WorldWideScience

Sample records for previous assessment years

  1. Elevated ozone negatively affects photosynthesis of current-year leaves but not previous-year leaves in evergreen Cyclobalanopsis glauca seedlings

    International Nuclear Information System (INIS)

    Zhang, Weiwei; Feng, Zhaozhong; Wang, Xiaoke; Niu, Junfeng

    2014-01-01

    To assess the effects of leaf age/layer on the response of photosynthesis to chronic ozone (O 3 ), Cyclobalanopsis glauca seedlings, a dominant evergreen broadleaf tree species in sub-tropical regions, were exposed to either ambient air (AA) or elevated O 3 (AA + 60 ppb O 3 , E-O 3 ) for two growing seasons in open-top chambers. Chlorophyll content, gas exchange and chlorophyll a fluorescence were investigated three times throughout the 2nd year of O 3 exposure. Results indicated that E-O 3 decreased photosynthetic parameters, particularly light-saturated photosynthesis rate, stomatal conductance and effective quantum yield of PSII photochemistry of current-year leaves but not previous-year leaves. Stomatal conductance of plants grown under ambient conditions partially contributed to the different response to E-O 3 between leaf layers. Light radiation or other physiological and biochemical processes closely related to photosynthesis might play important roles. All suggested that leaf ages or layers should be considered when assessing O 3 risk on evergreen woody species. -- Highlights: • Response of evergreen Cyclobalanopsis glauca to O 3 was investigated. • Elevated O 3 significantly reduced photosynthesis of current-year leaves. • Previous-year leaves showed little response to O 3 . • Stomatal conductance contributes to the response difference to O 3 among leaf ages. -- Impacts of elevated O 3 on photosynthesis of evergreen woody species depend on leaf ages

  2. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    OpenAIRE

    Barbosa, Angélica Mércia Pascon; Dias, Adriano; Marini, Gabriela; Calderon, Iracema Mattos Paranhos; Witkin, Steven; Rudge, Marilza Vieira Cunha

    2011-01-01

    OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes ...

  3. Chlorinated, brominated and fluorinated organic pollutants in African Penguin eggs: 30 years since the previous assessment.

    Science.gov (United States)

    Bouwman, Hindrik; Govender, Danny; Underhill, Les; Polder, Anuschka

    2015-05-01

    The African Penguin population has drastically declined over the last 100 years. Changes in food availability due to over-fishing and other oceanographic changes seem to be major causes. However, it has also been 30 years since organic pollutants as a potential factor have been assessed. We analysed penguin eggs collected in 2011 and 2012 from two breeding colonies 640 km apart: Robben Island near Cape Town on the Atlantic Ocean coast, and Bird Island near Port Elizabeth on the Indian Ocean coast of South Africa. We quantified organochlorine pesticides, brominated flame retardants, and perfluorinated compounds (PFCs). Compared to 30 years ago, concentrations of ΣDDT have remained about the same or slightly lower, while ΣPCBs declined almost four-fold. The use of DDT in malaria control is unlikely to have contributed. PFCs were detected in all eggs. Indications (non-significant) of eggshell thinning associated with ΣDDT and ΣPCB was found. It seems therefore that the concentrations of measured organic pollutants the African Penguin eggs are not contributing directly to its current demise, but concerns remain about thinner shells and desiccation. Effects of combinations of compounds and newer compounds cannot be excluded, as well as more subtle effects on reproduction, development, and behaviour. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Pulmonary Aspergillosis in a Previously Healthy 13-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Jonathan H. Rayment

    2016-01-01

    Full Text Available Chronic granulomatous disease (CGD is a rare, polygenic primary immunodeficiency. In this case report, we describe a previously healthy 13-year-old boy who presented with multifocal pulmonary aspergillosis and was subsequently diagnosed with an autosomal recessive form of chronic granulomatous disease. CGD has a variable natural history and age of presentation and should be considered when investigating a patient with recurrent or severe infections with catalase-positive organisms.

  5. Aortic pseudoaneurysm detected on external jugular venous distention following a Bentall procedure 10 years previously.

    Science.gov (United States)

    Fukunaga, Naoto; Shomura, Yu; Nasu, Michihiro; Okada, Yukikatsu

    2010-11-01

    An asymptomatic 49-year-old woman was admitted for the purpose of surgery for aortic pseudoaneurysm. She had Marfan syndrome and had undergone an emergent Bentall procedure 10 years previously. About six months previously, she could palpate distended bilateral external jugular veins, which became distended only in a supine position and without any other symptoms. Enhanced computed tomography revealed an aortic pseudoaneurysm originating from a previous distal anastomosis site. During induction of general anesthesia in a supine position, bilateral external jugular venous distention was remarkable. Immediately after a successful operation, distention completely resolved. The present case emphasizes the importance of physical examination leading to a diagnosis of asymptomatic life-threatening diseases in patients with a history of previous aortic surgery.

  6. Focusing on first year assessment: Surface or deep approaches to learning?

    Directory of Open Access Journals (Sweden)

    Sharn Donnison

    2012-08-01

    Full Text Available This paper investigates the assessment and learning approaches that some first year students employ to assist them in their transition into their first year of study and extends our previous work on first year student engagement and timely academic support (Penn-Edwards & Donnison, 2011. It is situated within the First Year transition and student engagement literature and specifically speaks to concepts of learning within that body of literature. In this paper we argue that while students are in the transitional period of their studies, the use of assessment as a motivator for learning (surface approach is valid first year pedagogy and forms an initial learning stage in the student’s progress towards being lifelong learners. 

  7. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Angélica Mércia Pascon Barbosa

    2011-01-01

    Full Text Available OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes. RESULTS: The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6% and two years after a cesarean (44.8% vs. 18.4%. Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%. Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence. CONCLUSIONS: The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies.

  8. The chronic obstructive pulmonary disease assessment test improves the predictive value of previous exacerbations for poor outcomes in COPD.

    Science.gov (United States)

    Miravitlles, Marc; García-Sidro, Patricia; Fernández-Nistal, Alonso; Buendía, María Jesús; Espinosa de Los Monteros, María José; Esquinas, Cristina; Molina, Jesús

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) exacerbations have a negative impact on the quality of life of patients and the evolution of the disease. We have investigated the prognostic value of several health-related quality of life questionnaires to predict the appearance of a composite event (new ambulatory or emergency exacerbation, hospitalization, or death) over a 1-year follow-up. This was a multicenter, prospective, observational study. Patients completed four questionnaires after recovering from an exacerbation (COPD Assessment Test [CAT], a Clinical COPD Questionnaire [CCQ], COPD Severity Score [COPDSS], and Airways Questionnaire [AQ20]). Patients were followed-up until the appearance of the composite event or for 1 year, whichever came first. A total of 497 patients were included in the study. The majority of them were men (89.7%), with a mean age of 68.7 (SD 9.2) years, and a forced expiratory volume in 1 second of 47.1% (SD 17.5%). A total of 303 (61%) patients experienced a composite event. Patients with an event had worse mean scores of all questionnaires at baseline compared to patients without event: CAT=12.5 vs 11.3 (P=0.028); CCQ=2.2 vs 1.9 (P=0.013); COPDSS=12.3 vs 10.9 (P=0.001); AQ20=8.3 vs 7.5 (P=0.048). In the multivariate analysis, only previous history of exacerbations and CAT score ≥13.5 were significant risk factors for the composite event. A CAT score ≥13.5 increased the predictive value of previous exacerbations with an area under the receiver operating characteristic curve of 0.864 (95% CI: 0.829-0.899; P=0.001). The predictive value of previous exacerbations significantly increased only in one of the four trialled questionnaires, namely in the CAT questionnaire. However, previous history of exacerbations was the strongest predictor of the composite event.

