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  1. Performance and consistency of indicator groups in two biodiversity hotspots.

    Directory of Open Access Journals (Sweden)

    Joaquim Trindade-Filho

    Full Text Available In a world limited by data availability and limited funds for conservation, scientists and practitioners must use indicator groups to define spatial conservation priorities. Several studies have evaluated the effectiveness of indicator groups, but still little is known about the consistency in performance of these groups in different regions, which would allow their a priori selection.We systematically examined the effectiveness and the consistency of nine indicator groups in representing mammal species in two top-ranked Biodiversity Hotspots (BH: the Brazilian Cerrado and the Atlantic Forest. To test for group effectiveness we first found the best sets of sites able to maximize the representation of each indicator group in the BH and then calculated the average representation of different target species by the indicator groups in the BH. We considered consistent indicator groups whose representation of target species was not statistically different between BH. We called effective those groups that outperformed the target-species representation achieved by random sets of species. Effective indicator groups required the selection of less than 2% of the BH area for representing target species. Restricted-range species were the most effective indicators for the representation of all mammal diversity as well as target species. It was also the only group with high consistency.We show that several indicator groups could be applied as shortcuts for representing mammal species in the Cerrado and the Atlantic Forest to develop conservation plans, however, only restricted-range species consistently held as the most effective indicator group for such a task. This group is of particular importance in conservation planning as it captures high diversity of endemic and endangered species.

  2. Performance and consistency of indicator groups in two biodiversity hotspots.

    Science.gov (United States)

    Trindade-Filho, Joaquim; Loyola, Rafael Dias

    2011-01-01

    In a world limited by data availability and limited funds for conservation, scientists and practitioners must use indicator groups to define spatial conservation priorities. Several studies have evaluated the effectiveness of indicator groups, but still little is known about the consistency in performance of these groups in different regions, which would allow their a priori selection. We systematically examined the effectiveness and the consistency of nine indicator groups in representing mammal species in two top-ranked Biodiversity Hotspots (BH): the Brazilian Cerrado and the Atlantic Forest. To test for group effectiveness we first found the best sets of sites able to maximize the representation of each indicator group in the BH and then calculated the average representation of different target species by the indicator groups in the BH. We considered consistent indicator groups whose representation of target species was not statistically different between BH. We called effective those groups that outperformed the target-species representation achieved by random sets of species. Effective indicator groups required the selection of less than 2% of the BH area for representing target species. Restricted-range species were the most effective indicators for the representation of all mammal diversity as well as target species. It was also the only group with high consistency. We show that several indicator groups could be applied as shortcuts for representing mammal species in the Cerrado and the Atlantic Forest to develop conservation plans, however, only restricted-range species consistently held as the most effective indicator group for such a task. This group is of particular importance in conservation planning as it captures high diversity of endemic and endangered species.

  3. Consistent van der Waals radii for the whole main group.

    Science.gov (United States)

    Mantina, Manjeera; Chamberlin, Adam C; Valero, Rosendo; Cramer, Christopher J; Truhlar, Donald G

    2009-05-14

    Atomic radii are not precisely defined but are nevertheless widely used parameters in modeling and understanding molecular structure and interactions. The van der Waals radii determined by Bondi from molecular crystals and data for gases are the most widely used values, but Bondi recommended radius values for only 28 of the 44 main-group elements in the periodic table. In the present Article, we present atomic radii for the other 16; these new radii were determined in a way designed to be compatible with Bondi's scale. The method chosen is a set of two-parameter correlations of Bondi's radii with repulsive-wall distances calculated by relativistic coupled-cluster electronic structure calculations. The newly determined radii (in A) are Be, 1.53; B, 1.92; Al, 1.84; Ca, 2.31; Ge, 2.11; Rb, 3.03; Sr, 2.49; Sb, 2.06; Cs, 3.43; Ba, 2.68; Bi, 2.07; Po, 1.97; At, 2.02; Rn, 2.20; Fr, 3.48; and Ra, 2.83.

  4. Migraine patients consistently show abnormal vestibular bedside tests

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    Eliana Teixeira Maranhão

    2015-01-01

    Full Text Available Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs.Objective To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls.Method Cross-sectional study including sixty individuals – thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls.Results Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity.Conclusion Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  5. Migraine patients consistently show abnormal vestibular bedside tests.

    Science.gov (United States)

    Maranhão, Eliana Teixeira; Maranhão-Filho, Péricles; Luiz, Ronir Raggio; Vincent, Maurice Borges

    2016-01-01

    Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs. To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR) responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls. Cross-sectional study including sixty individuals - thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls. Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity). Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  6. Group Membership, Group Change, and Intergroup Attitudes: A Recategorization Model Based on Cognitive Consistency Principles

    Science.gov (United States)

    Roth, Jenny; Steffens, Melanie C.; Vignoles, Vivian L.

    2018-01-01

    The present article introduces a model based on cognitive consistency principles to predict how new identities become integrated into the self-concept, with consequences for intergroup attitudes. The model specifies four concepts (self-concept, stereotypes, identification, and group compatibility) as associative connections. The model builds on two cognitive principles, balance–congruity and imbalance–dissonance, to predict identification with social groups that people currently belong to, belonged to in the past, or newly belong to. More precisely, the model suggests that the relative strength of self-group associations (i.e., identification) depends in part on the (in)compatibility of the different social groups. Combining insights into cognitive representation of knowledge, intergroup bias, and explicit/implicit attitude change, we further derive predictions for intergroup attitudes. We suggest that intergroup attitudes alter depending on the relative associative strength between the social groups and the self, which in turn is determined by the (in)compatibility between social groups. This model unifies existing models on the integration of social identities into the self-concept by suggesting that basic cognitive mechanisms play an important role in facilitating or hindering identity integration and thus contribute to reducing or increasing intergroup bias. PMID:29681878

  7. Group Membership, Group Change, and Intergroup Attitudes: A Recategorization Model Based on Cognitive Consistency Principles

    Directory of Open Access Journals (Sweden)

    Jenny Roth

    2018-04-01

    Full Text Available The present article introduces a model based on cognitive consistency principles to predict how new identities become integrated into the self-concept, with consequences for intergroup attitudes. The model specifies four concepts (self-concept, stereotypes, identification, and group compatibility as associative connections. The model builds on two cognitive principles, balance–congruity and imbalance–dissonance, to predict identification with social groups that people currently belong to, belonged to in the past, or newly belong to. More precisely, the model suggests that the relative strength of self-group associations (i.e., identification depends in part on the (incompatibility of the different social groups. Combining insights into cognitive representation of knowledge, intergroup bias, and explicit/implicit attitude change, we further derive predictions for intergroup attitudes. We suggest that intergroup attitudes alter depending on the relative associative strength between the social groups and the self, which in turn is determined by the (incompatibility between social groups. This model unifies existing models on the integration of social identities into the self-concept by suggesting that basic cognitive mechanisms play an important role in facilitating or hindering identity integration and thus contribute to reducing or increasing intergroup bias.

  8. Group Membership, Group Change, and Intergroup Attitudes: A Recategorization Model Based on Cognitive Consistency Principles.

    Science.gov (United States)

    Roth, Jenny; Steffens, Melanie C; Vignoles, Vivian L

    2018-01-01

    The present article introduces a model based on cognitive consistency principles to predict how new identities become integrated into the self-concept, with consequences for intergroup attitudes. The model specifies four concepts (self-concept, stereotypes, identification, and group compatibility) as associative connections. The model builds on two cognitive principles, balance-congruity and imbalance-dissonance, to predict identification with social groups that people currently belong to, belonged to in the past, or newly belong to. More precisely, the model suggests that the relative strength of self-group associations (i.e., identification) depends in part on the (in)compatibility of the different social groups. Combining insights into cognitive representation of knowledge, intergroup bias, and explicit/implicit attitude change, we further derive predictions for intergroup attitudes. We suggest that intergroup attitudes alter depending on the relative associative strength between the social groups and the self, which in turn is determined by the (in)compatibility between social groups. This model unifies existing models on the integration of social identities into the self-concept by suggesting that basic cognitive mechanisms play an important role in facilitating or hindering identity integration and thus contribute to reducing or increasing intergroup bias.

  9. Connectome-scale group-wise consistent resting-state network analysis in autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Yu Zhao

    2016-01-01

    Full Text Available Understanding the organizational architecture of human brain function and its alteration patterns in diseased brains such as Autism Spectrum Disorder (ASD patients are of great interests. In-vivo functional magnetic resonance imaging (fMRI offers a unique window to investigate the mechanism of brain function and to identify functional network components of the human brain. Previously, we have shown that multiple concurrent functional networks can be derived from fMRI signals using whole-brain sparse representation. Yet it is still an open question to derive group-wise consistent networks featured in ASD patients and controls. Here we proposed an effective volumetric network descriptor, named connectivity map, to compactly describe spatial patterns of brain network maps and implemented a fast framework in Apache Spark environment that can effectively identify group-wise consistent networks in big fMRI dataset. Our experiment results identified 144 group-wisely common intrinsic connectivity networks (ICNs shared between ASD patients and healthy control subjects, where some ICNs are substantially different between the two groups. Moreover, further analysis on the functional connectivity and spatial overlap between these 144 common ICNs reveals connectomics signatures characterizing ASD patients and controls. In particular, the computing time of our Spark-enabled functional connectomics framework is significantly reduced from 240 hours (C++ code, single core to 20 hours, exhibiting a great potential to handle fMRI big data in the future.

  10. Concept of grouping in partitioning of HLW for self-consistent fuel cycle

    International Nuclear Information System (INIS)

    Kitamoto, A.; Mulyanto

    1993-01-01

    A concept of grouping for partitioning of HLW has been developed in order to examine the possibility of a self-consistent fuel recycle. The concept of grouping of radionuclides is proposed herein, such as Group MA1 (MA below Cm), Group MA2 (Cm and higher MA), Group A ( 99 Tc and I), Group B (Cs and Sr) and Group R (the partitioned remain of HLW). Group B is difficult to be transmuted by neutron reaction, so a radiation application in an industrial scale should be developed in the future. Group A and Group MA1 can be burned by a thermal reactor, on the other hand Group MA2 should be burned by a fast reactor. P-T treatment can be optimized for the in-core and out-core system, respectively

  11. Accuracy and Consistency of Respiratory Gating in Abdominal Cancer Patients

    International Nuclear Information System (INIS)

    Ge, Jiajia; Santanam, Lakshmi; Yang, Deshan; Parikh, Parag J.

    2013-01-01

    Purpose: To evaluate respiratory gating accuracy and intrafractional consistency for abdominal cancer patients treated with respiratory gated treatment on a regular linear accelerator system. Methods and Materials: Twelve abdominal patients implanted with fiducials were treated with amplitude-based respiratory-gated radiation therapy. On the basis of daily orthogonal fluoroscopy, the operator readjusted the couch position and gating window such that the fiducial was within a setup margin (fiducial-planning target volume [f-PTV]) when RPM indicated “beam-ON.” Fifty-five pre- and post-treatment fluoroscopic movie pairs with synchronized respiratory gating signal were recorded. Fiducial motion traces were extracted from the fluoroscopic movies using a template matching algorithm and correlated with f-PTV by registering the digitally reconstructed radiographs with the fluoroscopic movies. Treatment was determined to be “accurate” if 50% of the fiducial area stayed within f-PTV while beam-ON. For movie pairs that lost gating accuracy, a MATLAB program was used to assess whether the gating window was optimized, the external-internal correlation (EIC) changed, or the patient moved between movies. A series of safety margins from 0.5 mm to 3 mm was added to f-PTV for reassessing gating accuracy. Results: A decrease in gating accuracy was observed in 44% of movie pairs from daily fluoroscopic movies of 12 abdominal patients. Three main causes for inaccurate gating were identified as change of global EIC over time (∼43%), suboptimal gating setup (∼37%), and imperfect EIC within movie (∼13%). Conclusions: Inconsistent respiratory gating accuracy may occur within 1 treatment session even with a daily adjusted gating window. To improve or maintain gating accuracy during treatment, we suggest using at least a 2.5-mm safety margin to account for gating and setup uncertainties

  12. Memory for stereotype (in)consistent information : The role of in-group identification

    NARCIS (Netherlands)

    Doosje, Bertjan; Spears, Russell; de Redelijkheid, Hans; van Onna, Joost

    Effects of identification with one's group on memory of stereotype consistent and inconsistent information about one's group were examined in two studies. In the first study, we focused on supporters of a low status soccer team, and observed that diehard fans were more likely to remember

  13. A self-consistent, absolute isochronal age scale for young moving groups in the solar neighbourhood

    OpenAIRE

    Bell, Cameron P. M.; Mamajek, Eric E.; Naylor, Tim

    2015-01-01

    We present a self-consistent, absolute isochronal age scale for young (< 200 Myr), nearby (< 100 pc) moving groups in the solar neighbourhood based on homogeneous fitting of semi-empirical pre-main-sequence model isochrones using the tau^2 maximum-likelihood fitting statistic of Naylor & Jeffries in the M_V, V-J colour-magnitude diagram. The final adopted ages for the groups are: 149+51-19 Myr for the AB Dor moving group, 24+/-3 Myr for the {\\beta} Pic moving group (BPMG), 45+11-7 Myr for the...

  14. Consistent Individual Differences Drive Collective Behavior and Group Functioning of Schooling Fish.

    Science.gov (United States)

    Jolles, Jolle W; Boogert, Neeltje J; Sridhar, Vivek H; Couzin, Iain D; Manica, Andrea

    2017-09-25

    The ubiquity of consistent inter-individual differences in behavior ("animal personalities") [1, 2] suggests that they might play a fundamental role in driving the movements and functioning of animal groups [3, 4], including their collective decision-making, foraging performance, and predator avoidance. Despite increasing evidence that highlights their importance [5-16], we still lack a unified mechanistic framework to explain and to predict how consistent inter-individual differences may drive collective behavior. Here we investigate how the structure, leadership, movement dynamics, and foraging performance of groups can emerge from inter-individual differences by high-resolution tracking of known behavioral types in free-swimming stickleback (Gasterosteus aculeatus) shoals. We show that individual's propensity to stay near others, measured by a classic "sociability" assay, was negatively linked to swim speed across a range of contexts, and predicted spatial positioning and leadership within groups as well as differences in structure and movement dynamics between groups. In turn, this trait, together with individual's exploratory tendency, measured by a classic "boldness" assay, explained individual and group foraging performance. These effects of consistent individual differences on group-level states emerged naturally from a generic model of self-organizing groups composed of individuals differing in speed and goal-orientedness. Our study provides experimental and theoretical evidence for a simple mechanism to explain the emergence of collective behavior from consistent individual differences, including variation in the structure, leadership, movement dynamics, and functional capabilities of groups, across social and ecological scales. In addition, we demonstrate individual performance is conditional on group composition, indicating how social selection may drive behavioral differentiation between individuals. Copyright © 2017 The Author(s). Published by

  15. A self-consistent, absolute isochronal age scale for young moving groups in the solar neighbourhood

    Science.gov (United States)

    Bell, Cameron P. M.; Mamajek, Eric E.; Naylor, Tim

    2015-11-01

    We present a self-consistent, absolute isochronal age scale for young ( ≲ 200 Myr), nearby ( ≲ 100 pc) moving groups in the solar neighbourhood based on homogeneous fitting of semi-empirical pre-main-sequence model isochrones using the τ2 maximum-likelihood fitting statistic of Naylor & Jeffries in the MV, V - J colour-magnitude diagram. The final adopted ages for the groups are as follows: 149^{+51}_{-19} {Myr} for the AB Dor moving group, 24 ± 3 Myr for the β Pic moving group (BPMG), 45^{+11}_{-7} {Myr} for the Carina association, 42^{+6}_{-4} {Myr} for the Columba association, 11 ± 3 Myr for the η Cha cluster, 45 ± 4 Myr for the Tucana-Horologium moving group (Tuc-Hor), 10 ± 3 Myr for the TW Hya association and 22^{+4}_{-3} {Myr} for the 32 Ori group. At this stage we are uncomfortable assigning a final, unambiguous age to the Argus association as our membership list for the association appears to suffer from a high level of contamination, and therefore it remains unclear whether these stars represent a single population of coeval stars. Our isochronal ages for both the BPMG and Tuc-Hor are consistent with recent lithium depletion boundary (LDB) ages, which unlike isochronal ages, are relatively insensitive to the choice of low-mass evolutionary models. This consistency between the isochronal and LDB ages instils confidence that our self-consistent, absolute age scale for young, nearby moving groups is robust, and hence we suggest that these ages be adopted for future studies of these groups. Software implementing the methods described in this study is available from http://www.astro.ex.ac.uk/people/timn/tau-squared/.

  16. Self-consistent embedding of density-matrix renormalization group wavefunctions in a density functional environment.

    Science.gov (United States)

    Dresselhaus, Thomas; Neugebauer, Johannes; Knecht, Stefan; Keller, Sebastian; Ma, Yingjin; Reiher, Markus

    2015-01-28

    We present the first implementation of a density matrix renormalization group algorithm embedded in an environment described by density functional theory. The frozen density embedding scheme is used with a freeze-and-thaw strategy for a self-consistent polarization of the orbital-optimized wavefunction and the environmental densities with respect to each other.

  17. CONSISTENT HUMORAL IMMUNITY CONDITION IN PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS ON THE BACKGROUND OF PARASITIC INVASION

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    Natal'ya Saval'eva

    2015-11-01

    Full Text Available The article reveals the results of the immunity humoral chain investigation in patients with the chronic generalized periodontitis (CGP, severity level I-II, in combination with parasitosis. The purpose of the investigation is to verify the role and place of humoral immunity in CGP pathology in patients with parasitosis. Materials and methods. Immunologic investigations were conducted among 540 patients with the chronic generalized periodontitis, severity level I-II, on the background of parasitic invasions (gisrdiasis, enterobiasis, toxocarosis – (principle groups. The experimental group consisted of 90 CGP patients, severity level I-II, without parasitic invasions. The control group consisted of 30 people without the parodontium pathology and the chronic pathology of other organs and systems, who were considered practically healthy during the investigation. Humoral immunity condition in CGP patients was estimated by the content level of antibodies against etiological inflectional agents in the blood serum and the common antigenic determinant (CAD of microbes, antimicrobial IgG- antibodies affinity, by the content of IgА. IgМ, IgЕ, CIC, complement activity. Results and conclusions. It is noted that increasing of IgE, CIC and complement levels in blood are the peculiarity of immune structures in the organism of CGP patients with parasitosis, compared with CGP patients without parasitosis. While investigating the qualitative characteristics of the produced antimicrobial antibodies, it was found that in CGP patients, I-II severity level, with parasitosis the antibodies affinity was significantly lower than in CGP patients without parasitosis. Weak antibody immune response to the microbial factor and low produced antimicrobial antibodies affinity, apparently, explain the impossibility for the patient to neutralize and eliminate the bacteria, populating the periodontal pockets, as well as to maintain normal mouth cavity biocenosis. The obtained

  18. Group sparse multiview patch alignment framework with view consistency for image classification.

    Science.gov (United States)

    Gui, Jie; Tao, Dacheng; Sun, Zhenan; Luo, Yong; You, Xinge; Tang, Yuan Yan

    2014-07-01

    No single feature can satisfactorily characterize the semantic concepts of an image. Multiview learning aims to unify different kinds of features to produce a consensual and efficient representation. This paper redefines part optimization in the patch alignment framework (PAF) and develops a group sparse multiview patch alignment framework (GSM-PAF). The new part optimization considers not only the complementary properties of different views, but also view consistency. In particular, view consistency models the correlations between all possible combinations of any two kinds of view. In contrast to conventional dimensionality reduction algorithms that perform feature extraction and feature selection independently, GSM-PAF enjoys joint feature extraction and feature selection by exploiting l(2,1)-norm on the projection matrix to achieve row sparsity, which leads to the simultaneous selection of relevant features and learning transformation, and thus makes the algorithm more discriminative. Experiments on two real-world image data sets demonstrate the effectiveness of GSM-PAF for image classification.

  19. Weyl consistency conditions and a local renormalisation group equation for general renormalisable field theories

    International Nuclear Information System (INIS)

    Osborn, H.

    1991-01-01

    A local renormalisation group equation which realises infinitesimal Weyl rescalings of the metric and which is an extension of the usual Callan-Symanzik equation is described. In order to ensure that any local composite operators, with dimensions so that on addition to the basic lagrangian they preserve renormalisability, are well defined for arbitrarily many insertions into correlation functions the couplings are assumed to depend on χ. Local operators are then defined by functional differentiation with respect to the couplings just as the energy-momentum tensor is given by functional differentiation with respect to the metric. The local renormalisation group equation contains terms depending on derivatives of the couplings as well as the curvature tensor formed from the metric, constrained by power counting. Various consistency relations arising from the commutativity of Weyl transformations are derived, extending previous one-loop results for the trace anomaly to all orders. In two dimensions the relations give an alternative derivation of the c-theorem and similar extensions are obtained in four dimensions. The equations are applied in detail to general renormalisable σ-models in two dimensions. The Curci-Paffuti relation is derived without any commitment to a particular regularisation scheme and further equations used to construct an action for the vanishing of the β-functions are also obtained. The discussion is also extended to σ-models with a boundary, as appropriate for open strings, and relations for the additional β-functions present in such models are obtained. (orig.)

  20. Internal consistency & validity of Indian Disability Evaluation and Assessment Scale (IDEAS in patients with schizophrenia

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    Sandeep Grover

    2014-01-01

    Full Text Available Background & objectives: The Indian Disability Evaluation and Assessment Scale (IDEAS has been recommended for assessment and certification of disability by the Government of India (GOI. However, the psychometric properties of IDEAS as adopted by GOI remain understudied. Our aim, thus, was to study the internal consistency and validity of IDEAS in patients with schizophrenia. Methods: A total of 103 consenting patients with residual schizophrenia were assessed for disability, quality of life (QOL and psychopathology using the IDEAS, WHO QOL-100 and Positive and Negative symptom scale (PANSS respectively. Internal consistency was calculated using Cronbach′s alpha. For construct validity, relations between IDEAS, and psychopathology and QOL were studied. Results: The inter-item correlations for IDEAS were significant with a Cronbach′s alpha of 0.721. All item scores other than score on communication and understanding; total and global IDEAS scores correlated significantly with the positive, negative and general sub-scales, and total PANSS scores. Communication and understanding was significantly related to negative sub-scale score only. Total and global disability scores correlated negatively with all the domains of WHOQOL-100 (ρ<0.01. The individual IDEAS item scores correlated negatively with various WHOQOL-100 domains (ρ0< 0.01. Interpretation & conclusions: This study findings showed that the GOI-modified IDEAS had good internal consistency and construct validity as tested in patients with residual schizophrenia. Similar studies need to be done with other groups of patients.

  1. Capacity of burning and transmutation reactor and grouping in partitioning of HLW in self-consistent fuel recycle

    International Nuclear Information System (INIS)

    Kitamoto, A.; Mulyanto

    1993-01-01

    The concept of capacity of B/T reactor and grouping for partitioning of HLW has been developed in order to perform self-consistent fuel recycle. The concept of grouping of radionuclides is proposed herein, such as Group MA1 (MA below Cm), Group MA2 (Cm and higher MA), Group A ( 99 Te, 129 I, and 135 Cs), Group B ( 137 Cs and 90 Sr) and Group R (the partitioned remain of HLW). In this study P-T treatment were optimized for the in-core and out-core system, respectively. (author). 7 refs., 10 figs

  2. Consistences for introducing more vector potentials in the same group, by BRST algorithm

    International Nuclear Information System (INIS)

    Doria, R.; Carvalho, F.A.R. de

    1989-01-01

    The BRS formalism for quantum formulation of gauge theory is analysed applying to extended models. The quantum effective Lagrangian of gauge is established, invariant under s and s→ for a system with vector potentials belong to one Abelian group of gauge. The BRS charge associated to the system is calculated. (M.C.K.)

  3. Polystyrene Backbone Polymers Consisting of Alkyl-Substituted Triazine Side Groups for Phosphorescent OLEDs

    OpenAIRE

    Salert, Beatrice Ch. D.; Wedel, Armin; Grubert, Lutz; Eberle, Thomas; Anémian, Rémi; Krueger, Hartmut

    2012-01-01

    This paper describes the synthesis of new electron-transporting styrene monomers and their corresponding polystyrenes all with a 2,4,6-triphenyl-1,3,5-triazine basic structure in the side group. The monomers differ in the alkyl substitution and in the meta-/paralinkage of the triazine to the polymer backbone. The thermal and spectroscopic properties of the new electron-transporting polymers are discussed in regard to their chemical structures. Phosphorescent OLEDs were prepared using the obta...

  4. Assessing the reliability of predictive activity coefficient models for molecules consisting of several functional groups

    Directory of Open Access Journals (Sweden)

    R. P. Gerber

    2013-03-01

    Full Text Available Currently, the most successful predictive models for activity coefficients are those based on functional groups such as UNIFAC. In contrast, these models require a large amount of experimental data for the determination of their parameter matrix. A more recent alternative is the models based on COSMO, for which only a small set of universal parameters must be calibrated. In this work, a recalibrated COSMO-SAC model was compared with the UNIFAC (Do model employing experimental infinite dilution activity coefficient data for 2236 non-hydrogen-bonding binary mixtures at different temperatures. As expected, UNIFAC (Do presented better overall performance, with a mean absolute error of 0.12 ln-units against 0.22 for our COSMO-SAC implementation. However, in cases involving molecules with several functional groups or when functional groups appear in an unusual way, the deviation for UNIFAC was 0.44 as opposed to 0.20 for COSMO-SAC. These results show that COSMO-SAC provides more reliable predictions for multi-functional or more complex molecules, reaffirming its future prospects.

  5. A consistent homogenization procedure to obtain few-group cell parameters

    International Nuclear Information System (INIS)

    Pierini, G.

    1979-01-01

    The criterion, according to which one heterogeneous and one homogeneous cell are equivalent if they have the same boundary values of both the flux and the normal components of the current, is used to homogenize radially an axially infinite cylindrical cell, with azimuth independent properties and moderatur adequately described by diffusion theory. The method, which leads to the definition of a full matrix of diffusion coefficients, provides a new and simple definition of the few-group cell parameters, which are nearly independent of the environment. (orig.) [de

  6. Emotional ties that bind: the roles of valence and consistency of group emotion in inferences of cohesiveness and common fate.

    Science.gov (United States)

    Magee, Joe C; Tiedens, Larissa Z

    2006-12-01

    In three studies, observers based inferences about the cohesiveness and common fate of groups on the emotions expressed by group members. The valence of expressions affected cohesiveness inferences, whereas the consistency of expressions affected inferences of whether members have common fate. These emotion composition effects were stronger than those due to the race or sex composition of the group. Furthermore, the authors show that emotion valence and consistency are differentially involved in judgments about the degree to which the group as a whole was responsible for group performance. Finally, it is demonstrated that valence-cohesiveness effects are mediated by inferences of interpersonal liking and that consistency-common fate effects are mediated by inferences of psychological similarity. These findings have implications for the literature on entitativity and regarding the function of emotions in social contexts.

  7. Polystyrene Backbone Polymers Consisting of Alkyl-Substituted Triazine Side Groups for Phosphorescent OLEDs

    Directory of Open Access Journals (Sweden)

    Beatrice Ch. D. Salert

    2012-01-01

    Full Text Available This paper describes the synthesis of new electron-transporting styrene monomers and their corresponding polystyrenes all with a 2,4,6-triphenyl-1,3,5-triazine basic structure in the side group. The monomers differ in the alkyl substitution and in the meta-/paralinkage of the triazine to the polymer backbone. The thermal and spectroscopic properties of the new electron-transporting polymers are discussed in regard to their chemical structures. Phosphorescent OLEDs were prepared using the obtained electron-transporting polymers as the emissive layer material in blend systems together with a green iridium-based emitter 13 and a small molecule as an additional cohost with wideband gap characteristics (CoH-001. The performance of the OLEDs was characterized and discussed in regard to the chemical structure of the new electron-transporting polymers.

  8. Item wording and internal consistency of a measure of cohesion: the group environment questionnaire.

    Science.gov (United States)

    Eys, Mark A; Carron, Albert V; Bray, Steven R; Brawley, Lawrence R

    2007-06-01

    A common practice for counteracting response acquiescence in psychological measures has been to employ both negatively and positively worded items. However, previous research has highlighted that the reliability of measures can be affected by this practice (Spector, 1992). The purpose of the present study was to examine the effect that the presence of negatively worded items has on the internal reliability of the Group Environment Questionnaire (GEQ). Two samples (N = 276) were utilized, and participants were asked to complete the GEQ (original and revised) on separate occasions. Results demonstrated that the revised questionnaire (containing all positively worded items) had significantly higher Cronbach alpha values for three of the four dimensions of the GEQ. Implications, alternatives, and future directions are discussed.

  9. A diagnostic test for apraxia in stroke patients: internal consistency and diagnostic value.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, F.C.; Kinebanian, A.

    1999-01-01

    The internal consistency and the diagnostic value of a test for apraxia in patients having had a stroke are presented. Results indicate that the items of the test form a strong and consistent scale: Cronbach's alpha as well as the results of a Mokken scale analysis present good reliability and good

  10. Validity test and its consistency in the construction of patient loyalty model

    Science.gov (United States)

    Yanuar, Ferra

    2016-04-01

    The main objective of this present study is to demonstrate the estimation of validity values and its consistency based on structural equation model. The method of estimation was then implemented to an empirical data in case of the construction the patient loyalty model. In the hypothesis model, service quality, patient satisfaction and patient loyalty were determined simultaneously, each factor were measured by any indicator variables. The respondents involved in this study were the patients who ever got healthcare at Puskesmas in Padang, West Sumatera. All 394 respondents who had complete information were included in the analysis. This study found that each construct; service quality, patient satisfaction and patient loyalty were valid. It means that all hypothesized indicator variables were significant to measure their corresponding latent variable. Service quality is the most measured by tangible, patient satisfaction is the most mesured by satisfied on service and patient loyalty is the most measured by good service quality. Meanwhile in structural equation, this study found that patient loyalty was affected by patient satisfaction positively and directly. Service quality affected patient loyalty indirectly with patient satisfaction as mediator variable between both latent variables. Both structural equations were also valid. This study also proved that validity values which obtained here were also consistence based on simulation study using bootstrap approach.

  11. Do effects of common case-mix adjusters on patient experiences vary across patient groups?

    NARCIS (Netherlands)

    de Boer, Dolf; van der Hoek, Lucas; Rademakers, Jany; Delnoij, Diana; van den Berg, Michael

    2017-01-01

    Many survey studies in health care adjust for demographic characteristics such as age, gender, educational attainment and general health when performing statistical analyses. Whether the effects of these demographic characteristics are consistent between patient groups remains to be determined. This

  12. Do effects of common casemix adjusters on patient experiences vary across patient groups?

    NARCIS (Netherlands)

    Boer, D. de; Hoek, L. van der; Rademakers, J.; Delnoij, D.; Berg, M. van den

    2017-01-01

    Background: Many survey studies in health care adjust for demographic characteristics such as age, gender, educational attainment and general health when performing statistical analyses. Whether the effects of these demographic characteristics are consistent between patient groups remains to be

  13. Assessment of disabilities in stroke patients with apraxia : Internal consistency and inter-observer reliability

    NARCIS (Netherlands)

    van Heugten, CM; Dekker, J; Deelman, BG; Stehmann-Saris, JC; Kinebanian, A

    1999-01-01

    In this paper the internal consistency and inter-observer reliability of the assessment of disabilities in stroke patients with apraxia is presented. Disabilities were assessed by means of observation of activities of daily living (ADL). The study was conducted at occupational therapy departments in

  14. Assessment of disabilities in stroke patients with apraxia: internal consistency and inter-observer reliability.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    1999-01-01

    In this paper the internal consistency and inter-observer reliability of the assessment of disabilities in stroke patients with apraxia is presented. Disabilities were assessed by means of observation of activities of daily living (ADL). The study was conducted at occupational therapy departments in

  15. Participation in online patient support groups endorses patients' empowerment

    NARCIS (Netherlands)

    van Uden-Kraan, C. F.; Drossaert, Constance H C; Taal, E; Seydel, E. R.; van de Laar, Mart A F J

    Objective: Although much has been expected of the empowering effect of taking part in online patient support groups, there is no direct evidence thus far for the effects of participation on patient empowerment. Hence our exploring to what extent patients feel empowered by their participation in

  16. Inter-arm blood pressure difference in hospitalized elderly patients--is it consistent?

    Science.gov (United States)

    Grossman, Alon; Weiss, Avraham; Beloosesky, Yichayaou; Morag-Koren, Nira; Green, Hefziba; Grossman, Ehud

    2014-07-01

    Inter-arm blood pressure difference (IAD) is recognized as a risk factor for cardiovascular mortality. Its reproducibility in the elderly is unknown. The authors determined the prevalence and reproducibility of IAD in hospitalized elderly patients. Blood pressure was measured simultaneously in both arms on two different days in elderly individuals hospitalized in a geriatric ward. The study included 364 elderly patients (mean age, 85±5 years). Eighty-four patients (23%) had systolic IAD >10 and 62 patients (17%) had diastolic IAD >10 mm Hg. A total of 319 patients had two blood pressure measurements. Systolic and diastolic IAD remained in the same category in 203 (64%) and 231 (72%) patients, respectively. Correlations of systolic and diastolic IAD between the two measurements were poor. Consistency was not affected by age, body mass index, comorbidities, or treatment. IAD is extremely common in hospitalized elderly patients, but, because of poor consistency, its clinical significance in this population is uncertain. ©2014 Wiley Periodicals, Inc.

  17. Patient-provider concordance with behavioral change goals drives measures of motivational interviewing consistency.

    Science.gov (United States)

    Laws, Michael Barton; Rose, Gary S; Beach, Mary Catherine; Lee, Yoojin; Rogers, William S; Velasco, Alyssa Bianca; Wilson, Ira B

    2015-06-01

    Motivational Interviewing (MI) consistent talk by a counselor is thought to produce "change talk" in clients. However, it is possible that client resistance to behavior change can produce MI inconsistent counselor behavior. We applied a coding scheme which identifies all of the behavioral counseling about a given issue during a visit ("episodes"), assesses patient concordance with the behavioral goal, and labels providers' counseling style as facilitative or directive, to a corpus of routine outpatient visits by people with HIV. Using a different data set of comparable encounters, we applied the concepts of episode and concordance, and coded using the Motivational Interviewing Treatment Integrity system. Patient concordance/discordance was not observed to change during any episode. Provider directiveness was strongly associated with patient discordance in the first study, and MI inconsistency was strongly associated with discordance in the second. Observations that MI-consistent behavior by medical providers is associated with patient change talk or outcomes should be evaluated cautiously, as patient resistance may provoke MI-inconsistency. Counseling episodes in routine medical visits are typically too brief for client talk to evolve toward change. Providers with limited training may have particular difficulty maintaining MI consistency with resistant clients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Spatial variability in intertidal macroalgal assemblages on the North Portuguese coast: consistence between species and functional group approaches

    Science.gov (United States)

    Veiga, P.; Rubal, M.; Vieira, R.; Arenas, F.; Sousa-Pinto, I.

    2013-03-01

    Natural assemblages are variable in space and time; therefore, quantification of their variability is imperative to identify relevant scales for investigating natural or anthropogenic processes shaping these assemblages. We studied the variability of intertidal macroalgal assemblages on the North Portuguese coast, considering three spatial scales (from metres to 10 s of kilometres) following a hierarchical design. We tested the hypotheses that (1) spatial pattern will be invariant at all the studied scales and (2) spatial variability of macroalgal assemblages obtained by using species will be consistent with that obtained using functional groups. This was done considering as univariate variables: total biomass and number of taxa as well as biomass of the most important species and functional groups and as multivariate variables the structure of macroalgal assemblages, both considering species and functional groups. Most of the univariate results confirmed the first hypothesis except for the total number of taxa and foliose macroalgae that showed significant variability at the scale of site and area, respectively. In contrast, when multivariate patterns were examined, the first hypothesis was rejected except at the scale of 10 s of kilometres. Both uni- and multivariate results indicated that variation was larger at the smallest scale, and thus, small-scale processes seem to have more effect on spatial variability patterns. Macroalgal assemblages, both considering species and functional groups as surrogate, showed consistent spatial patterns, and therefore, the second hypothesis was confirmed. Consequently, functional groups may be considered a reliable biological surrogate to study changes on macroalgal assemblages at least along the investigated Portuguese coastline.

  19. SU-E-J-29: Audiovisual Biofeedback Improves Tumor Motion Consistency for Lung Cancer Patients

    International Nuclear Information System (INIS)

    Lee, D; Pollock, S; Makhija, K; Keall, P; Greer, P; Arm, J; Hunter, P; Kim, T

    2014-01-01

    Purpose: To investigate whether the breathing-guidance system: audiovisual (AV) biofeedback improves tumor motion consistency for lung cancer patients. This will minimize respiratory-induced tumor motion variations across cancer imaging and radiotherapy procedues. This is the first study to investigate the impact of respiratory guidance on tumor motion. Methods: Tumor motion consistency was investigated with five lung cancer patients (age: 55 to 64), who underwent a training session to get familiarized with AV biofeedback, followed by two MRI sessions across different dates (pre and mid treatment). During the training session in a CT room, two patient specific breathing patterns were obtained before (Breathing-Pattern-1) and after (Breathing-Pattern-2) training with AV biofeedback. In each MRI session, four MRI scans were performed to obtain 2D coronal and sagittal image datasets in free breathing (FB), and with AV biofeedback utilizing Breathing-Pattern-2. Image pixel values of 2D images after the normalization of 2D images per dataset and Gaussian filter per image were used to extract tumor motion using image pixel values. The tumor motion consistency of the superior-inferior (SI) direction was evaluated in terms of an average tumor motion range and period. Results: Audiovisual biofeedback improved tumor motion consistency by 60% (p value = 0.019) from 1.0±0.6 mm (FB) to 0.4±0.4 mm (AV) in SI motion range, and by 86% (p value < 0.001) from 0.7±0.6 s (FB) to 0.1±0.2 s (AV) in period. Conclusion: This study demonstrated that audiovisual biofeedback improves both breathing pattern and tumor motion consistency for lung cancer patients. These results suggest that AV biofeedback has the potential for facilitating reproducible tumor motion towards achieving more accurate medical imaging and radiation therapy procedures

  20. SU-E-J-29: Audiovisual Biofeedback Improves Tumor Motion Consistency for Lung Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D; Pollock, S; Makhija, K; Keall, P [The University of Sydney, Camperdown, NSW (Australia); Greer, P [The University of Newcastle, Newcastle, NSW (Australia); Calvary Mater Newcastle Hospital, Newcastle, NSW (Australia); Arm, J; Hunter, P [Calvary Mater Newcastle Hospital, Newcastle, NSW (Australia); Kim, T [The University of Sydney, Camperdown, NSW (Australia); University of Virginia Health System, Charlottesville, VA (United States)

    2014-06-01

    Purpose: To investigate whether the breathing-guidance system: audiovisual (AV) biofeedback improves tumor motion consistency for lung cancer patients. This will minimize respiratory-induced tumor motion variations across cancer imaging and radiotherapy procedues. This is the first study to investigate the impact of respiratory guidance on tumor motion. Methods: Tumor motion consistency was investigated with five lung cancer patients (age: 55 to 64), who underwent a training session to get familiarized with AV biofeedback, followed by two MRI sessions across different dates (pre and mid treatment). During the training session in a CT room, two patient specific breathing patterns were obtained before (Breathing-Pattern-1) and after (Breathing-Pattern-2) training with AV biofeedback. In each MRI session, four MRI scans were performed to obtain 2D coronal and sagittal image datasets in free breathing (FB), and with AV biofeedback utilizing Breathing-Pattern-2. Image pixel values of 2D images after the normalization of 2D images per dataset and Gaussian filter per image were used to extract tumor motion using image pixel values. The tumor motion consistency of the superior-inferior (SI) direction was evaluated in terms of an average tumor motion range and period. Results: Audiovisual biofeedback improved tumor motion consistency by 60% (p value = 0.019) from 1.0±0.6 mm (FB) to 0.4±0.4 mm (AV) in SI motion range, and by 86% (p value < 0.001) from 0.7±0.6 s (FB) to 0.1±0.2 s (AV) in period. Conclusion: This study demonstrated that audiovisual biofeedback improves both breathing pattern and tumor motion consistency for lung cancer patients. These results suggest that AV biofeedback has the potential for facilitating reproducible tumor motion towards achieving more accurate medical imaging and radiation therapy procedures.

  1. Oral lichen planus patients exhibit consistent chromosomal numerical aberrations: A follow-up analysis.

    Science.gov (United States)

    Yahalom, Ran; Yarom, Noam; Shani, Tali; Amariglio, Ninet; Kaplan, Ilana; Trakhtenbrot, Luba; Hirshberg, Abraham

    2016-04-01

    Oral lichen planus (OLP) carries an increased risk for malignant transformation with aneuploid cells (ACs) being found in brush samples of a quarter of patients with OLP. Patients with OLP were followed and repeated brush samples were simultaneously analyzed for morphology and fluorescent in situ hybridization (FISH) using centromeric probes for chromosomes 2 and 8. Three patients with a high proportion of ACs developed oral cancer. Fifteen patients had ≥1% ACs (13 in affected sites and 2 in nonaffected sites), whereas only 2 of the 15 patients with <1% ACs in the first sample had ≥1% ACs in the second sample. A strong positive correlation between the results of the initial and repeated samples was found. High proportion of ACs in brush samples from patients with OLP may imply an impending malignant transformation. As FISH analysis is consistent over time, it can be used to identify a subgroup of patients who would require close follow-up. © 2015 Wiley Periodicals, Inc. Head Neck 38: E741-E746, 2016. © 2015 Wiley Periodicals, Inc.

  2. Simulated patient training: Using inter-rater reliability to evaluate simulated patient consistency in nursing education.

    Science.gov (United States)

    MacLean, Sharon; Geddes, Fiona; Kelly, Michelle; Della, Phillip

    2018-03-01

    Simulated patients (SPs) are frequently used for training nursing students in communication skills. An acknowledged benefit of using SPs is the opportunity to provide a standardized approach by which participants can demonstrate and develop communication skills. However, relatively little evidence is available on how to best facilitate and evaluate the reliability and accuracy of SPs' performances. The aim of this study is to investigate the effectiveness of an evidenced based SP training framework to ensure standardization of SPs. The training framework was employed to improve inter-rater reliability of SPs. A quasi-experimental study was employed to assess SP post-training understanding of simulation scenario parameters using inter-rater reliability agreement indices. Two phases of data collection took place. Initially a trial phase including audio-visual (AV) recordings of two undergraduate nursing students completing a simulation scenario is rated by eight SPs using the Interpersonal Communication Assessments Scale (ICAS) and Quality of Discharge Teaching Scale (QDTS). In phase 2, eight SP raters and four nursing faculty raters independently evaluated students' (N=42) communication practices using the QDTS. Intraclass correlation coefficients (ICC) were >0.80 for both stages of the study in clinical communication skills. The results support the premise that if trained appropriately, SPs have a high degree of reliability and validity to both facilitate and evaluate student performance in nurse education. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  3. Consistent association of type 2 diabetes risk variants found in europeans in diverse racial and ethnic groups.

    Directory of Open Access Journals (Sweden)

    Kevin M Waters

    2010-08-01

    Full Text Available It has been recently hypothesized that many of the signals detected in genome-wide association studies (GWAS to T2D and other diseases, despite being observed to common variants, might in fact result from causal mutations that are rare. One prediction of this hypothesis is that the allelic associations should be population-specific, as the causal mutations arose after the migrations that established different populations around the world. We selected 19 common variants found to be reproducibly associated to T2D risk in European populations and studied them in a large multiethnic case-control study (6,142 cases and 7,403 controls among men and women from 5 racial/ethnic groups (European Americans, African Americans, Latinos, Japanese Americans, and Native Hawaiians. In analysis pooled across ethnic groups, the allelic associations were in the same direction as the original report for all 19 variants, and 14 of the 19 were significantly associated with risk. In summing the number of risk alleles for each individual, the per-allele associations were highly statistically significant (P<10(-4 and similar in all populations (odds ratios 1.09-1.12 except in Japanese Americans the estimated effect per allele was larger than in the other populations (1.20; P(het = 3.8×10(-4. We did not observe ethnic differences in the distribution of risk that would explain the increased prevalence of type 2 diabetes in these groups as compared to European Americans. The consistency of allelic associations in diverse racial/ethnic groups is not predicted under the hypothesis of Goldstein regarding "synthetic associations" of rare mutations in T2D.

  4. Physically consistent data assimilation method based on feedback control for patient-specific blood flow analysis.

    Science.gov (United States)

    Ii, Satoshi; Adib, Mohd Azrul Hisham Mohd; Watanabe, Yoshiyuki; Wada, Shigeo

    2018-01-01

    This paper presents a novel data assimilation method for patient-specific blood flow analysis based on feedback control theory called the physically consistent feedback control-based data assimilation (PFC-DA) method. In the PFC-DA method, the signal, which is the residual error term of the velocity when comparing the numerical and reference measurement data, is cast as a source term in a Poisson equation for the scalar potential field that induces flow in a closed system. The pressure values at the inlet and outlet boundaries are recursively calculated by this scalar potential field. Hence, the flow field is physically consistent because it is driven by the calculated inlet and outlet pressures, without any artificial body forces. As compared with existing variational approaches, although this PFC-DA method does not guarantee the optimal solution, only one additional Poisson equation for the scalar potential field is required, providing a remarkable improvement for such a small additional computational cost at every iteration. Through numerical examples for 2D and 3D exact flow fields, with both noise-free and noisy reference data as well as a blood flow analysis on a cerebral aneurysm using actual patient data, the robustness and accuracy of this approach is shown. Moreover, the feasibility of a patient-specific practical blood flow analysis is demonstrated. Copyright © 2017 John Wiley & Sons, Ltd.

  5. PTEN expression is consistent in colorectal cancer primaries and metastases and associates with patient survival

    International Nuclear Information System (INIS)

    Atreya, Chloe E; Sangale, Zaina; Xu, Nafei; Matli, Mary R; Tikishvili, Eliso; Welbourn, William; Stone, Steven; Shokat, Kevan M; Warren, Robert S

    2013-01-01

    Phosphatase and tensin homologue deleted on chromosome 10 (PTEN) negatively regulates the phosphoinositide-3-kinase (PI3K) signaling pathway. In colorectal cancer (CRC), observed frequencies of loss of PTEN expression, concordant expression in primary tumors and metastases, and the association of PTEN status with outcome vary markedly by detection method. We determined the degree to which PTEN expression is consistent in 70 matched human CRC primaries and liver metastases using a validated immunohistochemistry assay. We found loss of PTEN expression in 12.3% of assessable CRC primaries and 10.3% of assessable liver metastases. PTEN expression (positive or negative) was concordant in 98% of matched colorectal primaries and liver metastases. Next we related PTEN status to mutations in RAS and PI3K pathway genes (KRAS, NRAS, BRAF, and PIK3CA) and to overall survival (OS). PTEN expression was not significantly associated with the presence or absence of mutations in RAS or PI3K pathway genes. The median OS of patients whose tumors did not express PTEN was 9 months, compared to 49 months for patients whose tumors did express PTEN (HR = 6.25, 95% confidence intervals (CI) (1.98, 15.42), P = 0.0017). The association of absent PTEN expression with increased risk of death remained significant in multivariate analysis (HR = 6.31, 95% CI (2.03, 17.93), P = 0.0023). In summary, PTEN expression was consistent in matched CRC primaries and in liver metastases. Therefore, future investigations of PTEN in metastatic CRC can use primary tumor tissue. In patients with liver-only metastases, loss of PTEN expression predicted poor OS. We observed concordant PTEN expression in 98% of colorectal cancer (CRC) primary and liver metastasis pairs using a validated immunohistochemistry assay. Consistent PTEN expression at both disease sites is significant because tumor tissue is usually available from CRC primaries but not metastases. Loss of PTEN expression associated with poor survival of

  6. Changes in human skull morphology across the agricultural transition are consistent with softer diets in preindustrial farming groups.

    Science.gov (United States)

    Katz, David C; Grote, Mark N; Weaver, Timothy D

    2017-08-22

    Agricultural foods and technologies are thought to have eased the mechanical demands of diet-how often or how hard one had to chew-in human populations worldwide. Some evidence suggests correspondingly worldwide changes in skull shape and form across the agricultural transition, although these changes have proved difficult to characterize at a global scale. Here, adapting a quantitative genetics mixed model for complex phenotypes, we quantify the influence of diet on global human skull shape and form. We detect modest directional differences between foragers and farmers. The effects are consistent with softer diets in preindustrial farming groups and are most pronounced and reliably directional when the farming class is limited to dairying populations. Diet effect magnitudes are relatively small, affirming the primary role of neutral evolutionary processes-genetic drift, mutation, and gene flow structured by population history and migrations-in shaping diversity in the human skull. The results also bring an additional perspective to the paradox of why Homo sapiens , particularly agriculturalists, appear to be relatively well suited to efficient (high-leverage) chewing.

  7. Do effects of common case-mix adjusters on patient experiences vary across patient groups?

    Science.gov (United States)

    de Boer, Dolf; van der Hoek, Lucas; Rademakers, Jany; Delnoij, Diana; van den Berg, Michael

    2017-11-22

    Many survey studies in health care adjust for demographic characteristics such as age, gender, educational attainment and general health when performing statistical analyses. Whether the effects of these demographic characteristics are consistent between patient groups remains to be determined. This is important as the rationale for adjustment is often that demographic sub-groups differ in their so-called 'response tendency'. This rationale may be less convincing if the effects of response tendencies vary across patient groups. The present paper examines whether the impact of these characteristics on patients' global rating of care varies across patient groups. Secondary analyses using multi-level regression models were performed on a dataset including 32 different patient groups and 145,578 observations. For each demographic variable, the 95% expected range of case-mix coefficients across patient groups is presented. In addition, we report whether the variance of coefficients for demographic variables across patient groups is significant. Overall, men, elderly, lower educated people and people in good health tend to give higher global ratings. However, these effects varied significantly across patient groups and included the possibility of no effect or an opposite effect in some patient groups. The response tendency attributed to demographic characteristics - such as older respondents being milder, or higher educated respondents being more critical - is not general or universal. As such, the mechanism linking demographic characteristics to survey results on patient experiences with quality of care is more complicated than a general response tendency. It is possible that the response tendency interacts with patient group, but it is also possible that other mechanisms are at play.

  8. Do effects of common case-mix adjusters on patient experiences vary across patient groups?

    Directory of Open Access Journals (Sweden)

    Dolf de Boer

    2017-11-01

    Full Text Available Abstract Background Many survey studies in health care adjust for demographic characteristics such as age, gender, educational attainment and general health when performing statistical analyses. Whether the effects of these demographic characteristics are consistent between patient groups remains to be determined. This is important as the rationale for adjustment is often that demographic sub-groups differ in their so-called ‘response tendency’. This rationale may be less convincing if the effects of response tendencies vary across patient groups. The present paper examines whether the impact of these characteristics on patients’ global rating of care varies across patient groups. Methods Secondary analyses using multi-level regression models were performed on a dataset including 32 different patient groups and 145,578 observations. For each demographic variable, the 95% expected range of case-mix coefficients across patient groups is presented. In addition, we report whether the variance of coefficients for demographic variables across patient groups is significant. Results Overall, men, elderly, lower educated people and people in good health tend to give higher global ratings. However, these effects varied significantly across patient groups and included the possibility of no effect or an opposite effect in some patient groups. Conclusion The response tendency attributed to demographic characteristics – such as older respondents being milder, or higher educated respondents being more critical – is not general or universal. As such, the mechanism linking demographic characteristics to survey results on patient experiences with quality of care is more complicated than a general response tendency. It is possible that the response tendency interacts with patient group, but it is also possible that other mechanisms are at play.

  9. Consistency of safety and efficacy of new oral anticoagulants across subgroups of patients with atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Jean-Christophe Lega

    Full Text Available AIMS: The well-known limitations of vitamin K antagonists (VKA led to development of new oral anticoagulants (NOAC in non-valvular atrial fibrillation (NVAF. The aim of this meta-analysis was to determine the consistency of treatment effects of NOAC irrespective of age, comorbidities, or prior VKA exposure. METHODS AND RESULTS: All randomized, controlled phase III trials comparing NOAC to VKA up to October 2012 were eligible provided their results (stroke/systemic embolism (SSE and major bleeding (MB were reported according to age (≤ or >75 years, renal function, CHADS2 score, presence of diabetes mellitus or heart failure, prior VKA use or previous cerebrovascular events. Interactions were considered significant at p <0.05. Three studies (50,578 patients were included, respectively evaluating apixaban, rivaroxaban, and dabigatran versus warfarin. A trend towards interaction with heart failure (p = 0.08 was observed with respect to SSE reduction, this being greater in patients not presenting heart failure (RR = 0.76 [0.67-0.86] than in those with heart failure (RR = 0.90 [0.78-1.04]; Significant interaction (p = 0.01 with CHADS2 score was observed, NOAC achieving a greater reduction in bleeding risk in patients with a score of 0-1 (RR 0.67 CI 0.57-0.79 than in those with a score ≥2 (RR 0.85 CI 0.74-0.98. Comparison of MB in patients with (RR 0.97 CI 0.79-1.18 and without (RR 0.76 CI 0.65-0.88 diabetes mellitus showed a similar trend (p = 0.06. No other interactions were found. All subgroups derived benefit from NOA in terms of SSE or MB reduction. CONCLUSIONS: NOAC appeared to be more effective and safer than VKA in reducing SSE or MB irrespective of patient comorbidities. Thromboembolism risk, evaluated by CHADS2 score and, to a lesser extent, diabetes mellitus modified the treatment effects of NOAC without complete loss of benefit with respect to MB reduction.

  10. Assessment of effects of atomoxetine in adult patients with ADHD: consistency among three geographic regions in a response maintenance study.

    Science.gov (United States)

    Tanaka, Yoko; Escobar, Rodrigo; Upadhyaya, Himanshu P

    2017-06-01

    A previous study (Upadhyaya et al. in Eur J Psychiatry 2013b; 27:185-205) reported that adults with attention-deficit/hyperactivity disorder (ADHD) demonstrated maintenance of response for up to 25 weeks after initially responding to atomoxetine treatment. In the present report, the consistency of treatment effect across three geographic regions (Europe, United States/Canada [US/Can], and Latin America [Latin Am]) was explored. Data were analyzed from a phase 3, multicenter, randomized, double-blind, maintenance-of-response (randomized withdrawal) trial of atomoxetine versus placebo in adults with ADHD. Patients were randomized to atomoxetine (N = 266) or placebo (N = 258) for 25 weeks. Consistency assessments included the interaction test, pairwise t tests, noninferiority, and the criteria from Basic Principles on Global Clinical Trials (Ministry of Health, Labour and Welfare of Japan 2007). Atomoxetine-treated patients maintained the improved ADHD symptoms relative to placebo-treated patients on the Conners' Adult ADHD Rating Scale Investigator-Rated: Screening Version 18-Item (CAARS-Inv:SV) total score in all three regions (atomoxetine-placebo mean difference = -4.55, -3.18, and -0.07 for Europe, US/Can, and Latin Am, respectively). For the Latin Am region, the mean change in total score (0.41) was notably smaller for the placebo group than for Europe (5.87) and US/Can (4.39). Similar results were observed for the CAARS-Inv:SV hyperactivity/impulsivity and inattention subscale scores. Overall, patients maintained the response with atomoxetine treatment compared to placebo; however, the magnitude of treatment effect differed among the regions studied, being numerically higher in the EU and US/Can than Latin Am. Trial registration http://www.clinicaltrials.gov/(NCT00700427 ).

  11. Quantitative CT assessment in chronic obstructive pulmonary disease patients: Comparison of the patients with and without consistent clinical symptoms and pulmonary function results

    International Nuclear Information System (INIS)

    Nam, Boda; Hwang, Jung Hwa; Lee, Young Mok; Park, Jai Soung; Jou, Sung Shick; Kim, Young Bae

    2015-01-01

    We compared the clinical and quantitative CT measurement parameters between chronic obstructive pulmonary disease (COPD) patients with and without consistent clinical symptoms and pulmonary function results. This study included 60 patients having a clinical diagnosis of COPD, who underwent chest CT scan and pulmonary function tests. These 60 patients were classified into typical and atypical groups, which were further sub-classified into 4 groups, based on their dyspnea score and the result of pulmonary function tests [typical 1: mild dyspnea and pulmonary function impairment (PFI); typical 2: severe dyspnea and PFI; atypical 1: mild dyspnea and severe PFI; atypical 2: severe dyspnea and mild PFI]. Quantitative measurements of the CT data for emphysema, bronchial wall thickness and air-trapping were performed using software analysis. Comparative statistical analysis was performed between the groups. The CT emphysema index correlated well with the results of the pulmonary functional test (typical 1 vs. atypical 1, p = 0.032), and the bronchial wall area ratio correlated with the dyspnea score (typical 1 vs. atypical 2, p = 0.033). CT air-trapping index also correlated with the results of the pulmonary function test (typical 1 vs. atypical 1, p = 0.012) and dyspnea score (typical 1 vs. atypical 2, p = 0.000), and was found to be the most significant parameter between the typical and atypical groups. Quantitative CT measurements for emphysema and airways correlated well with the dyspnea score and pulmonary function results in patients with COPD. Air-trapping was the most significant parameter between the typical vs. atypical group of COPD patients

  12. Quantitative CT assessment in chronic obstructive pulmonary disease patients: Comparison of the patients with and without consistent clinical symptoms and pulmonary function results

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Boda; Hwang, Jung Hwa [Dept. of Radiology, Soonchunhyang University Hospital, Seoul (Korea, Republic of); Lee, Young Mok [Bangbae GF Allergy Clinic, Seoul (Korea, Republic of); Park, Jai Soung [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Jou, Sung Shick [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kim, Young Bae [Dept. of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of)

    2015-09-15

    We compared the clinical and quantitative CT measurement parameters between chronic obstructive pulmonary disease (COPD) patients with and without consistent clinical symptoms and pulmonary function results. This study included 60 patients having a clinical diagnosis of COPD, who underwent chest CT scan and pulmonary function tests. These 60 patients were classified into typical and atypical groups, which were further sub-classified into 4 groups, based on their dyspnea score and the result of pulmonary function tests [typical 1: mild dyspnea and pulmonary function impairment (PFI); typical 2: severe dyspnea and PFI; atypical 1: mild dyspnea and severe PFI; atypical 2: severe dyspnea and mild PFI]. Quantitative measurements of the CT data for emphysema, bronchial wall thickness and air-trapping were performed using software analysis. Comparative statistical analysis was performed between the groups. The CT emphysema index correlated well with the results of the pulmonary functional test (typical 1 vs. atypical 1, p = 0.032), and the bronchial wall area ratio correlated with the dyspnea score (typical 1 vs. atypical 2, p = 0.033). CT air-trapping index also correlated with the results of the pulmonary function test (typical 1 vs. atypical 1, p = 0.012) and dyspnea score (typical 1 vs. atypical 2, p = 0.000), and was found to be the most significant parameter between the typical and atypical groups. Quantitative CT measurements for emphysema and airways correlated well with the dyspnea score and pulmonary function results in patients with COPD. Air-trapping was the most significant parameter between the typical vs. atypical group of COPD patients.

  13. Group elicitations yield more consistent, yet more uncertain experts in understanding risks to ecosystem services in New Zealand bays

    KAUST Repository

    Singh, Gerald G.; Sinner, Jim; Ellis, Joanne; Kandlikar, Milind; Halpern, Benjamin S.; Satterfield, Terre; Chan, Kai

    2017-01-01

    The elicitation of expert judgment is an important tool for assessment of risks and impacts in environmental management contexts, and especially important as decision-makers face novel challenges where prior empirical research is lacking or insufficient. Evidence-driven elicitation approaches typically involve techniques to derive more accurate probability distributions under fairly specific contexts. Experts are, however, prone to overconfidence in their judgements. Group elicitations with diverse experts can reduce expert overconfidence by allowing cross-examination and reassessment of prior judgements, but groups are also prone to uncritical

  14. Group elicitations yield more consistent, yet more uncertain experts in understanding risks to ecosystem services in New Zealand bays

    KAUST Repository

    Singh, Gerald G.

    2017-08-02

    The elicitation of expert judgment is an important tool for assessment of risks and impacts in environmental management contexts, and especially important as decision-makers face novel challenges where prior empirical research is lacking or insufficient. Evidence-driven elicitation approaches typically involve techniques to derive more accurate probability distributions under fairly specific contexts. Experts are, however, prone to overconfidence in their judgements. Group elicitations with diverse experts can reduce expert overconfidence by allowing cross-examination and reassessment of prior judgements, but groups are also prone to uncritical

  15. Experiences of patients with multiple sclerosis from group counseling

    OpenAIRE

    Mazaheri, Mina; Fanian, Nasrin; Zargham-Boroujeni, Ali

    2011-01-01

    BACKGROUND: Group counseling is one of the most important methods in somatic and psychological rehabilitation of the multiple sclerosis (M.S.) patients. Knowing these patients? experiences, feelings, believes and emotion based on learning in group is necessary to indicate the importance of group discussion on quality of life of the patients. This study was done to achieve experiences of M.S. patients from group training. METHODS: This was a qualitative study using phenomenological method. The...

  16. Pseudomonas aeruginosa diversity in distinct paediatric patient groups

    DEFF Research Database (Denmark)

    Tramper-Stranders, G.A.; Ent, C.K. van der; Wolfs, T.F.

    2008-01-01

    the other groups. A group of clonal isolates was observed among patients from the CF-chronic and CF-1 groups. These or different clonal isolates were not encountered among the three other patient groups. No characteristic resistance pattern could be identified among isolates from the distinct patient groups......Pseudomonas aeruginosa is a pathogen that often infects patients who are either immunocompromised or have local defects in host defences. It is known that cystic fibrosis (CF) patients are sometimes infected with certain clonal isolates. It is not clear whether these clonal isolates also infect non......-CF patients and whether clonality of isolates occurs in other patient groups. The aim of this study was to investigate P. aeruginosa diversity and the occurrence of clones within five distinct paediatric patient groups susceptible to P. aeruginosa infection. P. aeruginosa isolates were cultured from 157...

  17. Skin extensibility and consistency in patients with Ehlers-Danlos syndrome and benign joint hypermobility syndrome

    DEFF Research Database (Denmark)

    Remvig, L; Duhn, P H; Ullman, S

    2009-01-01

    OBJECTIVES: The reproducibility of clinical tests for skin extensibility and consistency, essential for differentiating between types of Ehlers-Danlos syndrome (EDS) and benign joint hypermobility syndrome (BJHS), is unknown. Paraclinical methods may provide objective differential diagnostic...

  18. Auditing Consistency and Usefulness of LOINC Use among Three Large Institutions - Using Version Spaces for Grouping LOINC Codes

    Science.gov (United States)

    Lin, M.C.; Vreeman, D.J.; Huff, S.M.

