Change in central macular thickness (CMT) and best corrected visual acuity at 6 months. Forty-one patients (mean age 66.4 years, 73.2% male) were recruited. Visual acuity and CMT were similar between groups at baseline (P > 0.2).After six months, both groups gained vision (mean +21.4 letters in TA group P < 0.0001, +12.5 letters in BVB, P = 0.002), with no significant difference between groups (P = 0.085). In addition, 60.9% of eyes receiving TA achieved a VA of ≥6/12 compared to 73.3% in the BVB group (P = 0.501). However, only TA was associated with a sustained reduction in CMT (-43.8-µm reduction TA vs. +37.3-µm increase BVB, P = 0.006 over 6 months). Following surgery, additional injections were required in 70.6% of participants in the BVB group, compared to 16.7% in the TA group (P < 0.0001). Three patients in the TA group experienced a rise of IOP over 21 mmHg (12.5%) during the 6-month follow-up; BVB had no cases (P = 0.130). There were no cases of endophthalmitis in either group. When administered at the time of cataract surgery in patients with DME, at 6 months both TA and BVB improve visual acuity; however, only TA results in a sustained reduction in CMT. Further follow-up will determine whether this translates into better long-term visual outcomes in the TA group. © 2016 Royal Australian and New

  16. Visiting CERN… like “common people”

    CERN Multimedia

    Antonella del Rosso

    2012-01-01

    Paul Young, the British pop star who made his name in the 80s, came to visit CERN on 17 December. His son brought him here because of his passion for science in general and physics in particular. Father and son found the visit exciting and CERN’s activities really thrilling. We could even expect a surprise for Paul's next visit…   The visiting group in the CMS Control Room (Photo credit: P. Geeraert, ESO). Paul Young, famous for his interpretation of “Love of the Common People”, came to CERN because his teenage son is going to be studying A-level physics at school next year and wanted to visit the Laboratory. “I was fascinated by the visit. CERN is a place I didn’t know much about, but my son knows a lot more about science than I do. The explanations we got were great. We enjoyed the visit very much,” he said enthusiastically. Paul Young and his son visited the CMS underground cavern with Michael Hoch. &...

  17. What do chaplains really do? I. Visitation in the New York Chaplaincy Study.

    Science.gov (United States)

    Handzo, George F; Flannelly, Kevin J; Murphy, Kathryn M; Bauman, John P; Oettinger, Margaret; Goodell, Elaine; Hasan, Yusuf H; Barrie, David P; Jacobs, Martha R

    2008-01-01

    The current study presents findings from the New York Chaplaincy Study about chaplain visits with patients and their families in 13 healthcare institutions in the Greater New York City area during 1994-1996. It documents the distribution of 34,279 clinical visits by religious affiliation, population served (patients, family and friends), and type of healthcare setting (acute care and non-acute care), and analyzes the number and duration of visits with patients by their medical status. Chaplains in acute settings tended to make less frequent but longer visits with patients than chaplains in non-acute settings. On average, chaplains spent less time with patients who were alone than they did during visits with patients whose family was present during the visit or visits with only family members. Average visit duration was positively related to the percentage of visits in each of the 13 facilities that were made in response to referrals (r = .65, p picture of what these particular chaplains did in these particular institutions over this particular time-period and are not intended to represent a standard of what chaplains should be doing.

  18. [Effects of different home visit strategies on prenatal care in Southern Brazil].

    Science.gov (United States)

    Cesar, Juraci A; Mendoza-Sassi, Raul A; Ulmi, Eduardo F; Dall'Agnol, Marinel M; Neumann, Nelson A

    2008-11-01

    This non-randomized community intervention study evaluated the impact of prenatal home visits by community health agents and volunteer leaders from the Children's Mission on prenatal care among poor pregnant women in Rio Grande, Rio Grande do Sul State, Brazil. Previously trained interviewers applied pre-coded questionnaires to the women at home, investigating demographic and reproductive characteristics, socioeconomic status, housing conditions, and prenatal care. Of the 339 pregnant women interviewed, 115 were assigned to the intervention group visited by community health agents, 116 to the group visited by volunteer leaders, and 108 to the control group. Pregnant women visited by community health agents began prenatal visits earlier than other groups, had more prenatal visits, lab tests, and clinical exams, and received more counseling on breastfeeding and iron supplementation. Participation by family members during medical consultations for pregnant women visited by volunteer leaders was higher than for community health agents. Pregnant women visited by community health agents received better prenatal care than the other groups. Home visits can improve the quality of prenatal care for poor women and increase participation by family members (mainly husbands) during the pregnancy.

  19. Proposal for a CERN Virtual Visit Service

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00085461; Hatzifotiadou, Despina; Lapka, Marzena; Petrilli, Achille; Alexopoulos, Angelos; Bressan, Beatrice; Pietrzyk, Bolek; Papanestis, Antonis; Baron, Thomas; Domaracky, Marek; Fernandes, Joao; Lavrut, Loic; Gillies, James; Fichet, Jacques Herve; Noyes, Dan; Catapano, Paola; Landua, Rolf

    2015-01-01

    This note proposes the development of a CERN-wide Virtual Visit Service. Such a service would build upon the experience of the LHC Experiments, CERN DG EDU and DG COM, and the expertise of CERN IT CIS, to develop a world-leading communication and educational programme designed to serve the entire community in an effective and economical manner. Administration and Operation of the service would be modelled on the highly successful CERN Visits and Collaboration Services, and would extend the reach of Education, Outreach, and Communication to audiences around the globe, many of who might not have the opportunity to visit the laboratory in person.

  20. ATLAS Virtual Visit Trondheim-28-05

    CERN Multimedia

    2014-01-01

    Norwegian University of Science and Technology in Trondheim is interested in collaborating with CERN on multidisciplinary development project for master level students called Challenge Based Innovation (CBI). Now they are participating to the virtual visit in order to understand how CERN actually works and experience the context they would be working on during the CBI project. The session will be followed with a separate video call with CBI organizers where the students can discuss the practical arrangements of the course - See more at: http://atlas-live-virtual-visit.web.cern.ch/atlas-live-virtual-visit/2014/Trondheim-2014.html#sthash.Q1WUmbcc.dpuf