  9. Year-to-year correlation, record length, and overconfidence in wind resource assessment

    Directory of Open Access Journals (Sweden)

    N. Bodini

    2016-08-01

    Full Text Available Interannual variability of wind speeds presents a fundamental source of uncertainty in preconstruction energy estimates. Our analysis of one of the longest and geographically most widespread extant sets of instrumental wind-speed observations (62-year records from 60 stations in Canada shows that deviations from mean resource levels persist over many decades, substantially increasing uncertainty. As a result of this persistence, the performance of each site's last 20 years diverges more widely than expected from the P50 level estimated from its first 42 years: half the sites have either fewer than 5 or more than 15 years exceeding the P50 estimate. In contrast to this 10-year-wide interquartile range, a 4-year-wide range (2.5 times narrower was found for "control" records where statistical independence was enforced by randomly permuting each station's historical values. Similarly, for sites with capacity factor of 0.35 and interannual variability of 6  %, one would expect 9 years in 10 to fall in the range 0.32–0.38; we find the actual 90  % range to be 0.27–0.43, or three times wider. The previously un-quantified effect of serial correlations favors a shift in resource-assessment thinking from a climatology-focused approach to a persistence-focused approach: for this data set, no improvement in P50 error is gained by using records longer than 4–5 years, and use of records longer than 20 years actually degrades accuracy.

  10. Five-year longitudinal assessment of the prognosis of apical microsurgery.

    Science.gov (United States)

    von Arx, Thomas; Jensen, Simon S; Hänni, Stefan; Friedman, Shimon

    2012-05-01

    Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohort for which the 1-year outcome was previously reported. Apical microsurgery procedures were uniformly performed using SuperEBA (Staident International, Staines, UK) or mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental Specialties, Tulsa, OK) root-end fillings or alternatively Retroplast capping (Retroplast Trading, Rorvig, Denmark). Subjects examined at 1 year (n = 191) were invited for the 5-year clinical and radiographic examination. Based on blinded, independent assessment by 3 calibrated examiners, the dichotomous outcome (healed or nonhealed) was determined and associated with patient-, tooth-, and treatment-related variables using logistic regression. At the 5-year follow-up, 9 of 191 teeth were unavailable, 12 of 191 teeth were extracted, and 170 of 191 teeth were examined (87.6% recall rate). A total of 129 of 170 teeth were healed (75.9%) compared with 83.8% at 1 year, and 85.3% were asymptomatic. Two significant outcome predictors were identified: the mesial-distal bone level at ≤ 3 mm versus >3 mm from the cementoenamel junction (78.2% vs 52.9% healed, respectively; odds ratio = 5.10; confidence interval, 1.67-16.21; P apical microsurgery was 8% poorer than assessed at 1 year. It also suggested that the prognosis was significantly impacted by the interproximal bone levels at the treated tooth and by the type of root-end filling material used. Copyright © 2012 American Association of Endodontists. All rights reserved.

  11. Fiscal Year 2013 Revegetation Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Nordstrom, Jenifer [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2013-11-01

    This report summarizes the Fiscal Year 2013 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: Summary of each site Assessment of vegetation status and site stabilization at each location Actions and Resolutions for each site. Six disturbed sites were evaluated for this assessment. One has achieved final stabilization. The remaining five sites not meeting the criteria for final stabilization will be evaluated again in the next fiscal year.

  12. Fiscal Year 2012 Revegetation Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jenifer Nordstrom

    2012-11-01

    This report summarizes the Fiscal Year 2012 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Actions and Resolutions for each site. Ten disturbed sites were evaluated for this assessment. Six have achieved final stabilization. The remaining four sites not meeting the criteria for final stabilization will be evaluated again in the next fiscal year.

  13. Formative Self-Assessment College Classes Improves Self-Regulation and Retention in First/Second Year Community College Students

    Science.gov (United States)

    Mahlberg, Jamie

    2015-01-01

    This research examined the influence formative self-assessment had on first/second year community college student self-regulatory practices. Previous research has shown that the ability to regulate one's learning activities can improve performance in college classes, and it has long been known that the use of formative assessment improves…

  14. [Assessment of central hemodynamic properties of the arterial wall in women with previous preeclampsia].

    Science.gov (United States)

    Polónia, Jorge; Olival, Catarina; Ribeiro, Sílvia; Silva, José A; Barbosa, Loide

    2014-06-01

    We investigated viscoelastic properties of the arterial wall in women with previous preeclampsia (PE) compared to those with normal pregnancy (NP). In a cross-sectional study 45 women with previous PE and 55 with NP were included, matched for age (PE 38±6 vs. NP 38±5 years, NS) and body mass index: (PE 25±4 vs. NP 26±4 kg/m(2), NS) studied, respectively, 76±34 and 86±48 months after delivery. We assessed arterial distensibility - pulse wave velocity (PWV, Complior) and reflected waves (augmentation pressure [AP], mmHg) and augmentation index (AIx) - in the central pressure wave and blood pressure (BP) on 24-h ambulatory BP monitoring (ABPM). PE showed higher (p<0.01) peripheral systolic blood pressure (SBP): PE 131±18 vs. NP 121±19, and central SBP: PE 122±18 vs. NP 110±19 mmHg, with less amplification of central-peripheral pressure: PE 10±4 vs. NP 12±5, p=0.041, and higher (p<0.05) AP: PE 10±3 vs. NP 8±2, and AIx: PE 26±5 vs. NP 20±5 mmHg, but PE and NP did not differ in pulse wave velocity. On ABPM, PE (n=39) vs. NP (n=33) had higher nighttime SBP: PE 121±10 vs. NP 108±10 mmHg and lower percentage nocturnal SBP fall: PE 11±6 vs. NP 18±11%, both p<0.02. During follow-up, the need for antihypertensive medication was seven times higher in PE than in NP. Women with previous PE have a greater risk of hypertension, higher nighttime BP values, blunted nocturnal BP fall and changes in central pressure suggestive of increased reflected waves and peripheral vascular resistance. These factors may contribute to their higher cardiovascular risk after pregnancy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  15. SONOGRAPHIC PREDICTION OF SCAR DEHISCENCE IN WOMEN WITH PREVIOUS CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Shubhada Suhas Jajoo