    2012-01-01

    Objectives We wanted to develop a method for evaluating the consistency and usefulness of LOINC code use across different institutions, and to evaluate the degree of interoperability that can be attained when using LOINC codes for laboratory data exchange. Our specific goals were to: 1) Determine if any contradictory knowledge exists in LOINC. 2) Determine how many LOINC codes were used in a truly interoperable fashion between systems. 3) Provide suggestions for improving the semantic interoperability of LOINC. Methods We collected Extensional Definitions (EDs) of LOINC usage from three institutions. The version space approach was used to divide LOINC codes into small sets, which made auditing of LOINC use across the institutions feasible. We then compared pairings of LOINC codes from the three institutions for consistency and usefulness. Results The number of LOINC codes evaluated were 1,917, 1,267 and 1,693 as obtained from ARUP, Intermountain and Regenstrief respectively. There were 2,022, 2,030, and 2,301 version spaces among ARUP & Intermountain, Intermountain & Regenstrief and ARUP & Regenstrief respectively. Using the EDs as the gold standard, there were 104, 109 and 112 pairs containing contradictory knowledge and there were 1,165, 765 and 1,121 semantically interoperable pairs. The interoperable pairs were classified into three levels: 1) Level I – No loss of meaning, complete information was exchanged by identical codes. 2) Level II – No loss of meaning, but processing of data was needed to make the data completely comparable. 3) Level III – Some loss of meaning. For example, tests with a specific ‘method’ could be rolled-up with tests that were ‘methodless’. Conclusions There are variations in the way LOINC is used for data exchange that result in some data not being truly interoperable across different enterprises. To improve its semantic interoperability, we need to detect and correct any contradictory knowledge within LOINC and add

  19. [Hepatitis C treatment in special patient groups].

    Science.gov (United States)

    Berenguer, Marina; Jorquera, Francisco; Ángel Serra, Miguel; Sola, Ricard; Castellano, Gregorio

    2014-07-01

    The treatment plan for chronic hepatitis C in special populations varies according to comorbidity and the current evidence on treatment. In patients with hepatitis C virus and HIV coinfection, the results of dual therapy (pegylated interferon plus ribavirin) are poor. In patients with genotype 1 infection, triple therapy (dual therapy plus boceprevir or telaprevir) has doubled the response rate, but protease inhibitors can interact with some antiretroviral drugs and provoke more adverse effects. These disadvantages are avoided by the new, second-generation, direct-acting antiviral agents. In patients who are candidates for liver transplantation or are already liver transplant recipients, the optimal therapeutic option at present is to combine the new antiviral agents, with or without ribavirin and without interferon. The treatment of patients under hemodialysis due to chronic renal disease continues to be dual therapy (often with reduced doses of pegylated interferon and ribavirin), since there is still insufficient information on triple therapy and the new antiviral agents. In mixed cryoglobulinemia, despite the scarcity of experience, triple therapy seems to be superior to dual therapy and may be used as rescue therapy in non-responders to dual therapy. However, a decision must always be made on whether antiviral treatment should be used concomitantly or after immunosuppressive therapy. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  20. Internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis.

    NARCIS (Netherlands)

    Steultjens, M.P.M.; Dekker, J.; Baar, M.E. van; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    1999-01-01

    Objective: To establish the internal consistency of validity of an observational method for assessing diasbility in mobility in patients with osteoarthritis (OA), Methods: Data were obtained from 198 patients with OA of the hip or knee. Results of the observational method were compared with results

  1. Internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis

    NARCIS (Netherlands)

    Steultjens, M. P.; Dekker, J.; van Baar, M. E.; Oostendorp, R. A.; Bijlsma, J. W.

    1999-01-01

    To establish the internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis (OA). Data were obtained from 198 patients with OA of the hip or knee. Results of the observational method were compared with results of self-report

  2. The guarantee of the consistency of patient information through modality worklist among PACS, RIS and imaging equipments

    International Nuclear Information System (INIS)

    Luo Min; Peng Chenglin; Wang Xiaolin; Luo Song; Lei Wenyong; Wang Kang; Wang Xuejian; Wen Hongyu; Wu Hongxing

    2003-01-01

    Objective: To realize the consistency of patient information through modality worklist among picture archiving and communication system (PACS), radiology information systems (RIS), and imaging equipments. Methods: Many digital modalities including GE Signa 1.5 T MR system, digital mammography, Agfa digital radiography, computed radiography, GE CT, and etc were installed in our hospital. Since the GE PACS system was in English version, the images were saved and the information was managed to PACS without a truly worklist. Two months later, while still using the previous PACS, the consistency of patient information was resolved through modality worklist by adopting the international advanced approach to realize thread worklist of digital imaging and communication in medicine. The information in Chinese will be transformed into information in English in RIS system and saved as the English information to worklist. Results: After the implementation and integration of PACS and RIS was achieved in my hospital, the consistency of patient information was guaranteed through modality worklist between RIS and imaging equipments and the first-rate effect was acquired. The patient information could be checked, edited, and created by using the Chinese RIS system on all diagnostic workstations. Conclusion: The consistency of patient information through modality worklist was realized among PACS, RIS, and imaging equipments, yet at present, the question of guarantee the consistency of patient information must be thought over in PACS building

  3. Experiences of patients with multiple sclerosis from group counseling.

    Science.gov (United States)

    Mazaheri, Mina; Fanian, Nasrin; Zargham-Boroujeni, Ali

    2011-01-01

    Group counseling is one of the most important methods in somatic and psychological rehabilitation of the multiple sclerosis (M.S.) patients. Knowing these patients' experiences, feelings, believes and emotion based on learning in group is necessary to indicate the importance of group discussion on quality of life of the patients. This study was done to achieve experiences of M.S. patients from group training. This was a qualitative study using phenomenological method. The samples were selected using purposeful sampling. Ten patients from M.S. society who had passed group training were included in the study. The group training was done through seven sessions weekly and voluntarily. The participants were interviewed using in-depth interview. The average time of each interview was between 30-50 minutes which has been recorded digitally and moved to a compact disc to transcribe and analysis. The data analyzed using 7-step Colaizzi method. The data were transformed into 158 codes, 12 sub-concepts and 4 main concepts including emotional consequences, communication, quality of life and needs. M.S can lead to multiple problems in patients such as somatic, behavioral, emotional and social disorders. Group psychotherapy is one of the methods which can decrease these problems and improve rehabilitation of the patients. Group discussion helps patients to overcome adverse feelings, behaviors and thoughts and guides them to move in a meaningful life. It also can improve quality of life and mental health of the patients.

  4. Importance of patient centred care for various patient groups.

    NARCIS (Netherlands)

    Rademakers, J.J.D.J.M.; Delnoij, D.M.J.; Boer, D. de

    2010-01-01

    Background: Though patient centred care is a somewhat ‘fuzzy’ concept, in general it is considered as something to strive for. However, preliminary evidence suggests that the importance of elements of patient-centred care (PCC), such as communication, information and shared decision making, may vary

  5. Physician groups' use of data from patient experience surveys.

    Science.gov (United States)

    Friedberg, Mark W; SteelFisher, Gillian K; Karp, Melinda; Schneider, Eric C

    2011-05-01

    In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. To examine whether and how physician groups are using patient experience data to improve patient care. During 2008, we conducted semi-structured interviews with the leaders of 72 participating physician groups (out of 117 groups receiving patient experience reports). Based on leaders' responses, we identified three levels of engagement with patient experience reporting: no efforts to improve (level 1), efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and efforts to improve group-wide performance (level 3). Groups' level of engagement and specific efforts to improve patient care. Forty-four group leaders (61%) reported group-wide improvement efforts (level 3), 16 (22%) reported efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and 12 (17%) reported no performance improvement efforts (level 1). Level 3 groups were more likely than others to have an integrated medical group organizational model (84% vs. 31% at level 2 and 33% at level 1; P customer service. The most commonly reported improvement initiatives were changing office workflow, providing additional training for nonclinical staff, and adopting or enhancing an electronic health record. Despite statewide public reporting, physician groups' use of patient experience data varied widely. Integrated organizational models were associated with greater engagement, and efforts to enhance clinicians' interpersonal skills were uncommon, with groups predominantly focusing on office workflow and support staff.

  6. A Study of Effectiveness of Rational, Emotive, Behavior Therapy (REBT) with Group Method on Decrease of Stress among Diabetic Patients

    OpenAIRE

    Kianoush Zahrakar

    2012-01-01

    Introduction: The purpose of the present research was studying the effectiveness of Rational Emotive Behavior Therapy (REBT) with Group method in decreasing stress of diabetic patients. Methods: The population of research consisted of all diabetic patients that are member of diabetic patient’s association 0f karaj city. The sample consisted of 30 diabetic patients (experimental group 15 persons and control group 15 persons) that selected through random sampling. Research design was experiment...

  7. Physician groups' use of data from patient experience surveys.

    NARCIS (Netherlands)

    Friedberg, M.W.; SteelFisher, G.K.; Karp, M.; Schneider, E.C.

    2011-01-01

    BACKGROUND: In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. OBJECTIVE: To

  8. Evaluation of the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision: An embedded evaluation

    Directory of Open Access Journals (Sweden)

    Khorasani Parvaneh

    2016-08-01

    Full Text Available Background and Objective: Currently, patient education has been considered in medical centers. Clinical provision, which is one of the legal tools with training-support dimensions, can evaluate the consistency between the implemented procedures and the planned ones. This study aimed to evaluate the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision. Materials and Methods: This longitudinal, embedded study was conducted during 2013-2015 in three stages of designing, implementation, and evaluation of the supervision program using randomized convenience sampling on 786 monitoring units (medical records of patients being discharged at Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. In the designing stage, the checklists for supervision of recording patient education and consistency of patient perception with the recorded trainings and the patient satisfaction questionnaire were designed and their valididty and reliability were established. In the implementation stage, structure of the monitoring program was designed with the cooperation of eight supervisors. During 12 months, 2333 checklists and questionnaires were completed at the time of hospital discharge in the evaluation stage. Data analysis was performed in SPSS, version 18, using One-way ANOVA. Results: After 12 months of embedded evaluation, the mean score of recording patient education was 88.5±21.75, and the mean scores of patient satisfaction with the training process and consistency between patients’ perception and the recorded trainings were 47.17±21.48 and 73±25.13, respectively. The mean scores of recording patient training and consistency between patients’ perception and the recorded trainings had an increasing trend (P<0.001, while the mean score of patient satisfaction reduced (P<0.001. Conclusion: The results of clinical supervision during

  9. Dreams and fantasies in psychodynamic group psychotherapy of psychotic patients.

    Science.gov (United States)

    Restek-Petrović, Branka; Orešković-Krezler, Nataša; Grah, Majda; Mayer, Nina; Bogović, Anamarija; Mihanović, Mate

    2013-09-01

    Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.

  10. Can diet combined with treatment scheduling achieve consistency of rectal filling in patients receiving radiotherapy to the prostate?

    International Nuclear Information System (INIS)

    McNair, Helen A.; Wedlake, Linda; McVey, Gerard P.; Thomas, Karen; Andreyev, Jervoise; Dearnaley, David P.

    2011-01-01

    Background and purpose: This pilot study investigates whether an individualized fluid and fibre prescription combined with a constant treatment can improve rectal filling consistency during radiotherapy. Methods and materials: Fibre, fluid intake and bowel function were assessed in 22 patients at a standard planning scan (SCT) and individualized dietary advice was prescribed to regularize bowel habit. Patients were requested to record frequency and type of bowel movements, fibre and fluid intake daily. Two subsequent CT scans were acquired at 7 (CCT1) and 10 days (CCT2) after SCT at a similar time. Rectal volume and gas were measured planning CT’s and ‘on treatment’ cone beam CT scans. We hypothesised that the difference in volume between CCT1 and CCT2 would be less than the difference between SCT and CCT1. Results: The mean (SD) change in volume between SCT to CCT1 and CCT1 to CCT2 was 5.68 cm 3 (26.2) and −8.6 cm 3 (40.1), respectively (p = 0.292). Of the 22 patients scanned 20 provided a complete record of dietary intake and bowel motion. The majority of patients either achieved or exceeded prescription. Change in rectal gas was the only correlation with change in rectal volume. Conclusion: Patient self reporting of bowel motion, fibre, fluid intake was achievable but consistency of rectal filling was not improved. Improved understanding of the aetiology and management of rectal gas is indicated.

  11. assessment of nutritional status of a group of hypertensive patients

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... Conclusion: Nutrition screening of hypertension is necessary for early intervention against hypertension ... patient within their environment so that they can be properly ..... Pressure Education Program Working Group. Arch.

  12. Should patient groups accept money from drug companies? No

    OpenAIRE

    Mintzes, Barbara

    2007-01-01

    Patient groups provide valuable support and advocacy for vulnerable people but funding the work can be difficult. Alastair Kent argues that not accepting industry money will unnecessarily limit the groups' effectiveness, but Barbara Mintzes believes that the money undermines their independence

  13. Should patient groups accept money from drug companies? Yes

    OpenAIRE

    Kent, Alastair

    2007-01-01

    Patient groups provide valuable support and advocacy for vulnerable people but funding the work can be difficult. Alastair Kent argues that not accepting industry money will unnecessarily limit the groups' effectiveness, but Barbara Mintzes believes that the money undermines their independence

  14. Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

    Science.gov (United States)

    Jemt, Torsten; Kowar, Jan; Nilsson, Mats; Stenport, Victoria

    2015-01-01

    Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

  15. Multidisciplinary patient education in groups increases knowledge on Osteoporosis

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Ryg, Jesper; Nissen, Nis

    2008-01-01

    of osteoporosis may be increased by a group-based multidisciplinary education programme. Methods: Three hundred patients, aged 45-81 years, recently diagnosed with osteoporosis and started on specific treatment, were randomized to either the ‘‘school'' or ‘‘control'' group. Teaching was performed by nurses...... level, the higher the gain in knowledge during the course (Rho520.25, pv0.01). Conclusions: A group-based multidisciplinary education programme significantly increases patients' knowledge of the disease.....

  16. 76 FR 60495 - Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group

    Science.gov (United States)

    2011-09-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group AGENCY: Agency for Healthcare Research and... voluntary relinquishment from The Patient Safety Group of its status as a Patient Safety Organization (PSO...

  17. The importance of patient-centered care for various patient groups.

    NARCIS (Netherlands)

    Boer, D. de; Delnoij, D.; Rademakers, J.

    2013-01-01

    Objectives: To assess differences in the importance ascribed to patient-centered care between various patient groups and demographic groups. Methods: Survey data collected using questionnaires were analyzed for patients that underwent hip or knee surgery (n=214), patients suffering from rheumatoid

  18. Patient advocacy groups: Need and opportunity in India

    Directory of Open Access Journals (Sweden)

    Kunal Shah

    2011-01-01

    Full Text Available With an increasing number of corporate hospitals, healthcare related issues, research trials and undue attention by media in India, there is a need to focus more on patient′s rights and protection. In India, multiple agencies like regulatory bodies, scientific review committees, ethics committees, NGOs, etc. work toward patient rights and protection. However, these agencies are inadequate to cater to the general issues related to patient′s rights. There′s a need to have a separate group of people who provide advocacy to the patient, or simply, a patient advocacy group which will work explicitly in these areas to increase transparency and credibility of healthcare system in India. This group will provide special attention to patient care and protection of rights from the planning stage rather than at the troubleshooting stage.

  19. Negative impact of asthma on patients in different age groups.

    Science.gov (United States)

    Alith, Marcela Batan; Gazzotti, Mariana Rodrigues; Montealegre, Federico; Fish, James; Nascimento, Oliver Augusto; Jardim, José Roberto

    2015-01-01

    To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years). From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador). The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012); "Have you been absent from school/work in the last 12 months?" (p age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups), whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups). In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance.

  20. Assessment of test-retest reliability and internal consistency of the Wisconsin Gait Scale in hemiparetic post-stroke patients

    Directory of Open Access Journals (Sweden)

    Guzik Agnieszka

    2016-09-01

    Full Text Available Introduction: A proper assessment of gait pattern is a significant aspect in planning the process of teaching gait in hemiparetic post-stroke patients. The Wisconsin Gait Scale (WGS is an observational tool for assessing post-stroke patients’ gait. The aim of the study was to assess test-retest reliability and internal consistency of the WGS and examine correlations between gait assessment made with the WGS and gait speed, Brunnström scale, Ashworth’s scale and the Barthel Index.

  1. Second-order perturbation theory with a density matrix renormalization group self-consistent field reference function: theory and application to the study of chromium dimer.

    Science.gov (United States)

    Kurashige, Yuki; Yanai, Takeshi

    2011-09-07

    We present a second-order perturbation theory based on a density matrix renormalization group self-consistent field (DMRG-SCF) reference function. The method reproduces the solution of the complete active space with second-order perturbation theory (CASPT2) when the DMRG reference function is represented by a sufficiently large number of renormalized many-body basis, thereby being named DMRG-CASPT2 method. The DMRG-SCF is able to describe non-dynamical correlation with large active space that is insurmountable to the conventional CASSCF method, while the second-order perturbation theory provides an efficient description of dynamical correlation effects. The capability of our implementation is demonstrated for an application to the potential energy curve of the chromium dimer, which is one of the most demanding multireference systems that require best electronic structure treatment for non-dynamical and dynamical correlation as well as large basis sets. The DMRG-CASPT2/cc-pwCV5Z calculations were performed with a large (3d double-shell) active space consisting of 28 orbitals. Our approach using large-size DMRG reference addressed the problems of why the dissociation energy is largely overestimated by CASPT2 with the small active space consisting of 12 orbitals (3d4s), and also is oversensitive to the choice of the zeroth-order Hamiltonian. © 2011 American Institute of Physics

  2. Evaluating the factor structure, item analyses, and internal consistency of hospital anxiety and depression scale in Iranian infertile patients

    Directory of Open Access Journals (Sweden)

    Payam Amini

    2017-09-01

    Full Text Available Background: The hospital anxiety and depression scale (HADS is a common screening tool designed to measure the level of anxiety and depression in different factor structures and has been extensively used in non-psychiatric populations and individuals experiencing fertility problems. Objective: The aims of this study were to evaluate the factor structure, item analyses, and internal consistency of HADS in Iranian infertile patients. Materials and Methods: This cross-sectional study included 651 infertile patients (248 men and 403 women referred to a referral infertility Center in Tehran, Iran between January 2014 and January 2015. Confirmatory factor analysis was used to determine the underlying factor structure of the HADS among one, two, and threefactor models. Several goodness of fit indices were utilized such as comparative, normed and goodness of fit indices, Akaike information criterion, and the root mean squared error of approximation. In addition to HADS, the Satisfaction with Life Scale questionnaires as well as demographic and clinical information were administered to all patients. Results: The goodness of fit indices through CFAs exposed that three and onefactor model provided the best and worst fit to the total, male and female datasets compared to the other factor structure models for the infertile patients. The Cronbach’s alpha for anxiety and depression subscales were 0.866 and 0.753 respectively. The HADS subscales significantly correlated with SWLS, indicating an acceptable convergent validity. Conclusion: The HADS was found to be a three-factor structure screening instrument in the field of infertility.

  3. Alexithymia and affective verbal behaviour of three groups of patients.

    Science.gov (United States)

    Ahrens, S

    1985-01-01

    The study described in this article was designed to investigate patients' response to affective stimuli on two levels of measurement: one was designed to yield information about cognitive attribution processes whereas the second level was aimed at uncovering deeper, more unconscious responses to the given stimuli. These were displayed as part of an experimental setting, in which three groups were compared: psychosomatic (duodenal ulcer), somatic and psychoneurotic patients. Systematic variation was introduced by showing either of two versions of a short film which differed in the degree of friendliness displayed by the main character. The results show differential effects on the two levels of measurement: in the case of the first level, an interpretation within the framework of current conceptualizations of alexithymia would have been possible, but results for the second level of measurement (utilizing Gottschalk-Gleser content analysis of speech) indicate that psychosomatic patients show the same kind of sensitive response to affective stimuli as patients from the other two groups.

  4. Interface Consistency

    DEFF Research Database (Denmark)

    Staunstrup, Jørgen

    1998-01-01

    This paper proposes that Interface Consistency is an important issue for the development of modular designs. Byproviding a precise specification of component interfaces it becomes possible to check that separately developedcomponents use a common interface in a coherent matter thus avoiding a very...... significant source of design errors. Awide range of interface specifications are possible, the simplest form is a syntactical check of parameter types.However, today it is possible to do more sophisticated forms involving semantic checks....

  5. Progressive dysautonomia in two patients with xeroderma pigmentosum group A.

    Science.gov (United States)

    Kobayashi, Osamu; Miyahara, Hiroaki; Abe, Naho; Goto, Chika; Okanari, Kazuo; Akiyoshi, Kensuke; Korematsu, Seigo; Izumi, Tatsuro

    2014-06-01

    Xeroderma pigmentosum group A (XPA) is a rare autosomal-recessive disorder caused by a defect in nucleotide excision repair. Progressive dysautonomia in patients with XPA is rarely described. Two juvenile male patients with XPA suffered from dysphagia, sleep interruption, and dysuria from the age of 10 to 19 years, successively. These autonomic symptoms might have been caused by progressive descending degeneration of cranial nerves IX and X and the sacral parasympathetic nerve, including Onuf's nucleus. One patient died from sudden cardiopulmonary arrest during postural change and tracheal suction. Heart rate variability analyses of these patients revealed parasympathetic dysautonomia, based on decreased high-frequency values. The insidiously progressive dysautonomia in these two patients with XPA suggested progressive descending degeneration extending from the medulla oblongata to the sacral spinal cord, which is an ominous sign of end-stage disease and a risk factor of sudden death attributable to XPA. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. The Functional Segregation and Integration Model: Mixture Model Representations of Consistent and Variable Group-Level Connectivity in fMRI

    DEFF Research Database (Denmark)

    Churchill, Nathan William; Madsen, Kristoffer Hougaard; Mørup, Morten

    2016-01-01

    flexibility: they only estimate segregated structure and do not model interregional functional connectivity, nor do they account for network variability across voxels or between subjects. To address these issues, this letter develops the functional segregation and integration model (FSIM). This extension......The brain consists of specialized cortical regions that exchange information between each other, reflecting a combination of segregated (local) and integrated (distributed) processes that define brain function. Functional magnetic resonance imaging (fMRI) is widely used to characterize...... brain regions where network expression predicts subject age in the experimental data. Thus, the FSIM is effective at summarizing functional connectivity structure in group-level fMRI, with applications in modeling the relationships between network variability and behavioral/demographic variables....

  7. "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups.

    Science.gov (United States)

    de Melo, Lucas Pereira; de Campos, Edemilson Antunes

    2014-01-01

    to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups. ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique. four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study. the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

  8. Features of Turner syndrome among a group of Cameroonian patients.

    Science.gov (United States)

    Wonkam, Ambroise; Veigne, Sandra W; Abass, Ali; Ngo Um, Suzanne; Noubiap, Jean Jacques N; Mbanya, Jean-Claude; Sobngwi, Eugene

    2015-06-01

    To describe the features of Turner syndrome among a group of Cameroonian patients. A descriptive cross-sectional study was conducted among patients with amenorrhea and/or short stature who attended the genetic unit of Yaoundé Gynecology, Obstetrics and Pediatric Hospital (Yaoundé, Cameroon) for a specialist consultation between July 1, 2007, and December 31, 2008. Sociodemographic, clinical, and cytogenetic data were collected. Turner syndrome was confirmed among 11 of the 14 participants (seven had monosomy of the X chromosome; four had mosaicism involving a structural abnormality of the second X chromosome). The mean age at diagnosis was 18.4±2.8years. The reasons for consultation were delayed puberty (n=10) and short stature (n=1). Nine patients had a short neck, nine had a forearm carrying-angle deformity, eight had a low hairline, and two had a webbed neck. Abdominal ultrasonography identified a horseshoe kidney in two patients and a rudimentary uterus in nine patients. None of the patients displayed cardiac abnormalities. Hypergonadotropic hypogonadism was reported among five patients. Eight patients did not receive hormonal treatment owing to advanced bone age or economic reasons. Late diagnosis and variable phenotypic expression were key features of Cameroonian patients with Turner syndrome. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Outcomes after autologous SCT in lymphoma patients grouped by weight.

    Science.gov (United States)

    Lau, J E; Weber, C; Earl, M; Rybicki, L A; Carlstrom, K D; Wenzell, C M; Hill, B T; Majhail, N S; Kalaycio, M

    2015-05-01

    Obesity continues to be an increasing global health issue contributing to the complexity of chemotherapy dosing in the field of SCT. Investigation into the optimal dosing weight used to calculate chemotherapy doses in obese patients undergoing SCT is limited and inconclusive. Our single-center, retrospective study compared safety and efficacy outcomes by body mass index (BMI) for 476 adult lymphoma patients who underwent auto-SCT with a myeloablative chemotherapeutic regimen of BU, CY and etoposide dosed using adjusted body weight. Three weight groups categorized based on BMI were defined: normal/underweight ⩽24.9 kg/m(2), overweight 25-29.9 kg/m(2) and obese ⩾30 kg/m(2). Severity of mucositis, incidence of secondary malignancy, incidence of bacteremia and median hospital length of stay did not differ among the groups. The median times to absolute neutrophil count and platelet recovery were 10 days (P=0.75) and 14 days (P=0.17), respectively. Obese patients had a lower 100-day mortality compared with other weight groups, although this did not translate into an OS benefit. OS and disease relapse were similar among the groups. Our study demonstrates that use of adjusted body weight to calculate chemotherapy doses does not negatively have an impact on outcomes in obese patients undergoing auto-SCT with BU, CY and etoposide.

  10. The advantages of "Dance-group" for psychotic patients.

    Science.gov (United States)

    Tavormina, Romina; Tavormina, Maurilio Giuseppe Maria; Nemoianni, Eugenio

    2014-11-01

    Psychosocial rehabilitation and in particular group dances allow the recovery of lost or compromised ability of patients with mental illness, and they facilitate their reintegration into the social context. The dance group has enabled users of the Day Centre of the Unit of Mental Health Torre del Greco ASL NA 3 south to achieve the objectives of rehabilitation such as: taking care of themselves, of their bodies and their interests, improving self-esteem , the management of pathological emotions, socialization and integration, overcoming the psychotic closing and relational isolation. In particular, patients with schizophrenia, psychotic and mood disorders had a concrete benefit from such rehabilitation activities, facilitating interpersonal relationships, therapy compliance and significantly improved mood, quality of life, providing them with the rhythm and the security in their relationship with each other. The dance group and for some individuals, also psychotherapy and drug therapy, have facilitated social inclusion, improved the quality of life and cured their diseases. The work is carrying out in a group with patients, practitioners, family members, volunteers, social community workers, following the operating departmental protocols. Using the chorus group "Sing that you go" as an operational tool for psychosocial rehabilitation and therapeutic element we promote the psychological well-being and the enhancement of mood.

  11. Acute Kidney Injury Classification in Neuro-ICU Patient Group

    Directory of Open Access Journals (Sweden)

    Canan Akıncı

    2012-12-01

    Full Text Available Objective: To investigate the role of acute kidney injury (AKI classification system for kidney injury outcome in neuro-Intensive care unit (ICU patients. Material and Method: Total 432 patients who admitted to ICU between 2005 and 2009 evaluated in this study. All patients’ AKI stage, Acute Physiology and Chronic Health Evaluation (APACHE-II, Sequential Organ Failure Assessment Score (SOFA, Glasgow Coma Score (GCS, Glasgow Outcome Score (GOS, mortality rate, length of ICU stay, need for intubation, and mechanical ventilation were recorded. Results: AKI was found in 24 of all 432 patents’ (5.5%. We found that, patients with AKI had higher APHACE-II score, SOFA score and mortality rates; longer ICU stay, duration of mechanical ventilation and intubation and lower GCS and GOS than without AKI group. Conclusion: Length of ICU stay and mortality rate were higher in AKI positive group.

  12. The usefulness of carotid sinus massage in different patient groups.

    Science.gov (United States)

    Kumar, Narasimhan Pradeep; Thomas, Alan; Mudd, Paul; Morris, Robert O; Masud, Tahir

    2003-11-01

    to determine the positive yield of carotid sinus massage in different patient groups: unexplained syncope, falls, dizziness and controls. observational study. teaching hospital. we studied consecutive patients over the age of 60 years referred to the 'falls clinic' with a history of unexplained syncope, unexplained falls and unexplained dizziness. We also studied asymptomatic control subjects recruited from a general practice register aged 60 years and over. All patients and control subjects underwent a full clinical assessment (comprehensive history and detailed clinical examination including supine and erect blood pressure measurements) and 12-lead electrocardiography. We performed carotid sinus massage in the supine position for 5 seconds separately on both sides followed by repeating the procedure in the upright positions using a motorised tilt table. Heart rate and blood pressure were recorded using a cardiac monitor and digital plethysmography respectively. The test was considered positive if carotid sinus massage produced asystole with more than a 3 second pause (cardioinhibitory type of carotid sinus syndrome), or a fall in systolic blood pressure of more than 50 mmHg in the absence of significant cardioinhibition (vasodepressor type of carotid sinus syndrome) or where there was evidence of both vasodepressor and cardio-inhibition as above (mixed type). we studied 44 asymptomatic control subjects and 221 symptomatic patients (130 with unexplained syncope, 41 with unexplained falls and 50 with unexplained dizziness). In the overall symptomatic patient group, the positive yield (any type of carotid sinus syndrome) was 17.6% (95% CI = 12.7-22.5). The positive yield in men (26.3% (95% CI = 16.4-36.2)) was twice that in women (13.1% (95% CI = 7.6-18.6)) (P = 0.014). Overall any type of carotid sinus syndrome was present in 22.3% (n = 29) of the syncope group, 17.1% (n = 7) in the unexplained fallers group and 6% (n = 3) in the dizziness group. We also found that

  13. The Effectiveness of Group Therapy on Rescuing Patients with Cancer

    Directory of Open Access Journals (Sweden)

    Hossein Malekzadeh Fini

    2017-09-01

    Full Text Available Recent studies show that the cancer has several negative results. The anxiety, depression and disappointment are more common than the others.  Hopefully thinking and cancer in two ways are related together. First the hopeful people use The problem-focused coping strategies more than the others and show less anxious and more agreement to diagnosis and treatment of cancer. So the goal of this survey is the effect of group hope therapy on reciliency of cancer patients. In this survey the Quasi-experiment and pre-test and pro test with control group is used. The society are all of the cancer patients who are coming to Kashan Imam Hassan institution and 16 of them are chose by available sampling and randomly put in two trial and control group. The trial group participated in nine group consultation sessions and the control group had no education. For toleration testing the Conroy Davidson questionnaire 2003 is used. Data are analysed by co variance analysis. The results show that the group hope therapy had a meaning full effect on toleration and the idea of personal competency, negative affection tolerance and acceptation of positive changing and spiritual control and affection s are affected the scales. Hope let people to have no stress and enable them to try to reach to their goals, the hope therapy try to enable people to have a view beyond the current situation and pain and suffering. So the toleration is not more than tolerance of the difficult situations and every things that make better the situation of cancer patients will increase the toreciliency.

  14. Self-Consistent-Field Method and τ-Functional Method on Group Manifold in Soliton Theory: a Review and New Results

    Directory of Open Access Journals (Sweden)

    Seiya Nishiyama

    2009-01-01

    Full Text Available The maximally-decoupled method has been considered as a theory to apply an basic idea of an integrability condition to certain multiple parametrized symmetries. The method is regarded as a mathematical tool to describe a symmetry of a collective submanifold in which a canonicity condition makes the collective variables to be an orthogonal coordinate-system. For this aim we adopt a concept of curvature unfamiliar in the conventional time-dependent (TD self-consistent field (SCF theory. Our basic idea lies in the introduction of a sort of Lagrange manner familiar to fluid dynamics to describe a collective coordinate-system. This manner enables us to take a one-form which is linearly composed of a TD SCF Hamiltonian and infinitesimal generators induced by collective variable differentials of a canonical transformation on a group. The integrability condition of the system read the curvature C = 0. Our method is constructed manifesting itself the structure of the group under consideration. To go beyond the maximaly-decoupled method, we have aimed to construct an SCF theory, i.e., υ (external parameter-dependent Hartree-Fock (HF theory. Toward such an ultimate goal, the υ-HF theory has been reconstructed on an affine Kac-Moody algebra along the soliton theory, using infinite-dimensional fermion. An infinite-dimensional fermion operator is introduced through a Laurent expansion of finite-dimensional fermion operators with respect to degrees of freedom of the fermions related to a υ-dependent potential with a Υ-periodicity. A bilinear equation for the υ-HF theory has been transcribed onto the corresponding τ-function using the regular representation for the group and the Schur-polynomials. The υ-HF SCF theory on an infinite-dimensional Fock space F∞ leads to a dynamics on an infinite-dimensional Grassmannian Gr∞ and may describe more precisely such a dynamics on the group manifold. A finite-dimensional Grassmannian is identified with a Gr

  15. Exploration of experiences in therapeutic groups for patients with severe mental illness: development of the Ferrara group experiences scale (FE- GES).

    Science.gov (United States)

    Caruso, Rosangela; Grassi, Luigi; Biancosino, Bruno; Marmai, Luciana; Bonatti, Luciano; Moscara, Maria; Rigatelli, Marco; Carr, Catherine; Priebe, Stefan

    2013-10-01

    Group therapies are routinely provided for patients with severe mental illness. The factors important to the group experience of patients are still poorly understood and are rarely measured. To support further research and practice, we aimed to develop a questionnaire that captures how patients experience groups within a community mental health context. An initial pool of 39 items was conceptually generated to assess different aspects of group experiences. Items were completed by 166 patients with severe mental illness attending group therapies in community mental health services in Italy. Patients with different psychiatric diagnoses who attended at least 5 group sessions were included. An exploratory factor analysis was used to identify different dimensions of group experiences and to reduce the number of items for each dimension. The resulting questionnaire has five subscales: 1) sharing of emotions and experiences, 2) cognitive improvement, 3) group learning, 4) difficulties in open expression and 5) relationships. Each subscale has 4 items. The scale and sub-scales have good internal consistency. The Ferrara Group Experiences Scale is conceptually derived and assesses dimensions of group experience that are theoretically and practically relevant. It is brief, easy to use and has good psychometric properties. After further validation, the scale may be used for research into patient experiences across different group therapy modalities and for evaluation in routine care.

  16. Group G streptococcal myositis in a patient with myeloproliferative neoplasm

    Directory of Open Access Journals (Sweden)

    Monica Midha, MD MBS

    2016-01-01

    Full Text Available While many cases of streptococcal infection are due to Lancefield groups A and B, there has been a rise in reported cases of infections due to group G streptococcus. We present a case of an individual with a hematologic malignancy who developed myositis secondary to group G streptococcus, with no clearly identifiable source of infection. The patient was managed with antibiotic therapy rather than surgical intervention due to high surgical risk related to severe thrombocytopenia. Targeted antibiotics initiated early in the course of disease may prevent the need for surgical intervention. Early diagnosis and treatment are critical to avoid the high morbidity and mortality of life-threatening infections caused by group G streptococcus.

  17. Patients who reattend after head injury: a high risk group.

    Science.gov (United States)

    Voss, M.; Knottenbelt, J. D.; Peden, M. M.

    1995-01-01

    OBJECTIVE--To assess risk factors for important neurosurgical effects in patients who reattend after head injury. DESIGN--Retrospective study. SUBJECTS--606 patients who reattended a trauma unit after minor head injury. MAIN OUTCOME MEASURES--Intracranial abnormality detected on computed tomography or the need for neurosurgical intervention. RESULTS--Five patients died: two from unrelated causes and three from raised intracranial pressure. On multiple regression analysis the only significant predictor for both abnormality on computed tomography (14.4% of reattenders) and the need for operation (5% of reattenders) was vault fracture seen on the skull radiograph (P personality change, and seizures were significantly associated only with abnormality on computed tomography. Headache, dizziness, nausea, and vomiting were common in reattenders but were found to have no independent significance. CONCLUSIONS--All patients who reattend after head injury should undergo computed tomography as at least 14% of scans can be expected to yield positive results. Where this facility is not available patients with predictors for operation should be urgently referred for neurosurgical opinion. Other patients can be readmitted and need referral only if symptoms persist despite symptomatic treatment or there is neurological deterioration while under observation. These patients are a high risk group and should be treated seriously. PMID:8520273

  18. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

    Science.gov (United States)

    Luo, Ai-Jing; Chang, Wei-Fu; Xin, Zi-Rui; Ling, Hao; Li, Jun-Jie; Dai, Ping-Ping; Deng, Xuan-Tong; Zhang, Lei; Li, Shao-Gang

    2018-01-01

    AIM To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund. PMID:29487824

  19. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm.

    Science.gov (United States)

    Luo, Ai-Jing; Chang, Wei-Fu; Xin, Zi-Rui; Ling, Hao; Li, Jun-Jie; Dai, Ping-Ping; Deng, Xuan-Tong; Zhang, Lei; Li, Shao-Gang

    2018-01-01

    To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

  20. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

    Directory of Open Access Journals (Sweden)

    Ai-Jing Luo

    2018-02-01

    Full Text Available AIM: To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP and build up an area-specified senile cataract diagnosis related group (DRG of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS: The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS: The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION: The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

  1. Comparison of folic acid levels in schizophrenic patients and control groups

    Science.gov (United States)

    Arthy, C. C.; Amin, M. M.; Effendy, E.

    2018-03-01

    Folic acid deficiency is a risk factor for schizophrenia through epidemiology, biochemistry and gene-related studies. Compared with healthy people, schizophrenic patients may have high homocysteine plasma values and homocysteine or low levels of folic acid, which seems to correlate with extrapyramidal motor symptoms caused by neuroleptic therapy and with symptoms of schizophrenia. In this present study, we focus on the difference of folic acid level between schizophrenic patient and control group. The study sample consisted of schizophrenic patients and 14 people in the control group and performed blood sampling to obtain the results of folic acid levels. The folic acid level in both groups was within normal range, but the schizophrenic patient group had lower mean folic acid values of 5.00 ng/ml (sb 1.66), compared with the control group with mean folic acid values of 10.75 ng/ml (sb 4.33). there was the group of the control group had a higher value of folic acid than the schizophrenic group.

  2. Professional groups driving change toward patient-centred care

    DEFF Research Database (Denmark)

    Burau, Viola; Carstensen, Kathrine; Lou, Stina

    2017-01-01

    BACKGROUND: Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim...... was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care. METHODS: A case study of the introduction of interprofessional, early discharge teams in stroke rehabilitation in Denmark was conducted with focus on day......-to-day coordination of care tasks and the professional groups' interests and strategies. The study included 5 stroke teams and 17 interviews with different health professionals conducted in 2015. RESULTS: Professional groups expressed highly positive professional interest in reorganised stroke rehabilitation...

  3. Theoretical study of hydrogen storage in a truncated triangular pyramid molecule consisting of pyridine and benzene rings bridged by vinylene groups

    Science.gov (United States)

    Ishikawa, Shigeru; Nemoto, Tetsushi; Yamabe, Tokio

    2018-06-01

    Hydrogen storage in a truncated triangular pyramid molecule C33H21N3, which consists of three pyridine rings and one benzene ring bridged by six vinylene groups, is studied by quantum chemical methods. The molecule is derived by substituting three benzene rings in a truncated tetrahedron hydrocarbon C36H24 with pyridine rings. The optimized molecular structure under C 3v symmetry shows no imaginary vibrational modes at the B3LYP/cc-pVTZ level of theory. The hydrogen storage process is investigated based on the MP2/cc-pVTZ method. Like the structure before substitution, the C33H21N3 molecule has a cavity that stores a hydrogen molecule with a binding energy of - 140 meV. The Langmuir isotherm shows that this cavity can store hydrogen at higher temperatures and lower pressures than usual physisorption materials. The C33H21N3 molecule has a kinetic advantage over the C36H24 molecule because the former molecule has a lower barrier (+ 560 meV) for the hydrogen molecule entering the cavity compared with the latter molecule (+ 730 meV) owing to the lack of hydrogen atoms narrowing the opening.

  4. Simulation research to enhance patient safety and outcomes: recommendations of the Simnovate Patient Safety Domain Group

    OpenAIRE

    Pucher, PH; Tamblyn, R; Boorman, D; Dixon-Woods, Mary Margaret; Donaldson, L; Draycott, T; Forster, A; Nadkarni, V; Power, C; Sevdalis, N; Aggarwal, R

    2017-01-01

    The use of simulation-based training has established itself in healthcare but its implementation has been varied and mostly limited to technical and non-technical skills training. This article discusses the possibilities of the use of simulation as part of an overarching approach to improving patient safety, and represents the views of the Simnovate Patient Safety Domain Group, an international multidisciplinary expert group dedicated to the improvement of patient safety. The application and ...

  5. Group consultations in antenatal care: Patients’ perspectives on what patient-patient communication provides

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

    Background and objectives: The group consultation, where a medical professional engages simultaneously with a group of patients, is increasingly being used in healthcare encounters. Its introduction has been associated with two perceived advantages: 1) that it can provide a more economically...... in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife...... in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis...

  6. Psychological Effects of Group Hypnotherapy on Breast Cancer Patients During Chemotherapy.

    Science.gov (United States)

    Téllez, Arnoldo; Rodríguez-Padilla, Cristina; Martínez-Rodríguez, Jorge Luis; Juárez-García, Dehisy M; Sanchez-Armass, Omar; Sánchez, Teresa; Segura, Guillermo; Jaime-Bernal, Leticia

    2017-07-01

    The purpose of this study was to evaluate the effect of group hypnotherapy on anxiety, depression, stress, self-esteem, optimism, and social support during chemotherapy, in patients with breast cancer, compared with a control group with standard medical care. Hypnotherapy consisted of 24 sessions that included suggestions to encourage relaxation, self-esteem, the resolution of past traumatic events, physical healing, and optimism. Results show that the hypnotherapy group significantly decreased anxiety, distress, increased self-esteem, and optimism in the first 12 sessions. However, at the end of the 24 sessions, only self-esteem and optimism remained significant compared with the control group. The convenience of using hypnotherapy to encourage optimism and self-esteem in patients with breast cancer during chemotherapy treatment is discussed given its protective effect on health.

  7. Group psychotherapy for parents of patients with schizophrenia.

    Science.gov (United States)

    Gruber, Ema N; Kajević, Milka; Agius, Mark; Martić-Biocina, Sanja

    2006-11-01

    During a four-month period, the authors provided group psychotherapy combining psychodynamic, supportive and psycho-educational approaches. The aim was to investigate whether this approach would enable parents of patients with schizophrenia to re-establish their psychic balance and the balance of the whole family system by reducing high expressed emotion. The following tools were administered: a socio-cultural questionnaire, MMPI and PIE psychological tests and two questionnaires for group evaluation. The socio-cultural questionnaire showed that the group of parents is heterogeneous. MMPI profiles showed truthful answers and well organized thinking; there were no psychopathological symptoms. The PIE test showed increased dimensions of sociability and trust. The dimensions of fear, sorrow and anger were decreased. Combinations of primary emotions (marked sociability and high self-protection) show that the parents are cautious, responsible and tend to feel guilt. The parents evaluated the group work as interesting and helpful and the group as a place where the parents can overcome the stigma of the disease that affects them, get information, find help and friends and find a way out of their social isolation. This combined approach changes the emotional profile of parents, reduces high expressed emotions (fear, sorrow and anger) in parents and helps re-establish their psychic balance and the balance of the whole family system.

  8. Benefits of extensive recruitment effort persist during follow-ups and are consistent across age group and survey method. The TRAILS study

    Directory of Open Access Journals (Sweden)

    Nederhof Esther

    2012-07-01

    . Conclusions First, extensive recruitment effort at the first assessment wave of a prospective population based cohort study has long lasting positive effects. Second, characteristics of hard-to-recruit responders are largely consistent across age groups and survey methods.

  9. Benefits of extensive recruitment effort persist during follow-ups and are consistent across age group and survey method. The TRAILS study.

    Science.gov (United States)

    Nederhof, Esther; Jörg, Frederike; Raven, Dennis; Veenstra, René; Verhulst, Frank C; Ormel, Johan; Oldehinkel, Albertine J

    2012-07-02

    assessment wave of a prospective population based cohort study has long lasting positive effects. Second, characteristics of hard-to-recruit responders are largely consistent across age groups and survey methods.

  10. Benefits of extensive recruitment effort persist during follow-ups and are consistent across age group and survey method. The TRAILS study

    Science.gov (United States)

    2012-01-01

    recruitment effort at the first assessment wave of a prospective population based cohort study has long lasting positive effects. Second, characteristics of hard-to-recruit responders are largely consistent across age groups and survey methods. PMID:22747967

  11. Psychometrics of shared decision making and communication as patient centered measures for two language groups.

    Science.gov (United States)

    Alvarez, Kiara; Wang, Ye; Alegria, Margarita; Ault-Brutus, Andrea; Ramanayake, Natasha; Yeh, Yi-Hui; Jeffries, Julia R; Shrout, Patrick E

    2016-09-01

    Shared decision making (SDM) and effective patient-provider communication are key and interrelated elements of patient-centered care that impact health and behavioral health outcomes. Measurement of SDM and communication from the patient's perspective is necessary in order to ensure that health care systems and individual providers are responsive to patient views. However, there is a void of research addressing the psychometric properties of these measures with diverse patients, including non-English speakers, and in the context of behavioral health encounters. This study evaluated the psychometric properties of 2 patient-centered outcome measures, the Shared Decision-Making Questionnaire-9 (SDM-Q) and the Kim Alliance Scale-Communication subscale (KAS-CM), in a sample of 239 English and Spanish-speaking behavioral health patients. One dominant factor was found for each scale and this structure was used to examine whether there was measurement invariance across the 2 language groups. One SDM-Q item was inconsistent with the configural invariance comparison and was removed. The remaining SDM-Q items exhibited strong invariance, meaning that item loadings and item means were similar across the 2 groups. The KAS-CM items had limited variability, with most respondents indicating high communication levels, and the invariance analysis was done on binary versions of the items. These had metric invariance (loadings the same over groups) but several items violated the strong invariance test. In both groups, the SDM-Q had high internal consistency, whereas the KAS-CM was only adequate. These findings help interpret results for individual patients, taking into account cultural and linguistic differences in how patients perceive SDM and patient-provider communication. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. The association between self-image and defence mechanisms in a group of adolescent patients receiving psychiatric treatment

    OpenAIRE

    Bartosz Treger; Feliks Matusiak; Maciej Pilecki; Monika Rogoż

    2015-01-01

    Objectives The aim of the study was to explore the relationship between various areas of self-image and defence mechanisms in adolescents. The study included a division into groups according to whether or not they were receiving psychiatric treatment. Methods Data were obtained from two groups: a clinical group (30 persons), consisting of adolescent patients of the Adolescent Inpatient Ward of the Child and Adolescent Psychiatry Clinic and a control group (40 persons), adolescents a...

  13. Magnetic resonance imaging in elderly patients with temporomandibular disorders. Comparison with other age groups

    Energy Technology Data Exchange (ETDEWEB)

    Yura, Shinya; Mabuchi, Akiko; Izumiyama, Yuri; Deyama, Ayako; Totsuka, Yasunori; Inoue, Nobuo [Hokkaido Univ., Sapporo (Japan). Graduate School of Dental Medicine

    2002-12-01

    To estimate the incidence of disc displacement, disc deformity, and bone changes of the temporomandibular joint in elderly patients with temporomandibular disorders, 55 elderly patients (110 joints) were examined by magnetic resonance imaging. The ages of the patients ranged from 65 to 89 years (average, 70 years). They consisted of 13 men and 42 women. Normal disc position was found in 40 joints (36.4%), anterior disc displacement with reduction in 17 joints (15.5%), and anterior disc displacement without reduction in 53 joints (48.2%) on magnetic resonance imaging. Thirty-eight (71.6%) of the 53 joints with anterior disc displacement without reduction had disc deformity and 33 (62.3%) had bone changes. The frequency of bone changes in the elderly group was higher than that in the younger group. Women had a higher incidence of bone changes than men. (author)

  14. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Heidi Schultz

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN. Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient's belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.   Type: Original Research

  15. Mutational spectrum of Xeroderma pigmentosum group A in Egyptian patients.

    Science.gov (United States)

    Amr, Khalda; Messaoud, Olfa; El Darouti, Mohamad; Abdelhak, Sonia; El-Kamah, Ghada

    2014-01-01

    Xeroderma pigmentosum (XP) is a rare autosomal recessive hereditary disease characterized by hyperphotosensitivity, DNA repair defects and a predisposition to skin cancers. The most frequently occurring type worldwide is the XP group A (XPA). There is a close relationship between the clinical features that ranged from severe to mild form and the mutational site in XPA gene. The aim of this study is to carry out the mutational analysis in Egyptian patients with XP-A. This study was carried out on four unrelated Egyptian XP-A families. Clinical features were examined and direct sequencing of the coding region of XPA gene was performed in patients and their parents. Direct sequencing of the whole coding region of the XPA gene revealed the identification of two homozygous nonsense mutations: (c.553C >T; p.(Gln185)) and (c.331G>T; p.(Glu111)), which create premature, stop codon and a homodeletion (c.374delC: p.Thr125Ilefs 15) that leads to frameshift and premature translation termination. We report the identification of one novel XPA gene mutation and two known mutations in four unrelated Egyptian families with Xermoderma pigmentosum. All explored patients presented severe neurological abnormalities and have mutations located in the DNA binding domain. This report gives insight on the mutation spectrum of XP-A in Egypt. This would provide a valuable tool for early diagnosis of this severe disease. © 2013 Elsevier B.V. All rights reserved.

  16. What the patient wants: Addressing patients' treatment targets in an integrative group psychotherapy programme.

    Science.gov (United States)

    Kealy, David; Joyce, Anthony S; Weber, Rainer; Ehrenthal, Johannes C; Ogrodniczuk, John S

    2018-02-13

    Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction. Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme. Correlation and regression analyses were used to examine associations between change in target object severity and patients' pre-treatment diagnosis, symptom distress, and treatment outcome expectancy, and between change in target objective severity and patients' ratings of group therapy process (group climate, therapeutic alliance, group cohesion). The relationship between change in target objective severity and longer-range life satisfaction was also examined in a subsample of patients who rated life satisfaction at follow-up. While change in target objective severity was not significantly related to pre-treatment variables, significant associations were found with several aspects of group therapy process. Patients' experience of a highly engaged group climate was uniquely associated with improvement in target object severity. Such improvement was significantly related to longer-term life satisfaction after controlling for general symptom change. The working atmosphere in group therapy contributes to patients' progress regarding individual treatment targets, and such progress is an important factor in later satisfaction. Attention to individualized treatment targets deserves further clinical and research attention in the context of integrative group therapy for personality dysfunction. This study found that patients attending an integrative group treatment programme for personality dysfunction experienced significant improvement in severity of distress

  17. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Amanda Brummel, PharmD

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN.Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient’s belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.

  18. A case series report of cancer patients undergoing group body psychotherapy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Astrid Grossert

    2017-09-01

    Full Text Available Background: Disturbances in bodily wellbeing represent a key source of psychosocial suffering and impairment related to cancer. Therefore, interventions to improve bodily wellbeing in post-treatment cancer patients are of paramount importance. Notably, body psychotherapy (BPT has been shown to improve bodily wellbeing in subjects suffering from a variety of mental disorders. However, how post-treatment cancer patients perceive and subjectively react to group BPT aiming at improving bodily disturbances has, to the best of our knowledge, not yet been described. Methods: We report on six patients undergoing outpatient group BPT that followed oncological treatment for malignant neoplasms. The BPT consisted of six sessions based on a scientific embodiment approach, integrating body-oriented techniques to improve patients’ awareness, perception, acceptance, and expression regarding their body. Results: The BPT was well accepted by all patients. Despite having undergone different types of oncological treatment for different cancer types and locations, all subjects reported having appreciated BPT and improved how they perceived their bodies. However, individual descriptions of improvements showed substantial heterogeneity across subjects. Notably, most patients indicated that sensations, perceptions, and other mental activities related to their own body intensified when proceeding through the group BPT sessions. Conclusion: The findings from this case series encourage and inform future studies examining whether group BPT is efficacious in post-treatment cancer patients and investigating the related mechanisms of action. The observed heterogeneity in individual descriptions of perceived treatment effects point to the need for selecting comprehensive indicators of changes in disturbances of bodily wellbeing as the primary patient-reported outcome in future clinical trials. While increases in mental activities related to their own body are commonly

  19. Improving insomnia in primary care patients: A randomized controlled trial of nurse-led group treatment.

    Science.gov (United States)

    Sandlund, Christina; Hetta, Jerker; Nilsson, Gunnar H; Ekstedt, Mirjam; Westman, Jeanette

    2017-07-01

    Insomnia is a common health problem, and most people who seek help for insomnia consult primary care. In primary care, insomnia treatment typically consists of hypnotic drugs, although cognitive behavioral therapy for insomnia is the recommended treatment. However, such treatment is currently available to few primary care patients. To evaluate the effects of a group treatment program for insomnia led by nurses in primary care. were the Insomnia Severity Index, a 2-week sleep diary, and a questionnaire on frequency of hypnotic drug use. A randomized controlled trial with pre- and post-treatment assessment and a 1-year post-treatment follow-up of the intervention group. Routine primary health care; 7 primary care centers in Stockholm, Sweden. Patients consulting primary care for insomnia were assessed for eligibility. To be included, patients had to have insomnia disorder and be 18 years or older. Patients were excluded if they if they worked night shifts or had severe untreated somatic and/or mental illness, bipolar disorder, or untreated sleep disorder other than insomnia. One-hundred and sixty-five patients 20 to 90 years were included. Most were women, and many had co-existing somatic and/or mental health problems. The post-treatment dropout rate was 20%. The intervention was a nurse-led group treatment for insomnia based on the techniques of cognitive behavioral therapy for insomnia. The nurses had 2days of training in how to deliver the program. Ninety patients were randomized to the intervention and 75 to the control group (treatment as usual). Data from 82 in the intervention and 71 in the control group were analyzed in accordance with intention-to-treat principles. Fifty-four of the 72 in the intervention group who participated in the group treatment program were followed up after 1year. Mean Insomnia Severity Index score decreased significantly from 18.4 to 10.7 after group treatment but remained unchanged after treatment as usual (17.0 to 16.6). The effect

  20. Microstructural Changes in Compressed Nerve Roots Are Consistent With Clinical Symptoms and Symptom Duration in Patients With Lumbar Disc Herniation.

    Science.gov (United States)

    Wu, Weifei; Liang, Jie; Ru, Neng; Zhou, Caisheng; Chen, Jianfeng; Wu, Yongde; Yang, Zong

    2016-06-01

    A prospective study. To investigate the association between microstructural nerve roots changes on diffusion tensor imaging (DTI) and clinical symptoms and their duration in patients with lumbar disc herniation. The ability to identify microstructural properties of the nervous system with DTI has been demonstrated in many studies. However, there are no data regarding the association between microstructural changes evaluated using DTI and symptoms assessed with the Oswestry Disability Index (ODI) and their duration. Forty consecutive patients with foraminal disc herniation affecting unilateral sacral 1 (S1) nerve roots were enrolled in this study. DTI with tractography was performed on the S1 nerve roots. Clinical symptoms were evaluated using an ODI questionnaire for each patient, and the duration of clinical symptoms was noted based on the earliest instance of leg pain and numbness. Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from tractography images. The mean FA value of the compressed lumbar nerve roots was significantly lower than the FA of the contralateral nerve roots (P leg pain, indicating that the microstructure of the nerve root has been damaged. 3.

  1. Patient informed governance of distributed research networks: results and discussion from six patient focus groups.

    Science.gov (United States)

    Mamo, Laura A; Browe, Dennis K; Logan, Holly C; Kim, Katherine K

    2013-01-01

    Understanding how to govern emerging distributed research networks is essential to their success. Distributed research networks aggregate patient medical data from many institutions leaving data within the local provider security system. While much is known about patients' views on secondary medical research, little is known about their views on governance of research networks. We conducted six focus groups with patients from three medical centers across the U.S. to understand their perspectives on privacy, consent, and ethical concerns of sharing their data as part of research networks. Participants positively endorsed sharing their health data with these networks believing that doing so could advance healthcare knowledge. However, patients expressed several concerns regarding security and broader ethical issues such as commercialism, public benefit, and social responsibility. We suggest that network governance guidelines move beyond strict technical requirements and address wider socio-ethical concerns by fully including patients in governance processes.

  2. [Prostate cancer patients with lymph node metastasis. Outcome in a consecutive group of 59 patients

    DEFF Research Database (Denmark)

    Roder, M.A.; Reinhardt, S.; Brasso, K.

    2008-01-01

    INTRODUCTION: The optimal management of prostate cancer patients with lymph node metastasis remains controversial. In this article, the outcome in a consecutive group of patients with newly diagnosed lymph node positive prostate cancer is presented. MATERIALS AND METHODS: In 59 patients...... with histological verified lymph node positive disease but without osseous metastasis, outcome is described by time to biochemical progression, time to metastasis and survival. RESULTS: Median age at diagnosis was 62 years. Median pre-treatment PSA was 21 ng/ml. Endocrine treatment was initiated within median 2...... patients died during follow-up, 15 deaths were attributable to prostate cancer. Estimated median survival was 5.5 years. CONCLUSION: Despite early androgen deprivation therapy, patients with lymph node positive prostate cancer have a grave prognosis with a high risk of progression and disease...

  3. Self-consistent-field method and τ-functional method on group manifold in soliton theory. II. Laurent coefficients of soliton solutions for sln and for sun

    International Nuclear Information System (INIS)

    Nishiyama, Seiya; Providencia, Joao da; Komatsu, Takao

    2007-01-01

    To go beyond perturbative method in terms of variables of collective motion, using infinite-dimensional fermions, we have aimed to construct the self-consistent-field (SCF) theory, i.e., time dependent Hartree-Fock theory on associative affine Kac-Moody algebras along the soliton theory. In this paper, toward such an ultimate goal we will reconstruct a theoretical frame for a υ (external parameter)-dependent SCF method to describe more precisely the dynamics on the infinite-dimensional fermion Fock space. An infinite-dimensional fermion operator is introduced through Laurent expansion of finite-dimensional fermion operators with respect to degrees of freedom of the fermions related to a υ-dependent and a Υ-periodic potential. As an illustration, we derive explicit expressions for the Laurent coefficients of soliton solutions for sl n and for su n on infinite-dimensional Grassmannian. The associative affine Kac-Moody algebras play a crucial role to determine the dynamics on the infinite-dimensional fermion Fock space

  4. The impact of diabetic retinopathy: perspectives from patient focus groups.

    Science.gov (United States)

    Coyne, Karin S; Margolis, Mary Kay; Kennedy-Martin, Tessa; Baker, Timothy M; Klein, Ronald; Paul, Matthew D; Revicki, Dennis A

    2004-08-01

    Diabetic retinopathy (DR) affects 50-85% of people with diabetes and may result in visual impairment or blindness. This exploratory qualitative research was conducted to evaluate the symptom experience of DR, its impact on daily activities and health-related quality of life (HRQL), and the applicability of two vision-specific questionnaires. Four focus groups (n = 15) were conducted with people with DR to explore their symptom experience and the impact on functioning and HRQL. Adults with type I or II diabetes and mild, moderate or severe non-proliferative DR (NPDR) or proliferative DR (PDR) were recruited. Content analysis and descriptive statistics were used to analyse the data. Participants described a range of symptoms and impact. Difficulty driving, especially at night, and trouble reading were noted with all levels of severity. Participants with PDR and decreased visual acuity have foregone many other important life aspects such as work, reading and sports. For the severely affected, diabetic care activities (e.g. exercising, reading nutritional labels, preparing insulin injections and glucose testing) were difficult to accomplish. Loss of independence, especially mobility and increased fear of accidents, had a profound impact on social activities. For those patients who had not experienced other complications of diabetes, the threat of vision loss was the most devastating. The loss of independence and mobility associated with decreased visual functioning and visual loss were major concerns. Moderate, severe NPDR and PDR associated with visual impairment have a significant impact on HRQL, particularly in the areas of independence, mobility, leisure and self-care activities.

  5. Characterization of a group unrelated patients with arthrogryposis multiplex congenita

    Directory of Open Access Journals (Sweden)

    Margarita Valdés-Flores

    2016-01-01

    Full Text Available Objective: Arthrogryposis multiplex congenita is a relatively rare neuromuscular syndrome, with a prevalence of 1:3000–5000 newborns. In this study, the authors describe the clinical features of a group of 50 unrelated Mexican patients with arthrogryposis multiplex congenita. Methods: Patients were diagnosed by physical and radiographic examination and the family history was evaluated. Results: Of the 50 cases, nine presented other features (pectum excavatum, cleft palate, mental retardation, ulnar agenesis, etc.. Environmental factors, as well as prenatal and family history, were analyzed. The chromosomal anomalies and clinical entities associated with arthrogryposis multiplex congenita were reported. No chromosomal aberrations were present in the cases with mental retardation. Three unrelated familial cases with arthrogryposis multiplex congenita were observed in which autosomal recessive, autosomal dominant and X-linked inheritance patterns are possible. A literature review regarding arthrogryposis multiplex congenita was also conducted. Conclusions: It is important to establish patient-specific physical therapy and rehabilitation programs. A multidisciplinary approach is necessary, with medical, surgical, rehabilitation, social and psychological care, including genetic counseling. Resumo: Objetivo: A Artrogripose múltipla congênita é uma síndrome neuromuscular relativamente rara, com prevalência de 1:3000-5000 recém-nascidos. É por isso que, neste estudo, descrevemos as características clínicas de um grupo de 50 casos de pacientes mexicanos não relacionados com Artrogripose múltipla congênita. Métodos: Os pacientes foram diagnosticados por exame físico e radiográfico, e o histórico familiar foi avaliado. Resultados: Descrevemos 50 pacientes não relacionados com Artrogripose múltipla congênita.Nove deles apresentaram outras características (pectus excavatum, fissura palatina, retardo mental, agenesia da ulna, etc.. Foram

  6. Perioperative treatment of hemophilia A patients: blood group O patients are at risk of bleeding complications.

    Science.gov (United States)

    Hazendonk, H C A M; Lock, J; Mathôt, R A A; Meijer, K; Peters, M; Laros-van Gorkom, B A P; van der Meer, F J M; Driessens, M H E; Leebeek, F W G; Fijnvandraat, K; Cnossen, M H

    2016-03-01

    ESSENTIALS: Targeting of factor VIII values is a challenge during perioperative replacement therapy in hemophilia. This study aims to identify the extent and predictors of factor VIII underdosing and overdosing. Blood group O predicts underdosing and is associated with perioperative bleeding. To increase quality of care and cost-effectiveness of treatment, refining of dosing is obligatory. Perioperative administration of factor VIII (FVIII) concentrate in hemophilia A may result in both underdosing and overdosing, leading to respectively a risk of bleeding complications and unnecessary costs. This retrospective observational study aims to identify the extent and predictors of underdosing and overdosing in perioperative hemophilia A patients (FVIII levels < 0.05 IU mL(-1)). One hundred nineteen patients undergoing 198 elective, minor, or major surgical procedures were included (median age 40 years, median body weight 75 kg). Perioperative management was evaluated by quantification of perioperative infusion of FVIII concentrate and achieved FVIII levels. Predictors of underdosing and (excessive) overdosing were analyzed by logistic regression analysis. Excessive overdosing was defined as upper target level plus ≥ 0.20 IU mL(-1). Depending on postoperative day, 7-45% of achieved FVIII levels were under and 33-75% were above predefined target ranges as stated by national guidelines. A potential reduction of FVIII consumption of 44% would have been attained if FVIII levels had been maintained within target ranges. Blood group O and major surgery were predictive of underdosing (odds ratio [OR] 6.3, 95% confidence interval [CI] 2.7-14.9; OR 3.3, 95% CI 1.4-7.9). Blood group O patients had more bleeding complications in comparison to patients with blood group non-O (OR 2.02, 95% CI 1.00-4.09). Patients with blood group non-O were at higher risk of overdosing (OR 1.5, 95% CI 1.1-1.9). Additionally, patients treated with bolus infusions were at higher risk of excessive

  7. Patients with schizophrenia do not preserve automatic grouping when mentally re-grouping figures: shedding light on an ignored difficulty

    Directory of Open Access Journals (Sweden)

    Anne eGiersch

    2012-08-01

    Full Text Available Looking at a pair of objects is easy when automatic grouping mechanisms bind these objects together, but visual exploration can also be more flexible. It is possible to mentally ‘re-group’ two objects that are not only separate but belong to different pairs of objects. ‘Re-grouping’ is in conflict with automatic grouping, since it entails a separation of each item from the set it belongs to. This ability appears to be impaired in patients with schizophrenia. Here we check if this impairment is selective, which would suggest a dissociation between grouping and ‘re-grouping’, or if it impacts on usual, automatic grouping, which would call for a better understanding of the interactions between automatic grouping and ‘re-grouping’. Sixteen outpatients with schizophrenia and healthy controls had to identify two identical and contiguous target figures within a display of circles and squares alternating around a fixation point. Eye-tracking was used to check central fixation. The target pair could be located in the same or separate hemifields. Identical figures were grouped by a connector (grouped automatically or not (to be re-grouped. Attention modulation of automatic grouping was tested by manipulating the proportion of connected and unconnected targets, thus prompting subjects to focalize on either connected or unconnected pairs. Both groups were sensitive to automatic grouping in most conditions, but patients were unusually slowed down for connected targets while focalizing on unconnected pairs. In addition, this unusual effect occurred only when target were presented within the same hemifield. Patients and controls differed on this asymmetry between within- and across-hemifield presentation, suggesting that patients with schizophrenia do not re-group figures in the same way as controls do. We discuss possible implications on how ‘re-grouping’ ties in with ongoing, automatic perception in healthy volunteers.