    2018-01-01

    Full Text Available BACKGROUND Caesarean section (Sectio Caesarea is a surgical method for the completion of delivery. After various historical modifications of operative techniques, modern approach consists in the transverse dissection of the anterior wall of the uterus. The rate of vaginal birth after caesarean section was significantly reduced from year to year and the rate of repeated caesarean section is increased during the past 10 years. Evaluation of scar thickness is done by ultrasound, but it is still debatable size of thick scar that would be guiding “cut-off value” for the completion of the delivery method. To better assess the risk of uterine rupture, some authors have proposed sonographic measurement of lower uterine segment thickness near term assuming that there is an inverse correlation between LUS thickness and the risk of uterine scar defect. Therefore, this assessment for the management of women with prior CS may increase safety during labour by selecting women with the lowest risk of uterine rupture. The aim of the study is to study the diagnostic accuracy of sonographic measurements of the Lower Uterine Segment (LUS thickness near term in predicting uterine scar defects in women with prior Caesarean Section (CS. We aim to ascertain the best cut-off values for predicting uterine rupture. MATERIALS AND METHODS 100 antenatal women with history of previous one LSCS who come to attend antenatal clinic will be assessed for scar thickness by transabdominal ultrasonography and its correlation with intraoperative findings. This prospective longitudinal study was conducted for 1 year after IEC approval with inclusion criteria previous one LSCS. Exclusion criteria- 1 Previous myomectomy scar; 2 Previous 2 LSCS; 3 Previous hysterotomy scar. RESULTS Our findings indicate that there is a strong association between degree of LUS thinning measured near term and the risk of uterine scar defect at birth. In our study, optimal cut-off value for predicting

  16. Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously

    DEFF Research Database (Denmark)

    Simony, Ane; Hansen, Emil Jesper; Christensen, Steen Bach

    2016-01-01

    , is comparable to modern equipment. This is to our knowledge the first study to report increased rates of endometrial cancers in a cohort of AIS patients, and future attention is needed to reduce the radiation dose distributed to the AIS patients both pre-operatively and during surgery.......PURPOSE: To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously. METHODS: 215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence....... RESULTS: From the original cohort of 215 consecutive AIS patients, radiation information was available in 211 of the patients, and medical charts were available in 209 AIS patients. 170 (83 %) of the 205 AIS patients participated in the follow-up study with questionnaires. The calculated mean total...

  17. Arterial Destiffening in Previously Untreated Mild Hypertensives After 1 Year of Routine Clinical Management.

    Science.gov (United States)

    Rodilla, Enrique; Millasseau, Sandrine; Costa, Jose Antonio; Pascual, Jose Maria

    2017-05-01

    Arterial stiffness, measured with pulse wave velocity (PWV), is now classified as a marker of target organ damage (TOD) alongside left ventricular hypertrophy and moderately increased albuminuria. Interventional studies on treated hypertensive patients have shown that PWV could be improved. Our aim was to assess changes in arterial stiffness after 1 year of routine clinical practice in never-treated hypertensive patients. We studied 356 never-treated patients with suspected hypertension. After standard clinical assessment during which presence of TOD was evaluated, hypertension diagnosis was confirmed in 231 subjects who subsequently received standard routine care. Both hypertensive and the 125 controls came back for a follow-up visit after 1 year. Hypertensive patients were slightly older (46 ± 12 vs. 50 ± 12 years, P < 0.001), with higher mean arterial pressure (MAP)-adjusted PWV compared to controls (8.6 ± 2.0 vs. 8.0 ± 1.7 m/s, P < 0.001) and 47% of them presented 1 or more TOD. After 1 year of treatment, MAP was similar in both groups (94.9 vs. 96.2 mm Hg; P = ns), but adjusted PWV remained significantly higher in the hypertensive patients (7.8 ± 1.4 vs. 8.3 ± 1.7 m/s, P = 0.004). The prevalence of elevated PWV was reduced from 20% to 12%. All antihypertensive drugs achieved the same blood pressure (BP) and PWV reduction with the exception of vasodilating beta-blockers which gave slightly better results probably due to heart rate reduction. BP reduction in newly diagnosed hypertensive patients improves arterial stiffness within a year of real-life clinical practice. Patients with the highest PWV and the largest reduction of BP "destiffened" the most whatever antihypertensive class was used. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  18. Fiscal Year 2014 Revegetation Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Nordstrom, Jenifer [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-03-01

    This report summarizes the Fiscal Year 2014 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to document revegetation efforts at Idaho National Laboratory to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Actions and Resolutions for each site. Five disturbed sites were evaluated for this assessment. Four sites are recommended to be removed from the annual assessment, and one is recommended for continued evaluation. New sites are also identified for future monitoring as part of the annual assessment.

  19. Prevalence of pain in the head, back and feet in refugees previously exposed to torture: a ten-year follow-up study

    DEFF Research Database (Denmark)

    Olsen, Dorthe Reff; Montgomery, Edith; Bøjholm, Søren

    2007-01-01

    AIM: To estimate change over 10 years concerning the prevalence of pain in the head, back and feet, among previously tortured refugees settled in Denmark, and to compare associations between methods of torture and prevalent pain at baseline and at 10-year follow-up. METHODS: 139 refugees previous...... associated with the type and bodily focus of the torture. This presents a considerable challenge to future evidence-based development of effective treatment programs....

  20. Fiscal Year 2009 Revegetation Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Michael Lewis

    2009-10-01

    This report summarizes the Fiscal Year 2009 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Recommendation(s) for each site.

  1. Fiscal Year 2010 Revegetation Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jenifer Nordstrom; Mike Lewis

    2010-11-01

    This report summarizes the Fiscal Year 2010 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Recommendation(s) for each site.

  2. 26 CFR 1.960-4 - Additional foreign tax credit in year of receipt of previously taxed earnings and profits.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Additional foreign tax credit in year of... Foreign Corporations § 1.960-4 Additional foreign tax credit in year of receipt of previously taxed... inclusion either chose to claim a foreign tax credit as provided in section 901 or did not pay or accrue any...

  3. An Early Years Toolbox for Assessing Early Executive Function, Language, Self-Regulation, and Social Development: Validity, Reliability, and Preliminary Norms.

    Science.gov (United States)

    Howard, Steven J; Melhuish, Edward

    2017-06-01

    Several methods of assessing executive function (EF), self-regulation, language development, and social development in young children have been developed over previous decades. Yet new technologies make available methods of assessment not previously considered. In resolving conceptual and pragmatic limitations of existing tools, the Early Years Toolbox (EYT) offers substantial advantages for early assessment of language, EF, self-regulation, and social development. In the current study, results of our large-scale administration of this toolbox to 1,764 preschool and early primary school students indicated very good reliability, convergent validity with existing measures, and developmental sensitivity. Results were also suggestive of better capture of children's emerging abilities relative to comparison measures. Preliminary norms are presented, showing a clear developmental trajectory across half-year age groups. The accessibility of the EYT, as well as its advantages over existing measures, offers considerably enhanced opportunities for objective measurement of young children's abilities to enable research and educational applications.

  4. Toddler's Paralysis: An Acute Case of Leg Stiffening in a Previously Healthy 2-Year-Old.

    Science.gov (United States)

    Kahne, Kimberly Renee; Tay, Ee Tein

    2018-05-14

    Vegetarian and vegan diets are gaining popularity in the United States. Although appropriately planned vegetarian diets, including vegan diets, are healthful and nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases, not all families are aware of the nutritional supplements that may be required for their children. We describe a case of a 2-year-old previously healthy child consuming a vegan diet who presented to the pediatric emergency department with an acute inability to move her legs. Ionized calcium was found to be 0.89 mmol/L, and symptoms completely resolved within 2 hours of calcium gluconate infusion.

  5. AECB staff annual assessment of the Darlington Nuclear Generating Station for the year 1996

    International Nuclear Information System (INIS)

    1997-06-01

    The Atomic Energy Control Board is the independent federal agency that controls all nuclear activities in Canada. A major use of nuclear energy in Canada is electricity production. The AECB assesses every station's performance against legal requirements, including the conditions in the operating licence. Each station is inspected and all aspects of the station's operation and management is reviewed. This report is the AECB staff assessment of safety at the Darlington Nuclear Generating Station for 1996. Ontario Hydro operated the station in a safe manner in 1996. All four special safety systems were fully available 100 percent of the time. There were more problems that affected the safety support systems in 1996 than in the previous year

  6. Preoperative screening: value of previous tests.

    Science.gov (United States)

    Macpherson, D S; Snow, R; Lofgren, R P

    1990-12-15

    To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. Retrospective cohort analysis of computerized laboratory data (complete blood count, sodium, potassium, and creatinine levels, prothrombin time, and partial thromboplastin time). Urban tertiary care Veterans Affairs Hospital. Consecutive sample of 1109 patients who had elective surgery in 1988. At admission, 7549 preoperative tests were done, 47% of which duplicated tests performed in the previous year. Of 3096 previous results that were normal as defined by hospital reference range and done closest to the time of but before admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat values were outside a range considered acceptable for surgery. Most of the abnormalities were predictable from the patient's history, and most were not noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%; CI, 13% to 20%) repeat values at admission were outside a range considered acceptable for surgery (P less than 0.001, frequency of clinically important abnormalities of patients with normal previous results with those with abnormal previous results). Physicians evaluating patients preoperatively could safely substitute the previous test results analyzed in this study for preoperative screening tests if the previous tests are normal and no obvious indication for retesting is present.

  7. National Diet and Nutrition Survey: fat and fatty acid intakes from the first year of the rolling programme and comparison with previous surveys

    Science.gov (United States)

    Pot, Gerda K.; Prynne, Celia J.; Roberts, Caireen; Olson, Ashley; Nicholson, Sonja K.; Whitton, Clare; Teucher, Birgit; Bates, Beverley; Henderson, Helen; Pigott, Sarah; Swan, Gillian; Stephen, Alison M.

    2012-01-01

    High saturated fat intake is an established risk factor for several chronic diseases. The objective of the present study is to report dietary intakes and main food sources of fat and fatty acids (FA) from the first year of the National Diet and Nutrition Survey (NDNS) rolling programme in the UK. Dietary data were collected using 4d estimated food diaries (n896) and compared with dietary reference values (DRV) and previous NDNS results. Total fat provided 34–36% food energy (FE) across all age groups, which was similar to previous surveys for adults. Men (19–64 years) and older girls (11–18 years) had mean intakes just above the DRV, while all other groups had mean total fat intakes of <35% FE. SFA intakes were lower compared with previous surveys, ranging from 13 to 15% FE, but still above the DRV. Mean MUFA intakes were 12.5% FE for adults and children aged 4–18 years and all were below the DRV. Mean n–3 PUFA intake represented 0.7–1.1% FE. Compared with previous survey data, the direction of change for n–3 PUFA was upwards for all age groups, although the differences in absolute terms were very small. Trans-FA intakes were lower than in previous NDNS and were less than 2g/d for all age groups, representing 0.8% FE and lower than the DRV in all age groups. In conclusion, dietary intake of fat and FA is moving towards recommended levels for the UK population. However, there remains room for considerable further improvement. PMID:21767448

  8. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    showed a higher sensitivity to radioiodine, with more cases of early hypothyroidism, than non-operated patients. However, after 50 months of follow-up the outcome was identical. The results indicate that frequent assessment is necessary after radioiodine treatment of previously operated patients, since......Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  9. Year 2000 assessment report, Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Weir, D.

    1998-04-21

    The purpose of this report is to advise managers on the status of Year 2000 readiness at the Laboratory and provide a summary of critical issues to be addressed in order to ensure that the Year 2000 date rollover will not disrupt Laboratory Operations. The Laboratory`s Year 2000 council members are in the first phase of Year 2000 plans: gathering data and assessing the status of their divisions or programs. This first snapshot of the Laboratory Year 2000 readiness assessment is expected to grow and change over time as more refined assessments, plans, and schedules are developed and as more information becomes available. Here are findings to date: (1) Embedded systems` status not known. (2) Preliminary cost estimates for Year 2000 repairs, testing, and implementation are estimated to be at least $5.9 million, not including embedded systems. (3) The Laboratory is required to make unavoidable purchases of Year 2000-compliant products. (4) The Year 2000 short-term issue forces some long-term transition plans to be set aside. (5) The Laboratory is at risk for the following consequences if they can`t demonstrate an active Year 2000 program: risk of system failures; potential funding freezes by the OMB and DOE; legal liabilities; and risk to the UC contract. (6) The deadline for this project is immutable. (7) DOE is continually increasing reporting requirements, expanding from only DOE mission-essential to all operations. (7) DOE audit criticizes the Laboratory`s mission-essential systems planning.

  10. Prevalence and titers of yellow fever virus neutralizing antibodies in previously vaccinated adults.

    Science.gov (United States)

    Miyaji, Karina Takesaki; Avelino-Silva, Vivian Iida; Simões, Marisol; Freire, Marcos da Silva; Medeiros, Carlos Roberto de; Braga, Patrícia Emilia; Neves, Maria Angélica Acalá; Lopes, Marta Heloisa; Kallas, Esper Georges; Sartori, Ana Marli Christovam

    2017-04-03

    The World Health Organization (WHO) recommends one single dose of the Yellow Fever (YF) vaccine based on studies of antibody persistency in healthy adults. We assessed the prevalence and titers of YF virus neutralizing antibodies in previously vaccinated persons aged  60 years, in comparison to younger adults. We also evaluated the correlation between antibody titers and the time since vaccination among participants who received one vaccine dose, and the seropositivity among participants vaccinated prior to or within the past 10 years. previously vaccinated healthy persons aged  18 years were included. YF virus neutralizing antibody titers were determined by means of the 50% Plaque Reduction Neutralization Test. 46 persons aged  60 years and 48 persons aged 18 to 59 years were enrolled. There was no significant difference in the prevalence of YF virus neutralizing antibodies between the two groups (p = 0.263). However, titers were significantly lower in the elderly (p = 0.022). There was no correlation between YF virus neutralizing antibody titers and the time since vaccination. There was no significant difference in seropositivity among participants vaccinated prior to or within the past 10 years. the clinical relevance of the observed difference in YF virus neutralizing antibody titers between the two groups is not clear.