  8. Impact of Group Clinical Supervision on Patient Education Process: A Comprehensive Assessment of Patients, Staff, and Organization Dimensions

    Directory of Open Access Journals (Sweden)

    Afsaneh Jafari Moghadam

    2018-04-01

    Full Text Available Background: The most important barriers to patient education are nurses’ poor motivation and training, and poor quality of managerial supervision. Clinical supervision could be a powerful tool for overcoming these barriers. However, the associated patient, staff, and organization-related outcomes still require further research. Aim: The present study aimed to evaluate the patient-, staff-, and organization-related outcomes of group clinical supervision with the goal of improving patient education. Method: This quasi-experimental study was conducted on 35 nurses and mothers of 94 children admitted to the surgery and nephrology wards of Dr. Sheikh Hospital, Mashhad, Iran, in 2016. A 3-month clinical supervision program consisting of support, education, feedback, and facilitation stages was implemented with the assistance of education facilitators. The data were collected using the questionnaire of patient’s satisfaction with nurses’ education, Herzberg’s job motivation questionnaire, and the checklists of nurses’ education performance and quality of education documentation. Data analysis was performed by Mann-Whitney U test, Fisher’s exact test, and independent-t test in SPSS, version 14. Results: The mean ages of the nurses, patients, and mothers were 30.3±6.7, 5.2±3.8, and 32.2±6.2, respectively. Mann-Whitney U test showed a significant improvement in patients’ satisfaction with nurses’ education performance (P

  9. Views of patients on a group diabetes education programme using ...

    African Journals Online (AJOL)

    Objectives: This study was a qualitative assessment of a diabetes group education programme presented in community health centres of the Cape Town Metro District. The programme offered four sessions of group education and was delivered by trained health promoters using a guiding style derived from motivational ...

  10. Patient aggression towards different professional groups of healthcare workers

    Directory of Open Access Journals (Sweden)

    Krystyna Kowalczuk

    2017-03-01

    Nurses are most exposed to different forms of patient aggression, with verbal attacks being most prevalent. Nurses employed at inpatient healthcare units experienced aggression more frequently than those working in outpatient healthcare units.

  11. Views of patients on a group diabetes education programme using ...

    African Journals Online (AJOL)

    2012-09-06

    Sep 6, 2012 ... diabetes education or group motivational interviewing by mid- level health ..... events. Stress mostly revolved around family problems, work and the ... role of stress in managing their diabetes, and had embarked on different ...

  12. Análisis y clasificación de las urgencias hospitalarias mediante los Ambulatory Patient Groups Analysis and classification of hospital emergencies through Ambulatory Patient Groups

    Directory of Open Access Journals (Sweden)

    A. Conesa

    2003-12-01

    Full Text Available Objetivo: Describir la factibilidad y el resultado de la aplicación del sistema Ambulatory Patient Groups (APG a la casuística atendida en los servicios de urgencias de seis hospitales del área de Barcelona. Métodos: Confección de un conjunto mínimo básico de datos específico para urgencias (CMBDAU. Obtención de las variables necesarias en una muestra aleatoria de visitas atendidas, a partir de los informes de asistencia correspondientes. Aplicación del sistema APG a los episodios seleccionados. Resultados: Se ha codificado y agrupado en APG un total de 11.188 visitas de urgencias. Quince diagnósticos identifican el 25% de los episodios. El 50% de los procedimientos de urgencias son exploraciones complementarias sencillas. Quince APG agrupan el 50% de la casuística atendida en urgencias. Conclusiones: El CMBDAU es válido para describir la casuística de urgencias y su agrupación en APG proporciona resultados consistentes e interpretables. La aplicación generalizada de sistemas como los APG en urgencias requiere una validación previa en nuestro entorno de los valores de peso norteamericanos. También debe valorarse la disponibilidad de recursos técnicos y humanos suficientes para garantizar la calidad y la continuidad de un registro de estas características.Aim: To assess the feasibility and results of application of Ambulatory Patient Groups (APG patient's classification system to the case-mix of patients seen at the Emergency Departments (ED of 6 Barcelona metropolitan area hospitals. Methods: Development of a minimum discharge data set specific for the Emergency Departments (CMBDAU. Gathering of relevant variables from a random sample of patients seen at the ED using the ED discharge reports. Use of the APG classification system to those episodes. Results: A total of 11.188 episodes were codified and grouped with the APG system. Fifteen diagnostics identified 25% of all episodes. Nearly 50% of all procedures performed at the

  13. Non-surgical care in patients with hip or knee osteoarthritis is modestly consistent with a stepped care strategy after its implementation.

    Science.gov (United States)

    Smink, Agnes J; Bierma-Zeinstra, Sita M A; Schers, Henk J; Swierstra, Bart A; Kortland, Joke H; Bijlsma, Johannes W J; Teerenstra, Steven; Voorn, Theo B; Dekker, Joost; Vliet Vlieland, Thea P M; van den Ende, Cornelia H M

    2014-08-01

    To improve the management of hip or knee osteoarthritis (OA), a stepped care strategy (SCS) has been developed that presents the optimal sequence for care in three steps. This study evaluates the extent to which clinical practice is consistent with the strategy after implementation and identifies determinants of SCS-consistent care. A 2-year observational prospective cohort study. General practices in the region of Nijmegen in the Netherlands. Three hundred and thirteen patients with hip or knee OA and their general practitioner (GP). Multifaceted interventions were developed to implement the strategy. Consistency between clinical practice and the strategy was examined regarding three aspects of care: (i) timing of radiological assessment, (ii) sequence of non-surgical treatment options and (iii) making follow-up appointments. Out of the 212 patients who reported to have had an X-ray, 92 (44%) received it in line with the SCS. The sequence of treatment was inconsistent with the SCS in 58% of the patients, which was mainly caused by the underuse of lifestyle advice and dietary therapy. In 57% of the consultations, the patient reported to have been advised to make a follow-up appointment. No determinants that influenced all three aspects of care were identified. Consistency with the SCS was found in about half of the patients for each of the three aspects of care. Health care can be further optimized by encouraging GP s to use X-rays more appropriately and to make more use of lifestyle advice, dietary therapy and follow-up appointments. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  14. Somatic mosaicism for DNA repair capacity in fibroblasts derived from a group A xeroderma pigmentosum patient

    International Nuclear Information System (INIS)

    Chang, H.R.; Ishizaki, K.; Sasaki, M.S.; Toguchida, J.; Kato, M.; Nakamura, Y.; Kawamura, S.; Moriguchi, T.; Ikenaga, M.

    1989-01-01

    A female Japanese xeroderma pigmentosum (XP) patient with severe skin lesions and various neurologic abnormalities was assigned to complementation group A by conventional cell fusion studies. Ultraviolet (UV)-irradiated skin fibroblasts showed a biphasic survival curve, as measured by colony-forming ability. The surviving fraction decreased rapidly up to 2 J/m2 of UV, with a steep slope of D(O) (mean lethal dose) = 0.95 J/m2. At much higher doses it decreased more slowly, with D(O) = 3.5 J/m2. To elucidate the cause of this unique survival response, we isolated a large number of independent clones from single colonies and measured their responses to UV. Of 81 clones analyzed, ten showed a marked resistance to killing by UV, which was only slightly more sensitive than normal cells, and these clones had a rate of unscheduled DNA synthesis (UDS) that was about 45% of normal cells. By contrast, the remaining 71 clones were extremely sensitive to UV, typical of XP group A strains, and had a UDS level 1%-3% of normals. Analysis of restriction fragment length polymorphism using seven polymorphic DNA probes indicated that the UV-resistant clones were derived from the same individual as the UV-sensitive clones. These results clearly demonstrate that this patient's fibroblast cells consist of two types with differing responses to UV, and provide direct evidence of somatic mosaicism for DNA repair capacity in an XP patient

  15. TH-C-18A-06: Combined CT Image Quality and Radiation Dose Monitoring Program Based On Patient Data to Assess Consistency of Clinical Imaging Across Scanner Models

    Energy Technology Data Exchange (ETDEWEB)

    Christianson, O; Winslow, J; Samei, E [Duke University Medical Center, Durham, NC (United States)

    2014-06-15

    Purpose: One of the principal challenges of clinical imaging is to achieve an ideal balance between image quality and radiation dose across multiple CT models. The number of scanners and protocols at large medical centers necessitates an automated quality assurance program to facilitate this objective. Therefore, the goal of this work was to implement an automated CT image quality and radiation dose monitoring program based on actual patient data and to use this program to assess consistency of protocols across CT scanner models. Methods: Patient CT scans are routed to a HIPPA compliant quality assurance server. CTDI, extracted using optical character recognition, and patient size, measured from the localizers, are used to calculate SSDE. A previously validated noise measurement algorithm determines the noise in uniform areas of the image across the scanned anatomy to generate a global noise level (GNL). Using this program, 2358 abdominopelvic scans acquired on three commercial CT scanners were analyzed. Median SSDE and GNL were compared across scanner models and trends in SSDE and GNL with patient size were used to determine the impact of differing automatic exposure control (AEC) algorithms. Results: There was a significant difference in both SSDE and GNL across scanner models (9–33% and 15–35% for SSDE and GNL, respectively). Adjusting all protocols to achieve the same image noise would reduce patient dose by 27–45% depending on scanner model. Additionally, differences in AEC methodologies across vendors resulted in disparate relationships of SSDE and GNL with patient size. Conclusion: The difference in noise across scanner models indicates that protocols are not optimally matched to achieve consistent image quality. Our results indicated substantial possibility for dose reduction while achieving more consistent image appearance. Finally, the difference in AEC methodologies suggests the need for size-specific CT protocols to minimize variability in image

  16. TH-C-18A-06: Combined CT Image Quality and Radiation Dose Monitoring Program Based On Patient Data to Assess Consistency of Clinical Imaging Across Scanner Models

    International Nuclear Information System (INIS)

    Christianson, O; Winslow, J; Samei, E

    2014-01-01

    Purpose: One of the principal challenges of clinical imaging is to achieve an ideal balance between image quality and radiation dose across multiple CT models. The number of scanners and protocols at large medical centers necessitates an automated quality assurance program to facilitate this objective. Therefore, the goal of this work was to implement an automated CT image quality and radiation dose monitoring program based on actual patient data and to use this program to assess consistency of protocols across CT scanner models. Methods: Patient CT scans are routed to a HIPPA compliant quality assurance server. CTDI, extracted using optical character recognition, and patient size, measured from the localizers, are used to calculate SSDE. A previously validated noise measurement algorithm determines the noise in uniform areas of the image across the scanned anatomy to generate a global noise level (GNL). Using this program, 2358 abdominopelvic scans acquired on three commercial CT scanners were analyzed. Median SSDE and GNL were compared across scanner models and trends in SSDE and GNL with patient size were used to determine the impact of differing automatic exposure control (AEC) algorithms. Results: There was a significant difference in both SSDE and GNL across scanner models (9–33% and 15–35% for SSDE and GNL, respectively). Adjusting all protocols to achieve the same image noise would reduce patient dose by 27–45% depending on scanner model. Additionally, differences in AEC methodologies across vendors resulted in disparate relationships of SSDE and GNL with patient size. Conclusion: The difference in noise across scanner models indicates that protocols are not optimally matched to achieve consistent image quality. Our results indicated substantial possibility for dose reduction while achieving more consistent image appearance. Finally, the difference in AEC methodologies suggests the need for size-specific CT protocols to minimize variability in image

  17. Multifamily group treatment in a program for patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Fjell, Anne; Bloch Thorsen, Gerd Ragna; Friis, Svein

    2007-01-01

    Psychoeducational multifamily group treatment based on the McFarlane model was implemented for adult patients experiencing a first episode of psychosis and for the families of 301 patients. Patients were participants in a research project in Norway and Denmark. Of 301 patients 246 were invited...... to participate and 147 agreed. Patients' reluctance to participate increased with age. Most had to wait between six and 12 months until a sufficient number was gathered to start a group. Treatment was well received by patients and families. Care should be taken to prevent a long delay before group commencement...... at this stressful period in the lives of patients and families....

  18. Extensive validation of the pain disability index in 3 groups of patients with musculoskeletal pain.

    Science.gov (United States)

    Soer, Remko; Köke, Albère J A; Vroomen, Patrick C A J; Stegeman, Patrick; Smeets, Rob J E M; Coppes, Maarten H; Reneman, Michiel F

    2013-04-20

    A cross-sectional study design was performed. To validate the pain disability index (PDI) extensively in 3 groups of patients with musculoskeletal pain. The PDI is a widely used and studied instrument for disability related to various pain syndromes, although there is conflicting evidence concerning factor structure, test-retest reliability, and missing items. Additionally, an official translation of the Dutch language version has never been performed. For reliability, internal consistency, factor structure, test-retest reliability and measurement error were calculated. Validity was tested with hypothesized correlations with pain intensity, kinesiophobia, Rand-36 subscales, Depression, Roland-Morris Disability Questionnaire, Quality of Life, and Work Status. Structural validity was tested with independent backward translation and approval from the original authors. One hundred seventy-eight patients with acute back pain, 425 patients with chronic low back pain and 365 with widespread pain were included. Internal consistency of the PDI was good. One factor was identified with factor analyses. Test-retest reliability was good for the PDI (intraclass correlation coefficient, 0.76). Standard error of measurement was 6.5 points and smallest detectable change was 17.9 points. Little correlations between the PDI were observed with kinesiophobia and depression, fair correlations with pain intensity, work status, and vitality and moderate correlations with the Rand-36 subscales and the Roland-Morris Disability Questionnaire. The PDI-Dutch language version is internally consistent as a 1-factor structure, and test-retest reliable. Missing items seem high in sexual and professional items. Using the PDI as a 2-factor questionnaire has no additional value and is unreliable.

  19. Limited results of group self-management education for rheumatoid arthritis patients and their partners: explanations from the patient perspective

    NARCIS (Netherlands)

    Bode, C.; Taal, E.; Emons, P.A.A.; Galetzka, M.; Rasker, J.J.; Laar, M.A.F.J. van de

    2008-01-01

    This study aimed to identify the reasons for limited results of group self-management for RA patients and their partners from the patient perspective. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were

  20. Limited results of group self-management education for rheumatoid arthritis patients and their partners: Explanations from the patient perspective.

    NARCIS (Netherlands)

    Bode, Christina; Taal, Erik; Emons, P.A.A.; Galetzka, Mirjam; Rasker, Johannes J.; van de Laar, Mart A F J

    2008-01-01

    This study aimed to identify the reasons for limited results of group self-management for RA patients and their partners from the patient perspective. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were

  1. [Health education for varicose ulcer patients through group activities].

    Science.gov (United States)

    da Silva, Jodo Luis Almeida; Lopes, Marta Julia Marques

    2006-06-01

    It is a report on the group activities carried out with carriers of varicose ulcer in a health unit in Porto Alegre, Rio Grande do Sul, Brazil. The varicose ulcer presents factors, besides the biological ones, which interfere in the cicatrization, in the relapse cases and in its effective resolution. The proposed activities aimed at producing behavior changes with the intention of achieving self-care, providing information, socializing the participants, and stimulating cooperation, searching for joint solutions, aggregating interdisciplinary spirit and improving the care. Two groups have been formed and a thematic schedule established. The results have showed higher adhesion to the treatment, behavioral changes, and adapted and more effective attitudes of the health team.

  2. Patient Engagement Practices in Clinical Research among Patient Groups, Industry, and Academia in the United States: A Survey.

    Directory of Open Access Journals (Sweden)

    Sophia K Smith

    Full Text Available Patient-centered clinical trial design and execution is becoming increasingly important. No best practice guidelines exist despite a key stakeholder declaration to create more effective engagement models. This study aims to gain a better understanding of attitudes and practices for engaging patient groups so that actionable recommendations may be developed.Individuals from industry, academic institutions, and patient groups were identified through Clinical Trials Transformation Initiative and Drug Information Association rosters and mailing lists. Objectives, practices, and perceived barriers related to engaging patient groups in the planning, conduct, and interpretation of clinical trials were reported in an online survey. Descriptive and inferential statistical analysis of survey data followed a literature review to inform survey questions.Survey respondents (n = 179 valued the importance of involving patient groups in research; however, patient group respondents valued their contributions to research protocol development, funding acquisition, and interpretation of study results more highly than those contributions were valued by industry and academic respondents (all p < .001. Patient group respondents placed higher value in open communications, clear expectations, and detailed contract execution than did non-patient group respondents (all p < .05. Industry and academic respondents more often cited internal bureaucratic processes and reluctance to share information as engagement barriers than did patient group respondents (all p < .01. Patient groups reported that a lack of transparency and understanding of the benefits of collaboration on the part of industry and academia were greater barriers than did non-patient group respondents (all p< .01.Despite reported similarities among approaches to engagement by the three stakeholder groups, key differences exist in perceived barriers and benefits to partnering with patient groups among the

  3. Self-reported differences in empowerment between lurkers and posters in online patient support groups.

    NARCIS (Netherlands)

    van Uden-Kraan, Cornelia F.; Drossaert, Constance H C; Taal, Erik; Seydel, Erwin R.; van de Laar, M.A.

    2008-01-01

    BACKGROUND: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have

  4. Self-reported differences in empowerment between lurkers and posters in online patient support groups

    NARCIS (Netherlands)

    Kraan, C.F.; Drossaert, Constance H.C.; Taal, Erik; Seydel, E.R.; van de Laar, Mart A F J

    2008-01-01

    Background: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants’ feelings of “being empowered.” However, most studies of online patient support groups have

  5. Interventions for improving patients' trust in doctors and groups of doctors.

    Science.gov (United States)

    Rolfe, Alix; Cash-Gibson, Lucinda; Car, Josip; Sheikh, Aziz; McKinstry, Brian

    2014-03-04

    the studies.  Interventions were of three main types; three employed additional physician training, four were education for patients and three provided additional information about doctors in terms of financial incentives or consulting style. Additionally, several different measures of trust were employed.The studies gave conflicting results. Trials showing a small but statistically-significant increase in trust included: a trial of physician disclosure of financial incentives; a trial of providing choice of physician based on concordance between patient and physician beliefs about care; a trial of group visits for new inductees into a Health Maintenance Organisation; a trial of training oncologists in communication skills; and a trial of group visits for diabetic patients. However, trust was not affected in a subsequent larger trial of group visits for uninsured people with diabetes, nor with a decision aid for helping choose statins, another trial of disclosure of financial incentives or specifically training doctors to increase trust or cultural competence. There was no evidence of harm from any of the studies. Overall, there remains insufficient evidence to conclude that any intervention may increase or decrease trust in doctors. This may be due in part to the sensitivity of trust instruments, and a ceiling effect, as trust in doctors is generally high. It may be that current measures of trust are insufficiently sensitive. Further trials are required to explore the impact of doctors' specific training or the use of a patient-centred or decision-sharing approach on patients' trust, especially in the areas of healthcare provider choice, and induction into healthcare organisation. International trials would be of particular benefit. The review was constrained by the lack of consistency between trust measurements, timeframes and populations.

  6. Structural Consistency, Consistency, and Sequential Rationality.

    OpenAIRE

    Kreps, David M; Ramey, Garey

    1987-01-01

    Sequential equilibria comprise consistent beliefs and a sequentially ra tional strategy profile. Consistent beliefs are limits of Bayes ratio nal beliefs for sequences of strategies that approach the equilibrium strategy. Beliefs are structurally consistent if they are rationaliz ed by some single conjecture concerning opponents' strategies. Consis tent beliefs are not necessarily structurally consistent, notwithstan ding a claim by Kreps and Robert Wilson (1982). Moreover, the spirit of stru...

  7. Metacognitive group training for schizophrenia spectrum patients with delusions : a randomized controlled trial

    NARCIS (Netherlands)

    van Oosterhout, B.; Krabbendam, L.; de Boer, K.; Ferwerda, J.; van der Helm, M.; Stant, A. D.; van der Gaag, M.

    2014-01-01

    Background. Metacognitive training (MCT) for patients with psychosis is a psychological group intervention that aims to educate patients about common cognitive biases underlying delusion formation and maintenance, and to highlight their negative consequences in daily functioning. Method. In this

  8. Metacognitive group training for schizophrenia spectrum patients with delusions: A randomized controlled trial

    NARCIS (Netherlands)

    van Oosterhout, B.; Krabbendam, L.; de Boer, K.; Ferwerda, J.; van der Helm, M.; Stant, A.D.; van der Gaag, M.

    2014-01-01

    Background: Metacognitive training (MCT) for patients with psychosis is a psychological group intervention that aims to educate patients about common cognitive biases underlying delusion formation and maintenance, and to highlight their negative consequences in daily functioning. Method: In this

  9. Consistency of histopathological reporting of breast lesions detected by screening: findings of the U.K. National External Quality Assessment (EQA) Scheme. U. K. National Coordinating Group for Breast Screening Pathology.

    Science.gov (United States)

    Sloane, J P; Ellman, R; Anderson, T J; Brown, C L; Coyne, J; Dallimore, N S; Davies, J D; Eakins, D; Ellis, I O; Elston, C W

    1994-01-01

    The aim of the scheme was to determine consistency of histopathological reporting in the United Kingdom National Breast Screening Programme. This external quality assessment scheme involved 51 sets of 12 slides which were circulated to 186-251 pathologists at intervals of 6 months for 3 years. Participants recorded their diagnoses on standard reporting forms, which were submitted to the U.K. National Cancer Screening Evaluation Unit for analysis. A high level of consistency was achieved in diagnosing major categories of breast disease including invasive carcinoma and the important borderline lesions, radial scar and ductal carcinoma in situ (DCIS), the latter exceeding a national target set prior to the onset of the scheme. Atypical hyperplasia (AH) was reported with much less consistency although, where it was the majority opinion, over 86% of diagnoses were of benign disorders and only 14% were of DCIS. Inconsistency was encountered in subtyping and measuring DCIS, the former apparently due to current uncertainties about classification and the latter to poor circumscription, variation in size in different sections and merging with zones of AH. Reporting prognostic features of invasive carcinomas was variable. Measurement of size was achieved with adequate consistency except in a small number of very poorly circumscribed tumours. Grading and subtyping were inconsistent although the latter was not specifically tested and will be the subject of future study. Members of the National Coordinating Group achieved greater uniformity than the remainder of the participants in all diagnostic categories, but both groups experienced similar types of problem. Our findings suggest that participation in the scheme improves diagnostic consistency. In conclusion, consistency in diagnosing invasive carcinoma and radial scar is excellent, and good in DCIS, but improvements are desirable in diagnosing atypical hyperplasia, classifying DCIS and reporting certain prognostic features of

  10. Assessing stakeholder opinion on relations between cancer patient groups and pharmaceutical companies in Europe.

    Science.gov (United States)

    Leto di Priolo, Susanna; Fehervary, Andras; Riggins, Phil; Redmond, Kathy

    2012-01-01

    The relationship between the pharmaceutical industry and cancer patient groups has been the subject of much scrutiny and skepticism, and some high-profile negative media coverage has focused attention on some of the problematic aspects of the relationship. Both the pharmaceutical industry and cancer patient groups have made an effort in recent years to improve the transparency and openness of their relations, specifically with regard to the financial support offered by pharmaceutical companies to patient groups. The objectives of this survey were to benchmark perceptions held by different stakeholder groups about current relationships between cancer patient groups and pharmaceutical companies in Europe, and to explore opinions about ways in which partnerships between patient groups and pharmaceutical companies could evolve to the benefit of cancer patients. The survey was conducted using a structured questionnaire that contained a combination of matrix, scaled, and open-ended questions. The questionnaire was developed based on a literature search and the findings from ten in-depth interviews conducted with policy makers and advocates working at an EU level. Telephone interviews were carried out using a structured questionnaire with a convenience sample of 161 policy makers, cancer healthcare group representatives, and cancer patient group leaders from France, Germany, Hungary, Italy, Latvia, the Netherlands, Poland, Portugal, Romania, Spain, Sweden, and the UK. The interviews took place in the relevant language of the country. The current relationship between the pharmaceutical industry and cancer patient groups in Europe is generally viewed as positive, but it is also viewed as being unequal, not transparent enough, and not sufficiently patient-centric. There is broad agreement that cancer patient groups can help companies identify unmet needs and contribute to the development of innovative medicines; however, there is some concern about cancer patients

  11. A review of results from patient experience surveys during the introduction of group pre-radiotherapy patient information sessions

    International Nuclear Information System (INIS)

    Chapman, K.; James, S.

    2016-01-01

    Aim: The aims of the survey were to check that group pre-radiotherapy information sessions met patients' needs. The use of virtual technology (VT) through Patient Education And Radiotherapy Learning (PEARL) was incorporated part way through the survey period. Methods: Patients attending group pre-radiotherapy information sessions led by assistant practitioners between March and December 2014 were asked to complete questionnaires after they had attended at least five radiotherapy sessions. Key results: 305 patients attended sessions during the survey period. 129 questionnaires were distributed with 103 returned, resulting in an 80% response rate (Overall rate 34%). 102 (99%) patients responded that they were happy and comfortable to receive their radiotherapy information in a group setting. The majority of patients responded that they felt no additional information should be included. Conclusions and recommendations: The survey highlighted that almost all patients were happy to receive their information in a group setting. Patients attending non PEARL and PEARL sessions indicated high satisfaction levels with no notable differences between the groups. This has allayed MVCC staffs' original concerns that patients may find the use of VT as frightening in patient information sessions, so the centre is now confident to incorporate it in the future. The implementation of these sessions has seemed to be both feasible and an efficient use of staff time. All patients referred for radical breast radiotherapy are now invited to attend. It is recommended that regular patient experience surveys are conducted in the future to ensure they continue to meet patients' needs. - Highlights: • 102 (99%) patients responded happy to receive their information in a group setting. • 86 (83%) patients responded they felt no additional information should be included. • 58 (56%) patients provided complimentary comments about the sessions.

  12. [Echocardiographic indices of the right heart in patients with coronary artery disease in different age groups].

    Science.gov (United States)

    Gajfulin, R A; Sumin, A N; Arhipov, O G

    2016-01-01

    The aim of study was to examine echocardiographic indices of right heart chambers in patients with coronary artery disease in different age groups. On 678 patients aged 38-85 years, who underwent echocardiography, are including with the use of spectral tissue Doppler. Obtained 2 age groups: 1st - patients up to 60 years (n=282) and group 2nd - patients 60 years and older (n=396). In the analysis the obtained results in patients with coronary heart disease in older age groups showed an increase in right ventricular wall thickness, systolic and average pressure in the pulmonary artery. These changes were accompanied by deterioration in left ventricular diastolic function, while the systolic function of the left and right ventricle were independent of age. Thus, the results can be recommended for assessment of right ventricular dysfunction in patients of older age groups.

  13. Comparison of the prognosis among different age groups in elderly patients with hip fracture

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2008-01-01

    Full Text Available Background: The outcome of treatment of hip fractures in different age groups in the elderly population is largely unknown. Hence, we stratified elderly patients with hip fracture into age groups and compared the prognosis in various age groups. Materials and Methods: Among 459 patients with hip fracture treated at our hospital from 1997, 430 patients aged 65 years or above at the time of injury were studied. The patients comprised 98 males and 332 females and the ages at injury ranged from 65 to 103 years (mean 83.4 years. There were 167 cases of femoral neck fracture and 263 cases of trochanteric fractures. Surgery was performed in 383 cases, while 47 cases were treated conservatively. The subjects were classified by age into young-old for those aged 65-74 years (group A, n = 55, middle-old for those aged 75-84 years (group B, n = 172, old-old for those aged 85-94 (group C, n = 180, and oldest-old for those aged 95 years or above (group D, n = 23. The functional and survival prognosis at discharge in each group was investigated. Results: Numbers of patients who were ambulatory at discharge among those ambulatory before injury were 43 of 49 (87.8% in group A, 113 of 152 (74.3% in group B, 86 of 138 (62.3% in group C, and 5 of 14 (35.7% in group D, showing worse recovery of walking ability as age advanced. Among those ambulatory before injury, 42 patients in group A, 139 patients in group B, 130 patients in group C, and 12 patients in group D underwent surgery and of these patients, 38 patients (90.5% in group A, 109 patients (78.4% in group B, 83 patients (63.8% in group C, and 5 patients (41.7% in group D were ambulatory at discharge. On the other hand, the numbers of patients who were ambulatory at discharge among those receiving conservative treatment were 5 of 7 (71.4% in group A, 4 of 13 (30.8% in group B, 3 of 8 (37.5% in group C, and 0 of 2 (0% in group D, showing better walking ability in surgical patients than in conservatively treated

  14. [Obsessive-compulsive symptoms, tics, stereotypic movements or need for absolute consistency? The occurrence of repetitive activities in patients with pervasive developmental disorders--case studies].

    Science.gov (United States)

    Bryńska, Anita; Lipińska, Elzbieta; Matelska, Monika

    2011-01-01

    Repetitive and stereotyped behaviours in the form of stereotyped interests or specific routine activities are one ofthe diagnostic criteria in pervasive developmental disorders. The occurrence of repetitive behaviours in patients with pervasive developmental disorders is a starting point for questions about the type and classification criteria of such behaviours. The aim of the article is to present case studies of patients with pervasive developmental disorders and co-morbid symptoms in the form of routine activities, tics, obsessive-compulsive symptoms or stereotyped behaviours. The first case study describes a patient with Asperger's syndrome and obsessive compulsive symptoms. The diagnostic problems regarding complex motor tics are discussed in the second case study which describes a patient with Asperger's syndrome and Gilles de la Tourette syndrome. The third and fourth case study describes mono-zygotic twins with so called High Functioning Autism whose repetitive activities point to either obsessive compulsive symptoms, stereotypic movements, need for absolute consistency or echopraxia. The possible comorbidity of pervasive developmental disorders and symptoms in the form of repetitive behaviours, possible interactions as well as diagnostic challenges is discussed in the article.

  15. Best practices: increased attendance in inpatient group psychotherapy improves patient outcomes.

    Science.gov (United States)

    Page, Andrew C; Hooke, Geoffrey R

    2009-04-01

    This column describes an initiative that promoted increased attendance in group psychotherapy and its effect on patient outcomes. Information on patient- and staff-rated outcomes, readmission rates, and patient satisfaction was gathered for 2,782 inpatients in a private psychiatric facility in Australia. On average, after the initiative was implemented, patients went from attending one session per day to two sessions. Inpatients admitted after implementation had better patient- and staff-rated outcomes and lower rates of readmission within one month of discharge. However, patients' treatment satisfaction ratings declined. These findings indicate that increasing attendance in group psychotherapy can be a useful adjunct to hospital treatment.

  16. Experts' perspectives on SwissDRG: Second class care for vulnerable patient groups?

    Science.gov (United States)

    Leu, A; Wepf, H; Elger, B; Wangmo, T

    2018-03-14

    On the 1st of January 2012, Switzerland introduced the diagnosis-related group hospital tariff structure (SwissDRG). It was recognised that healthcare provided to the most vulnerable patient groups would be a challenge for the new SwissDRG. Coincident with the implementation of SwissDRG, we explored hospital experts' perceptions of which patient groups are vulnerable under the SwissDRG system, what has changed for this group, as well as solutions to ensure adequate access to health care for them. We interviewed 43 experts from 40 Swiss hospitals. Participating experts named several vulnerable patient groups who share some common characteristics. These hospital experts were concerned about the patient groups that are not financially profitable and questioned the practicability of the current regulation. At the same time, they highlighted the complexity associated with caring for this group under the new SwissDRG and reported measures at the macro, meso, and micro levels to protect vulnerable patient groups from negative effects. To curb negative outcomes for vulnerable patient groups after the introduction of the SwissDRG, the Swiss legislation has introduced various instruments including the acute and transitional care (ATC) measures. We conclude that ATC measures do not produce the expected effect the legislators had hoped for. More health data is needed to identify situations where vulnerable patient groups are more susceptible to inadequate health care access in Switzerland. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Can consistent benchmarking within a standardized pain management concept decrease postoperative pain after total hip arthroplasty? A prospective cohort study including 367 patients.

    Science.gov (United States)

    Benditz, Achim; Greimel, Felix; Auer, Patrick; Zeman, Florian; Göttermann, Antje; Grifka, Joachim; Meissner, Winfried; von Kunow, Frederik

    2016-01-01

    The number of total hip replacement surgeries has steadily increased over recent years. Reduction in postoperative pain increases patient satisfaction and enables better mobilization. Thus, pain management needs to be continuously improved. Problems are often caused not only by medical issues but also by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent, benchmarking. All patients included in the study had undergone total hip arthroplasty (THA). Outcome parameters were analyzed 24 hours after surgery by means of the questionnaires from the German-wide project "Quality Improvement in Postoperative Pain Management" (QUIPS). A pain nurse interviewed patients and continuously assessed outcome quality parameters. A multidisciplinary team of anesthetists, orthopedic surgeons, and nurses implemented a regular procedure of data analysis and internal benchmarking. The health care team was informed of any results, and suggested improvements. Every staff member involved in pain management participated in educational lessons, and a special pain nurse was trained in each ward. From 2014 to 2015, 367 patients were included. The mean maximal pain score 24 hours after surgery was 4.0 (±3.0) on an 11-point numeric rating scale, and patient satisfaction was 9.0 (±1.2). Over time, the maximum pain score decreased (mean 3.0, ±2.0), whereas patient satisfaction significantly increased (mean 9.8, ±0.4; p benchmarking a standardized pain management concept. But regular benchmarking, implementation of feedback mechanisms, and staff education made the pain management concept even more successful. Multidisciplinary teamwork and flexibility in adapting processes seem to be highly important for successful pain management.

  18. Occupational Therapy in the practice of therapeutic groups and workshops with mental health patients

    Directory of Open Access Journals (Sweden)

    Janaina Bussola Montrezor

    2013-12-01

    Full Text Available In this study, we aimed to demonstrate the effectiveness of occupational therapy to patients with mental disorders through therapy groups in an intensive inpatient unit. The following treatment groups were performed: focus groups, operative groups, drawing workshops, and arts workshops. The study included 280 patients (46.07% with ICD F20-29, 23.57% with ICD F30-39, and 14.28% with ICD F19. Of all the patients studied (n = 280, 54.00% participated in the operative groups, 52.85% in the focus groups, 46.80% in the drawing workshops, and 45.70% in the art workshops. In all groups, the participation of the ICD F20-29 group was higher (focus group with 49.25%, 54.00% in the operative group, 51.00% in the workshops of drawing, and 66.00% in art workshops, followed by the ICD F30-39 group with 24.25% in the focus group, 27.00% in the operative group, and 22.00% in the drawing workshops; the ICD F19 group stood out in the arts workshops. Patients with schizophrenia, psychoses, bipolar disorders, among others (ICD F20-20 and ICD F30-39 were the most active in the therapeutic groups, which discussed contents such as joy, anger, fear, thoughts of death, etc. The ICD F19 group presented the greatest participation in the art workshops, a fact that can be explained by the profile of these patients, because many have been in prison and/or admitted to long-stays in hospitals where they learned to perform manual tasks for subsequent survival in society. We concluded that therapeutic groups are effective in treating mental health patients because they contribute to hospital discharge and improve patients’ conditions.

  19. Self-help groups for former patients: relations with mental health professionals.

    Science.gov (United States)

    Emerick, R E

    1990-04-01

    Data from a national survey of 104 self-help groups for former mental patients were examined to assess actual and potential partnerships between these groups and mental health professionals. The groups' level of interaction with and attitudes toward professionals varied with the structure, affiliation, and service model of the groups. The majority were moderate "supportive" groups in which partnerships with professionals could occur but were problematic. Less common were radical "separatist" groups, with which professional partnerships were almost guaranteed to fail, and conservative "partnership" groups, with which partnerships were likely to succeed. Strong antipsychiatric attitudes throughout the mental patient movement suggest that mental health professionals who approach former-patient groups with narrow clinical conceptions of mental illness are likely to fail in establishing partnerships.

  20. [Impulsivity-focused Group Intervention to reduce Binge Eating Episodes in Patients with Binge Eating Disorder - A Group Training Program].

    Science.gov (United States)

    Schag, Kathrin; Leehr, Elisabeth J; Skoda, Eva-Maria; Becker, Sandra; Zipfel, Stephan; Giel, Katrin E

    2016-11-01

    Binge Eating Disorder (BED) is an eating disorder where cognitive behavioural therapy (CBT) could already show reliable efficacy. Relying on basic research, CBT interventions which especially focus on impulsivity could be effective, because binge eating episodes represent highly impulsive eating behaviour. For this reason, we developed a treatment concept about an impulsivity-focused behavioural group intervention for patients with BED, called IMPULS. The efficacy of IMPULS is currently investigated in a randomised controlled trial 1. IMPULS is drafted as a weekly group training programme with 5-6 participants per group. The essential interventions are food-related cue exposure with response prevention and the development of self-control strategies. These interventions are adapted onto the impulsivity concept from conventional treatment of addictive disorders and BED. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Individual neuropsychological support and group sessions for relatives to TBI patients

    DEFF Research Database (Denmark)

    Siert, Lars

    TITLE: Individual neuropsychological support and group sessions for relatives to TBI patients. OBJECTIVE: To describe how the neuropsychologist work with early and ongoing individual support and group sessions for relatives to adult TBI patients in the acute and sub acute phase and after discharge...

  2. Cross-cultural adaptation, reliability, internal consistency and validation of the Hand Function Sort (HFS©) for French speaking patients with upper limb complaints.

    Science.gov (United States)

    Konzelmann, M; Burrus, C; Hilfiker, R; Rivier, G; Deriaz, O; Luthi, F

    2015-03-01

    Functional evaluation of upper limb is not only based on clinical findings but requires self-administered questionnaires to address patients' perspective. The Hand Function Sort (HFS©) was only validated in English. The aim of this study was the French cross cultural adaptation and validation of the HFS© (HFS-F). 150 patients with various upper limbs impairments were recruited in a rehabilitation center. Translation and cross-cultural adaptation were made according to international guidelines. Construct validity was estimated through correlations with Disabilities Arm Shoulder and Hand (DASH) questionnaire, SF-36 mental component summary (MCS),SF-36 physical component summary (PCS) and pain intensity. Internal consistency was assessed by Cronbach's α and test-retest reliability by intraclass correlation. Cronbach's α was 0.98, test-retest reliability was excellent at 0.921 (95 % CI 0.871-0.971) same as original HFS©. Correlations with DASH were-0.779 (95 % CI -0.847 to -0.685); with SF 36 PCS 0.452 (95 % CI 0.276-0.599); with pain -0.247 (95 % CI -0.429 to -0.041); with SF 36 MCS 0.242 (95 % CI 0.042-0.422). There were no floor or ceiling effects. The HFS-F has the same good psychometric properties as the original HFS© (internal consistency, test retest reliability, convergent validity with DASH, divergent validity with SF-36 MCS, and no floor or ceiling effects). The convergent validity with SF-36 PCS was poor; we found no correlation with pain. The HFS-F could be used with confidence in a population of working patients. Other studies are necessary to study its psychometric properties in other populations.

  3. [Utilization of self-help groups and psychotherapy after psychosomatic-psychotherapeutic in-patient treatment].

    Science.gov (United States)

    Höflich, Anke; Matzat, Jürgen; Meyer, Friedhelm; Knickenberg, Rudolf J; Bleichner, Franz; Merkle, Wolfgang; Reimer, Christian; Franke, Wolfram; Beutel, Manfred E

    2007-05-01

    Until now little is known about the role of participation in self-help groups alone or combined with psychotherapy in post-in-patient care. In the present study 2933 patients were questioned about their experience of self-help groups and psychotherapy after discharge from a clinic for psychosomatic medicine and psychotherapy. Nearly 8 % of them utilized self-help groups (mostly combined with out-patient psychotherapy), and altogether 68 % out-patient psychotherapy following in-patient treatment. Patients without out-patient treatment were psychologically less burdened and had better resources than participants of self-help groups or psychotherapy. Self-help group members differed from patients in out-patient psychotherapy by expressing a more positive opinion of groupwork and higher openness to new experiences. Additionly, they had discussed the topic of self-help groups more frequently with their therapists. This may be a starting-point for promoting more self-help activities of patients in the future.

  4. [METABOLIC STATUS OF PATIENTS OF DIFFERENT AGE GROUPS ON THE STAGES OF OSTEOARTHRITIS].

    Science.gov (United States)

    Stogov, M V; Ovchinnikov, E N; Sazonova, N V

    2015-01-01

    This study investigated the biochemical parameters of blood and urine in patients with osteoarthritis in the stages of the pathological process in different age groups. The patients of all age groups in the stages of osteoarthritis demonstrated metabolic acidosis, activation of the antioxidant system and increase in acute phase proteins. In addition to the total for all age groups metabolic shifts the characteristic age-related changes were observed: activated reaction of lipid peroxidation in middle-aged patients and negative calcium balance, with increasing energy metabolism disorders in elderly patients.

  5. ABO-Rh blood groups distribution in cardiac syndrome X patients

    OpenAIRE

    Kheradmand, Fatemeh; Rasmi, Yousef; Nemati, Mohaddeseh; Mohammadzad, Mir Hossein Seyed

    2012-01-01

    Background: Data on frequency distribution of ABO-Rh blood groups in cardiac syndrome X (CSX) patients are not available. We aimed to investigate the distribution of ABO-Rh blood groups in these patients. Materials and Methods: A total of 247 CSX patients’ records were reviewed in a cross-sectional study from 2006 to 2010. One hundred forty six patients (59.1%) were female, and the mean patient age was 52 ± 11 years. The frequency of ABO-Rh blood groups was compared to the frequency of these ...

  6. MRI manifestations of thymus in myasthenia gravis (MG) patients in various age groups

    International Nuclear Information System (INIS)

    Wang Ying; Peng Xi; Li Zhizhao; Jiang Kuiming; Song Ting; Dong Tianfa; Xiao Youcheng

    2003-01-01

    Objective: To study MRI findings of the thymus in patients with myasthenia gravis (MG) in different age groups and to analyze the relationship between the morphological changes of thymus and the MG. Methods: In total 90 patients with MG (male: female=43:47) received MR scan and were divided into four groups (group A, B, C and D) by age. Fourteen patients out of 90 received additional enhanced scan. Group A included 33 patients aged under 10 years (m:f=18:15); 27 patients aged 11-25 years were in group B (m:f=12:15); group C had 17 patients aged 26-50 years (m:f=6:11); and in group D there were 13 patients whose ages were over 51 years (m:f=7:6). And 30 Non-MG patients aged 8-75 years were selected as control group, in which the thickness, the fat collection, and glandulous atrophy of thymus was studied on CT. Results: 1) The thymus was unremarkable in 44 cases out of 90 (48.88%). 2) Enlarged thymus was shown in 42 cases out of 90 (46.66%), in which non-nodular enlargement was revealed in 34 cases and nodular enlargement in 8 cases. There were 27 cases with abnormality of thymus out of 33 (81.81%) in group A, 12 cases out of 27 (44.44%) in group B and 3 cases in group C, but no abnormality was found in group D. 3) Only 4/90 patients (4.44%) had thymic mass that respectively seen in one case of group B, two of group C and one of group D. No evidence of the involvement of the adjacent structure was found on MRI in the cases of thymic mass. No thymus enlargement was revealed in control group. Fat collection in thymus was seen in both study groups and control group. Conclusion: Intimate relationship between the abnormality of the thymus gland and MG exists in children and teenagers. While in the middle-aged patients or the seniors, further studies should be made to find out whether there is a correlation

  7. Efficacy analysis of two drugs consisting platinum combined with first-line chemotherapeutics regimens on 117 elderly patients with advanced non-small cell lung carcinoma

    Directory of Open Access Journals (Sweden)

    Li-li ZHANG

    2013-09-01

    Full Text Available Objective To investigate the therapeutic effects of Gemcitabine(GEM, Vinorelbine(NVB,Paclitaxel(TAX and other first-line chemotherapeutics plus platinum containing drugs on the elderly patients with advanced non-small cell lung cancer(NSCLC who had undergone surgery, and analyze the clinicopathological factors influencing the prognosis. Methods One hundred and seventeen advanced NSCLC patients aged 60 or over were treated with GP(GEM+platinum, or NP(NVB+platinum, or TP(TAX+platinum, or other first-line chemotherapeutics plus platinum(OCP after surgery, and their clinical data were then retrospectively studied to look for the relationship of patients' prognosis to clinicopathological factors(gender, operation methods, pathologicaltypes, differentiation, clinical stages.The survival curve was plotted with Kaplan-Meier method, hypothesis test was performed by log-rank, and the independent prognostic factors were screened with Cox proportional hazards regression model. Results Theone-, three- and five-year survival rates of the 117 patients were 47.23%,17.52% and 8.05%, respectively. The progression free survival(PFS of GP, NP, TP and OCP groups were 6.0, 5.2, 6.1 and5.5 months(P>0.05, respectively. The median progression free survival was 5.7 months. Univariate and multivariate analysis showed that the differentiated degrees and clinical stages of elderly NSCLC patients were the independent prognostic factors. Conclusions Clinicopathological factors(differentiated degree andclinical stages are closely related to one-, three- and five-year survival rates of advanced NSCLC in elderly patients who received treatment of first-line chemotherapeutics plus platinum. However, the efficacy ofGP, NP, TP or OCP shows no significant difference.

  8. Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients

    OpenAIRE

    Bo Kyung Sohn; Yun Kyu Oh; Jung-Seok Choi; Jiyoun Song; Ahyoung Lim; Jung Pyo Lee; Jung Nam An; Hee-Jeong Choi; Jae Yeon Hwang; Hee-Yeon Jung; Jun-Young Lee; Chun Soo Lim

    2018-01-01

    Background : Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers. Methods : We conducted group CBT over a 12-week period...

  9. Protocol for the administration of haemofiltration fluids and using patient group electrolytes direction.

    Science.gov (United States)

    Kingston, Diana; Sykes, Siobhan; Raper, Sarah

    2002-01-01

    A patient group direction (PGD) is a specific written instruction for the supply or administration of named medicines in an identified clinical situation The introduction of a PGD must demonstrate a benefit for patients Haemofiltration is widely accepted as the treatment of choice when caring for critically ill patients in acute renal failure on an intensive care unit The haemofiltration PGD improves patient care by providing standardisation in administration of fluids and electrolytes and enabling nurses to respond rapidly to changes in biochemistry during haemofiltration This paper describes the development and implementation of a protocol to enable nurses to administer haemofiltration fluids and electrolytes under a patient group direction.

  10. Can consistent benchmarking within a standardized pain management concept decrease postoperative pain after total hip arthroplasty? A prospective cohort study including 367 patients

    Directory of Open Access Journals (Sweden)

    Benditz A

    2016-12-01

    Full Text Available Achim Benditz,1 Felix Greimel,1 Patrick Auer,2 Florian Zeman,3 Antje Göttermann,4 Joachim Grifka,1 Winfried Meissner,4 Frederik von Kunow1 1Department of Orthopedics, University Medical Center Regensburg, 2Clinic for anesthesia, Asklepios Klinikum Bad Abbach, Bad Abbach, 3Centre for Clinical Studies, University Medical Center Regensburg, Regensburg, 4Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany Background: The number of total hip replacement surgeries has steadily increased over recent years. Reduction in postoperative pain increases patient satisfaction and enables better mobilization. Thus, pain management needs to be continuously improved. Problems are often caused not only by medical issues but also by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent, benchmarking.Methods: All patients included in the study had undergone total hip arthroplasty (THA. Outcome parameters were analyzed 24 hours after surgery by means of the questionnaires from the German-wide project “Quality Improvement in Postoperative Pain Management” (QUIPS. A pain nurse interviewed patients and continuously assessed outcome quality parameters. A multidisciplinary team of anesthetists, orthopedic surgeons, and nurses implemented a regular procedure of data analysis and internal benchmarking. The health care team was informed of any results, and suggested improvements. Every staff member involved in pain management participated in educational lessons, and a special pain nurse was trained in each ward.Results: From 2014 to 2015, 367 patients were included. The mean maximal pain score 24 hours after surgery was 4.0 (±3.0 on an 11-point numeric rating scale, and patient satisfaction was 9.0 (±1.2. Over time, the maximum pain score decreased (mean 3.0, ±2.0, whereas patient satisfaction

  11. The Effectiveness of Mindfulness-Based Cognitive Group Therapy in Reducing Negative Automatic Thoughts and Dysfunctional Attitudes in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Fatemeh Mehdipour

    2017-06-01

    Full Text Available Background This study aimed to evaluate the effectiveness of mindfulness-based cognitive group therapy (MBCT in reducing negative automatic thoughts and dysfunctional attitudes in cancer patients. Methods The study was an applied and quasi-experimental research conducted by pre- and post-testing. The sample consisted of 30 cancer patients selected by purposive sampling and randomly placed in the control and the experimental group (15 individuals per group. The members of both groups filled out the automatic thoughts questionnaire (ATQ and the dysfunctional attitudes scale (DAS-26 at the pre- and the post-test stage. The collected data were analyzed by the SPSS software and multivariate analysis of covariance (MANCOVA tests. Results The results indicated that MBCT significantly reduced negative automatic thoughts (F = 126.15, P < 0.01 and dysfunctional attitudes (F = 179.53, P < 0.01 in the experimental group at the post-test stage in comparison to the control group. Conclusions Based on the results of this study, it is essential that therapeutic centers and support forums related to patients with refractory disorders use MBCT in their programs for reducing negative automatic thoughts and dysfunctional attitudes.

  12. The association between self-image and defence mechanisms in a group of adolescent patients receiving psychiatric treatment.

    Science.gov (United States)

    Treger, Bartosz; Matusiak, Feliks; Pilecki, Maciej; Rogoż, Monika

    2015-01-01

    The aim of the study was to explore the relationship between various areas of self-image and defence mechanisms in adolescents. The study included a division into groups according to whether or not they were receiving psychiatric treatment. Data were obtained from two groups: a clinical group (30 persons), consisting of adolescent patients of the Adolescent Inpatient Ward of the Child and Adolescent Psychiatry Clinic and a control group (40 persons), adolescents attending upper secondary school. The Defence Style Questionnaire DSQ-40 and the Offer Self Image Questionnaire were used in the study. Results showed no differences, in the maturity levels of the defence mechanisms, between the two groups. Subjects from the clinical group had a significantly lower self-image of themselves than subjects from the control group.. In both groups, the use of mature defence mechanisms was accompanied by a positive self-image, while the use of less mature defence mechanisms was associated with a lower self-image. Comparison of the groups revealed different relationships between the aspects of self-image and used defence mechanisms, in particular the mechanism of projection. Number of significant correlations was greater in the clinical group. In the context of lower self-image, the study revealed the importance of such defence mechanisms as projection, acting out, somatization or schizoid fantasies. The obtained results seem to confirm a hypothesis that the assessment of the maturity of defence mechanisms in the period of adolescence is less clear and clinically useful.

  13. An intervention to increase patients' trust in their physicians. Stanford Trust Study Physician Group.

    Science.gov (United States)

    Thom, D H; Bloch, D A; Segal, E S

    1999-02-01

    To investigate the effect of a one-day workshop in which physicians were taught trust-building behaviors on their patients' levels of trust and on outcomes of care. In 1994, the study recruited 20 community-based family physicians and enrolled 412 consecutive adult patients from those physicians' practices. Ten of the physicians (the intervention group) were randomly assigned to receive a one-day training course in building and maintaining patients' trust. Outcomes were patients' trust in their physicians, patients' and physicians' satisfaction with the office visit, continuity in the patient-physician relationship, patients' adherence to their treatment plans, and the numbers of diagnostic tests and referrals. Physicians and patients in the intervention and control groups were similar in demographic and other data. There was no significant difference in any outcome. Although their overall ratings were not statistically significantly different, the patients of physicians in the intervention group reported more positive physician behaviors than did the patients of physicians in the control group. The trust-building workshop had no measurable effect on patients' trust or on outcomes hypothesized to be related to trust.

  14. Barrett’s Oesophagus in an Achalasia Patient: Immunological Analysis and Comparison with a Group of Achalasia Patients

    Directory of Open Access Journals (Sweden)

    Samuel Torres-Landa

    2016-01-01

    Full Text Available The aim of the study was to characterize the presence of diverse CD4 and CD8 T cell subsets and regulatory cells in peripheral blood and lower oesophageal sphincter (LES from a young patient with BE/achalasia without treatment versus achalasia group. In order to characterize the circulating cells in this patient, a cytometric analysis was performed. LES tissue was evaluated by double-immunostaining procedure. Five healthy blood donors, 5 type achalasia patients, and 5 oesophagus tissue samples (gastrooesophageal junction from transplant donors were included as control groups. A conspicuous systemic inflammation was determined in BE/achalasia patient and achalasia versus healthy volunteer group. Nonetheless, a predominance of Th22, Th2, IFN-α-producing T cells, Tregs, Bregs, and pDCregs was observed in BE/achalasia patient versus achalasia group. A low percentage of Th1 subset in BE/achalasia versus achalasia group was determined. A noticeable increase in tissue of Th22, Th17, Th2, Tregs, Bregs, and pDCregs was observed in BE/achalasia versus achalasia group. Th1 subset was lower in the BE/achalasia patient versus achalasia group. This study suggests that inflammation is a possible factor in the pathogenesis of BE/achalasia. Further research needs to be performed to understand the specific cause of the correlation between BE and achalasia.

  15. Differences in outcomes between GOLD groups in patients with COPD in the TIOSPIR® trial

    DEFF Research Database (Denmark)

    Dusser, Daniel; Wise, Robert A; Dahl, Ronald

    2016-01-01

    BACKGROUND: The aim of this study was to evaluate whether Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification could predict mortality risk factors and whether baseline treatment intensity would relate to mortality within each group, using data from TIOSPIR(®), the largest...... randomized clinical trial in COPD performed to date. METHODS: A total of 17,135 patients from TIOSPIR(®) were pooled and grouped by GOLD grading (A-D) according to baseline Medical Research Council breathlessness score, exacerbation history, and spirometry. All-cause mortality and adjudicated cardiovascular...... (CV) and respiratory mortality were assessed. RESULTS: Of the 16,326 patients classified, 1,248 died on treatment. Group B patients received proportionally more CV treatment at baseline. CV mortality risk, but not all-cause mortality risk, was significantly higher in Group B than Group C patients (CV...

  16. ABO-Rh blood groups distribution in cardiac syndrome X patients.

    Science.gov (United States)

    Kheradmand, Fatemeh; Rasmi, Yousef; Nemati, Mohaddeseh; Mohammadzad, Mir Hossein Seyed

    2012-07-01

    Data on frequency distribution of ABO-Rh blood groups in cardiac syndrome X (CSX) patients are not available. We aimed to investigate the distribution of ABO-Rh blood groups in these patients. A total of 247 CSX patients' records were reviewed in a cross-sectional study from 2006 to 2010. One hundred forty six patients (59.1%) were female, and the mean patient age was 52 ± 11 years. The frequency of ABO-Rh blood groups was compared to the frequency of these blood groups in the West-Azerbaijan province, Iran; general population. Blood groups distribution among CSX patients showed phenotypes A, B, AB, O and Rh negative as 33.1%, 21.9%, 9.3%, 35.8%, and 7.9%, respectively. According to our results, there were no differences in ABO-Rh blood groups distribution between CSX patients and normal population. These data suggest that ABO-Rh blood groups might be unassociated with CSX.

  17. Assessment of the Etiologic Factors of Gingival Recession in a Group of Patients in Northwest Iran

    OpenAIRE

    Lafzi, Ardeshir; Abolfazli, Nader; Eskandari, Amir

    2009-01-01

    Background and aims Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. Materials and methods In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experien...

  18. Frequency of chromosomal aberrations in a group of patients carriers of gonosomopathies

    International Nuclear Information System (INIS)

    Quesada Dorta, Marlen; Bello Alvarez, Daisy; Gonzalez Fernandez, Pedro

    2004-01-01

    This paper was aimed at determining the frequency of chromosomal aberrations in a group of patients carriers of gonosomopathies and at relating in each case the meaning of the different chromosomal aberrations found to the patients' clinical diagnosis. 656 patients with presumptive diagnosis of gonosomopathies from different hospital institutions of the country that were received at the molecular genetics laboratory of Hermanos Ameijeiras Clinical and Surgical Hospital from 1982 to 2001, were studied. Of the total of patients with presumptive diagnosis of gonosomopathies, in 32.7 % (215/656) the clinical diagnosis was confirmed by the cytogenetic study. The chromosomal study was conducted by using G band techniques. The chromosomal rearrangements found were classified into 4 groups. The group of numerical gonosomopathies showed the highest frequency with 110 patients, accounting for 51 % of the total. It was followed by the group of numerical and structural alterations (mosaics) with 59 patients (27.0), the inversions of sex with 24 patients (12.0), and the group of structural gonosomopathies with 22 patients (10.0) The most common chromosomal aberrations were the numerical gonosomopathies (Turner and Klinefelter's syndrome). The chromosomal study in these patients is a very important diagnostic value indicator for the therapeutical conduct to be followed in every case

  19. Nursing staff-led behavioural group intervention in psychiatric in-patient care: Patient and staff experiences.

    Science.gov (United States)

    Salberg, Johanna; Folke, Fredrik; Ekselius, Lisa; Öster, Caisa

    2018-02-15

    A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staff-led behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care. © 2018 Australian College of Mental Health Nurses Inc.

  20. Comparison of familial and psychological factors in groups of encopresis patients with constipation and without constipation.

    Science.gov (United States)

    Çengel-Kültür, S Ebru; Akdemir, Devrim; Saltık-Temizel, İnci N

    2014-01-01

    The study aimed to evaluate the differences between groups of encopresis patients with constipation and without constipation. The Symptom Checklist- 90-Revised, the COPE Questionnaire, the Relationship Scales Questionnaire, the McMaster Family Assessment Device and the Parenting Style Scale were used to evaluate, respectively, maternal psychiatric symptoms, coping abilities, attachment style, family functioning and children's perceptions of parenting behaviors. Psychiatric diagnoses were evaluated using the K-SADS. A higher level of maternal psychiatric symptoms, impaired role and affective involvement functioning of the family and less psychological autonomy were observed in the group of encopresis patients with constipation than in the group of encopresis patients without constipation. No significant differences were found between the groups in psychiatric comorbidities, maternal coping abilities and attachment style. The two groups had a similar pattern of comorbid psychiatric disorders and maternal psychological factors, although some familial factors-related mainly to parental authority-were differentiated in the encopresis with constipation group.

  1. Frequency of abo blood groups among the diabetes mellitus type 2 patients

    International Nuclear Information System (INIS)

    Qureshi, M.A.; Bhatti, R.

    2003-01-01

    Objective: To study the frequency of ABO blood groups among diabetes mellitus type 2. Results: Comparison of blood groups frequency between the general population and diabetes type 2 patients was carried out in term of percentage. It was noticed that the values were 4.36, 17.15 and 7.34% higher for A, B and AB blood groups respectively in the diabetic patients. On the contrary, the value was 28.94% lower for the blood group O. Conclusion: Present study has supported the hypothesis that diabetes mellitus type 2 and blood groups are interrelated because of the broad genetic immunologic basis in both. It is concluded that the frequency of blood groups B and O is significantly higher and lower respectively in the diabetes mellitus type 2 patients as compared to the general population. (author)

  2. Patient grouping for dose surveys and establishment of diagnostic reference levels in paediatric computed tomography

    International Nuclear Information System (INIS)

    Vassileva, J.; Rehani, M.

    2015-01-01

    There has been confusion in literature on whether paediatric patients should be grouped according to age, weight or other parameters when dealing with dose surveys. The present work aims to suggest a pragmatic approach to achieve reasonable accuracy for performing patient dose surveys in countries with limited resources. The analysis is based on a subset of data collected within the IAEA survey of paediatric computed tomography (CT) doses, involving 82 CT facilities from 32 countries in Asia, Europe, Africa and Latin America. Data for 6115 patients were collected, in 34.5 % of which data for weight were available. The present study suggests that using four age groups, <1, >1-5, >5-10 and >10-15 y, is realistic and pragmatic for dose surveys in less resource countries and for the establishment of DRLs. To ensure relevant accuracy of results, data for >30 patients in a particular age group should be collected if patient weight is not known. If a smaller sample is used, patient weight should be recorded and the median weight in the sample should be within 5-10 % from the median weight of the sample for which the DRLs were established. Comparison of results from different surveys should always be performed with caution, taking into consideration the way of grouping of paediatric patients. Dose results can be corrected for differences in patient weight/age group. (authors)

  3. Frequency of ABO/Rhesus Blood Groups in Patients with Diabetes Mellitus.

    Science.gov (United States)

    Oner, Can; Dogan, Burcu; Telatar, Berrin; Celik Yagan, Canan Fidan; Oguz, Aytekin

    2016-01-01

    The correlation between ABO/Rh blood groups and diabetes mellitus is still controversial. The aim of this study was to determine the relationship between ABO/Rhesus blood groups and diabetes in Turkish population. This cross-sectional study was conducted in Istanbul Medeniyet University Göztepe Education and Training Hospital's Diabetes Units. The study group was composed of 421 patients with type-1 diabetes, 484 patients with type-2 diabetes and 432 controls. Blood samples were collected and tested for ABO/Rhesus blood groups. Data was analyzed by SPSS version 17.0. A significant association was found between blood groups and diabetes mellitus. The frequency of AB blood group was significantly higher in type-1 diabetics; and A blood group was significantly higher in type-2 diabetics. Furthermore, Rh negativity were significantly more frequent in type-2 diabetics.

  4. Barrett’s Oesophagus in an Achalasia Patient: Immunological Analysis and Comparison with a Group of Achalasia Patients

    OpenAIRE

    Samuel Torres-Landa; Janette Furuzawa-Carballeda; Enrique Coss-Adame; Miguel A. Valdovinos; Edgar Alejandro-Medrano; Bárbara Ramos-Ávalos; Braulio Martínez-Benítez; Gonzalo Torres-Villalobos

    2016-01-01

    The aim of the study was to characterize the presence of diverse CD4 and CD8 T cell subsets and regulatory cells in peripheral blood and lower oesophageal sphincter (LES) from a young patient with BE/achalasia without treatment versus achalasia group. In order to characterize the circulating cells in this patient, a cytometric analysis was performed. LES tissue was evaluated by double-immunostaining procedure. Five healthy blood donors, 5 type achalasia patients, and 5 oesophagus tissue sampl...