  11. Previous induced abortion among young women seeking abortion-related care in Kenya: a cross-sectional analysis.

    Science.gov (United States)

    Kabiru, Caroline W; Ushie, Boniface A; Mutua, Michael M; Izugbara, Chimaraoke O

    2016-05-14

    Unsafe abortion is a leading cause of death among young women aged 10-24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been minimal research on young women in this region who have multiple induced abortions. The objective of this study was therefore to assess the prevalence and correlates of reporting a previous induced abortion among young females aged 12-24 years seeking abortion-related care in Kenya. We used data on 1,378 young women aged 12-24 years who presented for abortion-related care in 246 health facilities in a nationwide survey conducted in 2012. Socio-demographic characteristics, reproductive and clinical histories, and physical examination assessment data were collected from women during a one-month data collection period using an abortion case capture form. Nine percent (n = 98) of young women reported a previous induced abortion prior to the index pregnancy for which they were receiving care. Statistically significant differences by previous history of induced abortion were observed for area of residence, religion and occupation at bivariate level. Urban dwellers and unemployed/other young women were more likely to report a previous induced abortion. A greater proportion of young women reporting a previous induced abortion stated that they were using a contraceptive method at the time of the index pregnancy (47 %) compared with those reporting no previous induced abortion (23 %). Not surprisingly, a greater proportion of young women reporting a previous induced abortion (82 %) reported their index pregnancy as unintended (not wanted at all or mistimed) compared with women reporting no previous induced abortion (64 %). Our study results show that about one in every ten young women seeking abortion-related care in Kenya reports a previous induced abortion. Comprehensive post-abortion care services targeting young women are needed. In particular, post

  12. 22 CFR 40.91 - Certain aliens previously removed.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  13. Fiscal Year 2016 Revegetation Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Nordstrom, Jenifer B. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-11-01

    This report summarizes the Fiscal Year (FY) 2016 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to document revegetation efforts at Idaho National Laboratory to verify restoration of disturbed vegetation and soil at various locations occurs as required. This report provides the following information for projects at Idaho National Laboratory completed during FY 2016 that were identified during the National Environmental Policy Act review process as having the potential to disturb soils or vegetation: 1) A summary of all projects identified as having the potential to require revegetation efforts 2) A summary of site disturbance and restoration efforts of each project. For FY 2016, one project required revegetation and sagebrush restoration. For other projects, implementation of best management practices minimized impacts to vegetation and revegetation efforts were not required.

  14. Efficacy and safety of 10,600-nm carbon dioxide fractional laser on facial skin with previous volume injections

    Directory of Open Access Journals (Sweden)

    Josiane Hélou

    2013-01-01

    Full Text Available Background: Fractionated carbon dioxide (CO 2 lasers are a new treatment modality for skin resurfacing. The cosmetic rejuvenation market abounds with various injectable devices (poly-L-lactic acid, polymethyl-methacrylate, collagens, hyaluronic acids, silicone. The objective of this study is to examine the efficacy and safety of 10,600-nm CO 2 fractional laser on facial skin with previous volume injections. Materials and Methods: This is a retrospective study including 14 patients treated with fractional CO 2 laser and who have had previous facial volume restoration. The indication for the laser therapy, the age of the patients, previous facial volume restoration, and side effects were all recorded from their medical files. Objective assessments were made through clinical physician global assessment records and improvement scores records. Patients′ satisfaction rates were also recorded. Results: Review of medical records of the 14 patients show that five patients had polylactic acid injection prior to the laser session. Eight patients had hyaluronic acid injection prior to the laser session. Two patients had fat injection, two had silicone injection and one patient had facial thread lift. Side effects included pain during the laser treatment, post-treatment scaling, post-treatment erythema, hyperpigmentation which spontaneously resolved within a month. Concerning the previous facial volume restoration, no granulomatous reactions were noted, no facial shape deformation and no asymmetry were encountered whatever the facial volume product was. Conclusion: CO 2 fractional laser treatments do not seem to affect facial skin which had previous facial volume restoration with polylactic acid for more than 6 years, hyaluronic acid for more than 0.5 year, silicone for more than 6 years, or fat for more than 1.4 year. Prospective larger studies focusing on many other variables (skin phototype, injected device type are required to achieve better

  15. Economic assessment of coal-fired and nuclear power generation in the year 2000 -Equal health hazard risk basis-

    International Nuclear Information System (INIS)

    Seong, Ki Bong; Lee, Byong Whi

    1989-01-01

    On the basis of equal health hazard risk, economic assessment of nuclear was compared with that of coal for the expansion planning of electric power generation in the year 2000. In comparing health risks, the risk of coal was roughly ten times higher than that of nuclear according to various previous risk assessments of energy system. The zero risk condition can never be achievable. Therefore, only excess relative health risk of coal over nuclear was considered as social cost. The social cost of health risk was estimated by calculation of mortality and morbidity costs. Mortality cost was $250,000 and morbidity cost was $90,000 in the year 2000.(1986US$) Through Cost/Benefit Analysis, the optimal emission standards of coal-fired power generation were predicted. These were obtained at the point of least social cost for power generation. In the year 2000, the optimal emission standard of SO x was analyzed as 165ppm for coal-fired power plants in Korea. From this assessment, economic comparison of nuclear and coal in the year 2000 showed that nuclear would be more economical than coal, whereas uncertainty of future power generation cost of nuclear would be larger than that of coal. (Author)

  16. Analysis of current research addressing complementary use of life-cycle assessment and risk assessment for engineered nanomaterials: have lessons been learned from previous experience with chemicals?

    International Nuclear Information System (INIS)

    Grieger, Khara D.; Laurent, Alexis; Miseljic, Mirko; Christensen, Frans; Baun, Anders; Olsen, Stig I.

    2012-01-01

    While it is generally agreed that successful strategies to address the health and environmental impacts of engineered nanomaterials (NM) should consider the well-established frameworks for conducting life-cycle assessment (LCA) and risk assessment (RA), scientific research, and specific guidance on how to practically apply these methods are still very much under development. This paper evaluates how research efforts have applied LCA and RA together for NM, particularly reflecting on previous experiences with applying these methods to chemicals. Through a literature review and a separate analysis of research focused on applying LCA and RA together for NM, it appears that current research efforts have taken into account some key “lessons learned” from previous experience with chemicals while many key challenges remain for practically applying these methods to NM. We identified two main approaches for using these methods together for NM: “LC-based RA” (traditional RA applied in a life-cycle perspective) and “RA-complemented LCA” (conventional LCA supplemented by RA in specific life-cycle steps). Hence, the latter is the only identified approach which genuinely combines LC- and RA-based methods for NM-risk research efforts to date as the former is rather a continuation of normal RA according to standard assessment procedures (e.g., REACH). Both these approaches along with recommendations for using LCA and RA together for NM are similar to those made previously for chemicals, and thus, there does not appear to be much progress made specific for NM. We have identified one issue in particular that may be specific for NM when applying LCA and RA at this time: the need to establish proper dose metrics within both methods.

  17. Heavy metal accumulation in soils, plants, and hair samples: an assessment of heavy metal exposure risks from the consumption of vegetables grown on soils previously irrigated with wastewater.

    Science.gov (United States)

    Massaquoi, Lamin Daddy; Ma, Hui; Liu, Xue Hui; Han, Peng Yu; Zuo, Shu-Mei; Hua, Zhong-Xian; Liu, Dian-Wu

    2015-12-01

    It is common knowledge that soils irrigated with wastewater accumulate heavy metals more than those irrigated with cleaner water sources. However, little is known on metal concentrations in soils and cultivars after the cessation of wastewater use. This study assessed the accumulation and health risk of heavy metals 3 years post-wastewater irrigation in soils, vegetables, and farmers' hair. Soils, vegetables, and hair samples were collected from villages previously irrigating with wastewater (experimental villages) and villages with no history of wastewater irrigation (control villages). Soil samples were digested in a mixture of HCL/HNO3/HCLO4/HF. Plants and hair samples were digested in HNO3/HCLO4 mixture. Inductive coupled plasma-optical emission spectrometer (ICP-OES) was used to determine metal concentrations of digested extracts. Study results indicate a persistence of heavy metal concentration in soils and plants from farms previously irrigated with wastewater. In addition, soils previously irrigated with wastewater were severely contaminated with cadmium. Hair metal concentrations of farmers previously irrigating with wastewater were significantly higher (P metal concentrations in hair samples of farmers previously irrigating with wastewater were not associated with current soil metal concentrations. The study concludes that there is a persistence of heavy metals in soils and plants previously irrigated with wastewater, but high metal concentrations in hair samples of farmers cannot be associated with current soil metal concentrations.

  18. Implementing first-year assessment principles: An analysis of selected scholarly literature

    OpenAIRE

    Theda Thomas

    2018-01-01

    Assessment plays an important role in students’ learning as students often frame their learning around their assessment tasks. Well-designed assessment can be used to facilitate first-year students making their social and academic transition to university. In 2009, Professor David Nicol prepared a framework for first-year assessment practices that included 12 principles. In this study, these principles were revisited and used to analyse papers from 2013 to 2016 in the journals: ‘Assessment & ...

  19. Laparoscopy After Previous Laparotomy

    Directory of Open Access Journals (Sweden)

    Zulfo Godinjak

    2006-11-01

    Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

  20. THE INFLUENCE OF THE ASSESSMENT MODEL AND METHOD TOWARD THE SCIENCE LEARNING ACHIEVEMENT BY CONTROLLING THE STUDENTS? PREVIOUS KNOWLEDGE OF MATHEMATICS.

    OpenAIRE

    Adam rumbalifar; I. g. n. Agung; Burhanuddin tola.

    2018-01-01

    This research aims to study the influence of the assessment model and method toward the science learning achievement by controlling the students? previous knowledge of mathematics. This study was conducted at SMP East Seram district with the population of 295 students. This study applied a quasi-experimental method with 2 X 2 factorial design using the ANCOVA model. The findings after controlling the students\\' previous knowledge of mathematics show that the science learning achievement of th...

  1. Environment, Safety, and Health Self-Assessment Report, Fiscal Year 2008

    Energy Technology Data Exchange (ETDEWEB)

    Chernowski, John

    2009-02-27

    Division Self-Assessment annually. The primary focus of the review is workplace safety. The MESH review is an evaluation of division management of ES&H in its research and operations, focusing on implementation and effectiveness of the division's ISM plan. It is a peer review performed by members of the LBNL Safety Review Committee (SRC), with staff support from OCA. Each division receives a MESH review every two to four years, depending on the results of the previous review. The ES&H Technical Assurance Program (TAP) provides the framework for systematic reviews of ES&H programs and processes. The intent of ES&H Technical Assurance assessments is to provide assurance that ES&H programs and processes comply with their guiding regulations, are effective, and are properly implemented by LBNL divisions. The Appendix B Performance Evaluation and Measurement Plan (PEMP) requires that LBNL sustain and enhance the effectiveness of integrated safety, health, and environmental protection through a strong and well-deployed system. Information required for Appendix B is provided by EH&S Division functional managers. The annual Appendix B report is submitted at the close of the fiscal year. This assessment is the Department of Energy's (DOE) primary mechanism for evaluating LBNL's contract performance in ISM.

  2. Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project.

    Science.gov (United States)

    Vanderwert, Ross E; Zeanah, Charles H; Fox, Nathan A; Nelson, Charles A

    2016-02-01

    Extreme social and cognitive deprivation as a result of institutional care has profound effects on developmental outcomes across multiple domains for many abandoned or orphaned children. The Bucharest Early Intervention Project (BEIP) examines the outcomes for children originally placed in institutions who were assessed comprehensively and then randomized to foster care (FCG) or care as usual (CAUG) and followed longitudinally. Here we report on the brain electrical activity (electroencephalogram: EEG) of 12-year-old children enrolled in the BEIP. Previous reports suggested improvement in resting EEG activity for the group of children placed in the foster care intervention, particularly those placed before 24 months of age compared to children who were randomized to CAUG or those placed into families after this age. At 12 years, differences between those in the FCG and those in the CAUG persist in the alpha band (8-13 Hz), but not in higher frequency bands (i.e. in the beta band; 15-30 Hz), except in those children placed into the FCG who remained in high quality care environments over the course of the study. These findings highlight the importance of maintaining a stable high quality caregiving environment, particularly for children exposed to early psychosocial deprivation, for promoting healthy brain development. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Validation of the Online version of the Previous Day Food Questionnaire for schoolchildren

    Directory of Open Access Journals (Sweden)

    Raquel ENGEL

    Full Text Available ABSTRACT Objective To evaluate the validity of the web-based version of the Previous Day Food Questionnaire Online for schoolchildren from the 2nd to 5th grades of elementary school. Methods Participants were 312 schoolchildren aged 7 to 12 years of a public school from the city of Florianópolis, Santa Catarina, Brazil. Validity was assessed by sensitivity, specificity, as well as by agreement rates (match, omission, and intrusion rates of food items reported by children on the Previous Day Food Questionnaire Online, using direct observation of foods/beverages eaten during school meals (mid-morning snack or afternoon snack on the previous day as the reference. Multivariate multinomial logistic regression analysis was used to evaluate the influence of participants’ characteristics on omission and intrusion rates. Results The results showed adequate sensitivity (67.7% and specificity (95.2%. There were low omission and intrusion rates of 22.8% and 29.5%, respectively when all food items were analyzed. Pizza/hamburger showed the highest omission rate, whereas milk and milk products showed the highest intrusion rate. The participants who attended school in the afternoon shift presented a higher probability of intrusion compared to their peers who attended school in the morning. Conclusion The Previous Day Food Questionnaire Online possessed satisfactory validity for the assessment of food intake at the group level in schoolchildren from the 2nd to 5th grades of public school.

  4. Five-year efficacy and safety of tenofovir-based salvage therapy for patients with chronic hepatitis B who previously failed LAM/ADV therapy.

    Science.gov (United States)

    Lim, Lucy; Thompson, Alexander; Patterson, Scott; George, Jacob; Strasser, Simone; Lee, Alice; Sievert, William; Nicoll, Amanda; Desmond, Paul; Roberts, Stuart; Marion, Kaye; Bowden, Scott; Locarnini, Stephen; Angus, Peter

    2017-06-01

    Multidrug-resistant HBV continues to be an important clinical problem. The TDF-109 study demonstrated that TDF±LAM is an effective salvage therapy through 96 weeks for LAM-resistant patients who previously failed ADV add-on or switch therapy. We evaluated the 5-year efficacy and safety outcomes in patients receiving long-term TDF±LAM in the TDF-109 study. A total of 59 patients completed the first phase of the TDF-109 study and 54/59 were rolled over into a long-term prospective open-label study of TDF±LAM 300 mg daily. Results are reported at the end of year 5 of treatment. At year 5, 75% (45/59) had achieved viral suppression by intent-to-treat analysis. Per-protocol assessment revealed 83% (45/54) were HBV DNA undetectable. Nine patients remained HBV DNA detectable, however 8/9 had very low HBV DNA levels (<264IU/mL) and did not meet virological criteria for virological breakthrough (VBT). One patient experienced VBT, but this was in the setting of documented non-compliance. The response was independent of baseline LAM therapy or mutations conferring ADV resistance. Four patients discontinued TDF, one patient was lost to follow-up and one died from hepatocellular carcinoma. Long-term TDF treatment appears to be safe and effective in patients with prior failure of LAM and a suboptimal response to ADV therapy. These findings confirm that TDF has a high genetic barrier to resistance is active against multidrug-resistant HBV, and should be the preferred oral anti-HBV agent in CHB patients who fail treatment with LAM and ADV. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Finding foundations: A model for information literacy assessment of first-year students

    Directory of Open Access Journals (Sweden)

    Zoe Fisher

    2017-08-01

    Full Text Available In Brief This article presents a case study in establishing an information literacy instruction and assessment program for first-year university students at the University of Colorado Denver. Rather than presenting assessment data, we document the process in which our department engaged with the student learning assessment cycle, with the intention of allowing other information literacy professionals to see how we established an instruction program for first-year English Composition. We include a description of in-class exercises, rubrics, and the procedures we followed in order to assess the foundational information literacy skills of first-year students on our campus. This assessment was not conducted to demonstrate what students learned from librarians (thereby illustrating the value of library instruction. Rather, we assessed student learning to ascertain the information literacy skills students bring with them into a first-year English Composition course.