  5. ABO blood group frequency in Ischemic heart disease patients in Pakistani population.

    Science.gov (United States)

    Sharif, Saima; Anwar, Naureen; Farasat, Tasnim; Naz, Shagufta

    2014-05-01

    To determine if there is any significant association between ABO blood groups and ischemic heart disease (IHD). The study was performed at Punjab Institute of Cardiology (PIC), Lahore. Study duration was from January 2012 to September 2012. This study included 200 IHD patients and 230 control individuals. Self design questionnaire was used to collect information regarding risk factors. Standard agglutination test was performed to determine the blood groups. Data was analyzed on SPSS 16. The prevalence of blood groups in IHD group was 34% in blood group A, 29% in blood group B, 14% in blood group AB and 23% in blood group O. In control group the distribution of B, A, AB and O blood groups were 34.4%, 20.9%, 12.6%, 32.2% respectively. Rh+ve factor was prevalent in 90.5% among IHD group and 92.6% in control subjects. The prevalence of IHD was more in males (63.5%) as compared to females (36.5%). Mean age was 56.4±0.86 (yrs) and BMI was 26.4±0.33 (kg/m(2)). The prevalence of hypertension was 58.5%, diabetes was 53%, family history of cardiac disease was 45%, 35.5% of patients were doing exercise regularly, 58.5% used ghee, and 58% were smokers. C onclusion: Subjects with blood group A had significantly (pblood groups.

  6. Distribution of ABO and Rh Blood Groups in Patients With Keratoconus: A Case-Control Study.

    Science.gov (United States)

    Naderan, Mohammad; Rajabi, Mohammad Taher; Shoar, Saeed; Kamaleddin, Mohammad Amin; Naderan, Morteza; Rezagholizadeh, Farzaneh; Zolfaghari, Masoome; Pahlevani, Rozhin

    2015-07-01

    Association of keratoconus (KC) with genetic predisposition and environmental factors has been well documented. However, no single study has investigated the possible relationship between ABO and Rh blood groups and KC. A case-control study was designed in a university hospital enrolling 214 patients with KC in the case group and equal number of age- and sex-matched healthy subjects in the control group. Primary characteristics, ABO blood group, and Rh factors were compared between the two groups. Topographic findings of KC eyes and the severity of the diseases were investigated according to the distribution of the blood groups. Blood group O and Rh(+) phenotype were most frequent in both groups. There was no significant difference between the two groups in terms of ABO blood groups or Rh factors. Mean keratometery (K), central corneal thickness, thinnest corneal thickness, flat K, steep K, sphere and cylinder, spherical equivalent, and uncorrected visual acuity were all similar between ABO blood groups and Rh(+) and Rh(-) groups. However, the best spectacle-corrected visual acuity (BCVA) had the highest value in AB blood group (0.35 ± 0.22 logMAR, P=0.005). Moreover, the blood group AB revealed the highest frequency for grade 3 KC, followed by grades 1, 2, and 4 (P=0.003). We observed no significant excess of any particular blood group among KC cases compared with healthy subjects. Except BCVA, none of the keratometric or topographic findings was significantly different between blood groups.

  7. Vibrotactile sense in patients with different upper limb disorders compared with a control group

    DEFF Research Database (Denmark)

    Laursen, Lise Hedegaard; Jepsen, Jørgen Riis; Sjøgaard, Gisela

    2006-01-01

    diagnostic tools to reveal underlying mechanisms for specific diagnoses. OBJECTIVE: To investigate the possible differences in vibration perception threshold (VPT) and tolerance to suprathreshold stimulation (STS) between controls and specific diagnostic ULD patient groups with uni- and bilateral neuropathy...... patients in all diagnostic groups had significantly higher VPT (Pgroups defined with neuropathy demonstrated significantly higher VPT in the limb with diagnoses compared with the contralateral limb without...... diagnoses. The highest VPTs were found in the patient group with unilateral neuropathy and MCD, and for the radial nerve, VPT was significantly higher than that for patients with unilateral MCD alone. These findings were confirmed by almost similar findings in STS responses. CONCLUSIONS: The ULD patients...

  8. Human studies of prepulse inhibition of startle: normal subjects, patient groups, and pharmacological studies.

    Science.gov (United States)

    Braff, D L; Geyer, M A; Swerdlow, N R

    2001-07-01

    Since the mid-1970s, cross-species translational studies of prepulse inhibition (PPI) have increased at an astounding pace as the value of this neurobiologically informative measure has been optimized. PPI occurs when a relatively weak sensory event (the prepulse) is presented 30-500 ms before a strong startle-inducing stimulus, and reduces the magnitude of the startle response. In humans, PPI occurs in a robust, predictable manner when the prepulse and startling stimuli occur in either the same or different modalities (acoustic, visual, or cutaneous). This review covers three areas of interest in human PPI studies. First, we review the normal influences on PPI related to the underlying construct of sensori- (prepulse) motor (startle reflex) gating. Second, we review PPI studies in psychopathological disorders that form a family of gating disorders. Third, we review the relatively limited but interesting and rapidly expanding literature on pharmacological influences on PPI in humans. All studies identified by a computerized literature search that addressed the three topics of this review were compiled and evaluated. The principal studies were summarized in appropriate tables. The major influences on PPI as a measure of sensorimotor gating can be grouped into 11 domains. Most of these domains are similar across species, supporting the value of PPI studies in translational comparisons across species. The most prominent literature describing deficits in PPI in psychiatrically defined groups features schizophrenia-spectrum patients and their clinically unaffected relatives. These findings support the use of PPI as an endophenotype in genetic studies. Additional groups of psychopathologically disordered patients with neuropathology involving cortico-striato-pallido-pontine circuits exhibit poor gating of motor, sensory, or cognitive information and corresponding PPI deficits. These groups include patients with obsessive compulsive disorder, Tourette's syndrome

  9. Therapeutic efficacy of a therapeutic cooking group from the patients' perspective.

    Science.gov (United States)

    Hill, Kimberly H; O'Brien, Kimberly A; Yurt, Roger W

    2007-01-01

    The purpose of this study was to evaluate the therapeutic efficacy of the cooking group from the burn survivors' perspective. By incorporating concepts of kitchen skills, energy conservation, and desensitization techniques, the cooking group can assist patients with the functional use of their hands, standing tolerance, return to former vocational activities, and socialization with other patients. A questionnaire was developed based on commonly expressed benefits of cooking group. Areas of interest included decreasing anxiety in the kitchen, distraction from their burns, socializing with other burn survivors, and the physical benefits of participating in the group. The results of this study indicate that participants regard the therapeutic cooking group as a valuable treatment modality that effectively combines functional activities with socialization to decrease burn related anxiety and increase motion in a supportive environment for patients with burns.

  10. [Effects of group psychological counseling on self-confidence and social adaptation of burn patients].

    Science.gov (United States)

    Dang, Rui; Wang, Yishen; Li, Na; He, Ting; Shi, Mengna; Liang, Yanyan; Zhu, Chan; Zhou, Yongbo; Qi, Zongshi; Hu, Dahai

    2014-12-01

    To explore the effects of group psychological counseling on the self-confidence and social adaptation of burn patients during the course of rehabilitation. Sixty-four burn patients conforming to the inclusion criteria and hospitalized from January 2012 to January 2014 in Xijing Hospital were divided into trial group and control group according to the method of rehabilitation, with 32 cases in each group. Patients in the two groups were given ordinary rehabilitation training for 8 weeks, and the patients in trial group were given a course of group psychological counseling in addition. The Rosenberg's Self-Esteem Scale was used to evaluate the changes in self-confidence levels, and the number of patients with inferiority complex, normal feeling, self-confidence, and over self-confidence were counted before and after treatment. The Abbreviated Burn-Specific Health Scale was used to evaluate physical function, psychological function, social relationship, health condition, and general condition before and after treatment to evaluate the social adaptation of patients. Data were processed with t test, chi-square test, Mann-Whitney U test, and Wilcoxon test. (1) After treatment, the self-confidence levels of patients in trial group were significantly higher than those in control group (Z = -2.573, P 0.05). (2) After treatment, the scores of psychological function, social relationship, health condition, and general condition were (87 ± 3), (47.8 ± 3.6), (49 ± 3), and (239 ± 10) points in trial group, which were significantly higher than those in control group [(79 ± 4), (38.3 ± 5.6), (46 ± 4), and (231 ± 9) points, with t values respectively -8.635, -8.125, -3.352, -3.609, P values below 0.01]. After treatment, the scores of physical function, psychological function, social relationship, health condition, and general condition in trial group were significantly higher than those before treatment (with t values from -33.282 to -19.515, P values below 0.05). The scores

  11. Hospital Patient Room Design: The Issues Facing 23 Occupational Groups Who Work in Medical/Surgical Patient Rooms.

    Science.gov (United States)

    Lavender, Steven A; Sommerich, Carolyn M; Patterson, Emily S; Sanders, Elizabeth B-N; Evans, Kevin D; Park, Sanghyun; Umar, Radin Zaid Radin; Li, Jing

    2015-01-01

    The aim of this study was to learn from a wide range of hospital staff members about how the design of the patient room in which they work adversely affects their ergonomics or hinders their job performance. In addition to providing a healing space for patients, hospital patient rooms need to serve as functional workplaces for the people who provide clinical care, to clean, or to maintain room functions. Therefore, from a design perspective, it is important to understand the needs of all the users of hospital patient rooms with regard to room design. One hundred forty-seven people, representing 23 different occupational stakeholder groups, participated in either focus groups or interviews in which they were asked to identify room design issues that affect the performance of their work tasks. Key issues shared across multiple stakeholder groups included an inability to have eye contact with the patient when entering the room, inadequate space around the bed for the equipment used by stakeholders, the physical demands experienced as stakeholders move furnishings to accomplish their activities or access equipment, and a lack of available horizontal surfaces. Unique issues were also identified for a number of stakeholder groups. There are a number of issues that should be addressed in the next generation of hospital patient rooms, or when refurbishing existing facilities, so that all occupational stakeholder groups can work effectively, efficiently, and without undue physical stress. © The Author(s) 2015.

  12. Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial.

    Science.gov (United States)

    van der Roer, Nicole; van Tulder, Maurits; Barendse, Johanna; Knol, Dirk; van Mechelen, Willem; de Vet, Henrica

    2008-09-01

    Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and guideline physiotherapy for primary care patients with non-specific chronic low back pain. The study was designed as pragmatic randomised controlled trial with a setup of 105 primary care physiotherapists in 49 practices and 114 patients with non-specific low back pain of more than 12 weeks duration participated in the study. In the intensive group training protocol exercise therapy, back school and operant-conditioning behavioural principles are combined. Patients were treated during 10 individual sessions along 20 group sessions. Usual care consisted of physiotherapy according to the Dutch guidelines for Low Back Pain. Main outcome measures were functional disability (Roland Morris disability questionnaire), pain intensity, perceived recovery and sick leave because of low back pain assessed at baseline and after 6, 13, 26 and 52 weeks. Both an intention-to-treat analysis and a per-protocol analysis were performed. Multilevel analysis did not show significant differences between both treatment groups on any outcome measures during the complete follow-up period, with one exception. After 26 weeks the protocol group showed more reduction in pain intensity than the guideline group, but this difference was absent after 52 weeks. We finally conclude that an intensive group training protocol was not more effective than usual physiotherapy for chronic low back pain.

  13. Myocardial 201Tl washout after combined dipyridamole submaximal exercise stress: Reference values from different patient groups

    International Nuclear Information System (INIS)

    Fridrich, L.

    1989-01-01

    Dipyridamole stress is favorable in patients unable to exercise maximally for 201 Tl myocardial scintigraphy. Aside from an analysis of uptake defects, proper washout analysis can be limited by heart rate variations when isolated dipyridamole stress is used. Heart rate standardized 201 Tl washout kinetics after a combined dipyridamole and submaximal exercise stress protocol (CDSE), feasible in elderly patients as well as in patients with peripheral artery disease, were therefore studied to investigate the 201 Tl washout after CDSE in differently defined patient groups: Group I comprised 19 patients with documented heart disease and angiographically excluded coronary artery disease (CAD); group II contained 17 patients with a very low likelihood of CAD determined by both normal exercise radionuclide ventriculography and normal 201 Tl uptake. Group III comprised 56 patients with a 50% pretest likelihood of CAD but normal 201 Tl uptake. Mean washout values were nearly identical in all groups. Despite similar uptake patterns, however, washout standardized by CDSE was significantly lower than the normal washout values after maximal treadmill exercise. Thus an obviously lower 201 Tl washout after CDSE than after maximal treadmill exercise must be considered if washout analysis criteria after dipyridamole are applied to evaluate ischemic heart disease. Nevertheless, heart rate elevation achieved by additional submaximal exercise stress seems necessary, adequate and clinically safe for standardisation of washout analysis in dipyridamole 201 Tl scintigraphy. (orig.)

  14. Evidenced-Based Guidelines on the Treatment of Fibromyalgia Patients: Are They Consistent and If Not, Why Not? Have Effective Psychological Treatments Been Overlooked?

    Science.gov (United States)

    Thieme, Kati; Mathys, Marc; Turk, Dennis C

    2017-07-01

    We compared the recommendations and methodology of several recent evidence-based guidelines for the management of patients with fibromyalgia published by professional organizations: 1) American Pain Society (APS; 2005), 2) Association of the Scientific Medical Societies in Germany (AWMF; 2012), 3) Canadian Pain Society (CPS; 2013; also used in the United Kingdom), and 4) European League Against Rheumatism (EULAR; 2016). Each guideline used systematic reviews and meta-analyses as highest level of evidence; APS, CPS, and AWMF also included individual randomized clinical trials. The APS, CPS, and AWMF assigned the highest ranking of recommendation to aerobic exercise, cognitive-behavioral therapy, amitriptyline, and multicomponent treatment. In contrast, the most recent EULAR guidelines assign the highest level of recommendation to exercise, contrary to the 2008 EULAR guidelines, which recommended pharmacotherapy. Although there was some consistency for pharmacological treatment recommendations among the 4 guidelines, APS, CPS, and AWMF guidelines gave the higher ranking to cognitive-behavioral therapy and multicomponent treatments. The inconsistencies across guidelines can be attributed to the criteria used for study inclusion, outcome measures used, weighting systems, and composition of the review panels. A guideline consensus is needed to harmonize the discrepancies. This article presents an overview and highlights the inconsistencies of 4 recent clinical practice guidelines for treatment of fibromyalgia patients related to study inclusion criteria, outcome measures used, ranking system used, and composition of the review panels. The discrepancies suggest a need to create a guideline consensus to synthesize guidelines. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  15. Banding together: an investigation of post-surgery support groups for laparoscopic adjustable gastric banding patients

    Directory of Open Access Journals (Sweden)

    Melissa Opolski

    2014-09-01

    Full Text Available Though advocated as useful for patients, there is little in the literature regarding the use and effectiveness of bariatric support groups. This study investigated characteristics and experiences of bariatric patients who did and did not attend offered groups. Seventy-eight postoperative laparoscopic adjustable gastric banding patients from a private bariatric clinic completed mailed self-report questionnaires. Almost 60% reported having attended the clinic groups, with most wanting to meet other patients and obtain information rather than access psychological assistance. Participants reported generally positive experiences of attending. Nonattendance was often attributed to practical barriers. Satisfaction with support from others was not related to past or predicted future attendance, but higher psychological distress was related to and predictive of greater intention to attend future groups. Likely future attenders also held more positive beliefs about the groups than those who were unlikely to attend. Further research is required into potential positive and negative consequences of attendance, and characteristics of those who are likely to benefit or be harmed by attending. Interventions addressing stereotypes about support groups may help patients make informed decisions about whether to attend a bariatric support group.

  16. Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients.

    Science.gov (United States)

    Duarte, Priscila Silveira; Miyazaki, Maria Cristina; Blay, Sergio Luís; Sesso, Ricardo

    2009-08-01

    Depression is an important target of psychological assessment in patients with end-stage renal disease because it predicts their morbidity, mortality, and quality of life. We assessed the effectiveness of cognitive-behavioral therapy in chronic hemodialysis patients diagnosed with major depression by the Mini International Neuropsychiatric Interview (MINI). In a randomized trial conducted in Brazil, an intervention group of 41 patients was given 12 weekly sessions of cognitive-behavioral group therapy led by a trained psychologist over 3 months while a control group of 44 patients received the usual treatment offered in the dialysis unit. In both groups, the Beck Depression Inventory, the MINI, and the Kidney Disease and Quality of Life-Short Form questionnaires were administered at baseline, after 3 months of intervention or usual treatment, and after 9 months of follow-up. The intervention group had significant improvements, compared to the control group, in the average scores of the Beck Depression Inventory overall scale, MINI scores, and in quality-of-life dimensions that included the burden of renal disease, sleep, quality of social interaction, overall health, and the mental component summary. We conclude that cognitive-behavioral group therapy is an effective treatment of depression in chronic hemodialysis patients.

  17. Depression, anxiety, and somatic symptoms in older cancer patients: a comparison across age groups.

    Science.gov (United States)

    Cohen, Miri

    2014-02-01

    Previous studies have reported that older cancer patients experience lower psychological distress than younger patients, but most prior studies do not differentiate between age groups within the 'older' category. The aim of this study was to assess the intensity of the symptoms of depression, anxiety, and somatic symptoms among different age groups of older cancer patients. Participants were composed of 321 cancer patients 60 years and older, who were divided into three age groups: 60-69, 70-79, and 80+ years. The participants answered the Brief Symptom Inventory-18, which included subscales for depression, anxiety, and somatic symptoms and the cancer-related problem list, in addition to providing personal and cancer-related details. Depressive, anxiety, and somatic symptoms and cancer-related problems were lowest in the 70-79 years age group and highest in the 80+ years age group. Comparisons between pairs of groups showed significant differences between each of the groups in Brief Symptom Inventory total scores and between the 80+ years age group and the other two groups in regard to depressive symptoms and cancer-related problems. Differences, related to anxiety and somatic symptoms, were significant for the 70-79 year olds, in comparison with the youngest and oldest groups. Intensity of symptoms was explained by older age, higher number of cancer-related problems, female gender, and lower income. Nonlinear relations exist between age and psychological symptoms, which is in line with the postponement of age-related health and functional decline in the modern era. These results suggest that the study of psychological reactions to cancer should examine differences between age groups among older cancer patients. Copyright © 2013 John Wiley & Sons, Ltd.

  18. Are multi family groups appropriate for patients with first episode psychosis?

    DEFF Research Database (Denmark)

    Rossberg, Jan Ivar; Johannessen, J O; Klungsoyr, O

    2010-01-01

    OBJECTIVE: To compare outcome over 5 years for patients who participated in multi family groups (MFGs) to those who refused or were not offered participation. METHOD: Of 301 first episode psychotic patients aged 15-65 years, 147 participated in MFGs. Outcome was measured by drop-out rates, positive...

  19. Ground reaction force analysed with correlation coefficient matrix in group of stroke patients.

    Science.gov (United States)

    Szczerbik, Ewa; Krawczyk, Maciej; Syczewska, Małgorzata

    2014-01-01

    Stroke is the third cause of death in contemporary society and causes many disorders. Clinical scales, ground reaction force (GRF) and objective gait analysis are used for assessment of patient's rehabilitation progress during treatment. The goal of this paper is to assess whether signal correlation coefficient matrix applied to GRF can be used for evaluation of the status of post-stroke patients. A group of patients underwent clinical assessment and instrumented gait analysis simultaneously three times. The difference between components of patient's GRF (vertical, fore/aft, med/lat) and normal ones (reference GRF of healthy subjects) was calculated as correlation coefficient. Patients were divided into two groups ("worse" and "better") based on the clinical functional scale tests done at the beginning of rehabilitation process. The results obtained by these two groups were compared using statistical analysis. An increase of median value of correlation coefficient is observed in all components of GRF, but only in non-paretic leg. Analysis of GRF signal can be helpful in assessment of post-stroke patients during rehabilitation. Improvement in stroke patients was observed in non-paretic leg of the "worse" group. GRF analysis should not be the only tool for objective validation of patient's improvement, but could be used as additional source of information.

  20. Interpersonal and social rhythm group therapy for patients with bipolar disorder

    NARCIS (Netherlands)

    C.G. Bouwkamp (Christian); M.E. de Kruiff (Marije); T.M. van Troost (Thea); M.L. Snippe (Martine); M.B.J. Blom (Marc); R.F.P. de Winter (Remco F.); P.M.J. Haffmans (P.M. Judith)

    2013-01-01

    textabstractThis article describes Interpersonal and Social Rhythm Therapy (IPSRT) adapted for use in a group setting for patients with bipolar disorder. In a preliminary efficacy study, we studied the pre-post group treatment effect on affective symptoms. One-year pre-post findings in the IPSRT

  1. What is competent communication behaviour of patients in physician consultations? - Chronically-ill patients answer in focus groups.

    Science.gov (United States)

    Schmidt, Erika; Schöpf, Andrea C; Farin, Erik

    2017-09-01

    Many desirable outcomes depend on good patient-physician communication. Patient-based perspectives of what constitutes competent communication behavior with physicians are needed for patient-oriented health care. Therefore it was our main aim to identify competent patient communication skills from the patient's perspective. We also wanted to reveal any differences in opinion among various groups (chronic ischemic heart disease, chronic low back pain, breast cancer). This study examined nine guideline-supported focus groups in rehabilitation centers. The criterion for study inclusion was any one of the three diagnoses. Enrolled in the study were N = 49 patients (32 women) aged M = 60.1 (SD = 12.8). The interview recordings were transcribed and subjected to content analysis. We documented 396 commentaries in these interviews that were allocated to 82 different codes; these in turn resulted in the formation of 12 main topics. Examples are: posing questions, being an active and participatory patient, being aware of emotions and communicating them. This study represents stage two ('documentation of patient and clinician views') in the seven-stage model of communication research. Findings reveal that chronically-ill patients name behaviours that contribute to successful discussion with a physician. These enable us to develop communication trainings and design-measuring tools used for patient-based communication skills.

  2. Foot Problems in a Group of Patients with Rheumatoid Arthritis: An Unmet Need for Foot Care

    OpenAIRE

    Borman, Pinar; Ayhan, Figen; Tuncay, Figen; Sahin, Mehtap

    2012-01-01

    Objectives: The aim of this study was to evaluate the foot involvement in a group of RA patients in regard to symptoms, type and frequency of deformities, location, radiological changes, and foot care. Patients and Methods: A randomized selected 100 rheumatoid arthritis (RA) patients were recruited to the study. Data about foot symptoms, duration and location of foot pain, pain intensity, access to services related to foot, treatment, orthoses and assistive devices, and usefulness of therapie...

  3. Liver transplantation in HIV-positive patients: the position of the Brazilian groups.

    Science.gov (United States)

    Brandão, Ajacio Bandeira de Mello; Mariante-Neto, Guilherme

    2005-01-01

    Patients infected with the human immunodeficiency virus (HIV) have generally been excluded from consideration for liver transplantation. Recent advances in the management and prognosis of these patients suggest that this policy must be reevaluated. To identify the current position of Brazilian transplant centers concerning liver transplantation in asymptomatic HIV-infected patients with end-stage liver disease. A structured questionnaire was submitted by e-mail to Brazilian groups who perform liver transplantation and were active in late 2003, according to the Brazilian Association of Organ Transplantation. Of the 53 active groups, 30 e-mail addresses have been found of professionals working in 41 of these groups. Twenty-one responses (70%) were obtained. Most of the professionals (62%) reported that they do not include HIV-infected patients in waiting lists for transplants, primarily on account of the limited world experience. They also reported, however, that this issue will soon be discussed by the group. Those who accept these patients usually follow the guidelines provided by the literature: patients must fulfill the same inclusion criteria as the other patients with end-stage liver diseases, present low or undetectable HIV viral load, and a CD4 count above 250/mm3. They reported that there are 10 HIV-infected patients in waiting list and that only one patient has received a liver transplant in the country. Most centers do not accept in waiting lists for liver transplantation patients with HIV infection, even asymptomatic ones. However, advances in the management of HIV-infected patients suggest that this policy must be reevaluated. In Brazil, there is practically no experience in liver transplantation in HIV-positive patients.

  4. Cognitive–behavioral group therapy is an effective treatment for major depression in hemodialysis patients

    OpenAIRE

    Duarte, Priscila Silveira; Miyazaki, Maria Cristina; Blay, Sergio Luís; Sesso, Ricardo

    2009-01-01

    Depression is an important target of psychological assessment in patients with end-stage renal disease because it predicts their morbidity, mortality, and quality of life. We assessed the effectiveness of cognitive-behavioral therapy in chronic hemodialysis patients diagnosed with major depression by the Mini International Neuropsychiatric Interview (MINI). in a randomized trial conducted in Brazil, an intervention group of 41 patients was given 12 weekly sessions of cognitive-behavioral grou...

  5. The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations.

    Science.gov (United States)

    Sheff, Alex; Park, Elyse R; Neagle, Mary; Oreskovic, Nicolas M

    2017-07-25

    Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support.

  6. The effectiveness of support groups in Asian breast cancer patients: An integrative review

    Directory of Open Access Journals (Sweden)

    Fang-Yu Chou

    2016-01-01

    Full Text Available Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries. The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  7. The Effectiveness of Support Groups in Asian Breast Cancer Patients: An Integrative Review.

    Science.gov (United States)

    Chou, Fang-Yu; Lee-Lin, Frances; Kuang, Lily Y

    2016-01-01

    Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC) patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries). The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  8. Evaluation of quality of life and psychological aspects of Parkinson's disease patients who participate in a support group

    Directory of Open Access Journals (Sweden)

    Nathalie Ribeiro Artigas

    Full Text Available Parkinson's disease (PD is a neurodegenerative disorder that can dramatically impair patient quality of life (QoL.Objective:To analyze the QoL, motor capacity, depression, anxiety and social phobia of individuals who attended a patient support group (PSG compared to non-participants.Methods:A cross-sectional study was performed. The sample consisted of 20 individuals with PD who attended a PSG and another 20 PD patients who did not attend a support group for PD patients, serving as the control group (nPSG. All patients answered questionnaires on motor capacity (UPDRS, QoL (Parkinson's Disease Questionnaire- PDQ-39, depression (Beck Depression Inventory, anxiety (Beck Anxiety Inventory and social phobia (Liebowitz Social Anxiety Scale. To determine data distribution, the Shapiro-Wilk test was performed. For comparison of means, Student's t-test was applied. In cases of asymmetry, the Mann-Whitney test was employed. To assess the association between the scales, Pearson's correlation coefficient (symmetric distribution and Spearman's coefficient (asymmetric distribution were applied. For the association between qualitative variables, Pearson's Chi-squared test was performed. A significance level of 5% (p≤0.05 was adopted.Results:Individuals in the PSG had a significantly better QoL (p=0.002, and lower depression (p=0.026, anxiety (p<0.001 and social phobia (p=0.01 scores compared to the nPSG.Conclusion:The participation of PD patients in social activities such as support groups is associated with better QoL and fewer symptoms of depression, anxiety and social phobia.

  9. Stage of readiness of patients with behavioral dysphonia in pre and post-group voice therapy assessments.

    Science.gov (United States)

    Costa, Bianca Oliveira Ismael da; Silva, Priscila Oliveira Costa; Pinheiro, Renata Serrano de Andrade; Silva, Hêmmylly Farias da; Almeida, Anna Alice Figueirêdo de

    2017-08-10

    To verify the efficacy of group voice therapy in the stage of readiness and identify which items of the URICA-Voice range are more sensitive to post-therapy change in patients with behavioral dysphonia. An intervention study was conducted on 49 patients with behavioral dysphonia. An eclectic approach to group therapy was implemented over eight sessions, the first and last sessions consisting of assessments. The URICA-Voice range was used to evaluate the stage of readiness at pre- and post-therapy assessments. A descriptive and inferential statistical analysis was implemented for the results. Most participants were female, did not make professional use of voice, and had membranous vocal fold lesions. Most of them were in the Contemplation stage at in both moments, pre- and post-therapy. There was no significant change in the comparison of pre- and post-therapy scores. The majority of patients showed a reduction in the stage of readiness and some advanced to a higher stage. In the comparison of URICA-V range items, seven questions had equal or inferior responses in the post-therapy assessment. There was no statistical difference when comparing the pre- and post-therapy total average score of the URICA-Voice range. There were significant changes in the stage of readiness of patients in pre- and post-group speech therapy assessments.

  10. Relationship between ABO blood groups and head and neck cancer among Greek patients.

    Science.gov (United States)

    Kakava, Kassiani; Karelas, Ioannis; Koutrafouris, Ioannis; Damianidis, Savvas; Stampouloglou, Paulos; Papadakis, Georgios; Xenos, Antonios; Krania, Foteini; Sarof, Paulos; Tasopoulos, Georgios; Petridis, Nikolaos

    2016-01-01

    We examined the association of ABO blood groups with the different types of head and neck cancers. 195 diagnosed cases and 801 controls were selected from a Greek tertiary cancer center. Information regarding type of head and neck cancer and ABO blood group was collected and registered. The O blood group was found to be most prevalent followed by A, B and AB among the controls, whereas blood group A followed by O, B and AB was most prevalent among cancer patients. The difference among the distribution between the cases and controls was statistically significant in blood group A (pblood group A had 1.52-fold higher risk of developing head and neck cancer compared to people of other blood groups. Blood group A was found to be a potential risk factor for the development of head and neck cancers.

  11. Comparison of right and left side heart functions in patients with thalassemia major, patients with thalassemia intermedia, and control group.

    Science.gov (United States)

    Noori, Noormohammad; Mohamadi, Mehdi; Keshavarz, Kambiz; Alavi, Seyed Mostafa; Mahjoubifard, Maziar; Mirmesdagh, Yalda

    2013-01-01

    Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia, rendering its early diagnosis vital. We studied and compared echocardiographic findings in patients with beta thalassemia major, patients with beta thalassemia intermedia, and a control group. Eighty asymptomatic patients with thalassemia major and 22 asymptomatic cases with thalassemia intermedia (8-25 years old) were selected from those referred to Ali Asghar Hospital (Zahedan-Iran) between June 2008 and June 2009. Additionally, 80 healthy individuals within the same age and sex groups were used as controls. All the individuals underwent echocardiography, the data of which were analyzed with the Student t-test. The mean value of the pre-ejection period/ejection time ratio of the left ventricle during systole, the diameter of the posterior wall of the left ventricle during diastole, the left and right isovolumic relaxation times, and the right myocardial performance index in the patients with beta thalassemia major and intermedia increased significantly compared to those of the controls, but the other parameters were similar between the two patient groups. The mean values of the left and right pre-ejection periods, left ventricular end systolic dimension, and left isovolumic contraction time in the patients with thalassemia intermedia increased significantly compared to those of the controls. In the left side, myocardial performance index, left ventricular mass index, isovolumic contraction time, and deceleration time exhibited significant changes between the patients with thalassemia major and those with thalassemia intermedia, whereas all the echocardiographic parameters of the right side were similar between these two groups. The results showed that the systolic and diastolic functions of the right and left sides of the heart would be impaired in patients with thalassemia major and thalassemia intermedia. Consequently, serial echocardiography is suggested in

  12. Psychosocial functioning in patients with treatment-resistant depression after group cognitive behavioral therapy

    Directory of Open Access Journals (Sweden)

    Kunisato Yoshihiko

    2010-03-01

    Full Text Available Abstract Background Although patients with Treatment Resistant Depression (TRD often have impaired social functioning, few studies have investigated the effectiveness of psychosocial treatment for these patients. We examined whether adding group cognitive behavioral therapy (group-CBT to medication would improve both the depressive symptoms and the social functioning of patient with mild TRD, and whether any improvements would be maintained over one year. Methods Forty-three patients with TRD were treated with 12 weekly sessions of group-CBT. Patients were assessed with the Global Assessment of Functioning scale (GAF, the 36-item Short-Form Health Survey (SF-36, the Hamilton Rating Scale for Depression (HRSD, the Dysfunctional Attitudes Scale (DAS, and the Automatic Thought Questionnaire-Revised (ATQ-R at baseline, at the termination of treatment, and at the 12-month follow-up. Results Thirty-eight patients completed treatment; five dropped out. For the patients who completed treatment, post-treatment scores on the GAF and SF-36 were significantly higher than baseline scores. Scores on the HRSD, DAS, and ATQ-R were significantly lower after the treatment. Thus patients improved on all measurements of psychosocial functioning and mood symptoms. Twenty patients participated in the 12-month follow-up. Their improvements for psychosocial functioning, depressive symptoms, and dysfunctional cognitions were sustained at 12 months following the completion of group-CBT. Conclusions These findings suggest a positive effect that the addition of cognitive behavioural group therapy to medication on depressive symptoms and social functioning of mildly depressed patients, showing treatment resistance.

  13. How to develop a patient and carer advisory group in a quality improvement study.

    Science.gov (United States)

    Loud, Fiona; Jain, Neerja; Thomas, Nicola

    2013-09-01

    This paper explores how a group of people with renal or other vascular conditions collaborated with renal practitioners in undertaking a quality improvement project, the aim of which was to reduce variation in care for people with Stages 3-4 chronic kidney disease. The patient advisory group supporting the project took a decisive and leading role in the creation of self-management materials and subsequent training for healthcare professionals and patients. The role of the patient advisory group was evaluated informally throughout the project. Confidence amongst the patient advisory group members grew as the project developed. Clinicians are often unclear on how to involve patients and carers in quality improvement projects, yet it is increasingly recognised as important. In practice, patients with experience of long-term conditions can co-lead quality improvement projects. It is recommended that further evaluation of the role of advisory groups is warranted. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  14. Radioimmunoassay of serum group I and group II pepsinogens in normal controls and patients with various disorders

    International Nuclear Information System (INIS)

    Ichinose, M.; Miki, K.; Hayashi, R.; Niwa, H.; Oka, H.; Furihata, C.; Matsushima, T.; Kageyama, T.; Takahashi, K.

    1982-01-01

    A radioimmunoassay (RIA) for human group I pepsinogens (PgI) in serum was developed, using PgI purified from gastric mucosa. The sensitivity (0.7 μg/l) and reproducibility of the assay were satisfactory for clinical use. In normal controls total serum pepsinogen (T-Pg) level was 58.9 +- 31.7 μg/l (mean +- SD) (PgI, 43.6 +- 25.0 μg/l; PgII, 15.3 +- 11.1 μg/l). Peptic ulcer cases had elevated T-Pg levels (gastric ulcer, gastroduodenal ulcer and duodenal ulcer, in increasing order of magnitude). T-Pg levels were not useful for diagnosis of peptic ulcer because of a large overlap with normal controls. T-Pg levels were low in patients with gastric polyp and in aged subjects. In these groups, the decrease of PgI was more marked than that of PgII. (Auth.)

  15. Radioimmunoassay of serum group I and group II pepsinogens in normal controls and patients with various disorders

    Energy Technology Data Exchange (ETDEWEB)

    Ichinose, M.; Miki, K.; Hayashi, R.; Niwa, H.; Oka, H. (Tokyo Univ. (Japan). Faculty of Medicine); Furihata, C.; Matsushima, T. (Tokyo Univ. (Japan). Inst. for Medical Science); Kageyama, T.; Takahashi, K. (Kyoto Univ., Inuyama (Japan). Primate Research Inst.)

    1982-12-09

    A radioimmunoassay (RIA) for human group I pepsinogens (PgI) in serum was developed, using PgI purified from gastric mucosa. The sensitivity (0.7 ..mu..g/l) and reproducibility of the assay were satisfactory for clinical use. In normal controls total serum pepsinogen (T-Pg) level was 58.9 +- 31.7 ..mu..g/l (mean +- SD) (PgI, 43.6 +- 25.0 ..mu..g/l; PgII, 15.3 +- 11.1 ..mu..g/l). Peptic ulcer cases had elevated T-Pg levels (gastric ulcer, gastroduodenal ulcer and duodenal ulcer, in increasing order of magnitude). T-Pg levels were not useful for diagnosis of peptic ulcer because of a large overlap with normal controls. T-Pg levels were low in patients with gastric polyp and in aged subjects. In these groups, the decrease of PgI was more marked than that of PgII.

  16. When life gives you lemons: The effectiveness of culinary group intervention among cancer patients.

    Science.gov (United States)

    Barak-Nahum, Ayelet; Haim, Limor Ben; Ginzburg, Karni

    2016-10-01

    Previous studies have shown that the dietary habits of cancer patients and survivors have significant implications for their recovery and quality of life. The current study examined the effectiveness of an innovative culinary group intervention on cancer patients' quality of life through changes in their eating behaviors, as manifested by an increase in their tendency towards intuitive eating and healthy food choices. In total, 190 cancer patients participated in this study, and were allocated to an intervention or a wait-list control group. A battery of self-report questionnaires assessing food choices, intuitive eating, health-related quality of life, and subjective well-being was administered at two time points: Before the intervention (T1) and at the end of the three month intervention (T2). Analyses revealed an increase in health-related quality of life and well-being among the intervention group. Intuitive eating and healthy food choices also increased among the intervention but not wait-list control group. Finally, results indicated that participation in the culinary group intervention and improvements in health-related quality of life and well-being were mediated by changes in eating behaviors. Our findings demonstrate that nutrition and eating behaviors have a significant effect on cancer patients' physical and emotional adjustment. A culinary group intervention seems to target patients' physical and emotional needs and promote their adjustment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Effects of a novel multimodal group intervention on myocardial perfusion in patients with coronary heart disease (CHD)

    International Nuclear Information System (INIS)

    Theissen, P.; Schicha, H.; Albus, C.; Koehle, K.; Griebenow, R.; Son, P.

    2002-01-01

    Full text: Recently, it could be shown that a multimodal intervention can promote health behavior in patients with CHD. Purpose of the actual study was to evaluate the effects on somatic endpoints, e.g. myocardial perfusion. We randomly assigned 77 patients (age 54 ± 6.9 y, male 87 %) with angiographically documented CHD to a multimodal group intervention plus standardized cardiological care (INT n=39) or standardized cardiological care only (CO n = 38). The intervention, for out-patients only, consisted of 77.5 hours of group-psychotherapy, relaxation and exercise training, and teaching lessons for one year. A Thallium myocardial perfusion scintigraphy (MyoSc) (after bicycle exercise test and at rest; 70 - 110 MBq Thallium-201, SPECT-technique, quantitative wash-out (w.-o.) analysis derived from polar maps) was performed at baseline, after 2 years, and 3 years, respectively: A w.-o. increase res. decrease by 5 % or more indicated an improved / a diminished myocardial perfusion within the affected coronary artery territory. Results were analyzed on an intention to treat basis. 70/77 patients (91 %) completed the study (drop-outs CO n=4, INT n=3). After 2 years (1st interval), there was no significant difference between groups. After 3 years (2nd interval) 36/39 patients (92.3 %) of INT showed a stable or improved myocardial perfusion, compared to 18/38 patients (47.4 %) of CO (p= 0.008). The recent data analysis demonstrates the extra benefit of a multimodal intervention, compared to standardized cardiological care alone, on myocardial perfusion in CHD patients. (author)

  18. Age group analysis of psychological, physical and functional deterioration in patients hospitalized for pneumonia.

    Science.gov (United States)

    Martín-Salvador, Adelina; Torres-Sánchez, Irene; Sáez-Roca, Germán; López-Torres, Isabel; Rodríguez-Alzueta, Elisabeth; Valenza, Marie Carmen

    2015-10-01

    Hospital admissions due to pneumonia range from 1.1 to 4 per 1,000 patients and this figure increases with age. Hospitalization causes a decline in functional status. Physical impairment impedes recovery and constitutes a higher risk of disability and mortality in elderly people. The objective of this study is to assess the impact of hospital stay in patients with pneumonia related with age. A total of 116 patients with pneumonia were included in this study, and divided into two age groups:psychological and emotional profile were evaluated. Pneumonia severity, nutritional status, independence and comorbidities were also assessed. Statistical analyses revealed significant differences between both age groups in pneumonia severity and comorbidities. Significant improvements between admission and discharge were found in lung function in both groups (pgroup. Hospitalization leads to a significant physical impairment in patients admitted for pneumonia. This deterioration increases with age. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  19. Patient education in groups increases knowledge of osteoporosis and adherence to treatment

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Ryg, Jesper; Nielsen, Winnie

    2010-01-01

    OBJECTIVE: Non-adherence to pharmacological treatment in osteoporosis is a well-recognized problem. We hypothesized that a group-based educational programme would increase patients' knowledge and level of adherence with medical treatment. METHODS: A total of 300 patients (32 men aged 65 ± 9 years...... and 268 women aged 63 ± 8 years), recently diagnosed with osteoporosis, were randomised to either an osteoporosis school programme (four classes of 8-12 participants over four weeks) or a control group. Teaching was multidisciplinary, based on patients' experiences and background and designed to encourage...... empowerment. Patients' knowledge about osteoporosis and adherence to treatment was assessed with self-completed questionnaires at baseline and after 3, 12, and 24 months. RESULTS: There were no significant differences at baseline between the two groups with respect to knowledge score or level of adherence...

  20. Effect of Cognitive-behavioral Group Therapy on Anxiety and Depression Hemodialysis Patients in Kashan, Iran

    Directory of Open Access Journals (Sweden)

    Ahmadvand A.

    2012-04-01

    Full Text Available Background and Objectives: Hemodialysis as a treatment manner in chronic renal failure is a stressful process and has several various psycho-cognitive and social complications. The present study evaluated effect of cognitive-behavioral group therapy on anxiety and depression in hemodialysis patients. Methods: This research was a clinical trial study. Samples were young adults who were 18-45 years old. The Participants were divided into two groups (case & control. The Beck depression & anxiety inventories were used as a measure of psychological symptoms at pretest and posttest and Cognitive-behavioral group therapy as intervention was done at week12. Data Were analyzed with SPSS-16 and t-test, chi square. A p<0.05 was considered significant. Results: In this study, there was not a significant difference in the demographic characteristics between the two groups. Before of intervention, mean Anxiety score of the experimental group was 25.72±5.87, and in the case group it was 25.22±7.56 as well as mean Depression score in the two groups was 35.44±14.97, 33.11±9.2 respectively. The difference of the two groups in anxiety and depression scores was not significant. After the intervention, the mean anxiety score of experimental group was 15.94±6.23, and in the case group it was 28.05±10.04 (p<0.05. Mean of depression score in the experimental group was 22.27±13.32, and in the case group it was 33.94±9.46 (p<0.01.Conclusion: This research showed that group therapy (cognitive-behavioral decreased depression and anxiety remarkably in dialysis patients. Therefore, it is suggested that in addition to the prescription of medication, psychological interventions be done for such patients.

  1. Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients.

    Science.gov (United States)

    Sohn, Bo Kyung; Oh, Yun Kyu; Choi, Jung-Seok; Song, Jiyoun; Lim, Ahyoung; Lee, Jung Pyo; An, Jung Nam; Choi, Hee-Jeong; Hwang, Jae Yeon; Jung, Hee-Yeon; Lee, Jun-Young; Lim, Chun Soo

    2018-03-01

    Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers. We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF), the Beck Depression Inventory II (BDI-II), the Hamilton Rating Scale for Depression (HAM-D), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT. The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period. In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.

  2. Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Group).

    Science.gov (United States)

    Kim, Jae Kyoung; Jeong, Ina; Lee, Ji Yeon; Kim, Jung Hyun; Han, Ah Yeon; Kim, So Yeon; Joh, Joon Sung

    2018-03-07

    The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

  3. Comparing Facial Emotional Recognition in Patients with Borderline Personality Disorder and Patients with Schizotypal Personality Disorder with a Normal Group

    Directory of Open Access Journals (Sweden)

    Aida Farsham

    2017-04-01

    Full Text Available Objective: No research has been conducted on facial emotional recognition on patients with borderline personality disorder (BPD and schizotypal personality disorder (SPD. The present study aimed at comparing facial emotion recognition in these patients with the general population. The neurocognitive processing of emotions can show the pathologic style of these 2 disorders. Method:  Twenty BPD patients, 16 SPD patients, and 20 healthy individuals were selected by available sampling method. Structural Clinical Interview for Axis II, Millon Personality Inventory, Beck Depression Inventory and Facial Emotional Recognition Test was were conducted for all participants.Discussion: The results of one way ANOVA and Scheffe’s post hoc test analysis revealed significant differences in neuropsychology assessment of  facial emotional recognition between BPD and  SPD patients with normal group (p = 0/001. A significant difference was found in emotion recognition of fear between the 2 groups of BPD and normal population (p = 0/008. A significant difference was observed between SPD patients and control group in emotion recognition of wonder (p = 0/04(.The obtained results indicated a deficit in negative emotion recognition, especially disgust emotion, thus, it can be concluded that these patients have the same neurocognitive profile in the emotion domain.

  4. Comparing Facial Emotional Recognition in Patients with Borderline Personality Disorder and Patients with Schizotypal Personality Disorder with a Normal Group.

    Science.gov (United States)

    Farsham, Aida; Abbaslou, Tahereh; Bidaki, Reza; Bozorg, Bonnie

    2017-04-01

    Objective: No research has been conducted on facial emotional recognition on patients with borderline personality disorder (BPD) and schizotypal personality disorder (SPD). The present study aimed at comparing facial emotion recognition in these patients with the general population. The neurocognitive processing of emotions can show the pathologic style of these 2 disorders. Method: Twenty BPD patients, 16 SPD patients, and 20 healthy individuals were selected by available sampling method. Structural Clinical Interview for Axis II, Millon Personality Inventory, Beck Depression Inventory and Facial Emotional Recognition Test was were conducted for all participants. Discussion: The results of one way ANOVA and Scheffe's post hoc test analysis revealed significant differences in neuropsychology assessment of facial emotional recognition between BPD and SPD patients with normal group (p = 0/001). A significant difference was found in emotion recognition of fear between the 2 groups of BPD and normal population (p = 0/008). A significant difference was observed between SPD patients and control group in emotion recognition of wonder (p = 0/04(. The obtained results indicated a deficit in negative emotion recognition, especially disgust emotion, thus, it can be concluded that these patients have the same neurocognitive profile in the emotion domain.

  5. Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Wewer, V; Gluud, C; Schlichting, P

    1991-01-01

    A regional group of outpatients with chronic inflammatory bowel disease (ulcerative colitis, n = 396, and Crohn's disease, n = 125) was biochemically screened to estimate the prevalence of hepatobiliary dysfunction. Among the 396 patients with ulcerative colitis, 69 (17%; 95% confidence limits, 14...... primary sclerosing cholangitis, of whom two were primarily diagnosed; one patient had cholangiocarcinoma also primarily diagnosed; and two patients were found to have alcoholic hepatic damage. Among the 125 patients with Crohn's disease, 38 (30%; 95% confidence limits, 23-38%) had at least 1 abnormal...... the criteria for further evaluation as described above. One patient appeared to have epithelioid granuloma in the liver and one patient had alcoholic liver disease, whereas one patient refused further examination.(ABSTRACT TRUNCATED AT 250 WORDS)...

  6. [Effects of Meek skin grafting on patients with extensive deep burn at different age groups].

    Science.gov (United States)

    Di, H P; Niu, X H; Li, Q; Li, X L; Xue, J D; Cao, D Y; Han, D W; Xia, C D

    2017-03-20

    Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ (2) test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the

  7. Tracheostomy in special groups of critically ill patients: Who, when, and where?

    Science.gov (United States)

    Longworth, Aisling; Veitch, David; Gudibande, Sandeep; Whitehouse, Tony; Snelson, Catherine; Veenith, Tonny

    2016-01-01

    Tracheostomy is one of the most common procedures undertaken in critically ill patients. It offers many theoretical advantages over translaryngeal intubation. Recent evidence in a heterogeneous group of critically ill patients, however, has not demonstrated a benefit for tracheostomy, in terms of mortality, length of stay in Intensive Care Unit (ICU), or incidence of ventilator-associated pneumonia. It may be a beneficial intervention in articular subsets of ICU patients. In this article, we will focus on the evidence for the timing of tracheostomy and its effect on various subgroups of patients in critical care. PMID:27275076

  8. Prevalence of Intestinal Coccidial Infections among Different Groups of Immunocompromised Patients

    Directory of Open Access Journals (Sweden)

    Ghodratollah SALEHI SANGANI

    2016-10-01

    Full Text Available Background: Cryptosporidium and Isospora are known as one of the main cause of diarrhea in both immunocompetent and immunocompromised subjects, all over the world. Incidence of enteropathogens such as Cryptosporidium spp. and Isospora belli considerably has increased, since immunodeficiency virus (HIV rapidly disseminated. In addition, cancer patients are highly susceptible to opportunistic infections. This study aimed to estimate the prevalence of cryptosporidiosis and isosporiasis in immunocompromised patients in Tehran.Methods: This study carried out on patients admitted to Imam Khomeini hospital during 2013-2014. Stool samples collected from 350 immunocompromised patients. Formol-ether concentration was performed for all stool samples. Zeil-Neelsen technique was applied to stain the prepared smears and finally, all slides were examined by light microscope.Results: Out of 350 patients, 195 (55.7% and 155 (44.3% were male and female, respectively. Cryptosporidium oocysts were detected in 3 (0.9% samples including one sample from HIV+/AIDS patients and 2 samples from organ transplant recipients. Isospora oocysts were detected in 4 (1.1% samples consisting 2 HIV+/AIDS patients, one patients suffering from malignancy and one patients with other immunodeficiency diseases.Conclusion: Cryptosporidium sp, and I. belli are the most prevalent gastrointestinal parasitic protozoans that infect a broad range of individuals, particularly those patients who have a suppressed or deficient immunity system.

  9. Narratives of empowerment and compliance: studies of communication in online patient support groups.

    Science.gov (United States)

    Wentzer, Helle S; Bygholm, Ann

    2013-12-01

    New technologies enable new forms of patient participation in health care. The article discusses whether communication in online patient support groups is a source of individual as well as collective empowerment or to be understood within the tradition of compliance. The discussion is based on a qualitative analysis of patient communication in two online groups on the Danish portal sundhed.dk, one for lung patients and one for women with fertility problems. The object of study is the total sum of postings during a specific period of time - a total of 4301 posts are included. The textmaterial was analyzed according to the textual paradigm of Paul Ricoeur, and the three steps of critical interpretation. Thus, the analysis moves from describing communicative characteristics of the site to a thorough semantic analysis of its narrative structure of construing meaning, interaction and collective identity, and finally as a source of collective action. The meta-narratives of the two groups confirm online patient support groups for individual empowerment, for collective group identity, but not for collective empowerment. The collective identities of patienthood on the two sites are created by the users (patients) through specific styles of communication and interaction, referred to as 'multi-logical narratives'. In spite of the potential of online communities of opening up health care to the critical voice of the public, the analysis points to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. On a collective level, the site is empowering the individual users to comply with 'doctor's recommendations' as a group. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Consistent model driven architecture

    Science.gov (United States)

    Niepostyn, Stanisław J.

    2015-09-01

    The goal of the MDA is to produce software systems from abstract models in a way where human interaction is restricted to a minimum. These abstract models are based on the UML language. However, the semantics of UML models is defined in a natural language. Subsequently the verification of consistency of these diagrams is needed in order to identify errors in requirements at the early stage of the development process. The verification of consistency is difficult due to a semi-formal nature of UML diagrams. We propose automatic verification of consistency of the series of UML diagrams originating from abstract models implemented with our consistency rules. This Consistent Model Driven Architecture approach enables us to generate automatically complete workflow applications from consistent and complete models developed from abstract models (e.g. Business Context Diagram). Therefore, our method can be used to check practicability (feasibility) of software architecture models.

  11. The effect of multiple sclerosis on the professional life of a group of Brazilian patients

    Directory of Open Access Journals (Sweden)

    Yára Dadalti Fragoso

    2010-12-01

    Full Text Available OBJECTIVE: To assess the impact of multiple sclerosis (MS on the professional life of Brazilian patients. METHOD: One hundred MS patients were randomly selected from the database of the Brazilian Multiple Sclerosis Association (ABEM. An individual interview was carried out by telephone by a member of ABEM, who collected data on the patients' clinical status, educational level and professional lives. RESULTS: Complete data were obtained from 96 patients (27 males and 69 females aged 55.0±14.1 years, with average disease duration of 4.6±4.0 years. Eighty percent had eleven or more years of schooling. Among the whole group, 66% did not present limitations on walking. The longer the disease duration and the older the patient were, the higher the chances were that the patient was retired or receiving workers' compensation benefits. However, even among patients with MS for less than five years, the rate of non-participation in the workforce was 47.7%. Fatigue, paresthesia, cognitive dysfunction and pain were often cited as the motives for not working. CONCLUSION: MS patients presented high levels of unemployment, retirement and receipt of workers' compensation benefits, despite their high schooling levels. Age, disease duration and disability influenced these results for the whole group. However, even among younger patients with shorter disease duration and low disability, this finding remained.

  12. Functional outcomes of inpatient rehabilitation in very elderly patients with stroke: differences across three age groups.

    Science.gov (United States)

    Mutai, Hitoshi; Furukawa, Tomomi; Wakabayashi, Ayumi; Suzuki, Akihito; Hanihara, Tokiji

    2018-05-01

    Background As the population continues to age rapidly, clarifying the factors affecting the prognosis in very elderly stroke patients is essential to enhance the quality of their rehabilitation. Objectives To compare the functional recovery of elderly stroke patients classified into three age groups and to identify the predictors of functional recovery in the very elderly following acute inpatient rehabilitation. Methods Observational study: We collected data on 461 stroke patients in the neurology and neurosurgery ward and classified them into three age groups (65-74, 75-84, and ≥ 85 years). Functional recovery was compared among groups using the functional independence measure (FIM) at discharge and ADL recovery rate was compared using the Montebello rehabilitation factor score (MRFS). Multiple regression analysis was used to identify and compare the factors associated with functional recovery in each age group. Results Functional recovery in the ≥ 85 years group was lower than that in other age groups. Factors associated with activities of daily living (ADL) status (FIM at discharge) in the ≥ 85 years group were premorbid dependence (β = -0.183, p = 0.011), motor paralysis (β = -0.238, p = 0.001), and cognitive function (β = 0.586, p age increased. Factors associated with ADL recovery rates (MRFS) in the ≥ 85 years group were non-paretic limb function (β = -0.294, p = 0.004) and cognitive function (β = 0.201, p = 0.047). Conclusions This study identified the factors associated with functional recovery among very elderly stroke patients. Effective forms of rehabilitation for very elderly stroke patients that take these factors into consideration need to be investigated.

  13. Positive and Negative Perfectionism in Migrainus Patients Compaired with Control Group

    Directory of Open Access Journals (Sweden)

    H Afshar

    2008-01-01

    Full Text Available ABSTRACT: Introduction & Objective: The positive and negative effects of perfectionism on human cognition, affection and behavior have been emphasized. Perfectionism has been conceptualized as a multidimensional construct, with both adaptive and maladaptive aspects, which is one of the common personality traits that cause lifelong stress in human and results in anxiety, depression and physical and mental distress.The aim of this study was to assess the positive and negative perfectionism in migrainus patients in comparison with control group. Materials & Methods: This is an analytical (Case-control study which was performed on 91 migraine patients and 88 healthy individuals. The pqtients and controls completed a standard 40 item questionnaire for perfectionism – PANPS (20 for positive and 20 for negative perfectionism . The patients in both groups were matched for gender and age. Mean of positive and negative perfectionism scores for two groups was statistically analysed using SPSS software. Results: Mean positive perfectionism score was 83.47±8.5 for migraine group and 65.47±7.54 for control group (p=0.0001. The difference between two groups was significant. Mean of negative perfectionism score was 74.12±10.6 for migraine group and 51.79±7.8 for control group(p=0.0001. Conclusion: The results show that migraine patients have higher mean of perfectionism scores than healthy individuals. Based on this study and other clinical experiences more attention to psychotherapy is necessary for better management of migraine and recognition of personality profile in migraine patient helps to reduce patient’s complaints.

  14. Bitcoin Meets Strong Consistency

    OpenAIRE

    Decker, Christian; Seidel, Jochen; Wattenhofer, Roger

    2014-01-01

    The Bitcoin system only provides eventual consistency. For everyday life, the time to confirm a Bitcoin transaction is prohibitively slow. In this paper we propose a new system, built on the Bitcoin blockchain, which enables strong consistency. Our system, PeerCensus, acts as a certification authority, manages peer identities in a peer-to-peer network, and ultimately enhances Bitcoin and similar systems with strong consistency. Our extensive analysis shows that PeerCensus is in a secure state...

  15. Trial of a "credit card" asthma self-management plan in a high-risk group of patients with asthma.

    Science.gov (United States)

    D'Souza, W; Burgess, C; Ayson, M; Crane, J; Pearce, N; Beasley, R

    1996-05-01

    The "credit card" asthma self-management plan provides the adult asthmatic patient with simple guidelines for the self-management of asthma, which are based on the self-assessment of peak expiratory flow rate recordings and symptoms. The study was a trial of the clinical efficacy of the credit card plan in a high-risk group of asthmatic patients. In this "before-and-after" trial, patients discharged from the emergency department of Wellington Hospital, after treatment for severe asthma were invited to attend a series of hospital outpatient clinics at which the credit card plan was introduced. Questionnaires were used to compare markers of asthma morbidity, requirement for emergency medical care, and medication use during the 6-month period before and after intervention with the credit card plan. Of the 30 patients with asthma who attended the first outpatient clinic, 26 (17 women and 9 men) completed the program. In these 26 participants, there was a reduction in both morbidity and requirement for acute medical services: specifically, the proportion waking with asthma more than once a week decreased from 65% to 23% (p = 0.005) and the proportion visiting the emergency department for treatment of severe asthma decreased from 58% to 15% (p = 0.004). The patients attending the clinics commented favorably on the plan, in particular on its usefulness as an educational tool for monitoring and treating their asthma. Although the interpretation of this study is limited by the lack of a randomized control group, the findings are consistent with other evidence that the credit card asthma self-management plan can be an effective and acceptable system for improving asthma care in a high-risk group of adult patients with asthma.

  16. Use of the scoliosis research society outcomes instrument to evaluate patient outcome in untreated idiopathic scoliosis patients in Japan: part I: comparison with nonscoliosis group: preliminary/limited review in a Japanese population.

    Science.gov (United States)

    Watanabe, Kei; Hasegawa, Kazuhiro; Hirano, Toru; Uchiyama, Seiji; Endo, Naoto

    2005-05-15

    This preliminary study evaluates untreated Japanese patients with idiopathic scoliosis using the Scoliosis Research Society Outcomes Instrument (SRS-24). To determine the baseline patient outcome score using the SRS-24 for untreated Japanese scoliosis patients compared with a nonscoliosis group. The SRS instrument with 24 questions was developed to help evaluate patient-perceived outcomes of idiopathic scoliosis treatment. Evaluation of untreated Japanese idiopathic scoliosis patients using the SRS instrument has not been reported. Japanese idiopathic scoliosis patients (n = 141) (mean age, 13.6 years; range, 10-17 years) with a Cobb angle of more than 20 degrees who were not treated with a brace or surgery, were evaluated in comparison with a nonscoliosis group (healthy junior high school students; n = 72) using the SRS-24. The scoliosis group was categorized as mild deformity group with a major curve Cobb angle of less than 30 degrees, moderate deformity group with 30 degrees to 49 degrees, and severe deformity group with more than 50 degrees. The patients were evaluated using section 1 (15 questions) of the SRS-24, which was divided into four domains: total pain, general self-image, general function, and activity. Reliability, as determined by internal consistency, was validated using Cronbach's alpha for these domain scales. The severe deformity group had the lowest scores compared with the other deformity groups and the nonscoliosis group in pain (P self-image (P self-image of back appearance, were significantly lower in the scoliosis group than those in the nonscoliosis group. This tendency was more significant in the patients with greater curve magnitude. Scores for questions 14 and 15, evaluation of general self-image, in the scoliosis group were, however, higher than those in the nonscoliosis group. Internal consistency using Cronbach's alpha was 0.57 (pain), 0.27 (general self-image), -0.08 (general function), and 0.15 (overall level of activity

  17. Consistent classical supergravity theories

    International Nuclear Information System (INIS)

    Muller, M.

    1989-01-01

    This book offers a presentation of both conformal and Poincare supergravity. The consistent four-dimensional supergravity theories are classified. The formulae needed for further modelling are included

  18. Importance of hemodialysis-related outcomes: comparison of ratings by a self-help group, clinicians, and health technology assessment authors with those by a large reference group of patients

    Directory of Open Access Journals (Sweden)

    Janssen IM

    2016-12-01

    Full Text Available Inger M Janssen,1 Fueloep Scheibler,2 Ansgar Gerhardus3,4 1Department of Epidemiology and International Public Health, University of Bielefeld, Bielefeld, 2Department of Non-Drug Interventions, Institute for Quality and Efficiency in Health Care, Cologne, 3Department for Health Services Research, Institute for Public Health and Nursing Research, University of Bremen, 4Health Sciences Bremen, University of Bremen, Bremen, Germany Background: The selection of important outcomes is a crucial decision for clinical research and health technology assessment (HTA, and there is ongoing debate about which stakeholders should be involved. Hemodialysis is a complex treatment for chronic kidney disease (CKD and affects many outcomes. Apart from obvious outcomes, such as mortality, morbidity and health-related quality of life (HRQoL, others such as, concerning daily living or health care provision, may also be important. The aim of our study was to analyze to what extent the preferences for patient-relevant outcomes differed between various stakeholders. We compared preferences of stakeholders normally or occasionally involved in outcome prioritization (patients from a self-help group, clinicians and HTA authors with those of a large reference group of patients. Participants and methods: The reference group consisted of 4,518 CKD patients investigated previously. We additionally recruited CKD patients via a regional self-help group, nephrologists via an online search and HTA authors via an expert database or personal contacts. All groups assessed the relative importance of the 23 outcomes by means of a discrete visual analog scale. We used descriptive statistics to rank outcomes and compare the results between groups. Results: We received completed questionnaires from 49 self-help group patients, 19 nephrologists and 18 HTA authors. Only the following 3 outcomes were ranked within the top 7 outcomes by all 4 groups: safety, HRQoL and emotional state. The

  19. Risk and benefit of dual antiplatelet treatment among nonrevascularized myocardial infarction patients in different age groups

    DEFF Research Database (Denmark)

    Juul, Nikolai; Gislason, Gunnar; Olesen, Jonas Bjerring

    2017-01-01

    revascularization. METHODS: Patients admitted with first-time myocardial infarction in 2002-2010, not undergoing revascularization, were identified from nationwide Danish registers. Dual anti-platelet treatment use was assessed by claimed prescriptions. Stratified into age groups, risk of bleeding, all.......63; 95% CI 1.17-2.26), 60-69 years (HR=1.22; 95% CI 0.97-1.59, NS), 70-79 years (HR=1.42; 95% CI 1.17-1.72) and >79 years (HR=1.46; 95% CI 1.22-1.74). Similar tendencies in all four age groups were found in the propensity-matched population. CONCLUSION: Dual anti-platelet treatment use was less likely...... among elderly patients although similar effects regarding both risk and benefit were found in all age groups. Increased focus on initiating dual anti-platelet treatment in elderly, non-invasively treated myocardial infarction patients is warranted....

  20. Dually diagnosed patients' benefits of mutual-help groups and the role of social anxiety.

    Science.gov (United States)

    Timko, Christine; Cronkite, Ruth C; McKellar, John; Zemore, Sarah; Moos, Rudolf H

    2013-02-01

    There is debate about whether dually diagnosed patients benefit from mutual-help groups (MHGs), partly because social anxiety may make participation problematic. We examined dually diagnosed patients' participation in MHGs and outcomes at 6, 12, and 24 months post-treatment, and the extent to which social anxiety was associated with participation. We also examined whether MHG participation and social anxiety were related to outcomes, and whether social anxiety moderated associations between participation and outcomes. We found high rates of MHG participation. Among patients who attended at least one meeting, outcomes were positive. Social anxiety was not associated with levels of MHG participation, but more participation was associated with better outcomes. When social anxiety moderated associations between MHG participation and outcomes, patients with more social anxiety benefited more from participation. Treated dually diagnosed patients participate in, and benefit from, MHGs, and participation and benefits are comparable, or even strengthened, among more socially-anxious patients. Published by Elsevier Inc.

  1. The Comparative Study of ECG Findings in the Patients Suffered from Subarachnoid Hemorrhage and Control Group in Northeastern Iran

    Directory of Open Access Journals (Sweden)

    Karim Nikkhah

    2015-04-01

    Full Text Available Introduction: Subarachnoid Hemorrhage (SAH which accounts for (5% to 10% of cerebrovascular accidents is an important cause of mortality and disability. It can be complicated by many neurological and medical conditions including cardiovascular complications. During the course of SAH morphologic Electrocardiography (ECG changes, arrhythmias, myocardial injury and elevation of cardiac enzymes, subendocardial hemorrhage and necrosis may be observed. Materials and Methods:102 SAH patients, without any history of Ischemic heart Disease (IHD, admitted in Ghaem Hospital were studied. Their clinical and radiological parameters were evaluated. Three serial ECGs were performed within the first 72 hours for each patient and the ECG findings were analyzed. The control group consisted of 102 elective patients of Ghaem hospital without any expected heart disease. Results: ECG changes were observed in 60.8% of SAH patients with average age of (53.4±14.2 years and in (2.9% of control group. The ECG findings were as follows: chamber abnormalities (6.9%, conduction abnormalities (7.8%, repolarization abnormalities (49%, rhythm abnormalities (22.5% and pathologic Q wave (6.9%. According to this study, ECG changes are related to subarachnoid hemorrhage (p

  2. Multiplicative surrogate standard deviation: a group metric for the glycemic variability of individual hospitalized patients.

    Science.gov (United States)

    Braithwaite, Susan S; Umpierrez, Guillermo E; Chase, J Geoffrey

    2013-09-01

    Group metrics are described to quantify blood glucose (BG) variability of hospitalized patients. The "multiplicative surrogate standard deviation" (MSSD) is the reverse-transformed group mean of the standard deviations (SDs) of the logarithmically transformed BG data set of each patient. The "geometric group mean" (GGM) is the reverse-transformed group mean of the means of the logarithmically transformed BG data set of each patient. Before reverse transformation is performed, the mean of means and mean of SDs each has its own SD, which becomes a multiplicative standard deviation (MSD) after reverse transformation. Statistical predictions and comparisons of parametric or nonparametric tests remain valid after reverse transformation. A subset of a previously published BG data set of 20 critically ill patients from the first 72 h of treatment under the SPRINT protocol was transformed logarithmically. After rank ordering according to the SD of the logarithmically transformed BG data of each patient, the cohort was divided into two equal groups, those having lower or higher variability. For the entire cohort, the GGM was 106 (÷/× 1.07) mg/dl, and MSSD was 1.24 (÷/× 1.07). For the subgroups having lower and higher variability, respectively, the GGM did not differ, 104 (÷/× 1.07) versus 109 (÷/× 1.07) mg/dl, but the MSSD differed, 1.17 (÷/× 1.03) versus 1.31 (÷/× 1.05), p = .00004. By using the MSSD with its MSD, groups can be characterized and compared according to glycemic variability of individual patient members. © 2013 Diabetes Technology Society.

  3. Consistency of orthodox gravity

    Energy Technology Data Exchange (ETDEWEB)

    Bellucci, S. [INFN, Frascati (Italy). Laboratori Nazionali di Frascati; Shiekh, A. [International Centre for Theoretical Physics, Trieste (Italy)

    1997-01-01

    A recent proposal for quantizing gravity is investigated for self consistency. The existence of a fixed-point all-order solution is found, corresponding to a consistent quantum gravity. A criterion to unify couplings is suggested, by invoking an application of their argument to more complex systems.

  4. Quasiparticles and thermodynamical consistency

    International Nuclear Information System (INIS)

    Shanenko, A.A.; Biro, T.S.; Toneev, V.D.

    2003-01-01

    A brief and simple introduction into the problem of the thermodynamical consistency is given. The thermodynamical consistency relations, which should be taken into account under constructing a quasiparticle model, are found in a general manner from the finite-temperature extension of the Hellmann-Feynman theorem. Restrictions following from these relations are illustrated by simple physical examples. (author)

  5. Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

    Energy Technology Data Exchange (ETDEWEB)

    Kriz, Jan; Reinartz, Gabriele [Department of Radiation Oncology, University of Münster, Münster (Germany); Dietlein, Markus; Kobe, Carsten; Kuhnert, Georg [Department of Nuclear Medicine, University of Cologne, Cologne (Germany); Haverkamp, Heinz [First Department of Internal Medicine, University of Cologne, Cologne (Germany); Haverkamp, Uwe [Department of Radiation Oncology, University of Münster, Münster (Germany); Engenhart-Cabillic, Rita [Department of Radiation Oncology, University of Marburg, Marburg (Germany); Herfarth, Klaus [Department of Radiation Oncology, University Heidelberg, Heidelberg (Germany); Lukas, Peter [Department of Radiation Oncology, University of Innsbruck, Innsbruck (Austria); Schmidberger, Heinz [Department of Radiation Oncology, University of Mainz, Mainz (Germany); Staar, Susanne [Department of Radiation Oncology, Klinikum Bremen-Mitte, Bremen (Germany); Hegerfeld, Kira [Department of Radiation Oncology, University of Münster, Münster (Germany); Baues, Christian [Department of Radiation Oncology, University of Cologne, Cologne (Germany); Engert, Andreas [First Department of Internal Medicine, University of Cologne, Cologne (Germany); Eich, Hans Theodor, E-mail: hans.eich@ukmuenster.de [Department of Radiation Oncology, University of Münster, Münster (Germany)

    2015-05-01

    Purpose: To determine, in the setting of advanced-stage of Hodgkin lymphoma (HL), whether relapses occur in the irradiated planning target volume and whether the definition of local radiation therapy (RT) used by the German Hodgkin Study Group (GHSG) is adequate, because there is no harmonization of field and volume definitions among the large cooperative groups in the treatment of advanced-stage HL. Methods and Materials: All patients with residual disease of ≥2.5 cm after multiagent chemotherapy (CTX) were evaluated using additional positron emission tomography (PET), and those with a PET-positive result were irradiated with 30 Gy to the site of residual disease. We re-evaluated all sites of disease before and after CTX, as well as the PET-positive residual tumor that was treated in all relapsed patients. Documentation of radiation therapy (RT), treatment planning procedures, and portal images were carefully analyzed and compared with the centrally recommended RT prescription. The irradiated sites were compared with sites of relapse using follow-up computed tomography scans. Results: A total of 2126 patients were enrolled, and 225 patients (11%) received RT. Radiation therapy documents of 152 irradiated patients (68%) were analyzed, with 28 irradiated patients (11%) relapsing subsequently. Eleven patients (39%) had an in-field relapse, 7 patients (25%) relapsed outside the irradiated volume, and an additional 10 patients (36%) showed mixed in- and out-field relapses. Of 123 patients, 20 (16%) with adequately performed RT relapsed, compared with 7 of 29 patients (24%) with inadequate RT. Conclusions: The frequency and pattern of relapses suggest that local RT to PET-positive residual disease is sufficient for patients in advanced-stage HL. Insufficient safety margins of local RT may contribute to in-field relapses.

  6. Self-reported differences in empowerment between lurkers and posters in online patient support groups.

    Science.gov (United States)

    van Uden-Kraan, Cornelia F; Drossaert, Constance H C; Taal, Erik; Seydel, Erwin R; van de Laar, Mart A F J

    2008-06-30

    Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have focused on the members of these groups who actively contribute by sending postings (posters). Thus far, little is known about the impact for "lurkers" (ie, those who do not actively participate by sending postings). In the present study, we explored if lurkers in online patient support groups profit to the same extent as posters do. We searched the Internet with the search engine Google to identify all Dutch online support groups for patients with breast cancer, fibromyalgia, and arthritis. Invitations to complete an online survey were sent out by the owners of 19 groups. In the online questionnaire, we asked questions about demographic and health characteristics, use of and satisfaction with the online support group, empowering processes, and empowering outcomes. The online questionnaire was completed by 528 individuals, of which 109 (21%) identified themselves as lurkers. Lurkers (mean age 47 years) were slightly older than active participants (mean age 43 years, P = .002), had a shorter disease history (time since diagnosis 3.7 years vs 5.4 years, P = .001), and reported lower mental well-being (SF 12 subscore 37.7 vs 40.5, P = .004). No significant differences were found in other demographic variables. Posters indicated visiting the online support groups significantly more often for social reasons, such as curiosity about how other members were doing, to enjoy themselves, as a part of their daily routine (all P posters did not differ in their information-related reasons for visiting the online support group. Lurkers were significantly less satisfied with the online support group compared to posters (P posters. However, lurkers did not differ significantly from posters with regard to

  7. [Frequency of NAFLD in a group of patients with metabolic syndrome in Veracruz, Mexico].

    Science.gov (United States)

    Roesch-Dietlen, Federico; Dorantes-Cuéllar, Alicia; Carrillo-Toledo, Maria Graciela; Martínez-Sibaja, Cristina; Rojas-Carrera, Sonia; Bonilla-Rojas, Q C Sashenka; Uchino-Higueras, Virginia; Lagunas, Teresa; Carrasco-Arróniz, Miguel Angel; Soler-Leal, Bertha; León-Valdivieso, Johnatan; Cid-Juárez, Silvia; Martínez, José Angel

    2006-01-01

    Nonalcoholic fatty liver disease is a very common disease that is being described principally in obese, diabetic and hiperlipidemic patients without significant alcohol consumption (less than 28 ethanol Units per week). Nowadays it is considered as the hepatic manifestation of the metabolic syndrome. The frequency of Non Alcoholic Sreatohepatic (NASH) is 30 to 35% in general population, but it reaches to 70% in patients whose Body Mass Index (BMI) is above 30 kg/m2 as it occurs with diabetic patients. In Mexico there are only isolated reports about it's frequency, nearly 7.1% in general population and 18.5% in diabetic patients. To know the frequency of the Nonalcoholic fatty liver disease in patients who receive medical attention at the city of Veracruz. We studied 337 patients, who were divided into 4 groups: Normal Weight, Overweight, Obese and Diabetes type 2 patients. The individuals who reported previous hepatitis and alcohol consumption were excluded. All patients made a test in order to determinate: age, gender, presence of hepatic stigmata and complaints. Laboratory tests were done to all patients including: Blood glucose, seric lipids, transaminases, proteins and alkaline phosphatase. In those cases with impairment in transaminases results, it was done upper abdominal ultrasound (USG) and hepatic biopsy, in patients who accepted. We identified 53 cases (15.72%) with characteristics of Nonalcoholic fatty liver disease. The frequency in patient with normal weight and overweight was 7.14% to 7.76%, while in obese subjects it was 14.15% and 28% in diabetic patients; 73.58% of all patients were female and the other 28.41% were males. The average age of the group was 48.11 years, it was similar the specific age of the normal weight and obese patients, in overweight patients was 61.5 years and the average age in diabetics was 56.42 years. There were significant differences in the results of blood glucose level, glycosilated hemoglobin, cholesterol, seric lipid

  8. Health of women: associations among life events, social support, and personality for selected patient groups.

    Science.gov (United States)

    Norlander, T; Dahlin, A; Archer, T

    2000-02-01

    This study examined the effects of life events, social support, personality traits, and siblings' birth-order on the health of women. 199 middle-class participants were included. 95 women, randomly assigned from four different patient groups, were compared with a control group of 96 randomly selected women without any special health problems. They completed a questionnaire which included questions regarding family background, health, different life events, social support, and signs of disease and a projective test, the Sivik Psychosomatism Test. Analysis indicated that report of negative life events was associated with more physical symptoms than positive life events and that the patient groups reported more negative life events and less social support than the control group.

  9. Hand hygiene compliance in transplant and other special patient groups: an observational study.

    Science.gov (United States)

    Graf, Karolin; Ott, Ella; Wolny, Michael; Tramp, Nadine; Vonberg, Ralf-Peter; Haverich, Axel; Chaberny, Iris Freya

    2013-06-01

    This study evaluates hand hygiene behavior of health care workers in a German university hospital stratified for treatment of special patient groups (eg, transplant patients). From 2008 to 2010, comprehensive education and training of all health care workers was implemented to improve hand hygiene compliance. Consumption rates of alcohol-based hand rub and gloves were collected and evaluated. Of the 5,647 opportunities of hand disinfection evaluated, 1,607 occurred during care for transplant patients. To our knowledge, this is the largest survey of hand hygiene compliance in special patient groups on intensive care units in a university hospital in Germany. Health care workers on surgical intensive care units showed lower hand hygiene compliance compared with health care workers on other types of intensive care units. Compliance toward hand hygiene was significantly higher on hemato-oncologic and pediatric wards. In general, hand disinfection was performed significantly more frequently after an intervention than before (P hand hygiene compliance when caring for transplant patients or other patients (odds ratio, 1.16; 95% confidence interval: 0.95-1.42). Nurse's and physician's hand hygiene compliance improved because of education. Hand hygiene compliance is not increased in the care for transplant patients (despite their predisposition for nosocomial infections) compared with other patients. Additional studies will be necessary to further investigate these findings. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Exploring change in a group-based psychological intervention for multiple sclerosis patients.

    Science.gov (United States)

    Borghi, Martina; Bonino, Silvia; Graziano, Federica; Calandri, Emanuela

    2018-07-01

    The study is focused on a group-based cognitive behavioral intervention aimed at promoting the quality of life and psychological well-being of multiple sclerosis patients. The study investigates how the group intervention promoted change among participants and fostered their adjustment to the illness. The intervention involved six groups of patients (a total of 41 patients) and included four consecutive sessions and a 6-month follow-up. To explore change, verbatim transcripts of the intervention sessions were analyzed using a mixed-methods content analysis with qualitative data combined with descriptive statistics. The categories of resistance and openness to change were used to describe the process of change. Resistance and openness to change coexisted during the intervention. Only in the first session did resistance prevail over openness to change; thereafter, openness to change gradually increased and stabilized over time, and openness to change was then always stronger than resistance. The study builds on previous research on the effectiveness of group-based psychological interventions for multiple sclerosis patients and gives methodological and clinical suggestions to health care professionals working with multiple sclerosis patients. Implications for rehabilitation The study suggests that a group-based cognitive behavioral intervention for multiple sclerosis patients focused on the promotion of identity redefinition, a sense of coherence and self-efficacy in dealing with multiple sclerosis fosters the process of change and may be effective in promoting patients' adjustment to their illness. Health care professionals leading group-based psychological interventions for multiple sclerosis patients should be aware that resistance and openness to change coexist in the process of change. The study suggests that the duration of the intervention is a crucial factor: a minimum of three sessions appears to be necessary for group participants to develop greater openness

  11. Emotional Intelligence in a Group of Patients with First-Episode Psychosis in Iran

    Directory of Open Access Journals (Sweden)

    Hamid Reza Pooretemad

    2012-02-01

    Full Text Available This study was aimed to evaluate the Emotional Intelligence (EI of a group of patients with first episode psychosis in Iran as compared with a healthy control group. A case-control design was used. EI was assessed using Persian version of Bar-On Emotional Quotient inventory (EQ-i administered on 25 patients with history of a single psychotic episode in the last two years, as well as 64 healthy participants. The mean (±SD of EI scores of patients and healthy controls group was 319.8 (±40.9 and 328.8 (±33.3, respectively. Two-independent sample t-test revealed no significant difference in the EI scores of two groups (P=0.29. In contrast with chronic schizophrenia, the patients with first-episode psychosis were not different from the healthy subjects in terms of emotional intelligence score. It might be implied that the low emotional intelligence of the patients with chronic psychotic disorders is an accumulative result of the underlying disease over time.

  12. Effect of Cognitive-behavioral Group Therapy on Anxiety and Depression Hemodialysis Patients in Kashan, Iran

    OpenAIRE

    Ahmadvand A.; Saie R.; Sepehrmanesh Z.; Ghanbari A.R.

    2012-01-01

    Background and Objectives: Hemodialysis as a treatment manner in chronic renal failure is a stressful process and has several various psycho-cognitive and social complications. The present study evaluated effect of cognitive-behavioral group therapy on anxiety and depression in hemodialysis patients. Methods: This research was a clinical trial study. Samples were young adults who were 18-45 years old. The Participants were divided into two groups (case & control). The Beck depression & anxiet...

  13. Sociomedical sequels and quality of life in patients of old age group with proximal femoral fractures

    Directory of Open Access Journals (Sweden)

    T. A. Raskina

    2014-01-01

    Full Text Available The sociomedical significance of osteoporosis is determined by its sequels (vertebral and peripheral skeletal fractures that are responsible for high mortality and disability rates among persons in the old age group and accordingly for high material costs in the health care system.Objective: to study sociomedical sequels and quality of life in patients with proximal femoral fractures in the old age group.Subjects and methods. 956 patients with osteoporotic fractures were followed up. Major social sequels were traced in the patients 6, 12, and 24 months after femur fractures in relation to treatment options.Results. There were 10 (8.0% and 78 (66.7% bedridden patients in the surgical and medical treatment groups, respectively. Twenty four months after fracture, recovery of function was noted in 72 (57.6% and 32 (27.35% patients receiving surgical and medical treatment, respectively.Conclusion. The findings suggest that immediate and late sequels in patients with proximal femoral fractures depend on a treatment option.

  14. Group supervision for healthcare professionals within primary care for patients with psychosomatic health problems: a pilot intervention study.

    Science.gov (United States)

    Bullington, Jennifer; Cronqvist, Agneta

    2018-03-01

    In primary health care, efficacious treatment strategies are lacking for these patients, although the most prominent symptoms accounting for consultation in primary care often cannot be related to any biological causes. The aim was to explore whether group supervision from a specific phenomenological theory of psychosomatics could provide healthcare professionals treating patients with psychosomatic health issues within primary care a deeper understanding of these conditions and stimulate profession-specific treatment strategies. Our research questions were as follows: (i) What is the healthcare professionals' understanding of psychosomatics before and after the intervention? (ii) What are the treatment strategies for this group of patients before and after the intervention? The study was an explorative qualitative intervention pilot study. The six participants from a primary healthcare setting in a medium-sized city in Sweden participated in the study. A supervision group was formed, based on a mix of professions, age, gender and years of clinical experience. Supervision consisted of one 75-minutes meeting every month during the course of 6 months. Participants were interviewed before and after the supervision intervention. The study showed two distinct categories emerged from the data. One category of healthcare professionals espoused a psycho-educative approach, while the other lacked a cohesive approach. The supervision improved the second category of healthcare professionals' understanding of psychosomatics. The psycho-educative group did not change their understanding of psychosomatics, although they felt strengthened in their approach by the supervision. Profession-specific strategies were not developed. This pilot study indicates that a relatively short supervision intervention can aid clinicians in their clinical encounters with these patients; however, further research is necessary to ascertain the value of the specific phenomenologically based

  15. Effectiveness of Gestalt Group Therapy on Loneliness of Women Caregivers of Alzheimer Patients at Home

    Directory of Open Access Journals (Sweden)

    Hemn Saadati

    2014-12-01

    Full Text Available Objectives: Loneliness is a common experience of people, regardless of gender, age, socio economic and cultural experience in the course of its life. The aim of this study was to examine the effectiveness of Gestalt group therapy on the loneliness of Alzheimer’s caregivers. Methods: In an experimental study with a pre-post test design and control group, women participants were selected from Alzheimer Association of Iran. Total number of 50 women members was evaluated according to inclusion/ exclusion criteria. 28 participants selected and were divided into two equal groups randomly. Loneliness Scale was administered to both groups at the beginning. Gestalt therapy sessions were applied to the intervention group, each session 90 minutes weekly and continued for 12 successive weeks. The post-test data collected after the last session by administering Loneliness Scale. Data was analyzed by using t-test for independent group. Results: The results showed that the mean differences between the two groups were significant and gestalt therapy decreased the loneliness of member of intervention group significantly. Loneliness scores of intervention group in two sub-scales were also significantly lower in post-test compared to control group. Discussion: Gestalt therapy can be helpful in enhancing positive emotions and decreasing loneliness in Alzheimer caregivers which is one of the hardest emotions that these women threatens reduced and the introduction of enhanced quality of life of the caregivers and hence increase the quality of care for patients increased.

  16. Comparison in anesthetic effects of propofol among patients with different ABO blood groups.

    Science.gov (United States)

    Du, Yiri; Shi, Haixia; Yu, Jianshe

    2017-05-01

    Our study was aimed to investigate anesthetic effects of propofol in patients with different blood groups.A total of 72 participants were enrolled from patients arranged for surgeries of cholecystectomy, tonsillectomy, and spinal operation. Each blood group (A, B, AB, and O) contained 18 participants. Mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) were assayed with Philips monitor. These indexes were observed before propofol anesthesia (T0), and then were recorded when concentration of propofol was 1 μg/mL (T1), 2 μg/mL (T2), 3 μg/mL (T3), and 4 μg/mL (T4). The differences in MAP, HR, and BIS at T0 among groups were compared with the χ test. Multiple comparisons were adopted to calculate the differences in MAP, HR, and BIS between groups at T1, T2, T3, and T4.No significant differences in age, sex, and weight of all groups were found (P > .05). Before propofol anesthesia (T0), all the participants exhibited no differences in MAP, HR, and BIS (P > .05). Subsequently, we found obvious differences in ΔMAP, ΔHR, and ΔBIS between groups. The patients in the B blood group showed highest ΔMAP and ΔHR at each time point (P blood group exhibited highest value at T3 and T4 (P blood group remarkably affects the anesthetic effects of propofol.

  17. Should we assess clinical performance in single patient encounters or consistent behaviors of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles

    NARCIS (Netherlands)

    Oerlemans, M.; Dielissen, P.W.; Timmerman, A.; Ram, P.; Maiburg, B.; Muris, J.; Vleuten, C. van der

    2017-01-01

    BACKGROUND: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors' perceptions of behavioral

  18. The role of group education on quality of life in patients with a stoma.

    Science.gov (United States)

    Altuntas, Y E; Kement, M; Gezen, C; Eker, H H; Aydin, H; Sahin, F; Okkabaz, N; Oncel, M

    2012-11-01

    Stoma education has been traditionally given in a one-to-one setting. Since 2007, daily group education programmes were organised for stoma patients and their relatives by our stoma therapy unit. The programmes included lectures on stoma and stoma care, and social activities in which patients shared their experiences with each other. Patients were also encouraged to expand interaction with each other and organise future social events. A total of 72 patients [44 (61.1%) male with a mean (± SD) age of 56.8 ± 13.6 years] with an ileostomy (n= 51, 70.8%), a colostomy (n= 18, 25.0%) or a urostomy (n= 3, 4.2%) were included in the study. Patients were asked to answer a survey (SF-36) face-to-face before the initiation of the programme, which was repeated 3 months later via telephone call. The comparison of pre-education and post-education SF-36 scores revealed a statistically significant improvement in all 8-scale profiles, but not in vitality scale, and both psychometrically-based and mental health summary measures. Analyses disclosed that married patients and those who were living at rural districts seem to have the most improvement in life quality particularly in bodily pain, general health and role-emotional scales and mental health summary measure. In our opinion, group educations may be beneficial for stoma patients, and stoma therapy units may consider organising similar activities. © 2012 Blackwell Publishing Ltd.

  19. [Nutritional support and parenteral nutrition in the oncological patient: an expert group consensus report].

    Science.gov (United States)

    Camblor-Álvarez, Miguel; Ocón-Bretón, María Julia; Luengo-Pérez, Luis Miguel; Viruzuela, Juan Antonio; Sendrós-Maroño, María José; Cervera-Peris, Mercedes; Grande, Enrique; Álvarez-Hernández, Julia; Jiménez-Fonseca, Paula

    2018-01-10

    Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. To analyze and respond to different issues related to the nutritional management of cancer patients in the clinical setting. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition developed a list of topics related to the nutritional status of cancer patients, which were grouped into three blocks: Nutritional support; Parenteral nutrition (PN); and Home PN (HPN) in cancer patients. A literature search, which included articles published in Spanish, English, and French until February 2017, was carried out. The document was organized as a questionnaire with those questions that, according to the panel's criteria, could generate greater controversy or doubt. Of the 18 questions addressed, 9 focused on nutritional support: 5 were related to PN and 4 about HPN. Among the different recommendations, the panel emphasized that in the cancer patient, PN is indicated mainly when it is not possible to use the digestive tract and/or oral feeding and/or enteral nutrition is not sufficient or possible. Additionally, the objective of the HPN is to improve or maintain the nutritional status of a patient at home. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer Patients.

  20. Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Bo Kyung Sohn

    2018-03-01

    Full Text Available Background : Many patients with end-stage renal disease (ESRD undergoing hemodialysis (HD experience depression. Depression influences patient quality of life (QOL, dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers. Methods : We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF, the Beck Depression Inventory II (BDI-II, the Hamilton Rating Scale for Depression (HAM-D, the Beck Anxiety Inventory (BAI, and the Perceived Stress Scale (PSS. Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT. Results : The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period. Conclusion : In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.

  1. Detection of rare blood group, Bombay (Oh) phenotype patients and management by acute normovolemic hemodilution.

    Science.gov (United States)

    Shrivastava, Manisha; Navaid, Seema; Peethambarakshan, A; Agrawal, Kalpana; Khan, Athar

    2015-01-01

    Due to lack of correct blood grouping practices, the rare Bombay Oh phenotype may be missed, subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients needing immediate surgery is a challenge. This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH) in a hospital from central India. Blood grouping of patients and blood donors with a standard tube method was carried out and samples identified as rare Bombay phenotype were confirmed by saliva inhibition test. Surgical management of cases needing transfusion was done by ANH, as per the British Committee for Standards in Hematology guidelines. The incidence of Bombay phenotype was 0.002% or 1 in 51,924 in the study. Amongst three cases (patients) identified as Bombay phenotype, one was Bombay Oh, Rh negative. Two cases were missed in the first instance and one case actually did not require transfusion. In the absence of a blood donor registry for Bombay phenotype, the cases needing transfusion were successfully managed with ANH in the operation theatre. A simple test like blood grouping should be done with serious intention with incorporation of both forward and reverse grouping, so that no patient receives wrong blood leading to fatal hemolysis due to transfusion. ANH is a cost-effective transfusion option for suitable patients. Appropriate clinical decision making, use of strategies to decrease peri-operative blood losses and cost-effective country based planning could be more widely applied to improve clinical transfusion practice.

  2. Detection of rare blood group, Bombay (Oh phenotype patients and management by acute normovolemic hemodilution

    Directory of Open Access Journals (Sweden)

    Manisha Shrivastava

    2015-01-01

    Full Text Available Background: Due to lack of correct blood grouping practices, the rare Bombay Oh phenotype may be missed, subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients needing immediate surgery is a challenge. This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH in a hospital from central India. Materials and Methods: Blood grouping of patients and blood donors with a standard tube method was carried out and samples identified as rare Bombay phenotype were confirmed by saliva inhibition test. Surgical management of cases needing transfusion was done by ANH, as per the British Committee for Standards in Hematology guidelines. Results: The incidence of Bombay phenotype was 0.002% or 1 in 51,924 in the study. Amongst three cases (patients identified as Bombay phenotype, one was Bombay Oh, Rh negative. Two cases were missed in the first instance and one case actually did not require transfusion. In the absence of a blood donor registry for Bombay phenotype, the cases needing transfusion were successfully managed with ANH in the operation theatre. Conclusion: A simple test like blood grouping should be done with serious intention with incorporation of both forward and reverse grouping, so that no patient receives wrong blood leading to fatal hemolysis due to transfusion. ANH is a cost-effective transfusion option for suitable patients. Appropriate clinical decision making, use of strategies to decrease peri-operative blood losses and cost-effective country based planning could be more widely applied to improve clinical transfusion practice.

  3. Focus Groups in Elderly Ophthalmologic Patients: Setting the Stage for Quantitative Preference Elicitation.

    Science.gov (United States)

    Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Stock, Stephanie

    2016-02-01

    Patients suffering from age-related macular degeneration (AMD) are rarely actively involved in decision-making, despite facing preference-sensitive treatment decisions. This paper presents a qualitative study to prepare quantitative preference elicitation in AMD patients. The aims of this study were (1) to gain familiarity with and learn about the special requirements of the AMD patient population for quantitative data collection; and (2) to select/refine patient-relevant treatment attributes and levels, and gain insights into preference structures. Semi-structured focus group interviews were performed. An interview guide including preselected categories in the form of seven potentially patient-relevant treatment attributes was followed. To identify the most patient-relevant treatment attributes, a ranking exercise was performed. Deductive content analyses were done by two independent reviewers for each attribute to derive subcategories (potential levels of attributes) and depict preference trends. The focus group interviews included 21 patients. The interviews revealed that quantitative preference surveys in this population will have to be interviewer assisted to make the survey feasible for patients. The five most patient-relevant attributes were the effect on visual function [ranking score (RS): 139], injection frequency (RS: 101), approval status (RS: 83), side effects (RS: 79), and monitoring frequency (RS: 76). Attribute and level refinement was based on patients' statements. Preference trends and dependencies between attributes informed the quantitative instrument design. This study suggests that qualitative research is a very helpful step to prepare the design and administration of quantitative preference elicitation instruments. It especially facilitated familiarization with the target population and its preferences, and it supported attribute/level refinement.

  4. Clinical and genetic characteristics in a group of 45 patients with Turner syndrome (monocentric study).

    Science.gov (United States)

    Bucerzan, Simona; Miclea, Diana; Popp, Radu; Alkhzouz, Camelia; Lazea, Cecilia; Pop, Ioan Victor; Grigorescu-Sido, Paula

    2017-01-01

    Recent years have seen a shift in perspective on Turner syndrome, as it is no longer considered a significant disability due to therapeutic advances. The delay of diagnosis and the underdiagnosis are common in Turner syndrome, especially because of the great phenotypic variability and lack of firm diagnostic criteria. Our first aim was to assess the clinical and the cytogenetic characteristics and growth rate in growth hormone (GH)-treated patients as compared to those with spontaneous growth. The second aim was to analyze the Y chromosomal sequences. We analyzed 45 patients diagnosed with Turner syndrome in Genetic Pathology Centre of Cluj Emergency Children's Hospital. We carried out a study of the clinical features, the correlations between the karyotype and the phenotype, and we also made a research of Y chromosome sequences. The average age at diagnosis was 8.9±5.4 years. A significant association was observed between the number of external phenotypical abnormalities and internal malformations ( r =0.45), particularly the cardiovascular ones ( r =0.44). Patients treated with GH showed improvement in growth rate, with final stature significantly better than in untreated patients; benefits following treatment were greater if diagnosis was made before the age of 5 years. Thirteen percent of patients experienced spontaneous and complete puberty, whereas 30% experienced incomplete puberty. Patients with the 45,X genotype had a greater stature deficit and a higher incidence of cardiac malformations, compared with patients with 45,X/46,XX mosaic karyotype. Y chromosome sequences were found in only one patient, who subsequently underwent gonadectomy. The importance of this study resides, to the best of our knowledge, in the fact that the largest group of patients in Romania was analyzed and assessed. To draw firm conclusions on the most valuable clinical indicators for Turner syndrome diagnosis in clinical practice, studies on large groups of patients should be

  5. The group matters: an explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment.

    Science.gov (United States)

    Midtgaard, J; Rorth, M; Stelter, R; Adamsen, L

    2006-03-01

    A series of studies have shown that physical activity improves cancer patients functional capacity and quality of life (QOL). Few of these studies have included physical exercise carried out in a group setting. However, patient's experience with the in-group processes remains unexplored. This study investigated group cohesion and changes in QOL in 55 cancer patients undergoing chemotherapy who participated in a 9 h weekly group exercise programme for 6 weeks. The study used a method triangulation component design. Seven qualitative group interviews were conducted post-intervention. QOL (SF-36; EORTC QLQ-C30) was assessed at baseline and after Week 6. The interviews revealed that group cohesion was an interim goal aimed to maximize peak performance potential by patients. Group cohesion was characterized by a special 'esprit de corps' and enabled the group members to feel like sport teams. The programme made purposeful togetherness possible while allowing the patients an opportunity to let their illness fade into the background. Questionnaire data showed significant improvements in mental health, social and emotional functioning. This study identified a conceptualization of group cohesion that forms a valuable basis for a larger randomized controlled trial to conclude whether the observed changes are a result of this specific intervention.

  6. Extensive Validation of the Pain Disability Index in 3 Groups of Patients With Musculoskeletal Pain

    NARCIS (Netherlands)

    Soer, Remko; Koke, Albere J. A.; Vroomen, C.A.J.; Stegeman, Patrick; Smeets, Rob J. E. M.; Coppes, Maarten H.; Reneman, Michiel F.

    2013-01-01

    Study Design. A cross-sectional study design was performed. Objective. To validate the pain disability index (PDI) extensively in 3 groups of patients with musculoskeletal pain. Summary of Background Data. The PDI is a widely used and studied instrument for disability related to various pain

  7. Adjustment to cancer: exploring patients' experiences of participating in a psychodramatic group intervention.

    Science.gov (United States)

    Menichetti, J; Giusti, L; Fossati, I; Vegni, E

    2016-09-01

    The main purpose of the present study was to understand the subjective experience of patients adjusting to cancer by focusing on how that experience might be affected by participating in a psychodramatic group intervention. In-depth interviews using an interpretative-phenomenological approach were conducted with eight cancer patients involved in a psychodrama group. Four key themes were identified: (1) outside and inside relationships; (2) identities: nurturing other selves; (3) a feelings' gym: performing the internal world; and (4) many ends: mourning death and dying. Participation in cancer group using a psychodramatic approach provided positive results. In detail, the group setting: (1) favoured relationships in which it was possible to freely express oneself and (2) empowered patients in their feelings of being able to give and receive help; the psychodramatic approach: (1) supported the physical mobilisation of sense of agency and (2) permitted to deal with the grieving process. Cancer healthcare pathways would benefit from psychotherapeutic programmes using a similar approach, since psychodrama by actively involving body seems to works on areas that are often underwhelmed by other approaches, such as (i.e., physical mobilisation, body engagement, grieving adjustment). Psychodrama supports patients to achieve insights into their own possibilities to actively participate in their own life situations despite having cancer and undergoing treatment for it. © 2015 John Wiley & Sons Ltd.

  8. SPORTS GROUPS FOR CARDIAC PATIENTS IN THE NETHERLANDS AND IN GERMANY

    NARCIS (Netherlands)

    SCHAPERCLAUS, GA; DEGREEF, MHG; RISPENS, P; MONNICH, J; OUDHOF, JH

    A comparative pilot study of the structure, participants, and effects of Dutch versus German sports groups for cardiac patients (SCP) was made by the Department of Human Movement Sciences of the University of Groningen. A questionnaire was handed out to 10 SCP in the Netherlands and also to 5 German

  9. Characterization of geometrical random uncertainty distribution for a group of patients in radiotherapy

    International Nuclear Information System (INIS)

    Munoz Montplet, C.; Jurado Bruggeman, D.

    2010-01-01

    Geometrical random uncertainty in radiotherapy is usually characterized by a unique value in each group of patients. We propose a novel approach based on a statistically accurate characterization of the uncertainty distribution, thus reducing the risk of obtaining potentially unsafe results in CTV-PTV margins or in the selection of correction protocols.

  10. Participation in sports groups for patients with cardiac problems : An experimental study

    NARCIS (Netherlands)

    Schaperclaus, G; deGreef, M; Rispens, P; deCalonne, D; Landsman, M; Lie, KI; Oudhof, J

    1997-01-01

    An experimental study was carried out to determine the influence of participation in Sports Groups for Patients with Cardiac Problems (SPCP) on physical and mental fitness and on risk factor level after myocardial infarction. SPCP members (n = 74; 67 men and 7 women) were compared with Nonsporting

  11. The association of ABO blood groups with extent of coronary atherosclerosis in Croatian patients suffering from chronic coronary artery disease.

    Science.gov (United States)

    Karabuva, Svjetlana; Carević, Vedran; Radić, Mislav; Fabijanić, Damir

    2013-01-01

    The aim of study was to: 1) examine the relationship between ABO blood groups and extent of coronary atherosclerosis in patients with chronic coronary artery disease (CAD), 2) compare ABO blood groups distribution in CAD patients and general population, 3) examine possible differences in traditional risk factors frequency in CAD patients with different ABO blood groups. In the 646 chronic CAD patients (72.4% males) coronary angiograms were scored by quantitative assessment using multiple angiographic scoring system, Traditional risk factors were self reported or measured by standard methods. ABO blood distribution of patients was compared with group of 651 healthy blood donors (74.6% males). Among all ABO blood group patients there was no significant difference between the extent of coronary atherosclerosis with regard to all the three scoring systems: number of affected coronary arteries (P = 0.857), Gensini score (P = 0.818), and number of segments narrowed > 50% (P = 0.781). There was no significant difference in ABO blood group distribution between CAD patients and healthy blood donors. Among CAD patients, men with blood group AB were significantly younger than their pairs with non-AB blood groups (P = 0.008). Among CAD patients with AB blood group, males groups (P = 0.003). No association between ABO blood groups and the extent of coronary atherosclerosis in Croatian CAD patients is observed. Observation that AB blood group might possibly identify Croatian males at risk to develop the premature CAD has to be tested in larger cohort of patients.

  12. Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.

    Science.gov (United States)

    Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael

    2012-01-01

    Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.

  13. The group matters: an explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment

    DEFF Research Database (Denmark)

    Klausen, Julie Midtgaard; Rørth, Mikael Rahbek; Stelter, Reinhard

    2006-01-01

    . The programme made purposeful togetherness possible while allowing the patients an opportunity to let their illness fade into the background. Questionnaire data showed significant improvements in mental health, social and emotional functioning. This study identified a conceptualization of group cohesion......A series of studies have shown that physical activity improves cancer patients functional capacity and quality of life (QOL). Few of these studies have included physical exercise carried out in a group setting. However, patient's experience with the in-group processes remains unexplored. This study...

  14. Relation between ABO blood groups and Helicobacter pylori infection in symptomatic patients

    Directory of Open Access Journals (Sweden)

    Jaff MS

    2011-09-01

    Full Text Available Mohamad Salih Jaff Pathology Department, College of Medicine, Hawler Medical University (formerly Salahuddin University, Erbil, Kurdistan Region, Iraq Abstract: Epidemiological studies have demonstrated higher frequencies of the O blood group and the nonsecretor phenotype of ABH antigens among patients suffering from peptic ulcers. Since Helicobacter pylori has been established as the main etiological factor in this disease, controversies about the associations of the ABO and Lewis blood group phenotypes and secretor and nonsecretor phenotypes in relation to susceptibility towards infection by this bacillus have been presented. The aim of this study was to verify the frequencies of ABO and Rhesus (Rh blood groups in H. pylori seropositive symptomatic patients. The study included (n = 1108 patients with dyspepsia symptoms referred from an outpatient clinic in Erbil city for investigation. Age, sex, and residency were recorded as a routine laboratory framework. Patients underwent SD Bioline (Standard Diagnostics Inc, Kyonggi-do, South Korea and enzyme-linked immunosorbent assay serologic tests for H. pylori. ABO blood group phenotypes were determined by a standard hemagglutination test. Results showed that 64.8% of patients (n = 718/1108 were seropositive for H. pylori infection, and (35.2% (n = 390/1108 were seronegative. Of the seropositive patients, 40.8% (n = 293/718 were male and 59.2% (n = 425/718 were female; while of the seronegative patients, 46.7% (n = 182/390 were male and 53.3% (n = 208/390 were female. The mean age for seropositives and seronegatives was (38.0 ± 14.6 years and (37.6 ± 15.7 years respectively. The frequency of the ABO and Rh-positive (Rh+ blood groups among seropositive patients was (A = 32.0%, B = 19.5%, AB = 6.7%, O = 41.8%, and Rh+ = 92.5% and was (A = 32.3%, B = 28.2%, AB = 8.0%, O = 31.5%, and Rh+ = 92.5% in seronegatives. The results of this study suggest that ABO blood groups, age, and gender influence

  15. The effect of Varenicline on smoking cessation in a group of young asthma patients

    DEFF Research Database (Denmark)

    Westergaard, Christian G; Porsbjerg, Celeste; Backer, Vibeke

    2015-01-01

    BACKGROUND: Tobacco use causes long-term morbidity and mortality. In patients with asthma, the frequency of smokers is high; however, asthmatic smokers experience more pronounced symptoms, accelerated loss of lung function and treatment resistance. Varenicline is an effective drug in smoking...... cessation, when investigated in COPD patients and general populations. The aim of the present study was to evaluate the effect of Varenicline on tobacco cessation in young asthmatics. METHODS: In a randomized, placebo-controlled, double-blinded trial, 52 asthmatic current smokers (age 19-40) ≥ 10 cigarettes....... RESULTS: In the Varenicline group, at week 12, 69% of the patients quit smoking vs. 36% in the placebo group (p = 0.017, intended-to-treat analysis), but after 24 weeks, a high relapse rate was present (quit rates 19% vs. 16%, NS). After 6 weeks of treatment, significant improvements in airway...

  16. Preliminary Effectiveness and Sustainability of Group Aerobic Exercise Program in Patients with Schizophrenia.

    Science.gov (United States)

    Yoon, Sol; Ryu, Je-Kwang; Kim, Chan-Hyung; Chang, Jhin-Goo; Lee, Hwa-Bock; Kim, Do-Hoon; Roh, Daeyoung

    2016-09-01

    The objective of this study was to examine the feasibility and sustained effect of a group aerobic exercise program in patients with schizophrenia. Twenty-four schizophrenic patients participated in a group-based individually tailored 90-minute outdoor cycling session per week for 3 months with intervention to enhance motivation. Physical health was evaluated by anthropometric measures, cardiorespiratory (CR) fitness, and blood tests. Mental health was assessed on self-esteem, interpersonal relationship, quality of life, and global function. Attrition rate for the exercise program was 8.3%. Exercise program significantly increased participant's self-esteem, positive relationship, global function, and quality of life. CR fitness significantly improved after 3 months. At the 9-month follow-up, 6 months after program completion, only in interpersonal relationship change the improved effects were maintained. These findings support the feasibility of group aerobic exercise program with high level of adherence and its long-term benefits in positive relationship change.

  17. Evaluation the consistency of location of moist desquamation and skin high dose area for breast cancer patients receiving adjuvant radiotherapy after breast conservative surgery

    International Nuclear Information System (INIS)

    Sun, Li-Min; Huang, Eng-Yen; Liang, Ji-An; Meng, Fan-Yun; Chang, Gia-Hsin; Tsao, Min-Jen

    2013-01-01

    To evaluate whether the location of moist desquamation matches high dose area for breast cancer patients receiving adjuvant radiotherapy (RT) after breast conservative surgery. One hundred and nine breast cancer patients were enrolled to this study. Their highest skin dose area (the hot spot) was estimated from the treatment planning. We divided the irradiated field into breast; sternal/parasternal; axillary; and inframammary fold areas. The location for moist desquamation was recorded to see if it matches the hot spot. We also analyzed other possible risk factors which may be related to the moist desquamation. Forty-eight patients with 65 locations developed moist desquamation during the RT course. Patients with larger breast sizes and easy to sweat are two independent risk factors for moist desquamation. The distribution of moist desquamation occurred most in the axillary area. All nine patients with the hot spots located at the axillary area developed moist desquamation at the axillary area, and six out of seven patients with the hot spots located at the inframammary fold developed moist desquamation there. The majority of patients with moist desquamation over the breast or sternal/parasternal areas had the hot spots located at these areas. For a patient with moist desquamation, if a hot spot is located at the axillary or inframammary fold areas, it is very likely to have moist desquamation occur there. On the other hand, if moist desquamation occurs over the breast or sternal/parasternal areas, we can highly expect these two areas are also the hot spot locations

  18. Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group

    Directory of Open Access Journals (Sweden)

    Roberto Gallego-Pinazo

    2014-12-01

    Full Text Available Purpose: This study was designed to evaluate the visual and anatomical outcomes after cataract surgery in diabetic patients with different intraoperative therapeutic strategies. Methods: The research design comprised of a multicentric, retrospective, interventional study conducted at 6 centers in Argentina, Brazil, Costa Rica, Puerto Rico, Spain, and Venezuela. We included 138 diabetic patients with at least 6-month follow-up following phacoemulsification and intraocular lens implantation. Best-corrected visual acuity (BCVA and central subfield thickness were collected at baseline and at 1-, 2-, 3-, and 6-month follow-up. Of these, 42 cases were not treated with any intraoperative coadjuvant medication (Group 1, 59 patients received intraoperative bevacizumab (Group 2 and 37 patients received intraoperative triamcinolone (4 mg/0.1 ml (Group 3. Results: The mean logMAR [± standard deviation (SD] BCVA improved from 0.82 (± 0.43 at baseline, to 0.14 (± 0.23 at 6-month follow-up (p<0.001 in Group 1; from 0.80 (± 0.48 to 0.54 (± 0.45 (p<0.001 in Group 2; and from 1.0 (± 0.40 to 0.46 (± 0.34 (p<0.001 in Group 3. The mean central subfield thickness increased from 263.57 µm (± 35.7 at baseline to 274.57 µm (± 48.7 at 6-month follow-up (p=0.088 in Group 1; from 316.02 µm (± 100.4 to 339.56 µm (± 145.3 (p=0.184 in Group 2; and from 259.18 µm (± 97.9 to 282.21 µm (± 87.24 (p=0.044 in Group 3. Conclusion: Diabetic patients may significantly benefit from cataract surgery. This study provides evidence to support the use of intravitreal triamcinolone or bevacizumab at the time of cataract surgery in cases with pre-existent diabetic macular edema or moderate-severe non-proliferative diabetic retinopathy.

  19. Carbapenem Breakpoints for Acinetobacter baumannii Group: Supporting Clinical Outcome Data from Patients with Bacteremia.

    Science.gov (United States)

    Lee, Yi-Tzu; Chiang, Mei-Chun; Kuo, Shu-Chen; Wang, Yung-Chih; Lee, I-Hsin; Chen, Te-Li; Yang, Ya-Sung

    2016-01-01

    The carbapenem breakpoints set by different organizations for Acinetobacter are discordant, but supporting clinical data are lacking. This study aimed to provide the first clinical outcome data to support the carbapenem breakpoints for Acinetobacter baumannii (Ab) group in patients with bacteremia. This study included 117 adults who received carbapenems for treatment of Ab group bacteremia in Taipei Veterans General Hospital over an 8-year period. We analyzed 30-day mortality rates among patient groups acquiring isolates with different carbapenem minimal inhibitory concentrations (MICs). The carbapenem MIC breakpoint derived from classification and regression tree (CART) analysis to delineate the risk of 30-day mortality was between MICs of ≤ 4 mg/L and ≥ 8 mg/L. Mortality rate was higher in patients acquiring isolates with carbapenem MIC ≥ 8 mg/L than ≤ 4 mg/L, by bivariate (54.9% [28/51] vs 25.8% [17/66]; P = 0.003) and survival analysis (P = 0.001 by log-rank test). Multivariate analysis using logistic regression and Cox regression models including severity of illness indices demonstrated that treating patients with Ab group bacteremia caused by isolates with a carbapenem MIC ≥ 8 mg/L with carbapenem was an independent predictor of 30-day mortality (odds ratio, 5.125; 95% confidence interval [CI], 1.946-13.498; P = 0.001, and hazard ratio, 2.630; 95% CI, 1.431-4.834; P = 0.002, respectively). The clinical outcome data confirmed that isolates with MIC ≤ 4 mg/L were susceptible to carbapenem, and those with MIC ≥ 8 mg/L were resistant in patients with Ab group bacteremia.

  20. Patients with xeroderma pigmentosum complementation groups C, E and V do not have abnormal sunburn reactions.

    Science.gov (United States)

    Sethi, M; Lehmann, A R; Fawcett, H; Stefanini, M; Jaspers, N; Mullard, K; Turner, S; Robson, A; McGibbon, D; Sarkany, R; Fassihi, H

    2013-12-01

    Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is divided into eight complementation groups: XP-A to XP-G (classical XP) and XP variant (XP-V). Severe and prolonged sunburn reactions on minimal sun exposure have been considered a cardinal feature of classical XP. However, it has recently become clear that not all patients have abnormal sunburn reactions. To examine sunburn reactions in a cohort of patients with XP and correlate this to the complementation group. Sixty patients with XP attending the U.K. National XP Service from 2010 to 2012 were studied. Their history of burning after minimal sun exposure was assessed using a newly developed sunburn severity score. The age at which the first skin cancer was histologically diagnosed in each patient, and the presence of any neurological abnormality, was also recorded. Sunburn severity scores were abnormally high in patients with XP-A, XP-D, XP-F and XP-G compared with non-XP controls. There was no significant difference in sunburn score of patients with XP-C, XP-E and XP-V compared with controls (P > 0·05). Patients with XP-C, XP-E and XP-V were more likely to have skin cancer diagnosed at an earlier age than those with severe sunburn on minimal sun exposure. In addition, patients with XP with severe sunburn had an increased frequency of neurological abnormalities. Not all patients with XP have a history of severe and prolonged sunburn on minimal sun exposure. The normal sunburn response of patients with XP-C, XP-E and XP-V may relate to the preservation of transcription-coupled DNA repair in these groups. Those with a history of severe sunburn on minimal sun exposure developed their first skin cancer at an older age compared with patients with XP-C, XP-E and XP-V, but they had an increased frequency of neurological abnormalities. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. © 2013 British Association of

  1. Cost-utility of a specific collaborative group intervention for patients with functional somatic syndromes.

    Science.gov (United States)

    Konnopka, Alexander; König, Hans-Helmut; Kaufmann, Claudia; Egger, Nina; Wild, Beate; Szecsenyi, Joachim; Herzog, Wolfgang; Schellberg, Dieter; Schaefert, Rainer

    2016-11-01

    Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline. Costs were assessed via questionnaire. Quality adjusted life years (QALYs) were calculated using the SF-6D index, derived from the 36-item short-form health survey (SF-36). We calculated patients' net-monetary-benefit (NMB), estimated the treatment effect via regression, and generated cost-effectiveness acceptability curves. Using intention-to-treat analysis, total costs during the 12-month study period were 5777EUR in the intervention, and 6858EUR in the control group. Controlling for possible confounders, we found a small, but significant positive intervention effect on QALYs (+0.017; p=0.019) and an insignificant cost saving resulting from a cost-increase in the control group (-10.5%; p=0.278). NMB regression showed that the probability of CGI to be cost-effective was 69% for a willingness to pay (WTP) of 0EUR/QALY, increased to 92% for a WTP of 50,000EUR/QALY and reached the level of 95% at a WTP of 70,375EUR/QALY. Subgroup analyses yielded that CGI was only cost-effective in severe somatic symptom severity (PHQ-15≥15). CGI has a high probability to be a cost-effective treatment for FSS, in particular for patients with severe somatic symptom severity. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Group climate in the voice therapy of patients with Parkinson's Disease.

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    Diaféria, Giovana; Madazio, Glaucya; Pacheco, Claudia; Takaki, Patricia Barbarini; Behlau, Mara

    2017-09-04

    To verify the impact that group dynamics and coaching strategies have on the PD patients voice, speech and communication, as well as the group climate. 16 individuals with mild to moderate dysarthria due to the PD were divided into two groups: the CG (8 patients), submitted to traditional therapy with 12 regular therapy sessions plus 4 additional support sessions; and the EG (8 patients), submitted to traditional therapy with 12 regular therapy sessions plus 4 sessions with group dynamics and coaching strategies. The Living with Dysarthria questionnaire (LwD), the self-evaluation of voice, speech and communication, and the perceptual-auditory analysis of the vocal quality were assess in 3 moments: pre-traditional therapy (pre); post-traditional therapy (post 1); and post support sessions/coaching strategies (post 2); in post 1 and post 2 moments, the Group Climate Questionnaire (GCQ) was also applied. CG and EG showed an improvement in the LwD from pre to post 1 and post 2 moments. Voice self-evaluation was better for the EG - when pre was compared with post 2 and when post 1 was compared with post 2 - ranging from regular to very good; both groups presented improvement in the communication self-evaluation. The perceptual-auditory evaluation of the vocal quality was better for the EG in the post 1 moment. No difference was found for the GCQ; however, the EG presented lower avoidance scores in post 2. All patients showed improvement in the voice, speech and communication self-evaluation; EG showed lower avoidance scores, creating a more collaborative and propitious environment for speech therapy.

  3. Self-help group and the quality of life of patients with multiple sclerosis - Pilot study

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    Anna Eliášová

    2015-12-01

    Full Text Available Aim: The goal of the pilot study was to compare the quality of life of patients with multiple sclerosis in the Presov region with or without the support of a self-help group. Design: The character of this pilot study on patients with MS was related to the use of self-help groups and their impact on the assessment of the quality of life of the respondents, with the help of a questionnaire (WHOQOL-BREF. Methods: The research was carried out in the Prešov region with the help of the standardized WHOQOL-BREF questionnaire. Ninety-one patients with MS participated in the pilot study (46 respondents attended a self-help group and 35 did not. Results: The groups, when compared, aided by the statistically evaluated WHOQOL-BREF domains, were found to show significant differences in their evaluation of quality of life in three domains: domain one: physical health; domain two: surviving; domain three: social relations. Better scores were achieved in these domains by those who attended a group. In the physical sphere, we noticed significant differences in sleep quality, and sexual satisfaction (p < 0.001, while in social and economic areas, there were significant differences in satisfaction with personal relationships (p < 0.001, and economic circumstances (p < 0.01, self-contentment (p < 0.01, and coping with negative feelings (p < 0.05. Conclusion: Patients with multiple sclerosis can live normal lives provided they are supported by their families, friends, health care professionals, and self-help groups.

  4. Clinical course teaching in transport of critically ill patients: Small group methods

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    Mohammad Taghi Beigmohammadi

    2016-10-01

    Full Text Available Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160 and other group the lecture base learning (n=160. In the clinical course, each participant under observation of an anesthesiologist in the operation room and ICU was acquainted with mask ventilation, intubation and learned to work with a defibrillator, infusion pump, portable ventilator and pulse oximeter. In lecture group, the anesthesiologist explained the topics by video and dummy. At the end of education course, the interns’ abilities were evaluated based on checklist method and scored by the project colleague in all educational items. Three hundred twenty interns, 122 males, and 198 females; were enrolled, two groups. The clinical course training caused improvements in the interns’ knowledge and abilities in intubation and use of the defibrillator and portable ventilator vs.lecture group significantly (P<0.005. The males were better than females in laryngoscopy, but the progress of the females was significantly better than males (P=0.003. The rate of adverse events was reduced significantly after clinical course teaching (P=0.041 Clinical course teaching could promote interns' clinical competencies in the transport of critically ill patients.

  5. Circadian Rhythms of Oxidative Stress Markers and Melatonin Metabolite in Patients with Xeroderma Pigmentosum Group A.

    Science.gov (United States)

    Miyata, Rie; Tanuma, Naoyuki; Sakuma, Hiroshi; Hayashi, Masaharu

    2016-01-01

    Xeroderma pigmentosum group A (XPA) is a genetic disorder in DNA nucleotide excision repair (NER) with severe neurological disorders, in which oxidative stress and disturbed melatonin metabolism may be involved. Herein we confirmed the diurnal variation of melatonin metabolites, oxidative stress markers, and antioxidant power in urine of patients with XPA and age-matched controls, using enzyme-linked immunosorbent assay (ELISA). The peak of 6-sulfatoxymelatonin, a metabolite of melatonin, was seen at 6:00 in both the XPA patients and controls, though the peak value is lower, specifically in the younger age group of XPA patients. The older XPA patients demonstrated an increase in the urinary levels of 8-hydroxy-2'-deoxyguanosine and hexanoyl-lysine, a marker of oxidative DNA damage and lipid peroxidation, having a robust peak at 6:00 and 18:00, respectively. In addition, the urinary level of total antioxidant power was decreased in the older XPA patients. Recently, it is speculated that oxidative stress and antioxidant properties may have a diurnal variation, and the circadian rhythm is likely to influence the NER itself. We believe that the administration of melatonin has the possibility of ameliorating the augmented oxidative stress in neurodegeneration, especially in the older XPA patients, modulating the melatonin metabolism and the circadian rhythm.

  6. Circadian Rhythms of Oxidative Stress Markers and Melatonin Metabolite in Patients with Xeroderma Pigmentosum Group A

    Directory of Open Access Journals (Sweden)

    Rie Miyata

    2016-01-01

    Full Text Available Xeroderma pigmentosum group A (XPA is a genetic disorder in DNA nucleotide excision repair (NER with severe neurological disorders, in which oxidative stress and disturbed melatonin metabolism may be involved. Herein we confirmed the diurnal variation of melatonin metabolites, oxidative stress markers, and antioxidant power in urine of patients with XPA and age-matched controls, using enzyme-linked immunosorbent assay (ELISA. The peak of 6-sulfatoxymelatonin, a metabolite of melatonin, was seen at 6:00 in both the XPA patients and controls, though the peak value is lower, specifically in the younger age group of XPA patients. The older XPA patients demonstrated an increase in the urinary levels of 8-hydroxy-2′-deoxyguanosine and hexanoyl-lysine, a marker of oxidative DNA damage and lipid peroxidation, having a robust peak at 6:00 and 18:00, respectively. In addition, the urinary level of total antioxidant power was decreased in the older XPA patients. Recently, it is speculated that oxidative stress and antioxidant properties may have a diurnal variation, and the circadian rhythm is likely to influence the NER itself. We believe that the administration of melatonin has the possibility of ameliorating the augmented oxidative stress in neurodegeneration, especially in the older XPA patients, modulating the melatonin metabolism and the circadian rhythm.

  7. Impaired Recognition of Facially Expressed Emotions in Different Groups of Patients with Sleep Disorders.

    Science.gov (United States)

    Crönlein, Tatjana; Langguth, Berthold; Eichhammer, Peter; Busch, Volker

    2016-01-01

    Recently it has been shown that acute sleep loss has a direct impact on emotional processing in healthy individuals. Here we studied the effect of chronically disturbed sleep on emotional processing by investigating two samples of patients with sleep disorders. 25 patients with psychophysiologic insomnia (23 women and 2 men, mean age: 51.6 SD; 10.9 years), 19 patients with sleep apnea syndrome (4 women and 15 men, mean age: 51.9; SD 11.1) and a control sample of 24 subjects with normal sleep (15 women and 9 men, mean age 45.3; SD 8.8) completed a Facial Expressed Emotion Labelling (FEEL) task, requiring participants to categorize and rate the intensity of six emotional expression categories: anger, anxiety, fear, happiness, disgust and sadness. Differences in FEEL score and its subscales among the three samples were analysed using ANOVA with gender as a covariate. Both patients with psychophysiologic insomnia and patients with sleep apnea showed significantly lower performance in the FEEL test as compared to the control group. Differences were seen in the scales happiness and sadness. Patient groups did not differ from each other. By demonstrating that previously known effects of acute sleep deprivation on emotional processing can be extended to persons experiencing chronically disturbed sleep, our data contribute to a deeper understanding of the relationship between sleep loss and emotions.

  8. Impaired Recognition of Facially Expressed Emotions in Different Groups of Patients with Sleep Disorders.

    Directory of Open Access Journals (Sweden)

    Tatjana Crönlein

    Full Text Available Recently it has been shown that acute sleep loss has a direct impact on emotional processing in healthy individuals. Here we studied the effect of chronically disturbed sleep on emotional processing by investigating two samples of patients with sleep disorders.25 patients with psychophysiologic insomnia (23 women and 2 men, mean age: 51.6 SD; 10.9 years, 19 patients with sleep apnea syndrome (4 women and 15 men, mean age: 51.9; SD 11.1 and a control sample of 24 subjects with normal sleep (15 women and 9 men, mean age 45.3; SD 8.8 completed a Facial Expressed Emotion Labelling (FEEL task, requiring participants to categorize and rate the intensity of six emotional expression categories: anger, anxiety, fear, happiness, disgust and sadness. Differences in FEEL score and its subscales among the three samples were analysed using ANOVA with gender as a covariate.Both patients with psychophysiologic insomnia and patients with sleep apnea showed significantly lower performance in the FEEL test as compared to the control group. Differences were seen in the scales happiness and sadness. Patient groups did not differ from each other.By demonstrating that previously known effects of acute sleep deprivation on emotional processing can be extended to persons experiencing chronically disturbed sleep, our data contribute to a deeper understanding of the relationship between sleep loss and emotions.

  9. Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion.

    Science.gov (United States)

    Murrihy, Rachael C; Byrne, Mitchell K; Gonsalvez, Craig J

    2009-02-01

    Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training.

  10. The influence of individual, group, and relative self-esteem on outcome for patients undergoing group cognitive-behavioural therapy treatment.

    Science.gov (United States)

    Parker, Thomas J; Page, Andrew C; Hooke, Geoff R

    2013-11-01

    Despite a strong association between individual self-esteem and treatment outcome in group cognitive-behavioural therapy (GCBT), no study has investigated how patient outcomes might be influenced by an individual's self-esteem relative to other group members. The study comprised a retrospective examination of patients' data and used a multiple regression analysis to identify predictors of treatment outcome. Patients' pre-treatment self-esteem scores were assessed on a continuum and assigned to be low, medium, or high. Therapy groups were assigned to be either low, balanced or high self-esteem groups based on averaged self-esteem scores of participants. In this study, 3,878 patients who had completed a 10-day intensive cognitive behavioural group therapy programme at a private psychiatric facility were included in the study. The Rosenberg Self-Esteem measure was chosen to assess self-esteem. The three subscales of the Depression Anxiety Stress Scales were used as the outcome measures. Patient outcomes were influenced by pre-treatment self-esteem scores, such that higher initial self-esteem was associated with better treatment outcomes. Low group self-esteem was predictive of significantly better outcomes for depression, relative to higher self-esteem groups. Additionally, the combined influence of high individual self-esteem and low group self-esteem was associated with significantly enhanced depression improvement. High self-esteem patients perform better on outcome measures following completion of GCBT. Low self-esteem groups show greater improvement in depression symptoms. Similar results for depression are achieved when patients with high self-esteem complete treatment in low self-esteem groups. © 2013 The British Psychological Society.

  11. Attitudes towards patient gender among psychiatric hospital staff: results of a case study with focus groups.

    Science.gov (United States)

    Krumm, Silvia; Kilian, Reinhold; Becker, Thomas

    2006-03-01

    There is an increasing awareness of gender-related issues in psychiatry. However, empirical findings on attitudes of psychiatric staff towards patient gender are limited. Gender-related issues are particularly relevant in the debate about mixed versus segregated sex wards, yet while the appropriateness of mixed-sex wards is questioned in Great Britain this is not the case in Germany. To investigate attitudes of psychiatric staff towards both patient gender and mixed versus segregated sex wards, we conducted a case study using focus groups with members of professional teams. We evaluated the transition process from two single-sex wards to two mixed-sex wards in a 330-bed psychiatric hospital in a rural area in south Germany. Staff described female patients as more externally oriented, motivating of others, demanding, and even sexually aggressive. Male patients, on the other hand, were described as more quiet, modest, or lazy. Furthermore, participants described the mixing process as a positive development whereas they did not see a need for gender-separated wards in order to protect vulnerable female patients. Some gender descriptions by professionals are "reversed" in comparison with gender stereotypes supposed to be present in wider society. The perception of crossed gender norms may affect staff attitudes towards the vulnerability of female patients in psychiatric settings and the provision of single-sex wards in in-patient psychiatric care. Practical implications are discussed against the background of a high rate of female patients with sexual abuse histories.