  6. 25 Years of Sustainability. A Critical Assessment

    Directory of Open Access Journals (Sweden)

    Petrişor Alexandru-Ionuţ

    2014-05-01

    Full Text Available 25 years have passed since the 'Brundtland Report‘ defined sustainability as a possibility to equally meet current and future needs. 15 years later, the author of the definition stated that despite of the fact that the definition does not need to be changed, its understanding bettered off during the interval. 25 years later, the present paper takes an in-depth look at the concept and its practical implications. One of the issues being addressed refers to the pillars of sustainability; their number increased by 25% to include the cultural pillar in addition to the economic, social, and cultural one. Spatial thinking added a new dimension, translating into concepts like 'sustainable communities‘ or 'self standing village‘ at the local level, and 'polycentricity‘ and 'cohesion‘ at the regional one. Furthermore, practical implications include environmental impact assessment (evolving towards strategic impact assessment, internalization of externalities, ecological restoration, and a new view on conservation, different from the one addressed by the 'Zero Growth Strategy‘. In addition, the paper discusses several criticism addressed to the concept and its implementation, attempting to reveal their underlying causes. Overall, the critical analysis shows that the attempts to achieve sustainability did not change the concept as much as its understanding.

  7. Three Mile Island epidemiologic radiation dose assessment revisited: 25 years after the accident.

    Science.gov (United States)

    Field, R William

    2005-01-01

    Over the past 25 years, public health concerns following the Three Mile Island (TMI) accident prompted several epidemiologic investigations in the vicinity of TMI. One of these studies is ongoing. This commentary suggests that the major source of radiation exposure to the population has been ignored as a potential confounding factor or effect modifying factor in previous and ongoing TMI epidemiologic studies that explore whether or not TMI accidental plant radiation releases caused an increase in lung cancer in the community around TMI. The commentary also documents the observation that the counties around TMI have the highest regional radon potential in the United States and concludes that radon progeny exposure should be included as part of the overall radiation dose assessment in future studies of radiation-induced lung cancer resulting from the TMI accident.

  8. Three Mile Island epidemiologic radiation dose assessment revisited: 25 years after the accident

    International Nuclear Information System (INIS)

    Field, R. W.

    2005-01-01

    Over the past 25 years, public health concerns following the Three Mile Island (TMI) accident prompted several epidemiologic investigations in the vicinity of TMI. One of these studies is ongoing. This commentary suggests that the major source of radiation exposure to the population has been ignored as a potential confounding factor or effect modifying factor in previous and ongoing TMI epidemiologic studies that explore whether or not TMI accidental plant radiation releases caused an increase in lung cancer in the community around TMI. The commentary also documents the observation that the counties around TMI have the highest regional radon potential in the United States and concludes that radon progeny exposure should be included as part of the overall radiation dose assessment in future studies of radiation-induced lung cancer resulting from the TMI accident. (authors)

  9. Late tamoxifen in patients previously operated for breast cancer without postoperative tamoxifen: 5-year results of a single institution randomised study

    International Nuclear Information System (INIS)

    Veronesi, Andrea; Miolo, GianMaria; Magri, Maria D; Crivellari, Diana; Scalone, Simona; Bidoli, Ettore; Lombardi, Davide

    2010-01-01

    A population of breast cancer patients exists who, for various reasons, never received adjuvant post-operative tamoxifen (TAM). This study was aimed to evaluate the role of late TAM in these patients. From 1997 to 2003, patients aged 35 to 75 years, operated more than 2 years previously for monolateral breast cancer without adjuvant TAM, with no signs of metastases and no contraindication to TAM were randomized to TAM 20 mg/day orally for 2 years or follow-up alone. Events were categorized as locoregional relapse, distant metastases, metachronous breast cancer, tumours other than breast cancer and death from any causes, whichever occurred first. The sample size (197 patients per arm, plus 10% allowance) was based on the assumption of a 30% decrease in the number of events occurring at a rate of 5% annually in the 10 years following randomization. Four hundred and thirty-three patients were randomized in the study (TAM 217, follow-up 216). Patients characteristics (TAM/follow-up) included: median age 55/55 years, median time from surgery 25/25 months (range, 25-288/25-294), in situ carcinoma 18/24, oestrogen receptor (ER) positive in 75/68, negative in 70/57, unknown in 72/91 patients. Previous adjuvant treatment included chemotherapy in 131/120 and an LHRH analogue in 11/13 patients. Thirty-six patients prematurely discontinued TAM after a median of 1 month, mostly because of subjective intolerance. Eighty-three events (TAM 39, follow-up 44) occurred: locoregional relapse in 10/8, distant metastases in 14/16, metachronous breast cancer in 4/10, other tumours in 11/10 patients. Less ER-positive secondary breast cancers occurred in the TAM treated patients than in follow-up patients (1 vs 10, p = 0.005). Event-free survival was similar in both groups of patients. This 5-year analysis revealed significantly less metachronous ER-positive breast cancers in the TAM treated patients. No other statistically significant differences have emerged thus far

  10. Immunogenicity and safety of tetravalent dengue vaccine in 2-11 year-olds previously vaccinated against yellow fever: randomized, controlled, phase II study in Piura, Peru.

    Science.gov (United States)

    Lanata, Claudio F; Andrade, Teresa; Gil, Ana I; Terrones, Cynthia; Valladolid, Omar; Zambrano, Betzana; Saville, Melanie; Crevat, Denis

    2012-09-07

    In a randomized, placebo-controlled, monocenter, observer blinded study conducted in an area where dengue is endemic, we assessed the safety and immunogenicity of a recombinant, live, attenuated, tetravalent dengue vaccine candidate (CYD-TDV) in 2-11 year-olds with varying levels of pre-existing yellow-fever immunity due to vaccination 1-7 years previously. 199 children received 3 injections of CYD-TDV (months 0, 6 and 12) and 99 received placebo (months 0 and 6) or pneumococcal polysaccharide vaccine (month 12). One month after the third dengue vaccination, serotype specific neutralizing antibody GMTs were in the range of 178-190 (1/dil) (versus 16.7-38.1 in the control group), a 10-20 fold-increase from baseline, and 94% of vaccines were seropositive to all four serotypes (versus 39% in the control group). There were no vaccine-related SAEs. The observed reactogenicity profile was consistent with phase I studies, with severity grade 1-2 injection site pain, headache, malaise and fever most frequently reported and no increase after subsequent vaccinations. Virologically confirmed dengue cases were seen after completion of the 3 doses: 1 in the CYD-TDV group (N=199), and 3 in the control group (N=99). A 3-dose regimen of CYD-TDV had a good safety profile in 2-11 year olds with a history of YF vaccination and elicited robust antibody responses that were balanced against the four serotypes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years.