  12. Comparison of Personality Characteristics and Coping Strategies in Patients With Multiple Sclerosis and Control Group

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    Mohammadi

    2015-09-01

    Full Text Available Background The present study aimed to investigate personality traits and coping strategies in patients with multiple sclerosis (MS who were admitted to Sina hospital compared with healthy individuals. Objectives The aim of the present study was to compare personality characteristics and coping strategies between patients with MS and healthy controls. Materials and Methods The study sample included 55 patients with MS and 57 matched healthy control individuals. The data were gathered via a demographic form, the ways of coping questionnaire, and the NEO five-factor inventory. The data were analyzed by multivariate analysis of variance (MANOVA, Pearson’s correlation coefficient, and logistic regression. Results No significant differences in personality characteristics were observed between patients and healthy controls (all P > 0.05. Only the coping strategy subscale of Distancing was significant between patients and healthy controls (P 0.05. Only the Neuroticism personality trait and the Distancing coping strategy were predictive of group membership (i.e., healthy or patient. Conclusions Our study suggests that the personality traits of patients with MS and healthy individuals are not significantly different. Patients with MS are likely to use the same coping strategies as healthy individuals, except in the subscale of Distancing.

  13. Young patients', parents', and survivors' communication preferences in paediatric oncology: Results of online focus groups

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    Kamps Willem A

    2007-11-01

    Full Text Available Abstract Background Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated communication preferences of childhood cancer patients, parents, and survivors of childhood cancer. Methods Communication preferences were examined by means of online focus groups. Seven patients (aged 8–17, 11 parents, and 18 survivors (aged 8–17 at diagnosis participated. Recruitment took place by consecutive inclusion in two Dutch university oncological wards. Questions concerned preferences regarding interpersonal relationships, information exchange and participation in decision making. Results Participants expressed detailed and multi-faceted views regarding their needs and preferences in communication in paediatric oncology. They agreed on the importance of several interpersonal and informational aspects of communication, such as honesty, support, and the need to be fully informed. Participants generally preferred a collaborative role in medical decision making. Differences in views were found regarding the desirability of the patient's presence during consultations. Patients differed in their satisfaction with their parents' role as managers of the communication. Conclusion Young patients' preferences mainly concur with current guidelines of providing them with medical information and enabling their participation in medical decision making. Still, some variation in preferences was found, which faces health care providers with the task of balancing between the sometimes conflicting preferences of young cancer patients and their parents.

  14. Patient perspectives on the impact of Crohn’s disease: results from group interviews

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    Norton BA

    2012-07-01

    Full Text Available Beth-Ann Norton,1 Rosemarie Thomas,2 Kathleen G Lomax,2 Sharon Dudley-Brown31Massachusetts General Hospital, Boston, MA, USA; 2Abbott Laboratories, Abbott Park, IL, USA; 3Johns Hopkins University, Schools of Medicine and Nursing, Baltimore, MD, USAAim: To understand the impact of Crohn’s disease (CD on various aspects of daily life from the perspective of patients living with CD. Awareness of the disease and biologic therapies, patient satisfaction and adherence, and physician (provider relationships were also assessed.Background: CD is a chronic, inflammatory, autoimmune disorder of the gastrointestinal tract that substantially impacts patients’ physical and emotional well-being. For patients eligible for biologic therapy, anti-tumor necrosis factor agents represent an important addition to the available therapies for CD.Methods: The study sample included biologic-naïve and biologic-experienced patients who had self-reported moderate to severe CD, were under the care of a specialist, and agreed to film a video diary and participate in a focus group. Data from the videos and group interviews were collected from May to June of 2009 and summarized qualitatively by grouping similar answers and quotations.Results: Of the 44 participants who submitted video diaries, 23 were biologic-experienced and 21 were biologic-naïve. Participants stated that CD caused fear and embarrassment, that they were reluctant to share the full impact of CD with family and providers, and that they relied on their provider for treatment decisions. Many participants accepted a new state of normalcy if their current medication helped their most bothersome symptoms without providing sustained remission. Participants receiving biologic therapy generally were more informed, more satisfied, and more likely to adhere to treatment regimens.Conclusion: Participants’ responses suggest a need for more patient education and more collaborative relationships between patients and

  15. Plasma homovanillic acid and treatment response in a large group of schizophrenic patients.

    Science.gov (United States)

    Chang, W H; Hwu, H G; Chen, T Y; Lin, S K; Lung, F W; Chen, H; Lin, W L; Hu, W H; Lin, H N; Chien, C P

    1993-10-01

    Plasma levels of homovanillic acid (pHVA), a metabolite of dopamine, were measured in ninety-five Chinese schizophrenic patients free of neuroleptics for at least four weeks. These patients were treated with classical antipsychotics for six weeks. Pretreatment pHVA was positively correlated with the subsequent clinical response (r = 0.408, p or = 50%, n = 47) had higher pretreatment pHVA levels than poor responders (BPRS improvement pHVA level was associated with a more consistent clinical response to the subsequent treatment. Using a pHVA level of 12 ng/ml as a demarcation point, 72% of patients (34 of 47) who had pHVA > or = 12 responded whereas 65% (31 of 48) who had pHVA levels may predict a better clinical response to antipsychotics. Based upon the pHVA findings, two hypothetical subtypes of schizophrenia are proposed.

  16. Internal consistency and factor structure of the Portuguese version of the Liebowitz Social Anxiety Scale among alcoholic patients Consistência interna e estrutura fatorial da versão em português da Escala de Ansiedade Social de Liebowitz entre pacientes alcoolistas

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    Mauro B Terra

    2006-12-01

    Full Text Available OBJECTIVE: Liebowitz Social Anxiety Scale is an instrument used to evaluate the severity of social phobia. It has been widely used in different contexts and cultures, presenting variable psychometric properties. The objective of this article is to investigate the internal consistency and the factor structure of this scale. METHOD: In a sample of 300 alcoholic patients hospitalized in 3 mental clinics in Southern Brazil, 74 of them were social phobics (24.6%. The Structured Clinical Interview for DSM-IV-Axis I Disorders - Patient Edition, a semi-structured clinical interview based on DSM-IV, was used to check for the diagnosis of social phobia. The internal consistency was measured by Cronbach's alpha. Data were subjected to a factor analysis with the principal component method of parameter estimation. Questionnaire items loading at 0.35 or above were considered in the final factor solution. RESULTS: The coefficient of internal consistency was 0.95. All items showed corrected item-total correlation coefficient above 0.15, considered the minimum requested index. The factor analysis resulted in 5 dimensions which corresponded to 52.9% of the total variance. The five factors extracted were: factor I - speaking in a group, factor II - activity in public, factor III - social interaction with unknown person, factor IV - attitude of disagreement or disapproval and factor V - social interaction in leisure activity. CONCLUSIONS: The scale proved to be reliable and structurally valid instrument for use in a population of alcoholic patients. The possibility of screening for social phobia through the use of the instrument may be helpful in identifying probable cases of the disorder among alcoholics.OBJETIVO: A Escala de Ansiedade Social de Liebowitz é um instrumento utilizado na avaliação da gravidade da fobia social. Tem sido amplamente usada em diferentes contextos e culturas, apresentando propriedades psicométricas variadas. O objetivo do artigo

  17. The trauma registry compared to All Patient Refined Diagnosis Groups (APR-DRG).

    Science.gov (United States)

    Hackworth, Jodi; Askegard-Giesmann, Johanna; Rouse, Thomas; Benneyworth, Brian

    2017-05-01

    Literature has shown there are significant differences between administrative databases and clinical registry data. Our objective was to compare the identification of trauma patients using All Patient Refined Diagnosis Related Groups (APR-DRG) as compared to the Trauma Registry and estimate the effects of those discrepancies on utilization. Admitted pediatric patients from 1/2012-12/2013 were abstracted from the trauma registry. The patients were linked to corresponding administrative data using the Pediatric Health Information System database at a single children's hospital. APR-DRGs referencing trauma were used to identify trauma patients. We compared variables related to utilization and diagnosis to determine the level of agreement between the two datasets. There were 1942 trauma registry patients and 980 administrative records identified with trauma-specific APR-DRG during the study period. Forty-two percent (816/1942) of registry records had an associated trauma-specific APR-DRG; 69% of registry patients requiring ICU care had trauma APR-DRGs; 73% of registry patients with head injuries had trauma APR-DRGs. Only 21% of registry patients requiring surgical management had associated trauma APR-DRGs, and 12.5% of simple fractures had associated trauma APR-DRGs. APR-DRGs appeared to only capture a fraction of the entire trauma population and it tends to be the more severely ill patients. As a result, the administrative data was not able to accurately answer hospital or operating room utilization as well as specific information on diagnosis categories regarding trauma patients. APR-DRG administrative data should not be used as the only data source for evaluating the needs of a trauma program. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY

    DEFF Research Database (Denmark)

    Elenius Madsen, Daniel

    2012-01-01

    Title: CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY Objectives: Orthognathic surgery involves surgical manipulation of jaw and face skeletal structure. A subgroup of patients undergoing orthognathic surgery suffers from excessive...... into account the complex interplay between coagulation factors, blood platelets and components of the fibrinolytic system. Patients undergoing orthognathic surgery were included in this prospective study, and their preoperative thrombelastographic data were collected and compared to their intraoperative blood...... predictive values. An α angleex above 67o did with 95% certainty predict a blood loss below 400 mL, and a receiver-operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.8. Conclusion: By means of the α angleex it is possible to separate orthognathic surgery patients according...

  19. Consistency in PERT problems

    OpenAIRE

    Bergantiños, Gustavo; Valencia-Toledo, Alfredo; Vidal-Puga, Juan

    2016-01-01

    The program evaluation review technique (PERT) is a tool used to schedule and coordinate activities in a complex project. In assigning the cost of a potential delay, we characterize the Shapley rule as the only rule that satisfies consistency and other desirable properties.

  20. Combined use of focalized meditation and group psychological intervention in patients with terminal chronic renal failure

    Directory of Open Access Journals (Sweden)

    Enma Taimara Cisneros Acosta

    2016-01-01

    Full Text Available Background: chronic renal failure is within the first 35 death causes in the country within the last five years.Objective: to determine the effectiveness of the combined use of the group psychological intervention with the focalized meditation (FM in the psychological rehabilitation of patients suffering from terminal chronic renal failure who underwent hemodialysis treatment in “Juan Bruno Zayas” General Hospital in Santiago de Cuba from January to June, 2014.Methods: a pre-test, post-test and control group intervention was carried out. The study sample was divided into three groups: one for the group psychological intervention (GPI, another one for the focalized meditation FM and the other one for the combined use of them both. The research process had three stages: the diagnostic phase with the use of: interview, observation, state-trait anxiety inventory (STAI, Beck Diagnostic Inventory (BDI, and coping ways questionnaire; the intervention, where treatment was imposed with six sessions of group psychological intervention to a group, eight sessions of focalized meditation to another one and the combination of them both to the other one; and the last phase, which was the post-intervention one, was carried out to evaluate the changes of the impaired adjustment and coping with emotional states, applying the same diagnostic techniques.Results: after the application of the therapeutic modalities, the results were: in the groups treated with the GPI and FM separately, the 80 % of the subjects reduced their anxiety levels; meanwhile, with the combination of the techniques, improvement was for the 100 % of the patients. The variable depression had a similar behavior. As for the coping styles: in the GPI group, 80 % of the subjects got active coping styles and the 20 % got mixed ones; in the FM group, the 40 % showed active styles, another 40 % passive styles, and 20 % got mixed ones; in the group with the combined treatment, the results were the

  1. Consistent high clinical pregnancy rates and low ovarian hyperstimulation syndrome rates in high-risk patients after GnRH agonist triggering and modified luteal support

    DEFF Research Database (Denmark)

    Iliodromiti, Stamatina; Blockeel, Christophe; Tremellen, Kelton P

    2013-01-01

    Are clinical pregnancy rates satisfactory and the incidence of OHSS low after GnRH agonist trigger and modified intensive luteal support in patients with a high risk of ovarian hyperstimulation syndrome (OHSS)?......Are clinical pregnancy rates satisfactory and the incidence of OHSS low after GnRH agonist trigger and modified intensive luteal support in patients with a high risk of ovarian hyperstimulation syndrome (OHSS)?...

  2. A Randomized Controlled Trial of a Mindfulness and Acceptance Group Therapy for Residential Substance Use Patients.

    Science.gov (United States)

    Shorey, Ryan C; Elmquist, Joanna; Gawrysiak, Michael J; Strauss, Catherine; Haynes, Ellen; Anderson, Scott; Stuart, Gregory L

    2017-09-19

    Substance use disorders are understood as a chronically relapsing condition that is difficult to treat. However, in recent years there have been promising developments in the treatment of substance use disorders, specifically with interventions based on mindfulness and acceptance and commitment therapy. Little research has examined whether these types of interventions may positively impact residential substance use treatment outcomes. Thus, in the current study we developed and examined, in a randomized controlled trial, a 4-week, eight-session, adjunctive mindfulness and acceptance group therapy for patients in residential substance use treatment. Our primary outcomes were substance use cravings, psychological flexibility, and dispositional mindfulness at treatment discharge. Patients (N = 117) from a private residential substance use facility were randomized to receive the adjunctive mindfulness and acceptance group or treatment-as-usual. Patients were assessed at treatment intake and at discharge from a 28-30-day residential program. Although treatment groups did not statistically differ at discharge on any primary outcome, small effect sizes favored the mindfulness and acceptance group on cravings and psychological flexibility. Conclusions/Importance: Continued research is needed to determine whether the addition of mindfulness and acceptance-based interventions improve outcomes long term following residential substance use treatment.

  3. Human Papillomavirus (HPV) in breast tumors: prevalence in a group of Mexican patients

    International Nuclear Information System (INIS)

    León, David Cantu de; Montiel, Delia Pérez; Nemcova, Jana; Mykyskova, Iva; Turcios, Elmer; Villavicencio, Verónica; Cetina, Lucely; Coronel, Alberto; Hes, Ondraj

    2009-01-01

    Breast cancer is one of the main health problems in developed countries, occupying first place in mortality in women. It is well-known that there are risk factors associated with breast cancer development. Nonetheless, in 50–80% of cases known risk factors have not been identified, this has generated the attempt to identify new factors related with this neoplasia as viral infections. The aim of this work is investigate the prevalence of HPV DNA in patients with breast lesions at the Instituto Nacional de Cancerologia de Mexico. Fifty-one cases of breast cancer were selected from the files of the institute and compared by age and tumor size with 43 cases of non malignant breast lesions (fibroadenoma, fibrocystic disease and phyllodes tumor). Paraffin embedded specimens were selected, HPV DNA was analyzed by polymerase chain reaction (PCR) and sequenced for different types of HPV in case of positivity for HPV-DNA. Descriptive analysis of clinical and pathological variables was performed and comparisons between positive and negative cases was done. All patients were mexican, mean age was 53.3, median age of menarche was 13 and median tumor size 9 cms. Cervicovaginal cytology was performed to all patients, 1 patient (1.9%) of cancer group had HPV and none in the other group, no cases were diagnosed with cervical dysplasia. In the group of carcinomas 36 (70.5%) were negative and 15 (29.4%) were positive to HPV-DNA, 10(66.6%) were positive for HPV 16, 3(20%) for HPV 18, two cases (13.4%) were positive for both. In the group of benign conditions all were negative to HPV-DNA. Presence of HPV in breast cancer in our group of cases is high in comparison to other authors; larger numbers of cases need to be analyzed in order to establish the exact role of this virus in the pathogenesis of breast cancer

  4. Which aspects of functioning are relevant for patients with ankylosing spondylitis: results of focus group interviews.

    Science.gov (United States)

    Boonen, Annelies; van Berkel, Monique; Cieza, Alarcos; Stucki, Gerold; van der Heijde, Désirée

    2009-11-01

    To investigate whether concepts important to patients with ankylosing spondylitis (AS) are covered by disease-specific self-report health status instruments. A qualitative focus group study was conducted with AS patients on problems in daily functioning. Group sessions with 4 to 5 patients each were organized up to the point that no new information was brought forward. Group sessions were tape-recorded, transcribed, and divided into meaning units. Concepts contained in the meaning units were extracted. Self-report instruments on health status specific for AS were identified in a literature search. Using the International Classification of Functioning, Disability and Health (ICF) as a common reference, it was determined whether the concepts identified in the focus groups were covered by the instruments. Nineteen patients participated in 4 focus group interviews. In total, 332 unique meaning units were linked to 90 second-level ICF categories, of which 25 referred to body functions, 10 to body structures, 35 to activities and participation and 30 to environmental factors. In addition, several concepts relating to personal factors were identified. Only 47 categories were also covered by one of the self-report instruments in AS. Only a minority of concepts addressed by the AS-specific questionnaires were not revealed as relevant in the interviews. Relevant aspects of the influence of AS are not covered by the classic disease-specific instruments. In particular, the influence of AS on socializing and leisure and the relevance of environmental and personal factors are not adequately assessed by available instruments.

  5. Human Papillomavirus (HPV in breast tumors: prevalence in a group of Mexican patients

    Directory of Open Access Journals (Sweden)

    Cetina Lucely

    2009-01-01

    Full Text Available Abstract Background Breast cancer is one of the main health problems in developed countries, occupying first place in mortality in women. It is well-known that there are risk factors associated with breast cancer development. Nonetheless, in 50–80% of cases known risk factors have not been identified, this has generated the attempt to identify new factors related with this neoplasia as viral infections. The aim of this work is investigate the prevalence of HPV DNA in patients with breast lesions at the Instituto Nacional de Cancerologia de Mexico. Methods Fifty-one cases of breast cancer were selected from the files of the institute and compared by age and tumor size with 43 cases of non malignant breast lesions (fibroadenoma, fibrocystic disease and phyllodes tumor. Paraffin embedded specimens were selected, HPV DNA was analyzed by polymerase chain reaction (PCR and sequenced for different types of HPV in case of positivity for HPV-DNA. Descriptive analysis of clinical and pathological variables was performed and comparisons between positive and negative cases was done. Results All patients were mexican, mean age was 53.3, median age of menarche was 13 and median tumor size 9 cms. Cervicovaginal cytology was performed to all patients, 1 patient (1.9% of cancer group had HPV and none in the other group, no cases were diagnosed with cervical dysplasia. In the group of carcinomas 36 (70.5% were negative and 15 (29.4% were positive to HPV-DNA, 10(66.6% were positive for HPV 16, 3(20% for HPV 18, two cases (13.4% were positive for both. In the group of benign conditions all were negative to HPV-DNA. Conclusion Presence of HPV in breast cancer in our group of cases is high in comparison to other authors; larger numbers of cases need to be analyzed in order to establish the exact role of this virus in the pathogenesis of breast cancer.

  6. Reduction in cardiovascular risk using a proactive multifactorial intervention is consistent among patients residing in Pacific Asian and non-Pacific Asian regions: a CRUCIAL trial subanalysis

    Directory of Open Access Journals (Sweden)

    Cho EJ

    2014-03-01

    Full Text Available Eun Joo Cho,1 Jae Hyung Kim,1 Santosh Sutradhar,2 Carla Yunis,2 Mogens Westergaard2On behalf of the CRUCIAL trial investigators1Department of Cardiology, St Paul's Hospital, The Catholic University of Korea, Seoul, Korea; 2Pfizer Inc., New York, NY, USABackground: Few trials have compared different approaches to cardiovascular disease prevention among Pacific Asian (PA populations. The Cluster Randomized Usual Care versus Caduet Investigation Assessing Long-term-risk (CRUCIAL trial demonstrated that a proactive multifactorial intervention (PMI approach (based on single-pill amlodipine/atorvastatin resulted in a greater reduction in calculated Framingham 10-year coronary heart disease (CHD risk compared with usual care (UC among hypertensive patients with additional risk factors. One-third of CRUCIAL patients resided in the PA region. The aim of this subanalysis was to compare two approaches to cardiovascular risk factor management (PMI versus UC among patients residing in PA and non-PA regions.Methods: This subanalysis of the CRUCIAL trial compared treatment-related changes in calculated CHD risk among patients residing in PA and non-PA regions. Sensitivity analyses were conducted among men and women and those with and without diabetes.Results: Overall, 448 patients (31.6% resided in the PA region and 969 patients (68.4% resided in non-PA regions. The PMI approach was more effective in reducing calculated CHD risk versus UC in both PA (−37.1% versus −3.5%; P<0.001 and non-PA regions (−31.1% versus −4.2%; P<0.001; region interaction P=0.131. PA patients had slightly greater reductions in total cholesterol compared with non-PA patients. PA patients without diabetes had slightly greater reductions in CHD risk compared with non-PA patients. Treatment effects were similar in men and women and those with diabetes.Conclusion: The PMI approach was more effective in reducing calculated Framingham 10-year CHD risk compared with UC among men and

  7. Oral health and nutritional status in a group of geriatric rehabilitation patients.

    Science.gov (United States)

    Andersson, Pia; Westergren, Albert; Karlsson, Siv; Rahm Hallberg, Ingalill; Renvert, Stefan

    2002-09-01

    The aims of this study were to evaluate the oral health status and nutritional status in a group of geriatric rehabilitation patients, and to analyse the relationship between these two parameters. Nurses at the ward performed structured assessments of oral and nutritional status using the Revised Oral Assessment Guide and the Subjective Global Assessment form in 223 newly admitted patients. Most oral health problems were found among patients who stayed longer at the hospital and were more dependent on help as compared with the healthier patients. Thirty-four per cent of the patients were either severely undernourished, at risk or suspected to be undernourished (UN). Oral health problems were more common among UN patients (p oral health problem was found on teeth or dentures (48%). Problems related to the tongue and lips were also common among UN patients (56 and 44%, respectively). Oral health status was correlated (r = 0.32) to nutritional status. Problems with swallowing had the strongest association to the nutritional status (OR 6.05; 95% CI 2.41-15.18). This study demonstrated that poor oral health status was related to undernourishment.

  8. Assessment of the etiologic factors of gingival recession in a group of patients in northwest iran.

    Science.gov (United States)

    Lafzi, Ardeshir; Abolfazli, Nader; Eskandari, Amir

    2009-01-01

    Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis. Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000). Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P teeth, existence of prosthesis, high frenal attachment, radiotherapy, systemic diseases and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05). Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR.

  9. Morcellation worsens survival outcomes in patients with undiagnosed uterine leiomyosarcomas: A retrospective MITO group study.

    Science.gov (United States)

    Raspagliesi, Francesco; Maltese, Giuseppa; Bogani, Giorgio; Fucà, Giovanni; Lepori, Stefano; De Iaco, Pierandrea; Perrone, Myriam; Scambia, Giovanni; Cormio, Gennaro; Bogliolo, Stefano; Bergamini, Alice; Bifulco, Giuseppe; Casali, Paolo Giovanni; Lorusso, Domenica

    2017-01-01

    To investigate the impact of morcellation on survival outcomes of patients affected by undiagnosed uterine sarcoma. This is a retrospective study performed in 8 referral centers of MITO group. Data of women undergoing morcellation for apparent benign uterine myomas who were ultimately diagnosed with stage I uterine sarcoma on final pathology were compared with data of women who did not undergo morcellation. Uterine sarcoma included: leiomyosarcomas (LMS), smooth muscle tumors of uncertain malignant potential (STUMP), low-grade endometrial stromal sarcomas (LG-ESS) and undifferentiated uterine sarcomas (UUS). Two-year survival outcomes were evaluated using Kaplan-Meir and Cox models. Overall 125 patients were identified: 31(24.8%), 21(16.8%) and 73(58.4%) patients had power morcellation during laparoscopy, non power morcellation during open surgery and non morcellation during open procedures, respectively. Considering patients affected by LMS, morcellation did not correlated with disease-free survival. However, patients undergoing either morcellation or power morcellation experienced a 3-fold increase risk of death in comparison to patients who had not morcellation (p=0.02). A trend towards an increase of recurrence was observed for patients undergoing morcellation for STUMP (HR 7.7, p=0.09); while no differences in survival outcomes were observed for patients with LG-ESS and UUS. Our data suggest that morcellation increase the risk of death in patients affected by undiagnosed LMS. Further prospective studies are warranted in order to assess the risk to benefit ratio of power morcellator utilization in patients with apparent benign uterine myomas. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Patient groups in art therapies: A case study of the health care field in Latvia

    Directory of Open Access Journals (Sweden)

    Vende K.

    2012-10-01

    Full Text Available The aim of the paper is to introduce the reader with an example of the arts therapies work in a children hospital in Latvia in order to describe art therapies work similarities and differences in three different specializations. Comparison will take place of patient groups in the work of art therapists in each specialization (art therapy, dance movement therapy and music therapy. The question of the research is: with which patient groups’ a specialist from a particular arts therapies specialization has worked within a year in VSIA BKUS children hospital “Gaiļezers” during the time period from 05.2009 to 05.2010?The results were gained by comparing patient groups at the age from 2,5 to 17 years in the children hospital and they showed that the art therapists and dance movement therapist most frequently were working with patients who have behaviour and emotional disorders. However music therapists are working more frequently with patients who have mental retardation.

  11. Group cognitive behavior therapy for Japanese patients with social anxiety disorder: preliminary outcomes and their predictors

    Directory of Open Access Journals (Sweden)

    Watanabe Norio

    2007-12-01

    Full Text Available Abstract Background A number of studies have provided strong evidence for the use of cognitive behavior therapy (CBT in the treatment of social anxiety disorder (SAD. However, all of the previous reports were from Europe and North America and it is unknown whether Western psychological therapies are effective for SAD in non-Western cultures. The present pilot study aimed to evaluate CBT program for SAD which was originally developed for Western patients, among Japanese patients. Methods Fifty-seven outpatients who participated in group CBT for SAD were evaluated using eight self-reported and one clinician-administered questionnaires to measure various aspects of SAD symptomatology at the beginning and at the end of the program. Pre- and post-treatment scores were compared and the magnitude of treatment effect was quantified as well based once on the intention-to-treat (ITT and once among the completers only. We also examined baseline predictors of the CBT outcomes. Results Seven patients (12% did not complete the program. For the ITT sample, the percentage of reduction was 20% to 30% and the pre to post treatment effect sizes ranged from 0.37 to 1.01. Among the completers, the respective figures were 20% to 33% and 0.41 to 1.19. We found no significant pretreatment predictor of the outcomes. Conclusion Group CBT for SAD is acceptable and can bring about a similar degree of symptom reduction among Japanese patients with SAD as among Western patients.

  12. Courtesy stigma--a focus group study of relatives of schizophrenia patients.

    Science.gov (United States)

    Angermeyer, Matthias C; Schulze, Beate; Dietrich, Sandra

    2003-10-01

    Stigmatization of people with mental illness has been investigated in numerous studies. Little research, however, has been done to explore how relatives of people with schizophrenia perceive and experience stigmatization and how they can fight such stigmatization. Aiming to explore stigma from the perspective of relatives of people with schizophrenia, focus group interviews were conducted with 122 members of advocacy groups from different parts of Germany. Focus group sessions were tape- and video-recorded and transcribed. Transcripts were coded using an inductive method, generating categories (domains) from the material. The analysis of focus group data shows that, contrary to previous research findings, discrimination and disadvantages encountered by relatives of schizophrenia patients reach far beyond the spheres of direct social interaction and access to social roles. Our study revealed two additional domains in which relatives encounter stigmatization: structural discrimination and public images of mental illness. Furthermore, psychiatry has been identified as one important source of stigma. Relatives also suggested numerous anti-stigma interventions. These can be grouped into five main categories: communication measures, support for the ill and their relatives, changes in mental health care, education and training, and control and supervision. Based on our findings,ways of how relatives of schizophrenia patients and mental health professionals can fight against stigma are discussed.

  13. Mapping of HLA- DQ haplotypes in a group of Danish patients with celiac disease

    DEFF Research Database (Denmark)

    Lund, Flemming; Hermansen, Mette N; Pedersen, Merete F

    2015-01-01

    BACKGROUND: A cost-effective identification of HLA- DQ risk haplotypes using the single nucleotide polymorphism (SNP) technique has recently been applied in the diagnosis of celiac disease (CD) in four European populations. The objective of the study was to map risk HLA- DQ haplotypes in a group...... of Danish CD patients using the SNP technique. METHODS: Cohort A: Among 65 patients with gastrointestinal symptoms we compared the HLA- DQ2 and HLA- DQ8 risk haplotypes obtained by the SNP technique (method 1) with results based on a sequence specific primer amplification technique (method 2...

  14. Neuropathology of tissues from patients treated by the Brain Tumor Study Group

    Energy Technology Data Exchange (ETDEWEB)

    Mahaley, M.S. Jr.; Vogel, F.S.; Burger, P.; Ghatak, N.R.

    1977-01-01

    The histopathologic diagnoses in 718 brain tumor patients entered in the Brain Tumor Study Group were reviewed, as well as those for 53 of these patients who were autopsied later. This review documented instances of progression of histologic anaplasia. Of particular interest in the autopsied cases were several instances of extensive necrosis in white matter distant from persisting glioma following chemotherapy and radiotherapy. This observation suggested the presence of a structural and/or metabolic alteration in the diseased hemisphere that perhaps makes it more susceptible to further alterations secondary to the adjunctive therapy.

  15. Outcomes of 847 childhood-onset systemic lupus erythematosus patients in three age groups.

    Science.gov (United States)

    Lopes, S R M; Gormezano, N W S; Gomes, R C; Aikawa, N E; Pereira, R M R; Terreri, M T; Magalhães, C S; Ferreira, J C; Okuda, E M; Sakamoto, A P; Sallum, A M E; Appenzeller, S; Ferriani, V P L; Barbosa, C M; Lotufo, S; Jesus, A A; Andrade, L E C; Campos, L M A; Bonfá, E; Silva, C A

    2017-08-01

    Objective The objective of this study was to assess outcomes of childhood systemic lupus erythematosus (cSLE) in three different age groups evaluated at last visit: group A early-onset disease (Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) (0 (0-9) vs 0 (0-6) vs 0 (0-7), p = 0.065) was comparable in the three groups. Further analysis of organ/system damage revealed that frequencies of neuropsychiatric (21% vs 10% vs 7%, p = 0.007), skin (10% vs 1% vs 3%, p = 0.002) and peripheral vascular involvements (5% vs 3% vs 0.3%, p = 0.008) were more often observed in group A compared to groups B and C. Frequencies of severe cumulative lupus manifestations such as nephritis, thrombocytopenia, and autoimmune hemolytic anemia were similar in all groups ( p > 0.05). Mortality rate was significantly higher in group A compared to groups B and C (15% vs 10% vs 6%, p = 0.028). Out of 69 deaths, 33/69 (48%) occurred within the first two years after diagnosis. Infections accounted for 54/69 (78%) of the deaths and 38/54 (70%) had concomitant disease activity. Conclusions This large multicenter study provided evidence that early-onset cSLE group had distinct outcomes. This group was characterized by higher mortality rate and neuropsychiatric/vascular/skin organ damage in spite of comparable frequencies of severe cumulative lupus manifestations. We also identified that overall death in cSLE patients was an early event mainly attributed to infection associated with disease activity.

  16. The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology.

    Science.gov (United States)

    Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W; Abernethy, April; Duffin, Kristina Callis; Bhushan, Reva; Garg, Amit; Merola, Joseph F; Maccarone, Mara; Christensen, Robin

    2015-02-01

    As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  17. [MODen: Psychoeducationnal therapeutic group program for schizophrenic patients, based on nutritional balance and pleasure, using cognitive functions: A pilot study].

    Science.gov (United States)

    Farhat, S L; Hochard, C; Orens, S; Gautier, C; Lambert, T; Geret, L; Bralet, M C

    2016-10-01

    Schizophrenia causes psychological difficulties (with positive and/or negative symptoms) as well as cognitive disabilities (attention, memory, executive functions and social cognition). Moreover, 40 to 60% of patients suffer from an excess of weight or obesity (due to bad eating habits, eating disorders or medication). All these difficulties impair their autonomy and their insertion into the society. In this context, setting-up a therapeutic tool, which may have cognitive benefits seems relevant. Thus, MODen is a therapeutic educational tool whose aim is to improve cognitive functions and the symptoms by using "nutritional balance" as an aid. In this treatment program, two therapists lead a group of 5 to 8 patients which group meets once a week during two to four hours for 16 weeks, divided in 4 cycles. The first three weeks of each cycle consists of theoretical instruction: patients talk about their eating habits, information is given about nutritional balance and preparation of meals. In the different cycles, flexibility, planning, memory and attention are trained. For instance, the work on categorisation of foods and nutritional balance allow enhancing flexibility abilities. Writing down the lists of different ingredients needed for one week's meals and preparation of meals train planning abilities. MODen also takes into account ecological issues such as the limited budget of patients to do their shopping (this budget is around 4 euros per meal in France). The budget is also linked to planning abilities and reasoning. Finally, during the last session of each cycle the group prepares a meal (from the shopping to cooking). This last session is all about sharing and social cognition abilities. By the end of the program, patients will have prepared four meals together. Also "homework" has to be done each week in order to facilitate memorisation of what has been learned during the last session and to prepare the beginning of the next session. In a pilot study with 8

  18. Reporting consistently on CSR

    DEFF Research Database (Denmark)

    Thomsen, Christa; Nielsen, Anne Ellerup

    2006-01-01

    This chapter first outlines theory and literature on CSR and Stakeholder Relations focusing on the different perspectives and the contextual and dynamic character of the CSR concept. CSR reporting challenges are discussed and a model of analysis is proposed. Next, our paper presents the results...... of a case study showing that companies use different and not necessarily consistent strategies for reporting on CSR. Finally, the implications for managerial practice are discussed. The chapter concludes by highlighting the value and awareness of the discourse and the discourse types adopted...... in the reporting material. By implementing consistent discourse strategies that interact according to a well-defined pattern or order, it is possible to communicate a strong social commitment on the one hand, and to take into consideration the expectations of the shareholders and the other stakeholders...

  19. Assessing the Financial Value of Patient Engagement: A Quantitative Approach from CTTI's Patient Groups and Clinical Trials Project.

    Science.gov (United States)

    Levitan, Bennett; Getz, Kenneth; Eisenstein, Eric L; Goldberg, Michelle; Harker, Matthew; Hesterlee, Sharon; Patrick-Lake, Bray; Roberts, Jamie N; DiMasi, Joseph

    2018-03-01

    While patient groups, regulators, and sponsors are increasingly considering engaging with patients in the design and conduct of clinical development programs, sponsors are often reluctant to go beyond pilot programs because of uncertainty in the return on investment. We developed an approach to estimate the financial value of patient engagement. Expected net present value (ENPV) is a common technique that integrates the key business drivers of cost, time, revenue, and risk into a summary metric for project strategy and portfolio decisions. We assessed the impact of patient engagement on ENPV for a typical oncology development program entering phase 2 or phase 3. For a pre-phase 2 project, the cumulative impact of a patient engagement activity that avoids one protocol amendment and improves enrollment, adherence, and retention is an increase in net present value (NPV) of $62MM ($65MM for pre-phase 3) and an increase in ENPV of $35MM ($75MM for pre-phase 3). Compared with an investment of $100,000 in patient engagement, the NPV and ENPV increases can exceed 500-fold the investment. This ENPV increase is the equivalent of accelerating a pre-phase 2 product launch by 2½ years (1½ years for pre-phase 3). Risk-adjusted financial models can assess the impact of patient engagement. A combination of empirical data and subjective parameter estimates shows that engagement activities with the potential to avoid protocol amendments and/or improve enrollment, adherence, and retention may add considerable financial value. This approach can help sponsors assess patient engagement investment decisions.

  20. Geometrically Consistent Mesh Modification

    KAUST Repository

    Bonito, A.

    2010-01-01

    A new paradigm of adaptivity is to execute refinement, coarsening, and smoothing of meshes on manifolds with incomplete information about their geometry and yet preserve position and curvature accuracy. We refer to this collectively as geometrically consistent (GC) mesh modification. We discuss the concept of discrete GC, show the failure of naive approaches, and propose and analyze a simple algorithm that is GC and accuracy preserving. © 2010 Society for Industrial and Applied Mathematics.

  1. [Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain].

    Science.gov (United States)

    Antúnez Sánchez, Leonardo Gregorio; de la Casa Almeida, María; Rebollo Roldán, Jesús; Ramírez Manzano, Antonio; Martín Valero, Rocío; Suárez Serrano, Carmen

    To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. Randomised clinical trial. Health Area of University Hospital Virgen del Rocío, Seville, Spain. A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. Patient-Centred Multidisciplinary Inpatient Care-Have Diagnosis-Related Groups an Effect on the Doctor-Patient Relationship and Patients' Motivation for Behavioural Change?

    Science.gov (United States)

    Romeyke, Tobias; Noehammer, Elisabeth; Ch Scheuer, Hans; Stummer, Harald

    2016-10-01

    The aim of this, the largest survey of patients performed to date, is to analyse the effects of diagnosis related groups (DRGs) on the doctor-patient relationship in the context of interdisciplinary patient-centered care. In addition, it is intended to investigate the possibility of motivating patients to change their behavioural patterns and lifestyle in the context of holistic therapy. Over a period of five years, a continuous survey was performed of hospitalised patients who were exercising their entitlement to interdisciplinary therapy in an acute, inpatient setting. The therapy was evaluated as good to very good both with and without the conditions of the case tariff fee system. Effects of the diagnosis related groups on the quality of the doctor-patient relationship could not be demonstrated (Mann-Whitney U test, p>0,05). A clear trend was evident in the influence on motivation to change behavioural patterns and lifestyle (Fisher's exact test, p=0,000). Studies of the effects of reimbursement systems in the context of interdisciplinary care are still in their infancy, despite the widespread use of diagnosis related groups. The mandatory character implicit in the case tariff fee system, which requires minimum qualitative standards for structural and procedural parameters in the context of providing interdisciplinary patient-centered care, can influence patients' behavioural patterns and lifestyle.

  3. Blood group genotyping: from patient to high-throughput donor screening.

    Science.gov (United States)

    Veldhuisen, B; van der Schoot, C E; de Haas, M

    2009-10-01

    Blood group antigens, present on the cell membrane of red blood cells and platelets, can be defined either serologically or predicted based on the genotypes of genes encoding for blood group antigens. At present, the molecular basis of many antigens of the 30 blood group systems and 17 human platelet antigens is known. In many laboratories, blood group genotyping assays are routinely used for diagnostics in cases where patient red cells cannot be used for serological typing due to the presence of auto-antibodies or after recent transfusions. In addition, DNA genotyping is used to support (un)-expected serological findings. Fetal genotyping is routinely performed when there is a risk of alloimmune-mediated red cell or platelet destruction. In case of patient blood group antigen typing, it is important that a genotyping result is quickly available to support the selection of donor blood, and high-throughput of the genotyping method is not a prerequisite. In addition, genotyping of blood donors will be extremely useful to obtain donor blood with rare phenotypes, for example lacking a high-frequency antigen, and to obtain a fully typed donor database to be used for a better matching between recipient and donor to prevent adverse transfusion reactions. Serological typing of large cohorts of donors is a labour-intensive and expensive exercise and hampered by the lack of sufficient amounts of approved typing reagents for all blood group systems of interest. Currently, high-throughput genotyping based on DNA micro-arrays is a very feasible method to obtain a large pool of well-typed blood donors. Several systems for high-throughput blood group genotyping are developed and will be discussed in this review.

  4. From feelings of imprisonment to group cohesion: A qualitative analysis of group analytic psychotherapy with dual diagnosed patients admitted to an acute inpatient psychiatric unit.

    Science.gov (United States)

    Sánchez Morales, Lidia; Eiroa-Orosa, Francisco José; Valls Llagostera, Cristina; González Pérez, Alba; Alberich, Cristina

    2018-05-01

    Group cohesion, the establishment of hope, and the expression of feelings have been said to be the basic ingredients of group psychotherapy. To date, there is few literature describing therapeutic processes in short stay settings such as acute psychiatric wards and with special patient groups such as addictions. Our goal with this study is to describe and analyze group processes in such contexts. We used a qualitative methodology combining constant comparative methods and hermeneutical triangulation to analyze therapeutic narratives in the context of a group analytic process carried following Foulkes' and Yalom's styles. The results provide a picture of the therapeutic process including the use of norms to strengthen group cohesion facilitating the expression of emotions in early stages of group development. This analysis is intended to be a guide for practitioners implementing group therapy in contexts involving several constraints, such as acute psychiatric wards.

  5. Pharmacotherapy and group cognitive behavioral therapy enhance follow-up treatment duration in gambling disorder patients.

    Science.gov (United States)

    Choi, Sam-Wook; Shin, Young-Chul; Youn, HyunChul; Lim, Se-Won; Ha, Juwon

    2016-01-01

    Longer treatment duration is important for the successful treatment of gambling disorder (GD). This retrospective study investigated the factors and interventions that might enhance treatment duration in GD patients in South Korea. A total of 758 outpatients with a primary diagnosis of GD, who were treated in a clinical practice from 2002 to 2011, were assessed by retrospective chart review. We compared the treatment duration according to pharmacotherapy and group cognitive behavioral therapy (CBT). Pharmacotherapy contributed to a longer duration of treatment maintenance, despite the patients' gambling severity (p gambling severity. The treatment maintenance duration was the longest in those receiving combined antidepressant pharmacotherapy and group CBT (F = 35.79, p prevention and treatment strategies.

  6. Group behavioral activation for patients with severe obesity and binge eating disorder: a randomized controlled trial.

    Science.gov (United States)

    Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata

    2015-03-01

    The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa. © The Author(s) 2014.

  7. Selection of high risk groups among prognostically favorable patients with breast cancer.

    Science.gov (United States)

    Andersen, J A; Fischermann, K; Hou-Jensen, K; Henriksen, E; Andersen, K W; Johansen, H; Brincker, H; Mouridsen, H T; Castberg, T; Rossing, N; Rørth, M

    1981-01-01

    In a prospective, nationwide, decentralized breast cancer project conducted by The Danish Breast Cancer Cooperative Group (DBCG) the recurrence rate within the first year after surgery was analysed in relation to tumor anaplasia. One thousand forty-eight patients met the requirements of eligibility, i.e. tumor size less than or equal to 5 cm with negative axillary nodes, and no skin or deep invasion. The recurrence rates in tumors with anaplasia Grades I, II, and III were 4, 9, and 14%, respectively (p = 0.001). Therefore, it seems possible, prospectively, among otherwise prognostically favorable patients, to select a group with high risk of recurrence which might benefit from adjuvant systemic therapy. PMID:7247527

  8. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

    Science.gov (United States)

    Busolo, David; Woodgate, Roberta

    2015-01-01

    The objective of this review is to synthesize the best available evidence on palliative care experiences of adult cancer patients from ethnocultural groups.More specifically, this systematic review seeks to answer the following questions:1. What are the palliative care experiences of adult cancer patients from diverse ethnocultural groups?2. What meanings do adult patients with cancer from diverse ethnocultural groups assign to their experiences with palliative care? Globally, over 20.4 million people need palliative care services annually. The majority of these people (19 million) are adults, with 34% of them being patients diagnosed with cancer. With the current increase in the aging population, especially in developed countries, the number of adults requiring palliative care is expected to rise. Furthermore, how palliative care is offered and received continues to be shaped by culture and ethnicity. Likewise, culture and ethnicity influence how palliative care patients experience diseases like cancer, and seek and utilize palliative care services. Also, healthcare providers sometimes find it challenging to address the palliative care needs of patients from different ethnocultural groups. Sometimes these challenges are believed to be due to cultural incompetence of the care provider. When palliative care patients and their providers differ in their perception of care needs and how to address them, negative palliative care experiences are likely to ensue. Therefore, as the demand for palliative care increases, and ethnocultural factors continue to affect palliation, it is important to gain a better understanding of palliative care experiences of patients from different ethnocultural groups.The terms culture and ethnicity have been defined and used differently in literature which sometimes lead to confusion. Ethnicity has been defined as distinctive shared origins or social backgrounds and traditions of a group of people that are maintained between generations and

  9. User-centered Design Groups to Engage Patients and Caregivers with a Personalized Health IT Tool

    Science.gov (United States)

    Maher, Molly; Kaziunas, Elizabeth; Ackerman, Mark; Derry, Holly; Forringer, Rachel; Miller, Kristen; O’Reilly, Dennis; An, Larry C.; Tewari, Muneesh; Hanauer, David A.; Choi, Sung Won

    2015-01-01

    Health information technology (IT) has opened exciting avenues for capturing, delivering and sharing data, and offers the potential to develop cost-effective, patient-focused applications. In recent years, there has been a proliferation of health IT applications such as outpatient portals. Rigorous evaluation is fundamental to ensure effectiveness and sustainability, as resistance to more widespread adoption of outpatient portals may be due to lack of user friendliness. Health IT applications that integrate with the existing electronic health record and present information in a condensed, user-friendly format could improve coordination of care and communication. Importantly, these applications should be developed systematically with appropriate methodological design and testing to ensure usefulness, adoption, and sustainability. Based on our prior work that identified numerous information needs and challenges of HCT, we developed an experimental prototype of a health IT tool, the BMT Roadmap. Our goal was to develop a tool that could be used in the real-world, daily practice of HCT patients and caregivers (users) in the inpatient setting. In the current study, we examined the views, needs, and wants of patients and caregivers in the design and development process of the BMT Roadmap through two user-centered Design Groups, conducted in March 2015 and April 2015, respectively: Design Group I utilized a low-fidelity paper-based prototype and Design Group II utilized a high-fidelity prototype presented to users as a web-app on Apple® iPads. There were 11 caregivers (median age 44, range 34–69 years) and 8 patients (median age 18 years, range 11–24 years) in the study population. The qualitative analyses revealed a wide range of responses helpful in guiding the iterative development of the system. Three important themes emerged from the Design Groups: 1) perception of core features as beneficial (views), 2) alerting the design team to potential issues with the user

  10. Cross-Cultural Adaptation, Reliability, Internal Consistency and Validation of the Spinal Function Sort (SFS) for French- and German-Speaking Patients with Back Complaints

    NARCIS (Netherlands)

    Borloz, S.; Trippolini, M. A.; Ballabeni, P.; Luthi, F.; Deriaz, O.

    Introduction Functional subjective evaluation through questionnaire is fundamental, but not often realized in patients with back complaints, lacking validated tools. The Spinal Function Sort (SFS) was only validated in English. We aimed to translate, adapt and validate the French (SFS-F) and German

  11. Blood group does not correlate with disease severity in patients with Fabry disease (alpha-galactosidase A deficiency)

    NARCIS (Netherlands)

    Linthorst, Gabor E.; Folman, Claudia C.; Aerts, Johannes M. F. G.; Hollak, Carla E. M.

    2003-01-01

    Blood groups B and P1 are substrates for the lysosomal enzyme alpha-galactosidase A. Therefore, patients with alpha-Gal A deficiency and blood groups B or P1 may exhibit more severe disease. In 48 Fabry patients distribution of blood group was not different from that in the Dutch population. No

  12. Case Studies of Chronic Insomnia Patients Participating in Group Cognitive Behavioral Therapy for Insomnia

    Directory of Open Access Journals (Sweden)

    Mi Jin Yi

    2012-10-01

    Full Text Available Background and Objective Pharmacotherapy currently widely used in the treatment of insomnia can be helpful in transient insomnia, but research regarding its effectiveness and safety of long-term use is not enough. Therefore, to complement the limitations of pharmacotherapy in the treatment of patients with insomnia, non-pharmacologic treatment methods (cognitive behavioral therapy, CBT are used. But CBT for insomnia appear to be costly and time-consuming compared to pharmacotherapy, clinical practice in the field can be difficult to be applied. We took the format of group therapy rather than individual therapy to complement the disadvantages of CBT and now we would like to have a thought into its meaning by reporting the effectiveness of group CBT for insomnia. Methods Patients were recruited at Sleep Center of St. Vincent’s Hospital, 2 men and 3 women led to a group of five patients. CBT is a treatment for correction factors that cause and maintain insomnia, it includes a variety of techniques such as sleep hygiene education, stimulus control, sleep restriction, relaxation and cognitive therapy. A series of treatment were performed five sessions once a week with a frequency from February to March 2012 and were proceeded for about 1 hour and 30 minutes per session. Results Results indicated that the subjective quality of sleep and sleep efficiency of all patients improved and Pittsburgh Sleep Quality Index and Beck Depression Inventory were decreased in spite of reducing dose of medication. Conclusions Like these cases, we can contribute to reduce the time and economic burden by performing group CBT for insomnia rather than individual therapy.

  13. Clinical and Laboratory Findings of a Group of Iranian Patients with Oral Lichen Planus

    OpenAIRE

    Darvishpoor Kakhki H.; Rad M.; Zarei MR.; Chamani G.

    2012-01-01

    atement of Problem: Lichen planus (LP) is a chronic disease that affects skin and mucous membranes. Lesions of oral lichen planus (OLP) can persist for a long time. Varying prevalence rates of oral lichen planus have been reported in different parts of the world, while information regarding the epidemiology of this disease in Iran is incomplete.Purpose: This study was designed to evaluate the characteristics of oral lichen planus in a group of Iranian patients and compare the results with sim...

  14. Cholecystectomy and Diagnosis-Related Groups (DRGs): Patient Classification and Hospital Reimbursement in 11 European Countries

    OpenAIRE

    Gerli Paat-Ahi; Ain Aaviksoo; Maria Świderek

    2014-01-01

    Background As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a procedure of cholecystectom...

  15. Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries

    OpenAIRE

    Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

    2012-01-01

    Background As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure ...

  16. Dose to patients and professionals in cardiology interventional: Progress of multicenter group Doccaci

    International Nuclear Information System (INIS)

    Sanchez, R. M.; Vano, E.; Fernandez, J. M.; Goicolea Ruigomez, J.; Pifarre, X.; Escaned, J.; Rovira, J. J.; Garcia del Blanco, B.; Carrera, F.; Diaz, J. F.; Ordiales, J. M.; Nogales, J. M.; Hernandez, J.; Bosa, F.; Rosales, F.; Saez, J. R.; Soler, M. M.; Romero, M. A.

    2013-01-01

    The multidisciplinary group and multicenter DOCCACI (dosimetry and quality assurance in interventional cardiology), sponsored by the section of haemodynamics of the Spanish society of Cardiology, is intended to propose reference levels to doses received by patients in interventional cardiology procedures such as recommended by the International Commission on radiological protection It also investigates the doses received by professionals, in particular dose in Crystallyne whose recommended limit dose has been reduced recently from 150 to 20 mSv/year. (Author)

  17. Toxoplasma Infection in Schizophrenia Patients: A Comparative Study with Control Group

    OpenAIRE

    Alipour, A; Shojaee, S; Mohebali, M; Tehranidoost, M; Abdi Masoleh, F; Keshavarz, H

    2011-01-01

    Background: Schizophrenia is a serious, chronic, and often debilitating neuropsychiatric disor­der. Its causes are still poorly understood. Besides genetic and non-genetic (environmental) fac­tors are thought to be important as the cause of the structural and functional deficits that character­ize schizophrenia. This study aimed to compare Toxoplasma gondii infection between schizo­phrenia patients and non-schizophrenia individuals as control group.Methods: A case-control study was designed i...

  18. Relevance of blood groups in transfusion of sickle cell disease patients.

    Science.gov (United States)

    Noizat-Pirenne, France

    2013-03-01

    Blood groups are clinically significant in sickle cell disease (SCD) as transfusion remains a key treatment in this pathology. The occurrence of a delayed haemolytic transfusion reaction (DHTR) is not rare and is a life-threatening event. The main cause of DHTR is the production of alloantibodies against red blood cell antigens. The high rate of alloimmunization in SCD patients is mainly due to the differences of red blood groups between patients of African descent, and the frequently Caucasian donors. From an immuno-haematological point of view, DHTR in SCD patients has specific features: classical antibodies known to be haemolytic can be encountered, but otherwise non significant antibodies, autoantibodies and antibodies related to partial and rare blood groups are also frequently found in individuals of African descent. In some cases, there are no detectable antibodies. As alloimmunization remains the main cause of DHTR, it is extremely important to promote blood donation by individuals of African ancestry to make appropriate blood available. Copyright © 2012 Académie des sciences. Published by Elsevier SAS. All rights reserved.

  19. Testing postural control among various osteoporotic patient groups: a literature review.

    Science.gov (United States)

    de Groot, Maartje H; van der Jagt-Willems, Hanna C; van Campen, Jos P C M; Lems, Willem F; Lamoth, Claudine J C

    2012-10-01

    Osteoporosis can cause vertebral fractures, which might lead to a flexed posture, impaired postural control and consequently increased fall risk. Therefore, the aim of the present review was to examine whether postural control of patients with osteoporosis, vertebral fractures, thoracic kyphosis and flexed posture is affected. Furthermore, instruments measuring postural control were evaluated and examined for sensitivity and easy clinical use. Until February 2011, electronic databases were systematically searched for cross-sectional studies. Methodological quality was assessed with a modified Downs & Black scale. Of the 518 found studies, 18 studies were included. Postural control was generally affected for patients with vertebral fractures, thoracic kyphosis and flexed posture. Patients with osteoporosis had impaired postural control when assessed with computerized instruments. Easy performance-based tests did not show any impairments. There is evidence for an impaired postural control in all patient groups included. Impaired postural control is an important risk factor for falls. Functional performance tests are not sensitive and specific enough to detect affected postural control in patients with osteoporosis. To detect impaired postural control among osteoporotic patients and to obtain more insight into the underlying mechanisms of postural control, computerized instruments are recommended, such as easy-to-use ambulant motion-sensing (accelerometry) technology. © 2012 Japan Geriatrics Society.

  20. Quantitative analysis of hepatitis C virus activity in vivo in different groups of untreated patients.

    Science.gov (United States)

    Manzin, A; Solforosi, L; Giostra, F; Bianchi, F B; Bruno, S; Rossi, S; Gabrielli, A; Candela, M; Petrelli, E; Clementi, M

    1997-01-01

    Highly sensitive competitive PCR (cPCR) and competitive reverse transcription PCR (cRT-PCR) methodologies were recently developed and applied for quantifying viral DNA and RNA species (including HCV RNA) present in clinical samples at low concentration. In this study, we used cRT-PCR to compare the viral load of 118 untreated patients with HCV infection and different clinical conditions (80 patients with chronic hepatitis, 18 infected subjects with persistently normal ALT levels and various degrees of liver injury, 10 HCV infected subjects that tested positive for anti-LKM1 antibodies, and 10 patients with HCV infection and cryoglobulinemia). The results indicate that while great individual variability of HCV viremia is detectable even among patients with similar clinical conditions, the mean HCV RNA copy number in samples from patients with different clinical conditions was similar in all groups with the single exception of patients that tested positive for anti-liver-kidney microsomal auto-antibodies type 1 (anti-LKM1); interestingly, lower HCV viremia levels were revealed in these anti-LKM1-positive cases with liver disease of uncertain pathogenesis.

  1. Is There a Relation between ABO Blood Groups and Clinical Outcome in Patients with Pemphigoid? A Case-Control Study.

    Science.gov (United States)

    Bakhtiari, Sedigheh; Toosi, Parviz; Azimi, Somayyeh; Esmaili, Nafiseh; Montazami, Ali; Rafieian, Nasrin

    2016-01-01

    Background. Relationship between blood groups and dermatologic diseases remains controversial and was not yet fully elucidated nor explained clearly. The aim of this study was to examine if any relation exists between different types of pemphigoid diseases and ABO blood group. Methods. In this case-control study, 159 pemphigoid patients and 152 healthy matched-controls were evaluated. All blood group (including Rh status) data for the study was obtained from the hospital medical records. Statistical comparisons were completed with chi-square test and logistic regression. Results. Blood group "O" was found in 32.9% of patients and 38.2% of control group. Blood group "A" was found among 30.8% of patients and 34.2% of control group, while group "B" was reported in 27.4% of cases and 21.1% of controls and "AB" was identified among 8.9% of patients and 6.6% of control group. 84.9% of patients were Rh positive, while in the control group 86.2% of patients were Rh positive. No significant differences were found regarding ABO blood groups (P = 0.46) or Rh (P = 0.76) between pemphigoid patients and control group. Also, older females had the higher risk of developing bullous pemphigoid. Conclusion. We found no relationship between ABO blood groups and pemphigoid disease.

  2. Impact of Pathologist Involvement in Sarcoma and Rare Tumor Patient Support Groups on Facebook: A Survey of 542 Patients and Family Members.

    Science.gov (United States)

    Haller, Jasmine; David, Marjorie Parker; Lee, Nathan E; Shalin, Sara C; Gardner, Jerad M

    2018-01-29

    - Patients with rare tumors have difficulty finding reliable information about their disease. Facebook patient support groups allow patients to educate one another. - To investigate how these patients perceive the value of pathologists, both in Facebook groups and real-world patient care. - Survey links were posted in 12 Facebook patient groups: 6 with an active pathologist member (angiosarcoma, epithelioid hemangioendothelioma, epithelioid sarcoma, dermatofibrosarcoma protuberans [×2], and desmoid fibromatosis), and 6 without "active" pathologist involvement (aggressive angiomyxoma, chondrosarcoma, Ewing sarcoma, leiomyosarcoma, liposarcoma, and osteosarcoma). - A total of 542 people responded (403 were patients): 264 from groups with a pathologist, and 278 from groups without active pathologist involvement. Of groups with an active pathologist, respondents agreed the pathologist's posts helped them better understand their disease (107 of 119; 90%) and relieved some of their disease-related anxiety (92 of 119; 77%). And for these groups 98% (117 of 119) of respondents agreed that having a pathologist in their group was a good thing; 83% (192 of 232) wanted more pathologists involved. More respondents from groups with an active pathologist (219 of 236; 93%) than without one (215 of 252; 85%) agreed: "pathologists are an important part of the patient care team for patients with cancer and other rare tumors" ( P = .008). - This study is the first to evaluate the impact of pathologist interaction with Facebook patient support groups and to assess perceptions about the specialty of pathology from a large group of patients with rare tumors. Pathologist involvement in Facebook patient groups appears to positively influence patient perception of the importance of pathologists. We hope these data will encourage more pathologists to participate in Facebook patient support groups.

  3. Clinical and genetic characteristics in a group of 45 patients with Turner syndrome (monocentric study

    Directory of Open Access Journals (Sweden)

    Bucerzan S

    2017-05-01

    chromosome sequences were found in only one patient, who subsequently underwent gonadectomy.Conclusion: The importance of this study resides, to the best of our knowledge, in the fact that the largest group of patients in Romania was analyzed and assessed. To draw firm conclusions on the most valuable clinical indicators for Turner syndrome diagnosis in clinical practice, studies on large groups of patients should be conducted. Keywords: Turner syndrome, diagnosis, phenotype, karyotype, GH treatment, Y chromosome sequences

  4. The Rucio Consistency Service

    CERN Document Server

    Serfon, Cedric; The ATLAS collaboration

    2016-01-01

    One of the biggest challenge with Large scale data management system is to ensure the consistency between the global file catalog and what is physically on all storage elements. To tackle this issue, the Rucio software which is used by the ATLAS Distributed Data Management system has been extended to automatically handle lost or unregistered files (aka Dark Data). This system automatically detects these inconsistencies and take actions like recovery or deletion of unneeded files in a central manner. In this talk, we will present this system, explain the internals and give some results.

  5. Manual patient transfers used most often by student and staff nurses are consistent with their perceptions of transfer training, and performance confidence.

    Science.gov (United States)

    van Wyk, Paula M; Weir, Patricia L; Andrews, David M

    2015-01-01

    A disconnect in manual patient transfer (MPT) training practices for nurses, between what is taught and used in academic and clinical settings, could have implications for injury. This study aimed to determine: 1. what MPTs student and staff nurses use in clinical settings, and 2. if the MPTs used most often were also the ones they perceived that they received training for and had the most confidence performing. Survey responses from student nurses (n=163) (mid-sized university) and staff nurses (n=33) (local hospital) regarding 19 MPTs were analyzed to determine which transfers were perceived to be used most often, and which ones they had received training for and had the greatest confidence performing. The MPTs nurses perceived using most often were the same transfers they had the greatest confidence performing and for which they perceived receiving training. However, these MPTs were not taught at the university at the time of this investigation. Reducing the disconnect between manual patient transfer training obtained in the academic and clinical environments will hopefully reduce the risk of injury for nurses and improve the quality of care for patients.

  6. Is cosmology consistent?

    International Nuclear Information System (INIS)

    Wang Xiaomin; Tegmark, Max; Zaldarriaga, Matias

    2002-01-01

    We perform a detailed analysis of the latest cosmic microwave background (CMB) measurements (including BOOMERaNG, DASI, Maxima and CBI), both alone and jointly with other cosmological data sets involving, e.g., galaxy clustering and the Lyman Alpha Forest. We first address the question of whether the CMB data are internally consistent once calibration and beam uncertainties are taken into account, performing a series of statistical tests. With a few minor caveats, our answer is yes, and we compress all data into a single set of 24 bandpowers with associated covariance matrix and window functions. We then compute joint constraints on the 11 parameters of the 'standard' adiabatic inflationary cosmological model. Our best fit model passes a series of physical consistency checks and agrees with essentially all currently available cosmological data. In addition to sharp constraints on the cosmic matter budget in good agreement with those of the BOOMERaNG, DASI and Maxima teams, we obtain a heaviest neutrino mass range 0.04-4.2 eV and the sharpest constraints to date on gravity waves which (together with preference for a slight red-tilt) favor 'small-field' inflation models

  7. Consistent Quantum Theory

    Science.gov (United States)

    Griffiths, Robert B.

    2001-11-01

    Quantum mechanics is one of the most fundamental yet difficult subjects in physics. Nonrelativistic quantum theory is presented here in a clear and systematic fashion, integrating Born's probabilistic interpretation with Schrödinger dynamics. Basic quantum principles are illustrated with simple examples requiring no mathematics beyond linear algebra and elementary probability theory. The quantum measurement process is consistently analyzed using fundamental quantum principles without referring to measurement. These same principles are used to resolve several of the paradoxes that have long perplexed physicists, including the double slit and Schrödinger's cat. The consistent histories formalism used here was first introduced by the author, and extended by M. Gell-Mann, J. Hartle and R. Omnès. Essential for researchers yet accessible to advanced undergraduate students in physics, chemistry, mathematics, and computer science, this book is supplementary to standard textbooks. It will also be of interest to physicists and philosophers working on the foundations of quantum mechanics. Comprehensive account Written by one of the main figures in the field Paperback edition of successful work on philosophy of quantum mechanics

  8. Foot problems in a group of patients with rheumatoid arthritis: an unmet need for foot care.

    Science.gov (United States)

    Borman, Pinar; Ayhan, Figen; Tuncay, Figen; Sahin, Mehtap

    2012-01-01

    The aim of this study was to evaluate the foot involvement in a group of RA patients in regard to symptoms, type and frequency of deformities, location, radiological changes, and foot care. A randomized selected 100 rheumatoid arthritis (RA) patients were recruited to the study. Data about foot symptoms, duration and location of foot pain, pain intensity, access to services related to foot, treatment, orthoses and assistive devices, and usefulness of therapies were determined by the questionnaire. Radiological changes were assessed according to modified Larsen scoring system. The scores of disease activity scale of 28 joints and Health Assessment Questionnaire indicating the functional status of RA patients were collected from patient files. A total of 100 RA patients (90 female, 10 male) with a mean age of 52.5 ±10.9 years were enrolled to the study. Eighty-nine of the 100 patients had experienced foot complaints/symptoms in the past or currently. Foot pain and foot symptoms were reported as the first site of involvement in 14 patients. Thirty-six patients had ankle pain and the most common sites of the foot symptoms were ankle (36%) and forefoot (30%) followed by hindfoot (17%) and midfoot (7%) currently. Forty-nine of the patients described that they had difficulty in performing their foot care. Insoles and orthopedic shoes were prescribed in 39 patients, but only 14 of them continued to use them. The main reasons for not wearing them were; 17 not helpful (43%), 5 made foot pain worse (12.8%), and 3 did not fit (7.6%). Foot symptoms were reported to be decreased in 24 % of the subjects after the medical treatment and 6 patients indicated that they had underwent foot surgery. Current foot pain was significantly associated with higher body mass index and longer disease duration, and duration of morning stiffness. The radiological scores did not correlate with duration of foot symptoms and current foot pain (p>0.05) but the total number of foot deformities was

  9. Diagnosis-related groups for stroke in Europe: patient classification and hospital reimbursement in 11 countries.

    Science.gov (United States)

    Peltola, Mikko; Quentin, Wilm

    2013-01-01

    Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems in the care of stroke. As part of the EuroDRG project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Sweden and Spain) compared how their DRG systems deal with stroke patients. The study aims to assist clinicians and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of stroke. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually represent at least 1% of stroke cases. In addition, standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify stroke patients according to different sets of variables (between 1 and 7 classification variables) into diverging numbers of DRGs (between 1 and 10 DRGs). In 6 of the countries more than half of the patients are concentrated within a single DRG. The countries' systems also vary with respect to the evaluation of different kinds of stroke patients. The most complex DRG is considered 3.8 times more resource intensive than an index case in Finland. By contrast, in England, the DRG system does not account for complex cases. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only EUR 907 in Poland but to EUR 7,881 in Ireland. Large variations in the classification of stroke patients raise concerns whether all systems rely on the most appropriate classification variables and whether the DRGs adequately reflect differences in the complexity of treating different groups of patients. Learning from other DRG systems may help in improving the national systems. Clinicians and

  10. Sociodemographic analysis of patients in radiation therapy oncology group clinical trials

    International Nuclear Information System (INIS)

    Chamberlain, Robert M.; Winter, Kathryn A.; Vijayakumar, Srinivasan; Porter, Arthur T.; Roach, M.; Streeter, Oscar; Cox, James D.; Bondy, Melissa L.

    1998-01-01

    Purpose: To assess the degree to which the sociodemographic characteristics of patients enrolled in Radiation Therapy Oncology Group (RTOG) clinical trails are representative of the general population. Methods and Materials: Sociodemographic data were collected on 4016 patients entered in 33 open RTOG studies between July 1991 and June 1994. The data analyzed included educational attainment, age, gender, and race. For comparison, we obtained similar data from the U.S. Department of Census. We also compared our RTOG data with Surveillance Epidemiology and End Results (SEER) data for patients who received radiation therapy, to determine how RTOG patients compared with cancer patients in general, and with patients with cancers at sites typically treated with radiotherapy. Results: Overall, the sociodemographic characteristics of patients entered in RTOG trials were similar to those of the Census data. We found that, in every age group of African-American men and at nearly every level of educational attainment, the proportion of RTOG trial participants mirrored the proportion in the census data. Significant differences were noted only in the youngest category of African-American men, where the RTOG accrues more in the lower educational categories and fewer with college experience. For African-American women, we found a similar pattern in every age group and at each level of educational attainment. As with men, RTOG trials accrued a considerably larger proportion of younger, less educated African-American women than the census reported. Using SEER for comparison, the RTOG enrolled proportionately more African-American men to trials all cancer sites combined, and for prostate and head and neck cancer. In head and neck trials, the RTOG enrolled nearly twice as many African-American men than would be predicted by SEER data. In lung cancer trials, RTOG underrepresented African-American men significantly; however, there was no difference for brain cancer trials. There were

  11. The Rules of Engagement: CTTI Recommendations for Successful Collaborations Between Sponsors and Patient Groups Around Clinical Trials.

    Science.gov (United States)

    Bloom, Diane; Beetsch, Joel; Harker, Matthew; Hesterlee, Sharon; Moreira, Paulo; Patrick-Lake, Bray; Selig, Wendy; Sherman, Jeffrey; Smith, Sophia K; Valentine, James E; Roberts, Jamie N

    2018-03-01

    To identify the elements necessary for successful collaboration between patient groups and academic and industry sponsors of clinical trials, in order to develop recommendations for best practices for effective patient group engagement. In-depth interviews, informed by a previously reported survey, were conducted to identify the fundamentals of successful patient group engagement. Thirty-two respondents from 3 sectors participated: patient groups, academic researchers, and industry. The findings were presented to a multistakeholder group of experts in January 2015. The expert group came to consensus on a set of actionable recommendations for best practices for patient groups and research sponsors. Interview respondents acknowledged that not all patient groups are created equal in terms of what they can contribute to a clinical trial. The most important elements for effective patient group engagement include establishing meaningful partnerships, demonstrating mutual benefits, and collaborating as partners from the planning stage forward. Although there is a growing appreciation by sponsors about the benefits of patient group engagement, there remains some resistance and some uncertainty about how best to engage. Barriers include mismatched expectations and a perception that patient groups lack scientific sophistication and that "wishful thinking" may cloud their recommendations. Patient groups are developing diverse skillsets and acquiring assets to leverage in order to become collaborators with industry and academia on clinical trials. Growing numbers of research sponsors across the clinical trials enterprise are recognizing the benefits of continuous and meaningful patient group engagement, but there are still mindsets to change, and stakeholders need further guidance on operationalizing a new model of clinical trial conduct.

  12. Patient input into the development and enhancement of ED discharge instructions: a focus group study.

    Science.gov (United States)

    Buckley, Barbara A; McCarthy, Danielle M; Forth, Victoria E; Tanabe, Paula; Schmidt, Michael J; Adams, James G; Engel, Kirsten G

    2013-11-01

    Previous research indicates that patients have difficulty understanding ED discharge instructions; these findings have important implications for adherence and outcomes. The objective of this study was to obtain direct patient input to inform specific revisions to discharge documents created through a literacy-guided approach and to identify common themes within patient feedback that can serve as a framework for the creation of discharge documents in the future. Based on extensive literature review and input from ED providers, subspecialists, and health literacy and communication experts, discharge instructions were created for 5 common ED diagnoses. Participants were recruited from a federally qualified health center to participate in a series of 5 focus group sessions. Demographic information was obtained and a Rapid Estimate of Adult Literacy in Medicine (REALM) assessment was performed. During each of the 1-hour focus group sessions, participants reviewed discharge instructions for 1 of 5 diagnoses. Participants were asked to provide input into the content, organization, and presentation of the documents. Using qualitative techniques, latent and manifest content analysis was performed to code for emergent themes across all 5 diagnoses. Fifty-seven percent of participants were female and the average age was 32 years. The average REALM score was 57.3. Through qualitative analysis, 8 emergent themes were identified from the focus groups. Patient input provides meaningful guidance in the development of diagnosis-specific discharge instructions. Several themes and patterns were identified, with broad significance for the design of ED discharge instructions. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  13. Change mechanisms of schema-centered group psychotherapy with personality disorder patients.

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    Wolfgang Tschacher

    Full Text Available BACKGROUND: This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain. METHODOLOGY AND FINDINGS: 69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome. CONCLUSIONS/SIGNIFICANCE: The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders.

  14. Diffuse optical characterization of an exercising patient group with peripheral artery disease

    Science.gov (United States)

    Putt, Mary; Chandra, Malavika; Yu, Guoqiang; Xing, Xiaoman; Han, Sung Wan; Lech, Gwen; Shang, Yu; Durduran, Turgut; Zhou, Chao; Yodh, Arjun G.; Mohler, Emile R.

    2013-01-01

    Abstract. Peripheral artery disease (PAD) is a common condition with high morbidity. While measurement of tissue oxygen saturation (StO2) has been demonstrated, this is the first study to assess both StO2 and relative blood flow (rBF) in the extremities of PAD patients. Diffuse optics is employed to measure hemodynamic response to treadmill and pedal exercises in 31 healthy controls and 26 patients. For StO2, mild and moderate/severe PAD groups show pronounced differences compared with controls. Pre-exercise mean StO2 is lower in PAD groups by 9.3% to 10.6% compared with means of 63.5% to 66.2% in controls. For pedal, relative rate of return of StO2 to baseline is more rapid in controls (p<0.05). Patterns of rBF also differ among groups. After both exercises, rBF tend to occur at depressed levels among severe PAD patients compared with healthy (p<0.05); post-treadmill, rBF tend to occur at elevated levels among healthy compared with severe PAD patients (p<0.05). Additionally, relative rate of return to baseline StO2 is more rapid among subjects with reduced levels of depression in rBF (p=0.041), even after adjustment for ankle brachial index. This suggests a physiologic connection between rBF and oxygenation that can be measured using diffuse optics, and potentially employed as an evaluative tool in further studies. PMID:23708193

  15. Reduction of Risk Factors in Patients with Behavioral Dysphonia After Vocal Group Therapy.

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    Silva, Wégina Jordâna Nascimento da; Lopes, Leonardo Wanderley; Macedo, Anny Elizabety Ramalho de; Costa, Denise Batista da; Almeida, Anna Alice Figueiredo de

    2017-01-01

    The origin and development of dysphonia, particularly behavioral dysphonia, is associated with several risk factors. Here, we verified the effectiveness of group therapy in reducing the risk factors, and established the association between risk factors and sex, age, profession, and diagnosis of laryngeal disorders in patients with behavioral dysphonia. This is a descriptive, quantitative, field intervention study. Participants (n = 26, adult patients of both sexes), with a diagnosis of behavioral dysphonia, received group therapy intervention. Data for risk factors were collected pre- and posttherapy using the Vocal Screening Protocol. The data were analyzed using descriptive and inferential statistics (Student t test, chi-squared test or Spearman correlation test). The majority (80.8%, n = 21) of patients were female, 65.4% (n = 17) were not in a vocal profession, and 42.3% (n = 11) presented with a lesion in the membranous portion of the vocal fold. The number of personal risk factors decreased after group therapy (P = 0.04). In addition, age was correlated with total (P = 0.001), environmental (P = 0.002), and personal (P = 0.003) vocal risk factors posttherapy. This study revealed an association between the reduction of personal risk factors and vocal group therapy, and a correlation between age and total, environmental, and personal vocal risk factors posttherapy. Thus, maintenance and origins of the behaviors that modify the behavioral aspects of the participants directly influence the production of individual vocal habits. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Cross-cultural adaptation, reliability, internal consistency and validation of the Spinal Function Sort (SFS) for French- and German-speaking patients with back complaints.

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    Borloz, S; Trippolini, M A; Ballabeni, P; Luthi, F; Deriaz, O

    2012-09-01

    Functional subjective evaluation through questionnaire is fundamental, but not often realized in patients with back complaints, lacking validated tools. The Spinal Function Sort (SFS) was only validated in English. We aimed to translate, adapt and validate the French (SFS-F) and German (SFS-G) versions of the SFS. Three hundred and forty-four patients, experiencing various back complaints, were recruited in a French (n = 87) and a German-speaking (n = 257) center. Construct validity was estimated via correlations with SF-36 physical and mental scales, pain intensity and hospital anxiety and depression scales (HADS). Scale homogeneities were assessed by Cronbach's α. Test-retest reliability was assessed on 65 additional patients using intraclass correlation (IC). For the French and German translations, respectively, α were 0.98 and 0.98; IC 0.98 (95% CI: [0.97; 1.00]) and 0.94 (0.90; 0.98). Correlations with physical functioning were 0.63 (0.48; 0.74) and 0.67 (0.59; 0.73); with physical summary 0.60 (0.44; 0.72) and 0.52 (0.43; 0.61); with pain -0.33 (-0.51; -0.13) and -0.51 (-0.60; -0.42); with mental health -0.08 (-0.29; 0.14) and 0.25 (0.13; 0.36); with mental summary 0.01 (-0.21; 0.23) and 0.28 (0.16; 0.39); with depression -0.26 (-0.45; -0.05) and -0.42 (-0.52; -0.32); with anxiety -0.17 (-0.37; -0.04) and -0.45 (-0.54; -0.35). Reliability was excellent for both languages. Convergent validity was good with SF-36 physical scales, moderate with VAS pain. Divergent validity was low with SF-36 mental scales in both translated versions and with HADS for the SFS-F (moderate in SFS-G). Both versions seem to be valid and reliable for evaluating perceived functional capacity in patients with back complaints.

  17. Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

    Science.gov (United States)

    Parnell, Aimee S; Shults, Justine; Gaynor, J William; Leonard, Mary B; Dai, Dingwei; Feudtner, Chris

    2014-02-01

    Administrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. We performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Every patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (pDRG (pDRG experienced a significantly increased mortality (pDRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. The impact of patient participation direct enhanced service on patient reference groups in primary care: a qualitative study.

    Science.gov (United States)

    Pollard, Lorraine; Agarwal, Shona; Harrad, Fawn; Lester, Louise; Cross, Ainsley; Wray, Paula; Smith, Gordon; Locke, Anthony; Sinfield, Paul

    2014-01-01

    NHS policy documents continue to make a wide-ranging commitment to patient involvement. The Patient Participation Direct Enhanced Service (PP-DES), launched in 2011, aimed to ensure patients are involved in decisions about the range and quality of services provided and commissioned by their practice through patient reference groups (PRGs). The aim of this exploratory study is to review the impact of the PP-DES (2011-13) on a sample of PRGs and assess how far it has facilitated their involvement in decisions about the services of their general practices. A qualitative methods design, using semi- structured interviews and focus groups, was employed to explore the experiences and views of GP practice staff (n = 24), PRG members (n = 80) at 12 GP practices, and other stakeholders (n = 4). Wide variation in the role and remit of the participating PRGs was found, which broadly ranged from activities to improve practice resources to supporting health promotion activities. The majority of PRG members were unfamiliar with the PP-DES scheme and its aims and purpose. Stakeholders and practice staff felt strongly that the main success of the PP-DES was that it had led to an increase in the number of PRGs being established in the locality. The PP-DES scheme has been a catalyst to establish PRGs. However, the picture was mixed in terms of the PRGs involvement in decisions about the services provided at their general practice as there was wide variation in the PRGs role and remit. The financial incentive alone, provided via the DES scheme, did not secure greater depth of PRG activity and power, however, as social factors were identified as playing an important role in PRGs' level of participation in decision making. Many PRGs have to become more firmly established before they are involved as partners in commissioning decisions at their practice.

  19. The Comparison of Sagittal Spinopelvic Parameters between Young Adult Patients with L5 Spondylolysis and Age-Matched Control Group

    Science.gov (United States)

    Oh, Young Min; Choi, Ha Young

    2013-01-01

    Objective To compare spinopelvic parameters in young adult patients with spondylolysis to those in age-matched patients without spondylolysis and investigate the clinical impact of sagittal spinopelvic parameters in patients with L5 spondylolysis. Methods From 2009 to 2012, a total of 198 young adult male patients with spondylolysis were identified. Eighty age-matched patients without spondylolysis were also selected. Standing lateral films that included both hip joints were obtained for each subject. Pelvic incidence (PI), sacral slope (SS), pelvic tilt, lumbar lordosis angle, sacral inclination, lumbosacral angle, and sacral table angle were measured in both groups. A comparative study of the spinopelvic parameters of these two groups was performed using SPSS 15.0 (SPSS Inc., Chicago, IL, USA). Results Among the aforementioned spinopelvic parameters, PI, SS and STA were significantly different between patients with spondylolysis and those without spondylolysis. PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Conclusion PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Patients with spondylolysis have low STA at birth, which remains constant during growth; a low STA translates into high SS. As a result, PI is also increased in accordance with SS. Therefore, we suggest that STA is an important etiologic factor in young adult patients with L5 spondylolysis. PMID:24278649

  20. Assessment of the etiologic factors of gingival recession in a group of patients in Northwest Iran

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    Ardeshir Lafzi

    2009-09-01

    Full Text Available Background and aims. Gingival recession (GR, a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. Materials and methods. In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis. Results. Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000. Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P < 0.05. The type of occlusion, axial inclination of teeth, existence of prosthesis, frenal attachment, and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05. Conclusions. Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR.

  1. Xeroderma pigmentosum complementation group F: Report of a case and review of Japanese patients.

    Science.gov (United States)

    Tofuku, Yukari; Nobeyama, Yoshimasa; Kamide, Ryoichi; Moriwaki, Shinichi; Nakagawa, Hidemi

    2015-09-01

    Xeroderma pigmentosum (XP) is an autosomal recessive genetic disorder characterized by extraordinary sensitivity to sunlight, resulting in cutaneous malignant tumors. Among XP, XP-F presents relatively uniquely in Japanese. To clarify the characteristics of this group, we describe a case of XP-F and review Japanese cases previously reported. A 50-year-old Japanese woman was referred to us with multiple, variously sized, light- or dark-brown macules on the face and sunlight-exposed extremities. She had experienced bulla formation with approximately 10 min of sunlight exposure during her elementary school years. Her parents had been first cousins, and her mother and sister had photosensitivity. She showed no neurological or developmental abnormalities. Ultraviolet (UV) irradiation testing revealed normal levels for minimal erythema dose with UV-A and UV-B. Sensitivity to UV-C and DNA repair ability in the patient's fibroblasts were indicated between that in normal individuals and that in an XP-A patient. Complementation assay revealed that transfection of the XPF gene led most efficient DNA repair compared with the other XP genes. Therefore, the patient was diagnosed with XP-F. Twenty-three cases of Japanese patients (six males, 17 females) with XP-F have been reported, including the present case. Our review suggested a relatively high prevalence of 50% (11/22) for cutaneous malignant tumors. A significant difference was evident in the mean age at first medical consultation between patients with cutaneous malignant tumors (53.6 years) and patients without such tumors (30.8 years). This suggests that cutaneous malignant tumors could occur in the age range of 30-50 years in XP-F patients. © 2015 Japanese Dermatological Association.

  2. Knowledge deficit of patients with stage 1-4 CKD: a focus group study.

    Science.gov (United States)

    Lopez-Vargas, Pamela A; Tong, Allison; Phoon, Richard K S; Chadban, Steven J; Shen, Yvonne; Craig, Jonathan C

    2014-04-01

    Patients with early-stage chronic kidney disease (CKD) must make lifestyle modifications and adhere to treatment regimens to prevent their progression to end-stage kidney disease. The aim of this study was to elicit the perspectives of patients with stage 1-4 CKD about their disease, with a specific focus on their information needs in managing and living with CKD and its sequelae. Patients with CKD stages 1-4 were purposively sampled from three major hospitals in Sydney, Australia to participate in focus groups. Transcripts were thematically analysed. From nine focus groups including 38 participants, six major themes were identified: medical attentiveness (shared decision-making, rapport, indifference and insensitivity); learning self-management (diet and nutrition, barriers to physical activity, medication safety); contextualizing comorbidities (prominence of CKD, contradictory treatment); prognostic uncertainty (hopelessness, fear of disease progression, disbelief regarding diagnosis); motivation and coping mechanisms (engage in research, pro-active management, optimism, feeling normal); and knowledge gaps (practical advice, access to information, comprehension of pathology results and CKD diagnosis, education for general practitioners). Patients capacity to slow the progression of CKD may be limited by their lack of knowledge about the disease, its comorbidities, psychosocial influences and their ability to interact and communicate effectively with their health-care provider. Support from a multidisciplinary care team, combined with provision of comprehensive, accessible and practical educational resources may enhance patients' ability and motivation to access and adhere to therapeutic and lifestyle interventions to retard progression of CKD. © 2014 Asian Pacific Society of Nephrology.

  3. Testing the effectiveness of group-based memory rehabilitation in chronic stroke patients.

    Science.gov (United States)

    Miller, Laurie A; Radford, Kylie

    2014-01-01

    Memory complaints are common after stroke, yet there have been very few studies of the outcome of memory rehabilitation in these patients. The present study evaluated the effectiveness of a new manualised, group-based memory training programme. Forty outpatients with a single-stroke history and ongoing memory complaints were enrolled. The six-week course involved education and strategy training and was evaluated using a wait-list crossover design, with three assessments conducted 12 weeks apart. Outcome measures included: tests of anterograde memory (Rey Auditory Verbal Learning Test: RAVLT; Complex Figure Test) and prospective memory (Royal Prince Alfred Prospective Memory Test); the Comprehensive Assessment of Prospective Memory (CAPM) questionnaire and self-report of number of strategies used. Significant training-related gains were found on RAVLT learning and delayed recall and on CAPM informant report. Lower baseline scores predicted greater gains for several outcome measures. Patients with higher IQ or level of education showed more gains in number of strategies used. Shorter time since onset was related to gains in prospective memory, but no other stroke-related variables influenced outcome. Our study provides evidence that a relatively brief, group-based training intervention can improve memory functioning in chronic stroke patients and clarified some of the baseline factors that influence outcome.

  4. Meeting the expectations of chronic tinnitus patients: comparison of a structured group therapy program for tinnitus management with a problem-solving group.

    Science.gov (United States)

    Wise, K; Rief, W; Goebel, G

    1998-06-01

    Two different group treatments were evaluated in 144 in-patients suffering from impairment due to chronic tinnitus. A tinnitus management therapy (TMT) was developed using principles of cognitive-behavioral therapy and compared with problem solving group therapy. Self-ratings were used to evaluate the help patients found in dealing with life problems and tinnitus as well as the degree to which they felt they were being properly treated and taken seriously. Patients showed significantly more satisfaction with the TMT group and evaluated the help they found in coping with tinnitus and life problems significantly higher. Thus, in the light of unsatisfactory medical solutions and the poor acceptance of some psychological treatments for tinnitus, TMT appears to be an acceptable and helpful treatment program.

  5. A Randomized Single Blind Parallel Group Study Comparing Monoherbal Formulation Containing Holarrhena antidysenterica Extract with Mesalamine in Chronic Ulcerative Colitis Patients

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    Sarika Johari

    2016-01-01

    Full Text Available Background: Incidences of side effects and relapses are very common in chronic ulcerative colitis patients after termination of the treatment. Aims and Objectives: This study aims to compare the treatment with monoherbal formulation of Holarrhena antidysenterica with Mesalamine in chronic ulcerative colitis patients with special emphasis to side effects and relapse. Settings and Design: Patients were enrolled from an Ayurveda Hospital and a private Hospital, Gujarat. The study was randomized, parallel group and single blind design. Materials and Methods: The protocol was approved by Institutional Human Research Ethics Committee of Anand Pharmacy College on 23rd Jan 2013. Three groups (n = 10 were treated with drug Mesalamine (Group I, monoherbal tablet (Group II and combination of both (Group III respectively. Baseline characteristics, factors affecting quality of life, chronicity of disease, signs and symptoms, body weight and laboratory investigations were recorded. Side effects and complications developed, if any were recorded during and after the study. Statistical Analysis Used: Results were expressed as mean ± SEM. Data was statistically evaluated using t-test, Wilcoxon test, Mann Whitney U test, Kruskal Wallis test and ANOVA, wherever applicable, using GraphPad Prism 6. Results: All the groups responded positively to the treatments. All the patients were positive for occult blood in stool which reversed significantly after treatment along with rise in hemoglobin. Patients treated with herbal tablets alone showed maximal reduction in abdominal pain, diarrhea, and bowel frequency and stool consistency scores than Mesalamine treated patients. Treatment with herbal tablet alone and in combination with Mesalamine significantly reduced the stool infection. Patients treated with herbal drug alone and in combination did not report any side effects, relapse or complications while 50% patients treated with Mesalamine exhibited the relapse with

  6. Epilepsy health consumer groups and charities; how representative of patients are they? The results of a pilot study.

    Science.gov (United States)

    Grinton, M; Leavy, Y; Ahern, D; Hughes, F; Duncan, S

    2013-07-01

    In the United Kingdom all health care providers are encouraged to consult with user groups. The submissions of charities and patient advocacy groups to NICE and SIGN are considered reflective of the patient groups they purport to represent, yet little is known about how representative they are. This pilot study was designed to ascertain how many patients attending a hospital based epilepsy clinic were members of such advocacy groups. Patients were asked to complete a brief 9-question questionnaire before they left the clinic. One hundred and twenty-five questionnaires were distributed, of which 101 were returned. Seventeen percent of patients were members of advocacy groups, with several being members of more than one charity/group. Only seven percent of the respondents had ever been contacted by an advocacy group to canvass their opinions. Seventy percent of patients questioned stated they thought a frank discussion with their physician, or specialist nurse was more likely to influence patient services. Patients with long duration of disease and taking multiple anti-epileptic drugs were more likely to be members of charity/advocacy groups. As patient charities in the U.K. are often in receipt of public funds, and actively seek to influence public policy this raises the question of whether they should be required to consult more widely with the people they claim to represent. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  7. Comparing Profile of Temperament and Character Dimensions in Patients with Major Depressive Disorder and Bipolar Mood Disorder and Control Group in the Iranian Sample

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    shahram hajirezaei

    2017-06-01

    Full Text Available Objective: This study was conducted to compare the profile of Temperament and Character dimensions in patients with major depressive disorder and bipolar mood disorder and control group.Methods: In this causal-comparative study the population consisted of two clinical groups (major depressive disorder and bipolar mood disorder and a non-clinical group. The sample was 193 subjects (77 patients with major depressive disorder, 86 patients with bipolar mood disorder, and 30 normal people with an age range of 18-65 years and the mean age of 40.1. They were selected from Roozbeh psychiatric hospital using available sampling method. Tools used in this research included Temperament and Character Inventory-140 and General Health Questionnaire-28. Collected data were analyzed by statistical methods of independent t-test and one-way analysis of variance using Statistical Package for the Social Sciences-22 software.Result: The results of comparing the groups showed that there was a significant difference among groups in dimensions of Novelty Seeking, Harm Avoidance, Persistence, Self-Directedness and Cooperativeness (P <0.05. The results showed that only in the Novelty Seeking dimension, the mean was different in males and females (P <0.05.Conclusion: In general, our results showed that patients with major depressive disorder and bipolar mood disorder have different personality profile in some dimensions of Temperament and Character compared with control group.

  8. Coping strategies used by traumatic spinal cord injury patients in Sri Lanka: a focus group study.

    Science.gov (United States)

    Arya, Sumedha; Xue, Siqi; Embuldeniya, Amanda; Narammalage, Harsha; da Silva, Tricia; Williams, Shehan; Ravindran, Arun

    2016-10-01

    Psychosocial consequences of traumatic spinal cord injury (SCI) have been well documented in Western populations, but there is no published literature on such incidence in the Sri Lankan population. The purpose of this study was to explore the psychosocial impact of SCI in a Sri Lankan population and to examine this population's coping mechanisms. Participants were recruited purposively at the Ragama Rheumatology and Rehabilitation Hospital, the sole rehabilitation facility for SCI patients in Sri Lanka. Focus groups were conducted with 23 consenting individuals. Interview transcripts were analysed using descriptive thematic analysis. Four domains of life impact, three types of active coping strategies and four types of external supports were identified. Decreased ambulation and burden on family life were significant concerns for male and female participants alike. Religious practices were reported most frequently as active coping strategies, followed by positive reframing and goal-setting. Reported external supports included guided physiotherapy, informational workshops, social support and peer networks. Rehabilitation efforts for Sri Lankan SCI patients should be sensitive to psychosocial concerns in addition to physical concerns in order to help patients re-integrate into their family lives and community. Furthermore, religious practices should be respected as possible aids to rehabilitation. Implications for Rehabilitation Rehabilitative efforts should be conscientious of patients' psychosocial well-being in addition to their physical well-being. Hospital-based rehabilitative efforts for traumatic spinal cord injury patients should promote functional independence and community re-integration. Spiritual and/or religious practices should be respected as ways by which traumatic spinal cord injury patients may confront personal challenges that arise following injury.

  9. The utilization of formal and informal home care by older patients with cancer: a Belgian cohort study with two control groups.

    Science.gov (United States)

    Baitar, Abdelbari; Buntinx, Frank; De Burghgraeve, Tine; Deckx, Laura; Bulens, Paul; Wildiers, Hans; van den Akker, Marjan

    2017-09-12

    The purpose of this paper is to analyse the utilization of formal and informal home care among older patients with cancer (OCP) and to compare this with middle-aged patients with cancer (MCP) and older patients without cancer (ONC). Additionally, we examined predictors of transitions towards formal care one year after a cancer diagnosis. OCP and MCP had to be recruited within three months after a cancer diagnosis and have an estimated life expectancy over six months. ONC consisted of patients without known cancer, seen by the general practitioner. Formal and informal care were compared between the patient groups at baseline, i.e. shortly after a cancer diagnosis and changes in care were studied after one year. A total of 844 patients were evaluable for formal care at baseline and 469 patients (56%) at follow-up. At baseline, about half of older adults and 18% of MCP used formal care, while about 85% of cancer patients and 57% ONC used informal care. Formal care increased for all groups after one year though not significantly in OCP. The amount of informal care only changed in MCP which decreased after one year. Cancer-related factors and changes in need factors predict a transition towards formal care after a cancer diagnosis. A cancer diagnosis has a different impact on the use of formal and informal care than ageing as such. The first year after a cancer diagnosis is an important time to follow-up on the patients' needs for home care.

  10. Atrophy of sacrospinal muscle groups in patients with chronic, diffusely radiating lumbar back pain

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    Laasonen, E.M.

    1984-01-01

    After surgery necessitated by lumbar back pain syndromes, radiolucency verified by CT may appear in the sacrospinal muscle group on the operate side. This radiolucency represents muscular atrophy and is in its most severe form a result of the replacement of muscle tissue with adipose tissue. Such muscular atrophy appeared in the present series in 31 out of all 156 patients (19.9%) and in 29 out of 94 patients operated on because of radiating lumbar back pain (30.9%). The radiological appearance, extent, and HU values of this muscular atrophy are presented in detail. Only weak correlations with the multitude of clinical symptoms and signs were found in this retrospective study. The effects of irreversible muscular atrophy on the indications for surgery and physiotherapy are discussed.

  11. Atrophy of sacrospinal muscle groups in patients with chronic, diffusely radiating lumbar back pain

    International Nuclear Information System (INIS)

    Laasonen, E.M.

    1984-01-01

    After surgery necessitated by lumbar back pain syndromes, radiolucency verified by CT may appear in the sacrospinal muscle group on the operate side. This radiolucency represents muscular atrophy and is in its most severe form a result of the replacement of muscle tissue with adipose tissue. Such muscular atrophy appeared in the present series in 31 out of all 156 patients (19.9%) and in 29 out of 94 patients operated on because of radiating lumbar back pain (30.9%). The radiological appearance, extent, and HU values of this muscular atrophy are presented in detail. Only weak correlations with the multitude of clinical symptoms and signs were found in this retrospective study. The effects of irreversible muscular atrophy on the indications for surgery and physiotherapy are discussed. (orig.)

  12. Cholecystectomy and Diagnosis-Related Groups (DRGs: Patient Classification and Hospital Reimbursement in 11 European Countries

    Directory of Open Access Journals (Sweden)

    Gerli Paat-Ahi

    2014-12-01

    Full Text Available Background As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain compared how their Diagnosis-Related Groups (DRG systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England. The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

  13. Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Paat-Ahi, Gerli; Aaviksoo, Ain; Swiderek, Maria

    2014-12-01

    As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

  14. [Superficial mycoses: comparative study between type 2 diabetic patients and a non-diabetic control group].

    Science.gov (United States)

    García-Humbría, Leila; Richard-Yegres, Nicole; Pérez-Blanco, Maigualida; Yegres, Francisco; Mendoza, Mireya; Acosta, Arnaldo; Hernández, Rosaura; Zárraga, Eluz

    2005-03-01

    Superficial mycoses are considered to affect more frequently patients with type 2 diabetes mellitus (DM-2), specially onychomycosis and Tinea pedis. The purpose of this study was to compare the dermatophytoses, candidiasis and Pitiriasis versicolor frequency between 40 patients with DM-2 and 40 healthy persons of either sex, 40 years old or more. Clinical, metabolic, mycologic and inmunologic studies against Candida albicans, were carried out. Both diabetics 75% (30/40) and controls 65% (26/40) presented a high frequency of superficial mycoses (no significant difference p = 0.329). Pitiriasis versicolor was not detected in diabetic patients. They presented Tinea unguium, concomitant with Tinea pedis, with a higher frequency. The predominant dermatophyte was Trichophyton rubrum 18/23 (78%) in diabetics and 8/16 (50%) in non diabetics. Candida was isolated as commensal from oral mucous: 23/40 (58%) in diabetics and 21/40 (52%) in non diabetics (serotipo A was the more frequent), and from onychomycosis: 11/40 (28%) in diabetics and 12/40 (30%) in non diabetics. The immunological response was the same in both groups: celular 100%, humoral 20%. No statistical correlation among superficial mycoses, blood glucose level, glycosylated hemoglobin values or the time suffering the disease was observed. The high susceptibility to dermatophytes and Candida sp. infection showed to be associated with age and no with the diabetic type 2 condition in those patients.

  15. Baseline patient reported outcomes are more consistent predictors of long-term functional disability than laboratory, imaging or joint count data in patients with early inflammatory arthritis: A systematic review.

    Science.gov (United States)

    Gwinnutt, James M; Sharp, Charlotte A; Symmons, Deborah P M; Lunt, Mark; Verstappen, Suzanne M M

    2018-03-15

    To assess baseline predictors of long-term functional disability in patients with inflammatory arthritis (IA). We conducted a systematic review of the literature from 1990 to 2017 using MEDLINE and EMBASE. Studies were included if (i) they were prospective observational studies, (ii) all patients had IA with symptom duration ≤2 years at baseline, (iii) follow-up was at least 5 years, and (iv) baseline predictors of HAQ score at long-term follow-up (i.e., ≥5 years following baseline) were assessed. Information on the included studies and estimates of the association between baseline variables and long-term HAQ scores were extracted from the full manuscripts. Of 1037 abstracts identified by the search strategy, 37 met the inclusion/exclusion criteria and were included in the review. Older age at baseline and female gender were reported to be associated with higher long-term HAQ scores in the majority of studies assessing these relationships, as were higher baseline HAQ and greater pain scores (total patients included in analyses reporting significant associations/total number of patients analysed: age 9.8k/10.7k (91.6%); gender 9.9k/11.3k (87.4%); HAQ 4.0k/4.0k (99.0%); pain 2.8k/2.9k (93.6%)). Tender joint count, erythrocyte sedimentation rate (ESR) and DAS28 were also reported to predict long-term HAQ score; other disease activity measures were less consistent (tender joints 2.1k/2.5k (84.5%); erythrocyte sedimentation rate 1.6k/2.2k (72.3%); DAS28 888/1.1k (79.2%); swollen joints 684/2.6k (26.6%); C-reactive protein 279/510 (54.7%)). Rheumatoid factor (RF) and erosions were not useful predictors (RF 546/4.6k (11.9%); erosions 191/2.7k (7.0%)), whereas the results for anti-citrullinated protein antibody positivity were equivocal (ACPA 2.0k/3.8k (52.9%)). Baseline age, gender, HAQ and pain scores are associated with long-term disability and knowledge of these may aid the assessment of prognosis. Copyright © 2018 The Authors. Published by Elsevier Inc. All

  16. [MMPI-2 profiles in groups of systemic autoimmune disease - rheumatoid arthritis and systemic lupus erythematosus - patients].

    Science.gov (United States)

    Csókási, Krisztina; Hargitai, Rita; Járai, Róbert; Nagy, László; Czirják, László; Kiss, Enikö Csilla

    2015-01-01

    Systemic autoimmune diseases like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are characterized by the alteration of immunological response, which can damage many organs and systems and result in a wide variety of clinical presentations. In addition to physical symptoms, psychiatric disorders are also common to many autoimmune diseases. Anxiety, depression, psychosis and cognitive deficits have the highest prevalence. The aim of this study was to display the degree of psychopathological symptoms in patients with RA and SLE. Female inpatients with RA (N=68) and SLE (N=78) were recruited from the Rheumatology and Immunology Clinic of the University of Pecs and were asked to complete the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and a short demografical form. The clinical personality profiles of the patient groups were explored and compared with each other. High scores (above 64T) were detected on the Hypochondriasis (Hs), Depression (D) and Hysteria (Hy) scales in both groups. Besides, the participants performed elevated scores on the Masculinity-Feminity (Mf), Psychasthenia (Pt) and Social Introversion (Si) clinical scales. They scored in the elevated range on the Physical Malfunctioning, Subjective Depression, Lassitude-Malaise and Somatic Complaints subscales of the neurotic triad. No significant difference was found on the ten clinical scales between the SLE and RA patients. Characteristics of MMPI-2 profiles in SLE and RA patients seem to be the consequence of the disease and a common feature of chronic conditions. High scores on the neurotic triad scales may reflect the comorbid psychiatric disorders and the somatic symptoms alike, so further investigations with the revised Hungarian MMPI-2 are needed.

  17. SOCIAL PARTICIPATION OF DIABETES AND EX-LEPROSY PATIENTS IN THE NETHERLANDS AND PATIENT PREFERENCE FOR COMBINED SELF-CARE GROUPS

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    Henry John Christiaan De Vries

    2014-08-01

    Full Text Available Introduction: Earlier we showed that neuropathic complications limit social participation of ex-leprosy patients, even in a non-endemic leprosy setting like the Netherlands. Self-care groups for ex-leprosy patients can strengthen self-worth of participants, prevent further handicap, and enable the exchange of coping strategies. For non-endemic leprosy settings with a very low rate of leprosy patients a self-care group exclusively for (exleprosy patients is not likely to be feasible. A combined group with patients facing comparable morbidity would be more efficient than disease specific self-care groups. Here, we studied the comparability in social constraints of diabetic patients and ex-leprosy patients. Moreover, we investigated if combined self-care groups for ex-leprosy patients and diabetic patients would be desirable and acceptable for possible participants.Methods: Social participation was studied based on in-depth interviews and Participation Scale information collected from 41 diabetic patients and compared with the data of 31 ex-leprosy patients from a prior study. Moreover, we made an inventory of potential strengths and limitations and attitudes towards combined self-care groups for diabetic patients with neuropathy.Results: The following themes emerged among diabetic patients: disease confrontation, dependency, conflict with partner or relatives, feelings of inferiority, stigma, abandoning social activities, fear of the future, lack of information and hiding the disease. These themes were very similar to those voiced by the previously interviewed ex-leprosy patients. The latter more often mentioned stigma and disease ignorance among Dutch health care workers. Whereas ex-leprosy patients perceived stigma on multiple fronts, diabetic patients only mentioned feeling inferior. Diabetic patients experienced some form of participation restriction in 39% of the cases as opposed to 71% of the ex-leprosy patients. Diabetic patients did

  18. [On the Way to Culture-Sensitive Patient Information Materials: Results of a Focus Group Study].

    Science.gov (United States)

    Ries, Zivile; Frank, Fabian; Bermejo, Isaac; Kalaitsidou, Chariklia; Zill, Jördis; Dirmaier, Jörg; Härter, Martin; Bengel, Jürgen; Hölzel, Lars

    2018-06-01

    This study was part of a double-blind randomised controlled trial aimed to evaluate the effects of culture-sensitive patient information materials (PIM) compared with standard translated material. The study aimed to obtain the data for the development of culture sensitive PIM about unipolar depression for the 4 largest migrant groups in Germany (Turkish, Polish, Russian and Italian migration background). A qualitative study using 4 manual-based focus groups (FG), one for each migrant group, with 29 participants (9 with a Turkish (TüG), 8 with a Polish (PoG), 5 with a Russian (RuG) and 7 with an Italian (ItG) migration background) was conducted. The discussions were recorded, transcribed and analyzed using qualitative content analysis. 7 categories were identified. For the (1.) development of a good culture-sensitive PIM an easy language, a clear structure, an assessable extent of information and the avoidance of stereotypes were highlighted cross-culturally in all four FG. RuG and PoG had the largest (2.) lack of information about the German health care system. Concerning the (3.) illness perception RuG named problems with recognizing and understanding depression. PoG, RuG and TüG thematized (4.) feared consequences of the illness and of professional helpseeking. ItG, PoG, RuG had fears concerning (5.) psychotropic drugs as a result from insufficient knowledge about medication. For (6.) doctor-patient relationship cultural specifics were identified in RuG and TüG and for (7.) migration or culture specific reasons for depression in RuG, ItG and TüG. Although the identified categories were relevant for all or for the majority of migrant groups, for most categories specific cultural aspects were discovered. These findings show the importance of a culture sensitive adaptation of PIM. © Georg Thieme Verlag KG Stuttgart · New York.

  19. The Role of Support Groups, Advocacy Groups,andOther Interested Parties in Improving the Care of Patients with Congenital Adrenal Hyperplasia: Pleas and Warnings

    Directory of Open Access Journals (Sweden)

    Lee PeterA

    2010-05-01

    Full Text Available In the era of advocacy groups, it seems appropriate to contemplate how best to utilize them for patient benefit in the management of those with disorders of sex development (DSD, including those with congenital adrenal hyperplasia (CAH. Such interactions, to be constructive, require a spirit of cooperation to optimize outcomes. A traditional view of advocacy groups as a type of defender of patients' rights appears outdated and it is time that the benefits of their participation be fully realized. Open dialogue with all patients/families, including those who feel harmed by prior care are paramount. We discuss several recent examples of interactions that illustrate how dialogue in the name of "advocacy" can have a negative impact on developing a framework for ongoing constructive dialogue and actions. Such approaches completely change the dynamics of subsequent interactions. Physicians involved in the care of individuals with DSD, including those with CAH, and patients should be aware of confrontational techniques and legal implications that may be used by some advocacy groups. Hopefully recent efforts to promote a multidisciplinary care approach for patients with DSD/CAH will continue to foster mutual cooperation between team members, where the common goal is improving patient/family outcomes and quality of life.

  20. The Role of Support Groups, Advocacy Groups, and Other Interested Parties in Improving the Care of Patients with Congenital Adrenal Hyperplasia: Pleas and Warnings

    Directory of Open Access Journals (Sweden)

    Christopher P. Houk

    2010-01-01

    Full Text Available In the era of advocacy groups, it seems appropriate to contemplate how best to utilize them for patient benefit in the management of those with disorders of sex development (DSD, including those with congenital adrenal hyperplasia (CAH. Such interactions, to be constructive, require a spirit of cooperation to optimize outcomes. A traditional view of advocacy groups as a type of defender of patients' rights appears outdated and it is time that the benefits of their participation be fully realized. Open dialogue with all patients/families, including those who feel harmed by prior care are paramount. We discuss several recent examples of interactions that illustrate how dialogue in the name of “advocacy” can have a negative impact on developing a framework for ongoing constructive dialogue and actions. Such approaches completely change the dynamics of subsequent interactions. Physicians involved in the care of individuals with DSD, including those with CAH, and patients should be aware of confrontational techniques and legal implications that may be used by some advocacy groups. Hopefully recent efforts to promote a multidisciplinary care approach for patients with DSD/CAH will continue to foster mutual cooperation between team members, where the common goal is improving patient/family outcomes and quality of life.

  1. Confirmatory double-blind, parallel-group, placebo-controlled study of efficacy and safety of edaravone (MCI-186) in amyotrophic lateral sclerosis patients.

    Science.gov (United States)

    Abe, Koji; Itoyama, Yasuto; Sobue, Gen; Tsuji, Shoji; Aoki, Masashi; Doyu, Manabu; Hamada, Chikuma; Kondo, Kazuoki; Yoneoka, Takatomo; Akimoto, Makoto; Yoshino, Hiide

    2014-12-01

    Our objective was to confirm the efficacy and safety of edaravone in amyotrophic lateral sclerosis (ALS) patients. We conducted a 36-week confirmatory study, consisting of 12-week pre-observation period followed by 24-week treatment period. Patients received placebo or edaravone i.v. infusion over 60 min for the first 14 days in cycle 1, and for 10 of the first 14 days during cycles 2 to 6. The efficacy primary endpoint was changed in the revised ALS functional rating scale (ALSFRS-R) scores during the 24-week treatment. Patients were treated with placebo (n = 104) and edaravone (n = 102). Changes in ALSFRS-R during the 24-week treatment were -6.35 ± 0.84 in the placebo group (n = 99) and -5.70 ± 0.85 in the edaravone group (n = 100), with a difference of 0.65 ± 0.78 (p = 0.411). Adverse events amounted to 88.5% (92/104) in the placebo group and 89.2% (91/102) in the edaravone group. In conclusion, the reduction of ALSFRS-R was smaller in the edaravone group than in the placebo group, but efficacy of edaravone for treatment of ALS was not demonstrated. Levels and frequencies of reported adverse events were similar in the two groups.

  2. Mobile Technology Use Across Age Groups in Patients Eligible for Cardiac Rehabilitation: Survey Study.

    Science.gov (United States)

    Gallagher, Robyn; Roach, Kellie; Sadler, Leonie; Glinatsis, Helen; Belshaw, Julie; Kirkness, Ann; Zhang, Ling; Gallagher, Patrick; Paull, Glenn; Gao, Yan; Partridge, Stephanie Ruth; Parker, Helen; Neubeck, Lis

    2017-10-24

    Emerging evidence indicates mobile technology-based strategies may improve access to secondary prevention and reduce risk factors in cardiac patients. However, little is known about cardiac patients' use of mobile technology, particularly for health reasons and whether the usage varies across patient demographics. This study aimed to describe cardiac patients' use of mobile technology and to determine variations between age groups after adjusting for education, employment, and confidence with using mobile technology. Cardiac patients eligible for attending cardiac rehabilitation were recruited from 9 hospital and community sites across metropolitan and rural settings in New South Wales, Australia. Participants completed a survey on the use of mobile technology devices, features used, confidence with using mobile technology, willingness and interest in learning, and health-related use. The sample (N=282) had a mean age of 66.5 (standard deviation [SD] 10.6) years, 71.9% (203/282) were male, and 79.0% (223/282) lived in a metropolitan area. The most common diagnoses were percutaneous coronary intervention (33.3%, 94/282) and myocardial infarction (22.7%, 64/282). The majority (91.1%, 257/282) used at least one type of technology device, 70.9% (200/282) used mobile technology (mobile phone/tablet), and 31.9% (90/282) used all types. Technology was used by 54.6% (154/282) for health purposes, most often to access information on health conditions (41.4%, 117/282) and medications (34.8%, 98/282). Age had an important independent association with the use of mobile technology after adjusting for education, employment, and confidence. The youngest group (mobile technology than the oldest (>69 years) age group (odds ratio [OR] 4.45, 95% CI 1.46-13.55), 5 times more likely to use mobile apps (OR 5.00, 95% CI 2.01-12.44), and 3 times more likely to use technology for health-related reasons (OR 3.31, 95% CI 1.34-8.18). Compared with the older group, the middle age group (56

  3. Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study

    NARCIS (Netherlands)

    Boeft, M. den; Huisman, D.; Wouden, J.C. van der; Numans, M.E.; Horst, H.E. van der; Lucassen, P.L.B.J.; Olde Hartman, T.C.

    2016-01-01

    BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) form a heterogeneous group and frequently attend their family physician (FP). Little is known about how FPs recognize MUPS in their patients. We conducted a focus group study to explore how FPs recognize MUPS and whether they

  4. Lung function decline rates according to GOLD group in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Kim J

    2015-09-01

    Full Text Available Joohae Kim,1 Ho Il Yoon,2 Yeon-Mok Oh,3 Seong Yong Lim,4 Ji-Hyun Lee,5 Tae-Hyung Kim,6 Sang Yeub Lee,7 Jin Hwa Lee,8 Sang-Do Lee,3 Chang-Hoon Lee11Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, 3Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 5Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, 6Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, 7Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University, 8Department of Internal Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of KoreaBackground: Since the Global Initiative for Chronic Obstructive Lung Disease (GOLD groups A-D were introduced, the lung function changes according to group have been evaluated rarely.Objective: We investigated the rate of decline in annual lung function in patients categorized according to the 2014 GOLD guidelines.Methods: Patients with COPD included in the Korean Obstructive Lung Disease (KOLD prospective study, who underwent yearly postbronchodilator spirometry at least three times, were included. The main outcome was the annual decline in postbronchodilator forced expiratory volume in 1 second (FEV1, which was analyzed by

  5. Association of C-reactive protein positivity among groups of patients with knee osteoarthritis in Erbil

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    Helen Ahmed Pirdawood

    2017-08-01

    Full Text Available Background and objective: Osteoarthritis is the most common joint disease and a leading cause of disability. Increased circulating levels of C-reactive protein have been associated with prevalent knee osteoarthritis. This study aimed to assess the association between C- reactive protein positivity in patients with knee osteoarthritis in Erbil Methods: Data from100 participants in this case-control study were enrolled from May 1st to December 1st, 2015 in Rizgary Teaching Hospital in Erbil city. Data were divided into two groups. The cases included 50 patients (17 male and 33 female with a mean age of 58.9 ±3.8 years and diagnosed with primary knee osteoarthritis of one or both knee joints. Controls included 50 persons (17 male and 33 female with a mean age of 58.1 ±3.9 years without knee osteoarthritis and matched for age, sex, and body mass index. C-reactive protein qualitatively measured. Patients were radiologically assessed by Kellgren and Lawrence grading scale (grade 0-4. Results: C-reactive protein was positive in 41 out of 50 (82% of knee osteoarthritis patients compared to 3 out of 50 (6% of healthy controls (P = 0.001. C- reactive protein positivity among knee osteoarthritis patients were significantly associated with body mass index, positive family history of knee osteoarthritis, duration of diseases, and Kellgren and Lawrence grade (P 0.05. Conclusion: C-reactive protein positivity was significantly associated with knee osteoarthritis compared to healthy controls. Furthermore, body mass index, positive family history of knee osteoarthritis, early osteoarthritis, and Kellgren and Lawrence grade II, were significantly associated with positive C-reactive protein in knee osteoarthritis.

  6. Decreased serum levels of sex steroids associated with osteoporosis in a group of Romanian male patients

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    Popa Florina Ligia

    2016-03-01

    Full Text Available Introduction. With age, sex hormone deficiency leads to reduced bone mineral density (BMD in men. The aim of our research is to analyze the role of serum sex steroids in assessing BMD in the men included in this study. Materials and methods. This cross-sectional study included 146 men aged 65-85 years old with osteopenia or osteoporosis (study group and 121 men with normal BMD (control group. Serum levels of total testosterone (Tt and free testosterone (Tf were measured by immunoassay, and estradiol (E2 levels were measured by the immunoenzymatic method. Femoral neck and lumbar spine BMD was examined by dual-energy X-ray absorptiometry. Results. Tf and E2 deficiency was significantly associated with low BMD (p=0.007. No association was found between Tt deficiency and reduced BMD. Tf levels (p<0.001 and E2 levels (p=0.003 were significantly lower in patients with reduced BMD compared to those with normal BMD. Significant more cases with low levels of Tf (p=0.015 and E2 (p<0.001 were found in patients with osteoporosis compared to those with osteopenia. Conclusions. Sex hormones deficiency in men was significantly correlated with the decrease of BMD. Determination of serum Tf and E2 levels is important in assessing the risk of osteoporosis in male subjects.

  7. Unique transcriptomic response to sepsis is observed among patients of different age groups.

    Science.gov (United States)

    Raymond, Steven L; López, María Cecilia; Baker, Henry V; Larson, Shawn D; Efron, Philip A; Sweeney, Timothy E; Khatri, Purvesh; Moldawer, Lyle L; Wynn, James L

    2017-01-01

    Sepsis is a major cause of morbidity and mortality, especially at the extremes of age. To understand the human age-specific transcriptomic response to sepsis, a multi-cohort, pooled analysis was conducted on adults, children, infants, and neonates with and without sepsis. Nine public whole-blood gene expression datasets (636 patients) were employed. Age impacted the transcriptomic host response to sepsis. Gene expression from septic neonates and adults was more dissimilar whereas infants and children were more similar. Neonates showed reductions in inflammatory recognition and signaling pathways compared to all other age groups. Likewise, adults demonstrated decreased pathogen sensing, inflammation, and myeloid cell function, as compared to children. This may help to explain the increased incidence of sepsis-related organ failure and death in adults. The number of dysregulated genes in septic patients was proportional to age and significantly differed among septic adults, children, infants, and neonates. Overall, children manifested a greater transcriptomic intensity to sepsis as compared to the other age groups. The transcriptomic magnitude for adults and neonates was dramatically reduced as compared to children and infants. These findings suggest that the transcriptomic response to sepsis is age-dependent, and diagnostic and therapeutic efforts to identify and treat sepsis will have to consider age as an important variable.

  8. Differentiating progress in a clinical group of fibromyalgia patients during and following a multicomponent treatment program.

    Science.gov (United States)

    Van Den Houte, Maaike; Luyckx, Koen; Van Oudenhove, Lukas; Bogaerts, Katleen; Van Diest, Ilse; De Bie, Jozef; Van den Bergh, Omer

    2017-07-01

    Treatments including multiple nonpharmacological components have beneficial effects on the key symptoms of fibromyalgia, although effects are limited and often do not persist. In this study, we examined different patterns of clinical progress and the dynamic interplay between predictors and outcomes over time. Fibromyalgia patients (N=153; 135 women) followed a multidisciplinary group program spanning 12weeks, aimed at "regaining control over daily functioning". Anxiety, depression, pain coping and kinesiophobia were used as predictor variables. Outcome variables were pain severity, pain-related disability, physical functioning and functional interference. All variables were assessed at 3 moments: on the first and last day of treatment, and 12weeks after the last day of treatment. Overall treatment effects were analyzed using mixed model analyses. Latent class growth analysis identifying different treatment trajectory classes was used to investigate individual differences in treatment effects. Finally, cross-lagged structural equation models were used to investigate the dynamic interplay between predictors and outcomes over time. Only a fourth to a third of the total group showed improvement on the outcome variables. These patients had lower baseline anxiety, depression and kinesiophobia, and improved more on anxiety, depression and kinesiophobia. Physical well-being had a stronger effect on anxiety and depression than vice versa. Physical functioning predicted relative changes in kinesiophobia, while kinesiophobia predicted relative changes in pain-related disability. The results emphasize the importance of tailoring treatments to individual needs in order to improve overall effectiveness of treatment programs. Copyright © 2017. Published by Elsevier Inc.

  9. Nonmotor Symptoms Groups in Parkinson's Disease Patients: Results of a Pilot, Exploratory Study

    Directory of Open Access Journals (Sweden)

    Santiago Perez Lloret

    2011-01-01

    Full Text Available Nonmotor symptoms (NMS like neuropsychiatric symptoms, sleep disturbances or autonomic symptoms are a common feature of Parkinson's disease (PD. To explore the existence of groups of NMS and to relate them to PD characteristics, 71 idiopathic non-demented PD out-patients were recruited. Sleep was evaluated by the PD Sleep Scale (PDSS. Several neuropsychiatric, gastrointestinal and urogenital symptoms were obtained from the NMSQuest. Sialorrhea or dysphagia severity was obtained from the Unified PD Rating Scale activities of daily living section. MADRS depression scale was also administered. Exploratory factor analysis revealed the presence of 5 factors, explaining 70% of variance. The first factor included PDSS measurement of sleep quality, nocturnal restlessness, off-related problems and daytime somnolence; the second factor included nocturia (PDSS and nocturnal activity; the third one included gastrointestinal and genitourinary symptoms; the forth one included nocturnal psychosis (PDSS, sialorrhea and dysphagia (UPDRS; and the last one included the MADRS score as well as neuropsychiatric symptoms. Sleep disorders correlated with presence of wearing-off, nocturia with age >69 years, and nocturnal psychosis with levodopa equivalent dose or UPDRS II score. Neuropsychiatric symptoms correlated with UPDRS II+III score and non-tricyclic antidepressants. These results support the occurrence of significant NMS grouping in PD patients.

  10. The Role of Conformity in Relation to Cohesiveness and Intimacy in Day-Hospital Groups of Patients with Schizophrenia.

    Science.gov (United States)

    Park, Il Ho; Park, Sun Young; Choi, Sulkee; Lee, Soo Young; Kim, Jae-Jin

    2017-07-01

    Conformity is defined as the act of adjusting one's behavior to match the social responses of others. Patients with schizophrenia often adjust their maladaptive behaviors by conforming in group treatment settings. This study aimed to examine whether the opinions of group members influence conformity of patients with schizophrenia who attend day-hospital programs. Nineteen patients with schizophrenia from four different day-hospital programs and 23 healthy controls from four different social clubs completed the homographic meaning choice task under conditions of prior exposure to the pseudo-opinions of their group members, strangers, and unknown information sources. Group influences on conformity were observed when the level of group cohesiveness was high and the level of intimacy was low across participant groups. Controls did not exhibit a significant effect of group influence on conformity, whereas patients were significantly influenced by their group members when making conformity-based decisions despite significantly lower intimacy and cohesiveness levels. These findings suggest that unlike controls, patients with schizophrenia tend to respond with conformity when influenced by the opinions of their affiliated group. In patients with schizophrenia group conformity may be used to select a more accurate decision and to enhance feelings of affiliation among them.

  11. Temperament traits and psychopathy in a group of patients with antisocial personality disorder.

    Science.gov (United States)

    Basoglu, Cengiz; Oner, Ozgur; Ates, Alpay; Algul, Ayhan; Bez, Yasin; Ebrinc, Servet; Cetin, Mesut

    2011-01-01

    The Psychopathy Checklist Revised (PCL-R) and Temperament and Character Inventory (TCI) have been used extensively in research of personality disorders; however, no previous study has investigated the relation between psychopathy factors and temperament and character traits in patients with antisocial personality disorder (ASPD). Our aim was to fill this gap in the literature. The PCL-R Factor scores and the TCI temperament and character scores were evaluated in 68 men with ASPD and 65 healthy male controls. The ASPD cases had significantly higher PCL-R Factor 1, Factor 2, and Total scores, as well as significantly higher TCI Novelty Seeking and Harm Avoidance scores, whereas the control group had higher TCI Reward Dependence, Persistence, Self-Directedness, and Cooperativeness scores. Correlation analysis revealed that, in the whole study group, PCL-R Factor 1, Factor 2, and Total scores were positively correlated with Novelty Seeking and Harm Avoidance scores and negatively correlated with Reward Dependence, Persistence, Self-Directedness, and Cooperativeness scores. When each group was analyzed separately, the correlations were not significant. Regression analysis supported the main findings. Our results showed that both PCL-R Factor 1 score, which is claimed to reflect "core psychopathy," and PCL-R Factor 2 score, which reflects criminal behaviors, were positively correlated with Novelty Seeking and Harm Avoidance and were negatively correlated with Reward Dependence in the whole sample. The reduced variance of PCL-R in each group might lead to nonsignificant associations within groups. Without the subjects with severe psychopathy in the present study, it might not be possible to show the association. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. A Novel Geriatric Screening Tool in Older Patients with Cancer: The Korean Cancer Study Group Geriatric Score (KG-7.

    Directory of Open Access Journals (Sweden)

    Jin Won Kim

    Full Text Available Geriatric assessment (GA is resource-consuming, necessitating screening tools to select appropriate patients who need full GA. The objective of this study is to design a novel geriatric screening tool with easy-to-answer questions and high performance objectively selected from a large dataset to represent each domain of GA. A development cohort was constructed from 1284 patients who received GA from May 2004 to April 2007. Items representing each domain of functional status, cognitive function, nutritional status, and psychological status in GA were selected according to sensitivity (SE and specificity (SP. Of the selected items, the final questions were chosen by a panel of oncologists and geriatricians to encompass most domains evenly and also by feasibility and use with cancer patients. The selected screening questions were validated in a separate cohort of 98 cancer patients. The novel screening tool, the Korean Cancer Study Group Geriatric Score (KG-7, consisted of 7 items representing each domain of GA. KG-7 had a maximal area under the curve (AUC of 0.93 (95% confidence interval (CI 0.92-0.95 in the prediction of abnormal GA, which was higher than that of G-8 (0.87, 95% CI 0.85-0.89 within the development cohort. The cut-off value was decided at ≤ 5 points, with a SE of 95.0%, SP of 59.2%, positive predictive value (PPV of 85.3%, and negative predictive value (NPV of 82.6%. In the validation cohort, the AUC was 0.82 (95% CI 0.73-0.90, and the SE, SP, PPV, and NPV were 89.5%, 48.6%, 77.3%, and 75.0%, respectively. Furthermore, patients with higher KG-7 scores showed significantly longer overall survival (OS in the development and validation cohorts. In conclusions, the KG-7 showed high SE and NPV to predict abnormal GA. The KG-7 also predicted OS. Given the results of our studies, the KG-7 could be used effectively in countries with high patient burden and low resources to select patients in need of full GA and intervention.

  13. Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

    Science.gov (United States)

    van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

    2016-05-28

    The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional

  14. Survival of gastrointestinal stromal tumor patients in the imatinib era: life raft group observational registry

    Directory of Open Access Journals (Sweden)

    Call Jerry

    2012-03-01

    Full Text Available Abstract Background Gastrointestinal stromal tumors (GIST, one of the most common mesenchymal tumors of the gastrointestinal tract, prior to routine immunohistochemical staining and the introduction of tyrosine kinase inhibitors, were often mistaken for neoplasms of smooth muscle origin such as leiomyomas, leiomyosarcomas or leiomyoblastomas. Since the advent of imatinib, GIST has been further delineated into adult- (KIT or PDGFRα mutations and pediatric- (typified by wild-type GIST/succinate dehydrogenase deficiencies types. Using varying gender ratios at age of diagnosis we sought to elucidate prognostic factors for each sub-type and their impact on overall survival. Methods This is a long-term retrospective analysis of a large observational study of an international open cohort of patients from a GIST research and patient advocacy's lifetime registry. Demographic and disease-specific data were voluntarily supplied by its members from May 2000-October 2010; the primary outcome was overall survival. Associations between survival and prognostic factors were evaluated by univariate Cox proportional hazard analyses, with backward selection at P Results Inflections in gender ratios by age at diagnosis in years delineated two distinct groups: above and below age 35 at diagnosis. Closer analysis confirmed the above 35 age group as previously reported for adult-type GIST, typified by mixed primary tumor sites and gender, KIT or PDGFRα mutations, and shorter survival times. The pediatric group ( Conclusions Pediatric- and adult-type GIST have been previously characterized in clinical settings and these observations confirm significant prognostic factors for each from a diverse real-world cohort. Additionally, these findings suggest that extra diligence be taken with "young adults" (aged 18-35 at diagnosis as pediatric-type GIST may present well beyond adolescence, particularly as these distinct sub-types have different causes, and consequently

  15. Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

    International Nuclear Information System (INIS)

    Medina, Edhelmira Lima; Loques, Orlando Filho; Mesquita, Cláudio Tinoco

    2013-01-01

    The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences

  16. Integrating spirituality into a group psychological therapy program for cancer patients.

    Science.gov (United States)

    Cunningham, Alastair J

    2005-06-01

    Although the importance of spiritual issues to people with cancer is by now widely acknowledged, there has been almost no research on the value of interventions specifically designed to enhance the spiritual experience of these patients. The present report describes an exploratory study on the effects of a brief psychoeducational course emphasizing spiritual aspects of coping and healing. Ninety-seven patients with various types and stages of cancer took part in the 8-session course as the third stage in a progressive, stepwise program of support and psychological education. Standard psychometric tests were administered at entry, 8 weeks, and 6 months. Written home assignments, returned by participants, provided an insight into their experience. Significant improvements in scores were found immediately following the intervention; by 6 months, however, these improvements above entry level had declined to about half the 8-week value. In their written homework, patients grappled with such issues as doubts about the existence of a god, judgment and forgiveness, guilt, projection, self-importance, and the meaning of love. As the course progressed, many claimed to be better able to accept their condition and to experience an enhanced sense of meaning in their lives, coupled with a heightened appreciation for the events of everyday life and less tendency to conflict with others. These preliminary findings indicate that further, more rigorous investigation would be worthwhile and support the growing view that addressing spiritual issues within the framework of group therapy can be of great benefit to people with cancer.

  17. Increased serum levels of high mobility group box 1 protein in patients with autistic disorder.

    Science.gov (United States)

    Emanuele, Enzo; Boso, Marianna; Brondino, Natascia; Pietra, Stefania; Barale, Francesco; Ucelli di Nemi, Stefania; Politi, Pierluigi

    2010-05-30

    High mobility group box 1 (HMGB1) is a highly conserved, ubiquitous protein that functions as an activator for inducing the immune response and can be released from neurons after glutamate excitotoxicity. The objective of the present study was to measure serum levels of HMGB1 in patients with autistic disorder and to study their relationship with clinical characteristics. We enrolled 22 adult patients with autistic disorder (mean age: 28.1+/-7.7 years) and 28 age- and gender-matched healthy controls (mean age: 28.7+/-8.1 years). Serum levels of HMGB1 were measured by enzyme-linked immunosorbent assay (ELISA). Compared with healthy subjects, serum levels of HMGB1 were significantly higher in patients with autistic disorder (10.8+/-2.6 ng/mL versus 5.6+/-2.5 ng/mL, respectively, Pautistic disorder. Increased HMGB1 may be a biological correlate of the impaired reciprocal social interactions in this neurodevelopmental disorder. Copyright 2010 Elsevier Inc. All rights reserved.

  18. Cognitive profile of patients with rotated drawing at copy or recall: a controlled group study.

    Science.gov (United States)

    Molteni, Federica; Traficante, Debora; Ferri, Francesca; Isella, Valeria

    2014-03-01

    When copying or recalling a figure from memory, some patient with dementia or focal brain lesions may rotate the drawing through ±90° or 180°. We have tried to clarify the nature of this phenomenon by investigating the cognitive profile of 22 patients who rotated the copy of the Rey-Osterrieth Complex Figure and 27 who rotated (only) the recall, and two control groups of cases with the same neuropsychiatric diagnoses, but no misorientation deficit. Brain MRI and FDG-PET images were also analysed. Predictor of rotation at the copy versus rotation at the recall was visuospatial impairment as measured by the copy of the Rey Figure; predictors of rotation at the copy versus no rotation were, again, visuospatial deficits, in addition to an abnormal performance at the task of selective attention. No specific profile of cognitive impairment distinguished patients with and without rotation at the recall. Disproportionate temporo-parieto-occipital atrophy or hypometabolism were evident in cases with misorientation of the copy, while predominant frontal abnormalities were found in cases of rotated recall. Based on these findings, rotated drawing at the copy is interpreted as a dorsal visual stream deficit, whose occurrence is more probable when attentional control is impaired. Rotation at recall seems to have a distinct, more anterior, neural substrate, but its dysexecutive nature has yet to be demonstrated. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. All patient refined-diagnostic related group and case mix index in acute care palliative medicine.

    Science.gov (United States)

    Lagman, Ruth L; Walsh, Declan; Davis, Mellar P; Young, Brett

    2007-03-01

    The All Patient Refined-Diagnostic Related Group (APR-DRG) is a modification of the traditional DRG that adds four classes of illness severity and four classes of mortality risk. The APR-DRG is a more accurate assessment of the complexity of care. When individuals with advanced illness are admitted to an acute inpatient palliative medicine unit, there may be a perception that they receive less intense acute care. Most of these patients, however, are multisymptomatic, have several comorbidities, and are older. For all patients admitted to the unit, a guide was followed by staff physicians to document clinical information that included the site(s) of malignancy, site(s) of metastases, disease complications, disease-related symptoms, and comorbidities. We then prospectively compared DRGs, APR-DRGs, and case mix index (CMI) from January 1-June 30, 2003, and February 1-July 31,2004, before and after the use of the guide. The overall mean severity of illness (ASOI) increased by 25% (P DRG classifications captured a higher severity of illness and may better reflect resource utilization.

  20. Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Medina, Edhelmira Lima, E-mail: edhyly@ic.uff.br; Loques, Orlando Filho [Instituto de Computação - Universidade Federal Fluminense, Niterói, RJ (Brazil); Mesquita, Cláudio Tinoco [Hospital Universitário Antônio Pedro - Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2013-08-15

    The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences.

  1. MANAGEMENT OF CLINICALLY CURED TONSILLOPHARYNGITIS IN PATIENTS WITH GROUP A STREPTOCOCCUS ISOLATED FROM A PHARYNGEAL SWAB

    Directory of Open Access Journals (Sweden)

    Radica Živković-Zarić

    2015-12-01

    Full Text Available The group A streptococcus (GAS tonsillopharyngitis is a very common disease in children’s age. Inappropriate use of antibiotics is frequently encountered, both for treatment purposes and for eradication of the causative agents. The aim of our study was to discover reasons and causes for inappropriate use of antibiotics in children. We have used the triangulation approach to the problem which was studied by the analysis of interviews, observation of patient-cases and by the review of medical records. We discovered that prescribers had very different attitudes towards curing GAS tonsillopharyngitis as well as towards curing GAS carriage. The physicians were under the pressure to prescribe antibiotics and the parents were prone to administer antibiotics to children by themselves. Such behavior could be partially explained by the lack of funds for laboratory analyses. Moreover, the patients were still allowed to buy antibiotics without prescriptions. General culture of using antibiotics should be increased to a higher level among both health workers and parents in order to change some irrational behavior when managing patients who have been cured from streptococcal tonsillopharyngitis.

  2. Maintaining consistency in distributed systems

    Science.gov (United States)

    Birman, Kenneth P.

    1991-01-01

    In systems designed as assemblies of independently developed components, concurrent access to data or data structures normally arises within individual programs, and is controlled using mutual exclusion constructs, such as semaphores and monitors. Where data is persistent and/or sets of operation are related to one another, transactions or linearizability may be more appropriate. Systems that incorporate cooperative styles of distributed execution often replicate or distribute data within groups of components. In these cases, group oriented consistency properties must be maintained, and tools based on the virtual synchrony execution model greatly simplify the task confronting an application developer. All three styles of distributed computing are likely to be seen in future systems - often, within the same application. This leads us to propose an integrated approach that permits applications that use virtual synchrony with concurrent objects that respect a linearizability constraint, and vice versa. Transactional subsystems are treated as a special case of linearizability.

  3. Effectiveness of Spiritual Group Therapy on Quality of Life and Spiritual Well-Being among Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sakineh Zamaniyan

    2016-03-01

    Full Text Available Cancer is deemed the century’s major health problem, and its increasing growth during the last decades has made experts concerned more than ever. Of all types of cancer, breast cancer is regarded as the second most common disease among women. The aim of this study was to determine the effectiveness of spiritual group therapy on quality of life and spiritual well-being among patients suffering from breast cancer. The present research was carried out between March and June 2011. The sample consisted of 24 participants randomly assigned to 2 groups: an experimental group (n, 12 and a control group (n, 12. All the subjects completed questionnaires on quality of life and spiritual well-being in pretest and posttest. The experimental group received 12 sessions of spiritual group therapy. The results demonstrated improvement in quality of life and spiritual well-being in the experimental group. In conclusion, spiritual group therapy can be used to improve quality of life and spiritual well-being (religious health and existential health among patients with breast cancer.

  4. A group approach to genetic counselling of cardiomyopathy patients: satisfaction and psychological outcomes sufficient for further implementation.

    Science.gov (United States)

    Otten, Ellen; Birnie, Erwin; Ranchor, Adelita V; van Tintelen, J Peter; van Langen, Irene M

    2015-11-01

    The introduction of next-generation sequencing in everyday clinical genetics practise is increasing the number of genetic disorders that can be confirmed at DNA-level, and consequently increases the possibilities for cascade screening. This leads to a greater need for genetic counselling, whereas the number of professionals available to provide this is limited. We therefore piloted group genetic counselling for symptomatic cardiomyopathy patients at regional hospitals, to assess whether this could be an acceptable alternative to individual counselling. We performed a cohort study with pre- and post-counselling patient measurements using questionnaires, supplemented with evaluations of the group counselling format by the professionals involved. Patients from eight regional hospitals in the northern part of the Netherlands were included. Questionnaires comprised patient characteristics, psychological measures (personal perceived control (PPC), state and trait anxiety inventory (STAI)), and satisfaction with counsellors, counselling content and design. In total, 82 patients (mean age 57.5 year) attended one of 13 group sessions. Median PPC and STAI scores showed significantly higher control and lower anxiety after the counselling. Patients reported they were satisfied with the counsellors, and almost 75% of patients were satisfied with the group counselling. Regional professionals were also, overall, satisfied with the group sessions. The genetics professionals were less satisfied, mainly because of their perceived large time investment and less-than-expected group interaction. Hence, a group approach to cardiogenetic counselling is feasible, accessible, and psychologically effective, and could be one possible approach to counselling the increasing patient numbers in cardiogenetics.

  5. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Science.gov (United States)

    2010-06-28

    ... Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... guidance to employers, group health plans, and health insurance issuers providing group health insurance...

  6. Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

    2012-02-01

    As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure of appendectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that together comprised at least 97% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify appendectomy patients according to different sets of variables (between two and six classification variables) into diverging numbers of DRGs (between two and 11 DRGs). The most complex DRG is valued 5.1 times more resource intensive than an index case in France but only 1.1 times more resource intensive than an index case in Finland. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the most complex case vignette amount to only 1,005 in Poland but to 12,304 in France. Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries' DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement.

  7. Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP Applied to Caregivers of Patients With Dementia

    Directory of Open Access Journals (Sweden)

    Serena Passoni

    2018-06-01

    Full Text Available Caregivers of patients with dementia experience high levels of stress and burden, with effects comparable to those of a traumatic event. Eye Movement Desensitization and Reprocessing (EMDR appear to be effective in recovering post-traumatic stress disorder (PTSD. We aimed at investigating the effectiveness of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP on the “caregiver syndrome”. Forty-four primary caregivers entered the study. They were randomly assigned to either the “immediate” branch, who received the treatment soon after recruitment, or to the “delayed” branch, who received it two months after recruitment. The treatment consisted of eight group sessions (one per week spanning over two months. Emotional distress was measured before the treatment, immediately after the end of it, and two months later (follow-up, by means of several clinical scales (Impact of Event Scale-Revised, IES-R; Caregiver Needs Assessment, CNA; Caregiver Burden Inventory, CBI; Anxiety and Depression Scale-Reduced Form, AD-R. The “immediate” branch improved significantly more than the “delayed” (control branch on The Impact of Event Scale-Revised, the Anxiety, and the Depression scales; however, after treatment such an improvement was maintained only in the first scale. The “delayed” branch took less advantage of the treatment, showing significant reduction only on the Depression scale, an effect which disappeared at follow-up. These preliminary results show for the first time that EMDR-IGTP reduces stress-related symptoms, anxiety, and depression in caregivers of patients with dementia. Interestingly, caregivers who were inserted in a waiting list after recruitment showed smaller treatment effects. Larger samples are needed to better interpret such differential clinical profiles.

  8. Group participants' experiences of a patient-directed group-based education program for the management of type 2 diabetes mellitus.

    Science.gov (United States)

    Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

    2017-01-01

    The objective of this study was to explore the experiences of individuals who participated in a group-based education program, including their motivators in relation to their diabetes management, and the perceived impact of group interactions on participants' experiences and motivation for self-management. Understanding individuals diagnosed with diabetes experiences of group-based education for the management of type 2 diabetes mellitus may guide the development and facilitation of these programs. Semi-structured interviews were conducted with all individuals who participated in the intervention. Using thematic analysis underpinned by self-determination theory, we developed themes that explored participants' motivators in relation to diabetes management and the impact of group interactions on their experiences and motivation. The key themes included knowledge, experience, group interactions and motivation. Participants perceived that the group interactions facilitated further learning and increased motivation, achieved through normalization, peer identification or by talking with, and learning from the experience of others. The results support the use of patient-centred programs that prioritize group interactions over the didactic presentation of content, which may address relevant psychological needs of people diagnosed with type 2 diabetes mellitus, and improve their motivation and health behaviours. Future group-based education programs may benefit from the use of self-determination theory as a framework for intervention design to enhance participant motivation.

  9. Survival of gastrointestinal stromal tumor patients in the imatinib era: life raft group observational registry

    International Nuclear Information System (INIS)

    Call, Jerry; Walentas, Christopher D; Eickhoff, Jens C; Scherzer, Norman

    2012-01-01

    Gastrointestinal stromal tumors (GIST), one of the most common mesenchymal tumors of the gastrointestinal tract, prior to routine immunohistochemical staining and the introduction of tyrosine kinase inhibitors, were often mistaken for neoplasms of smooth muscle origin such as leiomyomas, leiomyosarcomas or leiomyoblastomas. Since the advent of imatinib, GIST has been further delineated into adult- (KIT or PDGFRα mutations) and pediatric- (typified by wild-type GIST/succinate dehydrogenase deficiencies) types. Using varying gender ratios at age of diagnosis we sought to elucidate prognostic factors for each sub-type and their impact on overall survival. This is a long-term retrospective analysis of a large observational study of an international open cohort of patients from a GIST research and patient advocacy's lifetime registry. Demographic and disease-specific data were voluntarily supplied by its members from May 2000-October 2010; the primary outcome was overall survival. Associations between survival and prognostic factors were evaluated by univariate Cox proportional hazard analyses, with backward selection at P < 0.05 used to identify independent factors. Inflections in gender ratios by age at diagnosis in years delineated two distinct groups: above and below age 35 at diagnosis. Closer analysis confirmed the above 35 age group as previously reported for adult-type GIST, typified by mixed primary tumor sites and gender, KIT or PDGFRα mutations, and shorter survival times. The pediatric group (< age 18 at diagnosis) was also as previously reported with predominantly stomach tumors, females, wild-type GIST or SDH mutations, and extended survival. 'Young adults' however formed a third group aged 18-35 at diagnosis, and were a clear mix of these two previously reported distinct sub-types. Pediatric- and adult-type GIST have been previously characterized in clinical settings and these observations confirm significant prognostic factors for each

  10. Medication withdrawal may be an option for a select group of patients in relapsing-remitting multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Guilherme Sciascia do Olival

    2013-08-01

    Full Text Available This article describes the clinical and radiological evolution of a stable group of patients with relapsing-remitting multiple sclerosis that had their disease-modifying therapy (DMT withdrawn. Forty patients, which had made continuous use of one immunomodulator and had remained free of disease for at least 5 years, had their DMT withdrawn and were observed from 13 to 86 months. Out of the followed patients, 4 (10% patients presented with new attacks. In addition to these patients, 2 (5% patients had new lesions revealed by magnetic resonance imaging that did not correspond to clinical attacks. Despite these results, the difficult decision to withdraw medication requires careful analysis. Withdrawal, however, should not be viewed as simply the suspension of treatment because these patients should be evaluated periodically, and the immunomodulators should be readily reintroduced if new attacks occur. Nonetheless, medication withdrawal is an option for a select group of patients.

  11. Survival benefit of pancreaticoduodenectomy in a Japanese fashion for a limited group of patients with pancreatic head cancer.

    Science.gov (United States)

    Takao, Sonshin; Shinchi, Hiroyuki; Maemura, Kosei; Kurahara, Hiroshi; Natsugoe, Shoji; Aikou, Takashi

    2008-01-01

    To evaluate the clinical benefit of pancreaticoduodenectomy in a Japanese fashion for patients with pancreatic head cancer. One hundred and one patients underwent pancreatectomy for pancreatic head cancer between 1980 and 2001. Of these, 40 patients in the extended resection (ER) group had an extended lymphadenectomy and neural plexus dissection as a Japanese fashion, while 61 patients in the conventional resection (CR) group. Tumor status, morbidity, mortality, survival and pattern of recurrence were retrospectively studied. The incidence of R0 operations in the ER group was higher than that in the CR group (pJapanese fashion with an adequate extended resection might bring a survival benefit for patients with pStage IIA or IIB pancreatic head cancer.

  12. Low body weight and type of protease inhibitor predict discontinuation and treatment-limiting adverse drug reactions among HIV-infected patients starting a protease inhibitor regimen: consistent results from a randomized trial and an observational cohort

    DEFF Research Database (Denmark)

    Kirk, O; Gerstoft, J; Pedersen, C

    2001-01-01

    OBJECTIVES: To assess predictors for discontinuation and treatment-limiting adverse drug reactions (TLADR) among patients starting their first protease inhibitor (PI). METHODS: Data on patients starting a PI regimen (indinavir, ritonavir, ritonavir/saquinavir and saquinavir hard gel) in a randomi......OBJECTIVES: To assess predictors for discontinuation and treatment-limiting adverse drug reactions (TLADR) among patients starting their first protease inhibitor (PI). METHODS: Data on patients starting a PI regimen (indinavir, ritonavir, ritonavir/saquinavir and saquinavir hard gel....... Low body weight and initiation of ritonavir relative to other PIs were associated with an increased risk of TLADRs. Very consistent results were found in a randomized trial and an observational cohort....

  13. Group of family companions of hospitalized patients: an occupational therapy intervention strategy in a general hospital

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira Dahdah

    2013-08-01

    Full Text Available There is a consensus in the literature that the company of a family member during the hospitalization period increases patient recovery. However, this can have some negative effects on the caregiver’s health. With the purpose of reducing these negatives effects, it is useful to let family members express themselves. The State Hospital of Ribeirão Preto created a Group of Family Companions coordinated by the Occupational Therapy and Social Service. This study focuses on the assistance offered in a general hospital to families that undergo the whole illness and hospitalization process of their family member, suffering the impacts of this process in their daily lives, and on the intervention of Occupational Therapy in these cases.

  14. Merging Children's Oncology Group Data with an External Administrative Database Using Indirect Patient Identifiers: A Report from the Children's Oncology Group.

    Directory of Open Access Journals (Sweden)

    Yimei Li

    Full Text Available Clinical trials data from National Cancer Institute (NCI-funded cooperative oncology group trials could be enhanced by merging with external data sources. Merging without direct patient identifiers would provide additional patient privacy protections. We sought to develop and validate a matching algorithm that uses only indirect patient identifiers.We merged the data from two Phase III Children's Oncology Group (COG trials for de novo acute myeloid leukemia (AML with the Pediatric Health Information Systems (PHIS. We developed a stepwise matching algorithm that used indirect identifiers including treatment site, gender, birth year, birth month, enrollment year and enrollment month. Results from the stepwise algorithm were compared against the direct merge method that used date of birth, treatment site, and gender. The indirect merge algorithm was developed on AAML0531 and validated on AAML1031.Of 415 patients enrolled on the AAML0531 trial at PHIS centers, we successfully matched 378 (91.1% patients using the indirect stepwise algorithm. Comparison to the direct merge result suggested that 362 (95.7% matches identified by the indirect merge algorithm were concordant with the direct merge result. When validating the indirect stepwise algorithm using the AAML1031 trial, we successfully matched 157 out of 165 patients (95.2% and 150 (95.5% of the indirectly merged matches were concordant with the directly merged matches.These data demonstrate that patients enrolled on COG clinical trials can be successfully merged with PHIS administrative data using a stepwise algorithm based on indirect patient identifiers. The merged data sets can be used as a platform for comparative effectiveness and cost effectiveness studies.

  15. Measuring consistency of autobiographical memory recall in depression.

    LENUS (Irish Health Repository)

    Semkovska, Maria

    2012-05-15

    Autobiographical amnesia assessments in depression need to account for normal changes in consistency over time, contribution of mood and type of memories measured. We report herein validation studies of the Columbia Autobiographical Memory Interview - Short Form (CAMI-SF), exclusively used in depressed patients receiving electroconvulsive therapy (ECT) but without previous published report of normative data. The CAMI-SF was administered twice with a 6-month interval to 44 healthy volunteers to obtain normative data for retrieval consistency of its Semantic, Episodic-Extended and Episodic-Specific components and assess their reliability and validity. Healthy volunteers showed significant large decreases in retrieval consistency on all components. The Semantic and Episodic-Specific components demonstrated substantial construct validity. We then assessed CAMI-SF retrieval consistencies over a 2-month interval in 30 severely depressed patients never treated with ECT compared with healthy controls (n=19). On initial assessment, depressed patients produced less episodic-specific memories than controls. Both groups showed equivalent amounts of consistency loss over a 2-month interval on all components. At reassessment, only patients with persisting depressive symptoms were distinguishable from controls on episodic-specific memories retrieved. Research quantifying retrograde amnesia following ECT for depression needs to control for normal loss in consistency over time and contribution of persisting depressive symptoms.

  16. Measuring consistency of autobiographical memory recall in depression.

    Science.gov (United States)

    Semkovska, Maria; Noone, Martha; Carton, Mary; McLoughlin, Declan M

    2012-05-15

    Autobiographical amnesia assessments in depression need to account for normal changes in consistency over time, contribution of mood and type of memories measured. We report herein validation studies of the Columbia Autobiographical Memory Interview - Short Form (CAMI-SF), exclusively used in depressed patients receiving electroconvulsive therapy (ECT) but without previous published report of normative data. The CAMI-SF was administered twice with a 6-month interval to 44 healthy volunteers to obtain normative data for retrieval consistency of its Semantic, Episodic-Extended and Episodic-Specific components and assess their reliability and validity. Healthy volunteers showed significant large decreases in retrieval consistency on all components. The Semantic and Episodic-Specific components demonstrated substantial construct validity. We then assessed CAMI-SF retrieval consistencies over a 2-month interval in 30 severely depressed patients never treated with ECT compared with healthy controls (n=19). On initial assessment, depressed patients produced less episodic-specific memories than controls. Both groups showed equivalent amounts of consistency loss over a 2-month interval on all components. At reassessment, only patients with persisting depressive symptoms were distinguishable from controls on episodic-specific memories retrieved. Research quantifying retrograde amnesia following ECT for depression needs to control for normal loss in consistency over time and contribution of persisting depressive symptoms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Recommendations for the Involvement of Patient Research Partners (PRP) in OMERACT Working Groups. A Report from the OMERACT 2014 Working Group on PRP.

    Science.gov (United States)

    Cheung, Peter P; de Wit, Maarten; Bingham, Clifton O; Kirwan, John R; Leong, Amye; March, Lyn M; Montie, Pam; Scholte-Voshaar, Marieke; Gossec, Laure

    2016-01-01

    Patient participation in research is increasing; however, practical guidelines to enhance this participation are lacking. Specifically within the Outcome Measures in Rheumatology (OMERACT) organization, although patients have participated in OMERACT meetings since 2002, consensus about the procedures for involving patients in working groups has not been formalized. The objective is to develop a set of recommendations regarding patient research partner (PRP) involvement in research working groups. We conducted a systematic literature review on recommendations/guidelines of PRP involvement in research; elaborated a structured consensus process involving multiple participants to develop a set of recommendations; and sought endorsement of recommendations by OMERACT. In the 18 articles included in the literature review, there was general agreement on the broad concepts for recommendations covering PRP involvement in research although they were heterogeneous in detail. Most considered PRP involvement in all phases of research with early engagement, training, and support important, but details on the content were scarce. This review informed a larger consensus-building process regarding PRP inclusion in OMERACT research. Three overarching principles and 8 recommendations were developed, discussed, and refined at OMERACT 2014. The guiding principles were endorsed during the OMERACT plenary session. These recommendations for PRP involvement in OMERACT research reinforce the importance of patient participation throughout the research process as integral members. Although the applicability of the recommendations in other research contexts should be assessed, the generalizability is expected to be high. Future research should evaluate their implementation and their effect on outcome development.

  18. Comparison of Masking Level Difference in Patients with Multiple Sclerosis and Healthy Control Group

    Directory of Open Access Journals (Sweden)

    Soghrat Faghihzadeh

    2012-03-01

    Full Text Available Background and Aim: Multiple sclerosis (MS is a neurological disorder that involves central nervous system. Studies have showed that multiple sclerosis affects behavioral central auditory tests, such as masking release or masking level difference (MLD. The purpose of this study is to compare the masking level difference between multiple sclerosis patients and normal subjects.Methods: This cross sectional and non-interventional study was conducted on 32 multiple sclerosis patients aged between 20-50 years and 32 controls matched for age and gender in Faculty of Rehabilitation, Tehran University of Medical Sciences. masking level difference test was performed on each subject.Results: The mean masking level difference in the two groups was significantly different (p<0.01 however, gender did not prove to play a role in this difference.Conclusion: As part of the multiple sclerosis diagnosis panel, masking level difference test is an efficient modality for evaluation of hearing impairment and monitoring of rehabilitation progress.

  19. Serological Evidence of Immune Priming by Group A Streptococci in Patients with Acute Rheumatic Fever

    Directory of Open Access Journals (Sweden)

    Jeremy M Raynes

    2016-07-01

    Full Text Available Acute rheumatic fever (ARF is an autoimmune response to Group A Streptococcus (GAS infection. Repeated GAS exposures are proposed to ‘prime’ the immune system for autoimmunity. This notion of immune-priming by multiple GAS infections was first postulated in the 1960s, but direct experimental evidence to support the hypothesis has been lacking. Here we present novel methodology, based on antibody responses to GAS T‑antigens, that enables previous GAS exposures to be mapped in patient sera. T-antigens are surface expressed, type specific antigens and GAS strains fall into 18 major clades or T-types. A panel of recombinant T-antigens was generated and immunoassays were performed in parallel with serum depletion experiments allowing type-specific T‑antigen antibodies to be distinguished from cross-reactive antibodies. At least two distinct GAS exposures were detected in each of the ARF sera tested. Furthermore, no two sera had the same T-antigen reactivity profile suggesting that each patient was exposed to a unique series of GAS T‑types prior to developing ARF. The methods have provided much-needed experimental evidence to substantiate the immune-priming hypothesis, and will facilitate further serological profiling studies that explore the multifaceted interactions between GAS and the host.

  20. Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.

    Science.gov (United States)

    Aamland, Aase; Werner, Erik L; Malterud, Kirsti

    2013-06-01

    Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality. Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

  1. Focused development of advanced practice nurse roles for specific patient groups in a Swiss university hospital

    Science.gov (United States)

    Spichiger, Elisabeth; Zumstein-Shaha, Maya; Schubert, Maria; Herrmann, Luzia

    2018-02-01

    Background: To cover future health care needs of the population, new care models are necessary. The development of advanced nursing practice (ANP) offers the opportunity to meet these challenges with novel services. At the Inselspital, Bern University Hospital, ANP services and corresponding advanced practice nurse (APN) roles have been developed since 2011. Purpose: The aim is to develop innovative and evidence based ANP services to supplement health care for specific patient groups and their family members with the goal to improve safety and achieve better outcomes. Methods: Project-based ANP services are developed in close collaboration of clinical departments and the Nursing Development Unit (NDU) of the Directorate of Nursing. Structure, process and outcome data are collected for evaluation. Findings: Currently, five ANP services are established and running, eight more are in the developmental phase. Most services address the long term care of patients with chronic illnesses and their family members. Ten APNs work between 10 % and 80 %, three are leading an ANP-team. APNs work over 50 % in direct clinical practice, primarily in counselling. An ANP network connects APNs and NDU, promoting synergy and exchange. Conclusions: The available resources often constitute a challenge for the development of ANP services. Vital for the long-term success are an adequate extent of the position, the support by department directorate, the conceptual framework that is implemented across the whole hospital, and the development within project structures.

  2. Readthrough of stop codons by use of aminoglycosides in cells from xeroderma pigmentosum group C patients.

    Science.gov (United States)

    Kuschal, Christiane; Khan, Sikandar G; Enk, Benedikt; DiGiovanna, John J; Kraemer, Kenneth H

    2015-04-01

    Readthrough of premature termination (stop) codons (PTC) is a new approach to treatment of genetic diseases. We recently reported that readthrough of PTC in cells from some xeroderma pigmentosum complementation group C (XP-C) patients could be achieved with the aminoglycosides geneticin or gentamicin. We found that the response depended on several factors including the PTC sequence, its location within the gene and the aminoglycoside used. Here, we extended these studies to investigate the effects of other aminoglycosides that are already on the market. We reasoned that topical treatment could deliver much higher concentrations of drug to the skin, the therapeutic target, and thus increase the therapeutic effect while reducing renal or ototoxicity in comparison with systemic treatment. Our prior clinical studies indicated that only a few percent of normal XPC expression was associated with mild clinical disease. We found minimal cell toxicity in the XP-C cells with several aminoglycosides. We found increased XPC mRNA expression in PTC-containing XP-C cells with G418, paromomycin, neomycin and kanamycin and increased XPC protein expression with G418. We conclude that in selected patients with XP, topical PTC therapy can be investigated as a method of personalized medicine to alleviate their cutaneous symptoms. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  3. The efficacy of a brief group CBT program in treating patients diagnosed with bulimia nervosa: a brief report

    DEFF Research Database (Denmark)

    Jones, Allan; Clausen, Loa

    2013-01-01

    OBJECTIVE: The aim of the study was to evaluate the efficacy of a brief group cognitive behavior therapy (CBT) program in treating a large cohort of patients diagnosed with bulimia nervosa. METHOD: Treatment outcome defined as reductions in bulimia related behavioral symptoms and bulimia related...... distress was examined in 205 consecutive new patients enrolled in an eight-session group CBT program. RESULTS: Significant reductions in eating disorder pathology were found on all measures of bulimia related behavioral symptoms, as well as on all measures of bulimia related distress. DISCUSSION......: There is strong evidence for the efficacy of brief group CBT in treating patients with bulimia nervosa....

  4. Cognitive behavioral group therapy in panic disorder patients: the efficacy of CBGT versus drug treatment.

    Science.gov (United States)

    Dannon, Pinhas N; Gon-Usishkin, M; Gelbert, A; Lowengrub, K; Grunhaus, L

    2004-01-01

    The aim of our study was to evaluate the effectiveness of Cognitive Behavioral Group Therapy (CBGT) in the treatment of Panic Disorder (PD) and to compare the treatment outcome of CBGT versus Paroxetine pharmacotherapy. Fifty seven patients referred to our anxiety disorder clinic for the treatment of PD were randomly allocated to receive either CBGT or Paroxetine. Follow up was done by a masked rater after four and twelve weeks of treatment in order to compare the efficacy of CBGT versus Paroxetine. CBGT and Paroxetine were both effective in the short-term treatment of PD. Assessments at weeks four and twelve of treatment showed no statistically significant differences between the two groups in terms of treatment outcome. Treatment with CBGT alone for the acute phase of PD appears to be equally efficacious to treatment with Paroxetine alone. Our study shows that CBGT produced beneficial results, for it was associated with a reduction in the number and frequency of panic attacks and with an improved feeling of well-being.

  5. Social participation of diabetes and ex-leprosy patients in the Netherlands and patient preference for combined self-care groups.

    Science.gov (United States)

    de Vries, Henry J C; de Groot, Roos; van Brakel, Wim H

    2014-01-01

    Earlier, we showed that neuropathic complications limit social participation of ex-leprosy patients, even in a non-endemic leprosy setting like the Netherlands. Self-care groups for ex-leprosy patients can strengthen self-worth of participants, prevent further handicap, and enable the exchange of coping strategies. For non-endemic leprosy settings with a very low rate of leprosy patients, a self-care group exclusively for (ex)leprosy patients is not likely to be feasible. A combined group with patients facing comparable morbidity would be more efficient than disease-specific self-care groups. Here, we studied the comparability in social constraints of diabetic patients and ex-leprosy patients. Moreover, we investigated if combined self-care groups for ex-leprosy patients and diabetic patients would be desirable and acceptable for possible participants. Social participation was studied based on in-depth interviews and Participation Scale information collected from 41 diabetic patients and compared with the data of 31 ex-leprosy patients from a prior study. Moreover, we made an inventory of potential strengths and limitations and attitudes toward combined self-care groups for diabetic patients with neuropathy. The following themes emerged among diabetic patients: disease confrontation, dependency, conflict with partner or relatives, feelings of inferiority, stigma, abandoning social activities, fear of the future, lack of information, and hiding the disease. These themes were very similar to those voiced by the previously interviewed ex-leprosy patients. The latter more often mentioned stigma and disease ignorance among Dutch health care workers. Whereas ex-leprosy patients perceived stigma on multiple fronts, diabetic patients only mentioned feeling inferior. Diabetic patients experienced some form of participation restriction in 39% of the cases as opposed to 71% of the ex-leprosy patients. Diabetic patients did acknowledge the comparability with leprosy as far as

  6. [Prescription patterns for antilipidemic drugs in a group of Colombian patients].

    Science.gov (United States)

    Machado, Jorge Enrique; Moncada, Juan Carlos; Mesa, Giovanny

    2008-03-01

    To determine patterns in antilipidemic drug prescriptions among a group of patients covered by the General Social Security System (Sistema General de Seguridad Social) in Colombia. A descriptive, observational study was conducted of 41 580 hyperlipidemics of both sexes, who were over 20 years of age, undergoing treatment from at least April to June 2006, and were residents of one of 19 cities in Colombia. A database was created to track prescription data collected by the pharmaceutical company that dispenses medications to the patients. The mean age was 58.4+/-13.5 years; 58.9% of the participants were women. Of the total number of patients, 95.6% were receiving monotherapy, while 4.4% were receiving two or more antilipidemics. Prescriptions were ranked as follows: statins (70.9%), fibrates (27.5%), bile acid sequestrant resins (0.9%), and others (0.7%), all at low dosage levels. The most common therapy combinations were lovastatin + gemfibrozil (n = 1 568), cholestyramine + gemfibrozil (n = 92), and cholestyramine + lovastatin (n = 78). Comedications most frequently prescribed were: antihypertensive (60.9%), antiinflammatory (56.5%), antiulcer (22.9%), and antidiabetes drugs (20.6%), and acetylsalicylic acid (ASA, 3.8%). Antianginals and ASA were being underused, while antiinflamatories and antiulcer drugs were being overused. Dyslipidemia is a primary risk factor for developing coronary heart disease and stroke, frequent causes of morbidity and mortality in Colombia and the world. All of the antilipidemics are being used at lower-than-recommended dosage levels. Clearly there is a need for creating educational strategies to address these prescribing habits and for exploring clinical results of the pharmaceuticals studied.

  7. Construct validity, test-retest reliability and internal consistency of the Thai version of the disabilities of the arm, shoulder and hand questionnaire (DASH-TH) in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Buntragulpoontawee, Montana; Phutrit, Suphatha; Tongprasert, Siam; Wongpakaran, Tinakon; Khunachiva, Jeeranan

    2018-03-27

    This study evaluated additional psychometric properties of the Thai version of the disabilities of the arm, shoulder and hand questionnaire (DASH-TH) which included, test-retest reliability, construct validity, internal consistency of in patients with carpal tunnel syndrome. As for determining construct validity, the Thai EuroQOL questionnaire (EQ-5D-5L) was also administered in order to examine convergent and divergent validity. Fifty patients completed both questionnaires. The DASH-TH showed excellent test-retest reliability (intraclass correlation coefficient = 0.811) and internal consistency (Cronbach's alpha = 0.911). The exploratory factor analysis yielded a six-factor solution while the confirmatory factor analysis denoted that the hypothesized model adequately fit the data with a comparative fit index of 0.967 and a Tucker-Lewis index of 0.964. The related subscales between the DASH-TH and the Thai EQ-5D-5L were significantly correlated, indicating the DASH-TH's convergent and discriminant validity. The DASH-TH demonstrated good reliability, internal consistency construct validity, and multidimensionality, in assessing the upper extremity function in carpal tunnel syndrome patients.

  8. Validation of the Spine Oncology Study Group-Outcomes Questionnaire to assess quality of life in patients with metastatic spine disease.

    Science.gov (United States)

    Janssen, Stein J; Teunis, Teun; van Dijk, Eva; Ferrone, Marco L; Shin, John H; Hornicek, Francis; Schwab, Joseph H

    2017-06-01

    General questionnaires are often used to assess quality of life in patients with spine metastases, although a disease-specific survey did not exist until recently. The Spine Oncology Study Group has developed an outcomes questionnaire (SOSG-OQ) to measure quality of life in these patients. However, a scoring system was not developed, and the questionnaire was not validated in a group of patients, nor was it compared with other general quality of life questionnaires such as the EuroQol 5 Dimensions (EQ-5D) questionnaire. Our primary null hypothesis is that there is no association between the SOSG-OQ and EQ-5D. Our secondary null hypothesis is that there is no difference in coverage and internal consistency between the SOSG-OQ and EQ-5D. We also assess coverage, consistency, and validity of the domains within the SOSG-OQ. A survey study from a tertiary care spine referral center was used for this study. The patient sample consisted of 82 patients with spine metastases, myeloma, or lymphoma. The SOSG-OQ (27 questions, 6 domains) score ranges from 0 to 80, with a higher score indicating worse quality of life. The EQ-5D (5 questions, 5 domains) index score ranges from 0 to 1, with a higher score indicating better quality of life. The association between the SOSG-OQ and EQ-5D index score was assessed using the Spearman rank correlation. Instrument coverage and precision were assessed by determining item completion rate, median score with range, and floor and ceiling effect. Internal consistency was assessed using Cronbach alpha. Multitrait analysis and exploratory factor analysis were used to analyze properties of the individual domains in the SOSG-OQ. The Spearman rank correlation between the SOSG-OQ and EQ-5D questionnaire was high (r=-0.83, pquality of life in patients with metastatic spine disease. The SOSG-OQ is superior to the EQ-5D in terms of coverage and internal consistency but consists of more questions. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Should Health Care Organizations Use Information Gleaned from Organization-Sponsored Patient Support Groups in Strategic Planning?

    Science.gov (United States)

    Nambisan, Priya

    2017-11-01

    Online forums and partnerships with patients have several benefits, such as the creation of new products and services. However, as with any such initiatives, there are risks as well as benefits. Through analysis of a case of misinformation being spread through a health care provider-sponsored online support group for patients dealing with obesity, this article outlines best practices and strategies to deploy in such organization-sponsored patient support groups. These strategies would enable organizations and patients to use such forums to the fullest extent while preventing or managing their potential risks as best as possible. © 2017 American Medical Association. All Rights Reserved.

  10. New patient with both xeroderma pigmentosum and Cockayne syndrome establishes the new xeroderma pigmentosum complementation group H

    International Nuclear Information System (INIS)

    Moshell, A.N.; Ganges, M.B.; Lutzner, M.A.; Coon, H.G.; Barrett, S.F.; Dupuy, J.M.; Robbins, J.H.

    1983-01-01

    A second patient, XP-CS-2, has been discovered with both xeroderma pigmentosum and Cockayne syndrome. His fibroblasts have 30% of the normal rate of uv-induced unscheduled DNA synthesis. His fibroblasts were fused with those from each of the xeroderma pigmentosum groups A through G. His cells complemented every cell line, since in each case there were obtained multinucleate cells which had a normal amount of uv-induced unscheduled DNA synthesis. Since the XP-CS-2 cells complement all the currently established xeroderma pigmentosum complementation groups, this new XP-CS patient is in a new group which we designate group H. 10 references, 1 figure

  11. Modified risk stratification grouping using standard clinical and biopsy information for patients undergoing radical prostatectomy: Results from SEARCH.

    Science.gov (United States)

    Zumsteg, Zachary S; Chen, Zinan; Howard, Lauren E; Amling, Christopher L; Aronson, William J; Cooperberg, Matthew R; Kane, Christopher J; Terris, Martha K; Spratt, Daniel E; Sandler, Howard M; Freedland, Stephen J

    2017-12-01

    Prostate cancer is a heterogeneous disease, and risk stratification systems have been proposed to guide treatment decisions. However, significant heterogeneity remains for those with unfavorable-risk disease. This study included 3335 patients undergoing radical prostatectomy without adjuvant radiotherapy in the SEARCH database. High-risk patients were dichotomized into standard and very high-risk (VHR) groups based on primary Gleason pattern, percentage of positive biopsy cores (PPBC), number of NCCN high-risk factors, and stage T3b-T4 disease. Similarly, intermediate-risk prostate cancer was separated into favorable and unfavorable groups based on primary Gleason pattern, PPBC, and number of NCCN intermediate-risk factors. Median follow-up was 78 months. Patients with VHR prostate cancer had significantly worse PSA relapse-free survival (PSA-RFS, P < 0.001), distant metastasis (DM, P = 0.004), and prostate cancer-specific mortality (PCSM, P = 0.015) in comparison to standard high-risk (SHR) patients in multivariable analyses. By contrast, there was no significant difference in PSA-RFS, DM, or PCSM between SHR and unfavorable intermediate-risk (UIR) patients. Therefore, we propose a novel risk stratification system: Group 1 (low-risk), Group 2 (favorable intermediate-risk), Group 3 (UIR and SHR), and Group 4 (VHR). The c-index of this new grouping was 0.683 for PSA-RFS and 0.800 for metastases, compared to NCCN-risk groups which yield 0.666 for PSA-RFS and 0.764 for metastases. Patients classified as VHR have markedly increased rates of PSA relapse, DM, and PCSM in comparison to SHR patients, whereas UIR and SHR patients have similar prognosis. Novel therapeutic strategies are needed for patients with VHR, likely involving multimodality therapy. © 2017 Wiley Periodicals, Inc.

  12. Effects of Cognitive-Behavioral Group Therapy on Increased Life Expectancy of Male Patients with Gastric Cancer

    Directory of Open Access Journals (Sweden)

    E Mohammadian akerdi

    2016-06-01

    Full Text Available BACKGROUND AND OBJECTIVE: Cancers are a broad group of diseases, each having their own etiology, treatment, and prognosis. The majority of cancer patients experience a period of mental stress during their disease. Given the effective role of life expectancy in dealing with chronic diseases, such as stomach cancer, this study aimed to evaluate the effects of cognitive-behavioral group therapy on increased life expectancy of male patients with gastric cancer. METHODS: This quasi-experiment was conducted on 92 male patients with gastric cancer referring to Tuba Medical Center, Sari, Iran in 2014. Patients were randomly divided into two groups of test (n=46 and control (n=46. The two groups completed the Adult Hope Scale (AHS by Snyder in pretest stage. At the next stage, samples of the test group were exposed to 10 sessions of cognitive-behavioral group therapy (each session: 90 min, while the control group did not receive any special treatment. Both study groups completed the questionnaire again at the posttest stage, followed by the comparison of results. FINDINGS: In terms of life expectancy, mean scores of the test and control groups at the pretest stage were 37.21±4.7 and 36.26±4.73, respectively. Meanwhile, mean scores of the mentioned groups at the posttest stage were 40.02±3.87 and 36.23±4.8, respectively. A significant increase was observed in the mean scores of test and control groups at the posttest stage compared to before the intervention. Moreover, a significant difference was found between the study groups regarding life expectancy and its components (p<0.01. CONCLUSION: According to the results, cognitive-behavioral group therapy could increase life expectancy in patients with gastric cancer.

  13. Relationship between ABO blood groups and von Willebrand factor, ADAMTS13 and factor VIII in patients undergoing hemodialysis.

    Science.gov (United States)

    Rios, Danyelle R A; Fernandes, Ana Paula; Figueiredo, Roberta C; Guimarães, Daniela A M; Ferreira, Cláudia N; Simões E Silva, Ana C; Carvalho, Maria G; Gomes, Karina B; Dusse, Luci Maria Sant' Ana

    2012-05-01

    Several studies have demonstrated that non-O blood groups subjects present an increased VTE risk as compared to those carrying O blood group. The aim of this study was to investigate the ABO blood groups influence on factor VIII (FVIII) activity, von Willebrand factor (VWF), and ADAMTS13 plasma levels in patients undergoing hemodialysis (HD). Patients undergoing HD (N=195) and 80 healthy subjects (control group) were eligible for this cross-sectional study. The ABO blood group phenotyping was performed by the reverse technique. FVIII activity was measured through coagulometric method, and VWF and ADAMTS13 antigens were assessed by ELISA. FVIII activity and VWF levels were significantly higher and ADAMTS13 levels was decreased in HD patients, as compared to healthy subjects (P blood groups showed a significant increase in FVIII activity (P = 0.001) and VWF levels (P blood group. However, no significant difference was observed in ADAMTS13 levels (P = 0.767). In the control group, increased in FVIII activity (P = 0.001) and VWF levels (P = 0.002) and decreased in ADAMTS13 levels (P = 0.005) were observed in subjects carrying non-O blood groups as compared to carriers of O blood group.Our data confirmed that ABO blood group is an important risk factor for increased procoagulant factors in plasma, as FVIII and VWF. Admitting the possible role of kidneys in ADAMTS13 synthesis or on its metabolism, HD patients were not able to increase ADAMTS13 levels in order to compensate the increase of VWF levels mediated by ABO blood groups. Considering that non-O blood groups constitute a risk factor for thrombosis, it is reasonable to admit that A, B and AB HD patients need a careful and continuous follow-up in order to minimize thrombotic events.

  14. INCREASED VASOOCCLUSIVE CRISIS IN “O” BLOOD GROUP SICKLE CELL DISEASE PATIENTS: ASSOCIATION WITH UNDERLYING THROMBOSPONDIN LEVELS.

    Directory of Open Access Journals (Sweden)

    M. Al Huneini

    2017-04-01

    Full Text Available Abstract: Objectives: To explore the incidence of vaso-occlusive crisis (VOC in Blood Group “O” sickle cell disease (SCD patients, and correlate it with the blood group and thrombospondin (TSP levels. Methods: In 89 consecutive SCD patients, blood samples were obtained for vWF antigen, collagen binding activity, blood group typing, C-reactive protein, variant hemoglobin analysis (HPLC, Serum TSP 1 and TSP 2 levels, complete blood counts, liver function tests, LDH and renal function tests during VOC episodes and in steady state conditions. Results: In the steady state SCD patients (n=72, “O” blood group patients (n=37 showed significantly higher median serum TSP 1 and TSP 2 levels than the non “O” blood group patients [n=35] [p <0.05, Mann-Whitney test], with an inverse relation between VWF:Ag, Factor VIII:C and TSP levels. Furthermore, the serum TSP 1 and TSP 2 levels were significantly higher in patients presenting with acute VOC [n=17], and in those with repeated VOC’s (group 1, n=16 especially amongst those patients with blood group “O” [p, <0.05, Mann-Whitney test]. Conclusions: The study shows that there was an inverse relation between TSP and vWF levels, in blood group “O” SCD patients with an upregulation of the TSP levels. Expectedly, during active VOC crisis, the TSP 1 and TSP 2 levels were significantly elevated.    Key Words: VOC; SCD; TSP; vWD; Blood groups

  15. ‘On their side’: Focus group findings regarding the role of MRI radiographers and patient care

    International Nuclear Information System (INIS)

    Munn, Zachary; Jordan, Zoe; Pearson, Alan; Murphy, Frederick; Pilkington, Diana

    2014-01-01

    Introduction: Radiographers have been described as caring and concerned healthcare professionals, who are attentive to the needs of their patients. However, this may not always be the case, and patient care may be overlooked at times. Methods: A qualitative descriptive study using a focus group was conducted with radiographers to determine their views on patient care. The focus group included 7 MRI radiographers of varying levels of experience. The data was analysed following a process of thematic analysis. Results: 7 themes emerged from analysis of the data. These were; a trade-off, a wide range of patients with a wide range of issues, from one extreme to the other, it's not that bad, getting the patient scanned, room for improvement, and on their side. Conclusion: The radiographers considered themselves on the patient's side, with the main objective to get the patient scanned, in some way, to aid in their diagnosis and treatment

  16. Outcomes of Adolescent and Adult Patients with Lung Metastatic Osteosarcoma and Comparison of Synchronous and Metachronous Lung Metastatic Groups.

    Directory of Open Access Journals (Sweden)

    Ayse Gok Durnali

    Full Text Available Osteosarcomas with lung metastases are rather heterogenous group. We aimed to evaluate the clinicopathological characteristics and outcomes of osteosarcoma patients with lung metastases and to compare the synchronous and metachronous lung metastatic groups. A total of 93 adolescent and adult patients with lung metastatic osteosarcoma, from March 1995 to July 2011, in a single center, were included. Sixty-five patients (69.9% were male. The median age was 19 years (range, 14-74. Thirty-nine patients (41.9% had synchronous lung metastases (Group A and 54 patients (58.1% had metachronous lung metastases (Group B. The 5-year and 10-year post-lung metastases overall survival (PLM-OS was 17% and 15%, respectively. In multivariate analysis for PLM-OS, time to lung metastases (p = 0.010, number of metastatic pulmonary nodules (p = 0.020, presence of pulmonary metastasectomy (p = 0.007 and presence of chemotherapy for lung metastases (p< 0.001 were found to be independent prognostic factors. The median PLM-OS of Group A and Group B was 16 months and 9 months, respectively. In Group B, the median PLM-OS of the patients who developed lung metastases within 12 months was 6 months, whereas that of the patients who developed lung metastases later was 16 months. Time to lung metastases, number and laterality of metastatic pulmonary nodules, chemotherapy for lung metastatic disease and pulmonary metastasectomy were independent prognostic factors for patients with lung metastatic osteosarcoma. The best PLM-OS was in the subgroup of patients treated both surgery and chemotherapy. The prognosis of the patients who developed lung metastases within 12 months after diagnosis was worst.

  17. Consistency of ocular coherence tomography fast macular thickness mapping in diabetic diffuse macular edema

    International Nuclear Information System (INIS)

    Saraiva, Fabio Petersen; Costa, Patricia Grativol; Inomata, Daniela Lumi; Melo, Carlos Sergio Nascimento; Helal Junior, John; Nakashima, Yoshitaka

    2007-01-01

    Objectives: To investigate optical coherence tomography consistency on foveal thickness, foveal volume, and macular volume measurements in patients with and without diffuse diabetic macular edema. Introduction: Optical coherence tomography represents an objective technique that provides cross-sectional tomographs of retinal structure in vivo. However, it is expected that poor fixation ability, as seen in diabetic macular edema, could alter its results. Several authors have discussed the reproducibility of optical coherence tomography, but only a few have addressed the topic with respect to diabetic maculopathy. Methods: The study recruited diabetic patients without clinically evident retinopathy (control group) and with diffuse macular edema (case group). Only one eye of each patient was evaluated. Five consecutive fast macular scans were taken using Ocular Coherence Tomography 3; the 6 mm macular map was chosen. The consistency in measurements of foveal thickness, foveal volume, and total macular volume for both groups was evaluated using the Pearson's coefficient of variation. The T-test for independent samples was used in order to compare measurements of both groups. Results: Each group consisted of 20 patients. All measurements had a coefficient of variation less than 10%. The most consistent parameter for both groups was the total macular volume. Discussion: Consistency in measurement is a mainstay of any test. A test is unreliable if its measurements can not be correctly repeated. We found a good index of consistency, even considering patients with an unstable gaze. Conclusions: Optical coherence tomography is a consistent method for diabetic subjects with diffuse macular edema. (author)

  18. Consistency of ocular coherence tomography fast macular thickness mapping in diabetic diffuse macular edema

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    Saraiva, Fabio Petersen; Costa, Patricia Grativol; Inomata, Daniela Lumi; Melo, Carlos Sergio Nascimento; Helal Junior, John; Nakashima, Yoshitaka [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Oftalmologia]. E-mail: fabiopetersen@yahoo.com.br

    2007-07-01

    Objectives: To investigate optical coherence tomography consistency on foveal thickness, foveal volume, and macular volume measurements in patients with and without diffuse diabetic macular edema. Introduction: Optical coherence tomography represents an objective technique that provides cross-sectional tomographs of retinal structure in vivo. However, it is expected that poor fixation ability, as seen in diabetic macular edema, could alter its results. Several authors have discussed the reproducibility of optical coherence tomography, but only a few have addressed the topic with respect to diabetic maculopathy. Methods: The study recruited diabetic patients without clinically evident retinopathy (control group) and with diffuse macular edema (case group). Only one eye of each patient was evaluated. Five consecutive fast macular scans were taken using Ocular Coherence Tomography 3; the 6 mm macular map was chosen. The consistency in measurements of foveal thickness, foveal volume, and total macular volume for both groups was evaluated using the Pearson's coefficient of variation. The T-test for independent samples was used in order to compare measurements of both groups. Results: Each group consisted of 20 patients. All measurements had a coefficient of variation less than 10%. The most consistent parameter for both groups was the total macular volume. Discussion: Consistency in measurement is a mainstay of any test. A test is unreliable if its measurements can not be correctly repeated. We found a good index of consistency, even considering patients with an unstable gaze. Conclusions: Optical coherence tomography is a consistent method for diabetic subjects with diffuse macular edema. (author)

  19. Reflux esophagitis and gastroesophageal reflux disease: a cross-sectional study of gastroesophageal reflux disease patients by age group

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    Flora Filho Rowilson

    1999-01-01

    Full Text Available The purpose of this study was to explore the relationship between the intensity of acid reflux and severity of esophageal tissue damage in a cross-sectional study of patients with gastroesophageal reflux disease (GERD. Seventy-eight patients with were selected in accordance with the strict 24-hour ambulatory esophageal pHmetry (24h-pHM criteria and distributed into three age groups: Group A: 14 - 24 years of age. Group B: 25 - 54; and Group C: 55 - 64. The 24h-pHM was carried out in accordance with DeMeester standardization, and the Savary-Miller classification for the diagnosis of reflux esophagitis was used. The groups were similar in 24h-pHM parameters (p > 0.05, having above normal values. For the study group as a whole, there was no correlation between age group and intensity of acid reflux, and there was no correlation between intensity of acid reflux and severity of esophageal tissue damage. However, when the same patients were sub-grouped in accordance with the depth of their epithelial injury and then distributed into age groups, there was a significant difference in esophagitis without epithelial discontinuity. Younger patients had less epithelial damage than older patients. Additionally, although there was a significant progression from the least severe to the moderate stages of epithelial damage among the age groups, there was no apparent difference among the age groups in the distribution between the moderate stages and most severe stages. The findings support the conclusion that the protective response of individuals to acid reflux varies widely. Continued aggression by acid reflux appears to lead to the exhaustion of individual mechanisms of epithelial protection in some patients, but not others, regardless of age or duration of the disease. Therefore, the diagnosis and follow-up of GERD should include both measurements of the quantity of refluxed acid and an assessment of the damage to the esophageal epithelium.

  20. The Effect of Group Counseling on Physiological Aspect of Self-care and HbA1C Level of Patients with Diabetes Type II

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    Seyedreza Mazlom

    2015-06-01

    Full Text Available Background: The most important underlying cause of death in diabetic patients is poor self-care. The effect of education on self-care promotion has been widely investigated; however, the advisory role and impact of the treatment team have been scarcely investigated.  Aim: Determining the effect of group counseling on the psychological aspect of self-care and level of glycosylated hemoglobin in the patients with diabetes type II. Methods: In a randomized clinical trial, 73 patients with type II diabetes mellitus, who had been referred to Parsian Diabetes clinic of Mashhad in 2014, were divided into two groups of intervention and control. The group counseling program was performed in five 1.5-hour sessions with 3-day intervals, and each groups consisted of 8 to 10 people. The content of the meetings was problems in nutrition, exercise, diabetes mellitus disease, diabetes-related mental health problems, diabetes medications, and self-control of blood glucose. Researcher-made diabetes care questionnaire was filled and HbA1c test was measured before and two months after the intervention. Data were analyzed by SPSS version 11.5 using paired sample and independent t-tests. Results: In this study,27.3 percent of the subjects were male and 72.7 were female with the mean age of 49.1 ± 8.3. The scores of physiological aspect of self-care and HbA1C of the diabetic patients before the intervention was not significantly different between the groups; but in the post-intervention phase, the self-care in intervention group (49.1±5.8 significantly increased compared to the control group (31.8±12.2 (p

  1. Adjuvant chemotherapy for rectal cancer patients treated with preoperative (chemo)radiotherapy and total mesorectal excision: a Dutch Colorectal Cancer Group (DCCG) randomized phase III trial.

    Science.gov (United States)

    Breugom, A J; van Gijn, W; Muller, E W; Berglund, Å; van den Broek, C B M; Fokstuen, T; Gelderblom, H; Kapiteijn, E; Leer, J W H; Marijnen, C A M; Martijn, H; Meershoek-Klein Kranenbarg, E; Nagtegaal, I D; Påhlman, L; Punt, C J A; Putter, H; Roodvoets, A G H; Rutten, H J T; Steup, W H; Glimelius, B; van de Velde, C J H

    2015-04-01

    The discussion on the role of adjuvant chemotherapy for rectal cancer patients treated according to current guidelines is still ongoing. A multicentre, randomized phase III trial, PROCTOR-SCRIPT, was conducted to compare adjuvant chemotherapy with observation for rectal cancer patients treated with preoperative (chemo)radiotherapy and total mesorectal excision (TME). The PROCTOR-SCRIPT trial recruited patients from 52 hospitals. Patients with histologically proven stage II or III rectal adenocarcinoma were randomly assigned (1:1) to observation or adjuvant chemotherapy after preoperative (chemo)radiotherapy and TME. Radiotherapy consisted of 5 × 5 Gy. Chemoradiotherapy consisted of 25 × 1.8-2 Gy combined with 5-FU-based chemotherapy. Adjuvant chemotherapy consisted of 5-FU/LV (PROCTOR) or eight courses capecitabine (SCRIPT). Randomization was based on permuted blocks of six, stratified according to centre, residual tumour, time between last irradiation and surgery, and preoperative treatment. The primary end point was overall survival. Of 470 enrolled patients, 437 were eligible. The trial closed prematurely because of slow patient accrual. Patients were randomly assigned to observation (n = 221) or adjuvant chemotherapy (n = 216). After a median follow-up of 5.0 years, 5-year overall survival was 79.2% in the observation group and 80.4% in the chemotherapy group [hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.62-1.39; P = 0.73]. The HR for disease-free survival was 0.80 (95% CI 0.60-1.07; P = 0.13). Five-year cumulative incidence for locoregional recurrences was 7.8% in both groups. Five-year cumulative incidence for distant recurrences was 38.5% and 34.7%, respectively (P = 0.39). The PROCTOR-SCRIPT trial could not demonstrate a significant benefit of adjuvant chemotherapy with fluoropyrimidine monotherapy after preoperative (chemo)radiotherapy and TME on overall survival, disease-free survival, and recurrence rate. However, this trial did not complete

  2. Anxiety and depression symptoms among women attending group-based patient education courses for hereditary breast and ovarian cancer

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    List?l, Wenche; H?berg-Vetti, Hildegunn; Eide, Geir Egil; Bjorvatn, Cathrine

    2017-01-01

    Background Women carrying BRCA-mutations are facing significant challenges, including decision making regarding surveillance and risk-reducing surgery. They often report that they are left alone with these important decisions. In order to enhance the genetic counselling session we organized a group-based patient education (GPE) course for women with BRCA-mutations. The study aims were to characterize women attending a group-based patient education (GPE) course for hereditary breast and ovaria...

  3. NUTRITIONAL STATUS AND INTAKE PATTERN IN A GROUP OF ESRD SPANISH PATIENTS

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    Almudena Pérez Torres

    2012-06-01

    Conclusion: The undernourished patients percentage (reflected by the albumin and prealbumin increase decrease after the nutritional program. The well-nourished patients drop his weight and protein intake

  4. Analysis of toxicity in a group of patients treated for pancreatic cancer with combined modality 3D radiation therapy

    International Nuclear Information System (INIS)

    Fine, Robert M.; Fernandez-Vicioso, Eduardo; Higgins, Patrick; Schell, Michael; Sohn, Jason; Pelley, Robert; Walsh, R. M.; Vogt, David; Hermann, Robert

    1995-01-01

    Purpose: To evaluate the acute toxicity of a group of 37 pancreatic cancer patients treated with noncoplanar, nonopposed, conformal radiation therapy with concurrent chemotherapy (5-FU). Materials and Methods: We retrospectively evaluated a group of initially nonadvanced 37 pancreatic cancer patients treated with combined concurrent chemotherapy and 3D radiation therapy treated between 1992 until 1995. During this period we began treating the initially unresectable patients with preoperative chemo-RT (50.4 Gy) after treating an initial group of unresectable patients to a higher dose of 66.6 Gy. We also include a group of patients who received postop chemo-RT after Whipple resection (59.4 Gy). All radiation was delivered at a 1.8 Gy per fraction dose rate. The total group was made up of 37 patients of whom 21 were male (57%) and 16 female (43%). There were 22 (59%) head of pancreas lesions, 10 (27%) body of pancreas lesions, and 5 (14%) head and body of pancreas cancers. Of these 37 patients 7 (19%) were treated with chemo-RT as their only treatment, 10 patients (29%) were treated post Whipple resection, and 20 patients (54%) were treated with preoperative intent. Results: Three patients (8%) required a treatment break, one with a body and 2 with head lesions. Two of these patients stopped RT short of planned dose (32.56 and 46.8 Gy) both suffering from nausea, vomiting, and anorexia with the third, who finished a planned 66.6 Gy dose, after a 4 day rest for leukopenia. One of 20 patients (5%) preop patients underwent the planned post chemo-RT Whipple resection, while 4 of the 20 patients (20%), remained unresectable, but without disease progression and had Iodine 125 interstitial implants at exploration delivering a minimal tumor dose of 120 Gy on top or the 50.4 Gy delivered preoperatively. Four patients (11%) maintained a minimal Karnofsky score of 100, 23 patients (62%) maintained a minimal KPS of 90, 6 patients (16%) maintained a minimal KPS of 80, and 4

  5. Quality of diabetes care in Dutch care groups: no differences between diabetes patients with and without co-morbidity

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    Simone R de Bruin

    2013-12-01

    Full Text Available Objective: To evaluate the relationship between presence and nature of co-morbidity and quality of care for diabetes patients enrolled in diabetes disease management programmes provided by care groups.Methods: We performed an observational study within eight Dutch diabetes care groups. Data from patient record systems of care groups and patient questionnaires were used to determine quality of care. Quality of care was measured as provision of the recommended diabetes care, patients’ achievement of recommended clinical outcomes and patients’ perception of coordination and integration of care.Results: 527 diabetes patients without and 1187 diabetes patients with co-morbidity were included. Of the co-morbid patients, 7.8% had concordant co-morbid conditions only, 63.8% had discordant co-morbid diseases only and 28.4% had both types of conditions. Hardly any differences were observed between patients with and without co-morbidity in terms of provided care, achievement of clinical outcomes and perceived coordination and integration of care.Conclusions: Our study implies that care groups are able to provide similar quality of diabetes care for diabetes patients with and without co-morbidity. Considering the expected developments regarding additional disease management programmes in care groups, it is of importance to monitor quality of care, including patient experiences, for all chronic diseases. It will then become clear whether accountable provider-led organisations such as care groups are able to ensure quality of care for the increasing number of patients with multiple chronic conditions.

  6. Interprofessional communication skills training for serious illness: evaluation of a small-group, simulated patient intervention.

    Science.gov (United States)

    Bays, Alison M; Engelberg, Ruth A; Back, Anthony L; Ford, Dee W; Downey, Lois; Shannon, Sarah E; Doorenbos, Ardith Z; Edlund, Barbara; Christianson, Phyllis; Arnold, Richard W; O'Connor, Kim; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Fryer-Edwards, Kelly; Alexander, Stewart C; Tulsky, James A; Curtis, J Randall

    2014-02-01

    Communication with patients and families is an essential component of high-quality care in serious illness. Small-group skills training can result in new communication behaviors, but past studies have used facilitators with extensive experience, raising concerns this is not scalable. The objective was to investigate the effect of an experiential communication skills building workshop (Codetalk), led by newly trained facilitators, on internal medicine trainees' and nurse practitioner students' ability to communicate bad news and express empathy. Trainees participated in Codetalk; skill improvement was evaluated through pre- and post- standardized patient (SP) encounters. The subjects were internal medicine residents and nurse practitioner students at two universities. The study was carried out in anywhere from five to eight half-day sessions over a month. The first and last sessions included audiotaped trainee SP encounters coded for effective communication behaviors. The primary outcome was change in communication scores from pre-intervention to post-intervention. We also measured trainee characteristics to identify predictors of performance and change in performance over time. We enrolled 145 trainees who completed pre- and post-intervention SP interviews-with participation rates of 52% for physicians and 14% for nurse practitioners. Trainees' scores improved in 8 of 11 coded behaviors (p<0.05). The only significant predictors of performance were having participated in the intervention (p<0.001) and study site (p<0.003). The only predictor of improvement in performance over time was participating in the intervention (p<0.001). A communication skills intervention using newly trained facilitators