    Science.gov (United States)

    Esteves Lima, Rafael Paschoal; Cota, Luis Otávio Miranda; Silva, Tarcília Aparecida; Cortelli, Sheila Cavalca; Cortelli, José Roberto; Costa, Fernando Oliveira

    2017-01-01

    The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.

  12. Comparison of Updated Weight and Height Percentiles with Previous References in 6-17-Year-Old Children in Kayseri, Turkey.

    Science.gov (United States)

    Zararsız, Gökmen; Çiçek, Betül; Kondolot, Meda; Mazıcıoğlu, M Mümtaz; Öztürk, Ahmet; Kurtoğlu, Selim

    2017-03-01

    To compare updated weight and height percentiles of 6-17-year-old children from all socio-economic levels in Kayseri with previous local references and other national/international data. The second study "Determination of Anthropometric Measurements of Turkish Children and Adolescents study (DAMTCA II)" was conducted in Kayseri, between October 2007 and April 2008. Weight and height measurements from 4321 (1926 boys, 2395 girls) school children aged between 6 to 17 years were included in this cross-sectional study. Using these data, weight and height percentile curves were produced with generalized additive models for location, scale and shape (GAMLSS) and compared with the most recent references. Smoothed percentile curves including the 3 rd , 5 th , 10 th , 15 th , 25 th , 50 th , 75 th , 85 th , 90 th , 95 th , and 97 th percentiles were obtained for boys and girls. These results were compared with DAMTCA I study and with two national (İstanbul and Ankara) and international data from Asia and from Europe. This study provides updated weight and height references for Turkish school children aged between 6 and 17 years residing in Kayseri.

  13. Validation of SWAT+ at field level and comparison with previous SWAT models in simulating hydrologic quantity

    Science.gov (United States)

    GAO, J.; White, M. J.; Bieger, K.; Yen, H.; Arnold, J. G.

    2017-12-01

    Over the past 20 years, the Soil and Water Assessment Tool (SWAT) has been adopted by many researches to assess water quantity and quality in watersheds around the world. As the demand increases in facilitating model support, maintenance, and future development, the SWAT source code and data have undergone major modifications over the past few years. To make the model more flexible in terms of interactions of spatial units and processes occurring in watersheds, a completely revised version of SWAT (SWAT+) was developed to improve SWAT's ability in water resource modelling and management. There are only several applications of SWAT+ in large watersheds, however, no study pays attention to validate the new model at field level and assess its performance. To test the basic hydrologic function of SWAT+, it was implemented in five field cases across five states in the U.S. and compared the SWAT+ created results with that from the previous models at the same fields. Additionally, an automatic calibration tool was used to test which model is easier to be calibrated well in a limited number of parameter adjustments. The goal of the study was to evaluate the performance of SWAT+ in simulating stream flow on field level at different geographical locations. The results demonstrate that SWAT+ demonstrated similar performance with previous SWAT model, but the flexibility offered by SWAT+ via the connection of different spatial objects can result in a more accurate simulation of hydrological processes in spatial, especially for watershed with artificial facilities. Autocalibration shows that SWAT+ is much easier to obtain a satisfied result compared with the previous SWAT. Although many capabilities have already been enhanced in SWAT+, there exist inaccuracies in simulation. This insufficiency will be improved with advancements in scientific knowledge on hydrologic process in specific watersheds. Currently, SWAT+ is prerelease, and any errors are being addressed.

  14. Nebraska wind resource assessment first year results

    Energy Technology Data Exchange (ETDEWEB)

    Hurley, P.J.F.; Vilhauer, R. [RLA Consulting, Inc., Bothell, WA (United States); Stooksbury, D. [Univ. of Nebraska, Lincoln, NE (United States)

    1996-12-31

    This paper presents the preliminary results from a wind resource assessment program in Nebraska sponsored by the Nebraska Power Association. During the first year the measured annual wind speed at 40 meters ranged from 6.5 - 7.5 m/s (14.6 - 16.8 mph) at eight stations across the state. The site selection process is discussed as well as an overview of the site characteristics at the monitoring locations. Results from the first year monitoring period including data recovery rate, directionality, average wind speeds, wind shear, and turbulence intensity are presented. Results from the eight sites are qualitatively compared with other midwest and west coast locations. 5 figs., 2 tabs.

  15. Study of functional-performance deficits in athletes with previous ankle sprains

    Directory of Open Access Journals (Sweden)

    hamid Babaee

    2008-04-01

    Full Text Available Abstract Background: Despite the importance of functional-performance deficits in athletes with history of ankle sprain few, studies have been carried out in this area. The aim of this research was to study relationship between previous ankle sprains and functional-performance deficits in athletes. Materials and methods: The subjects were 40 professional athletes selected through random sampling among volunteer participants in soccer, basketball, volleyball and handball teams of Lorestan province. The subjects were divided into 2 groups: Injured group (athletes with previous ankle sprains and healthy group (athletes without previous ankle sprains. In this descriptive study we used Functional-performance tests (figure 8 hop test and side hop test to determine ankle deficits and limitations. They participated in figure 8 hop test including hopping in 8 shape course with the length of 5 meters and side hop test including 10 side hop repetitions in course with the length of 30 centimeters. Time were recorded via stopwatch. Results: After data gathering and assessing information distributions, Pearson correlation was used to assess relationships, and independent T test to assess differences between variables. Finally the results showed that there is a significant relationship between previous ankle sprains and functional-performance deficits in the athletes. Conclusion: The athletes who had previous ankle sprains indicated functional-performance deficits more than healthy athletes in completion of mentioned functional-performance tests. The functional-performance tests (figure 8 hop test and side hop test are sensitive and suitable to assess and detect functional-performance deficits in athletes. Therefore we can use the figure 8 hop and side hop tests for goals such as prevention, assessment and rehabilitation of ankle sprains without spending too much money and time.

  16. Function's evaluation, perfusion and metabolism by positron emission tomography associated with multislice tomography (PET/CT) in patient with previous diagnosis to myocardial necrosis

    International Nuclear Information System (INIS)

    Campisi, Roxana; Aramayo, Natalia; Osorio, Amilcar

    2010-01-01

    A 64-years-old male patient with previous diagnosis of myocardial necrosis as assessed by myocardial perfusion gated single photon emission computed tomography (gSPECT) with 3-vessel-disease, left ventricular dysfunction and symptomatic by epigastric pain. The patient was referred for myocardial viability assessment by positron emission tomography (PET) to define clinical management decision. (authors) [es

  17. Erlotinib-induced rash spares previously irradiated skin

    International Nuclear Information System (INIS)

    Lips, Irene M.; Vonk, Ernest J.A.; Koster, Mariska E.Y.; Houwing, Ronald H.

    2011-01-01

    Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

  18. Evaluation of general practitioners' assessment of overweight among children attending the five-year preventive child health examination: a cross-sectional survey.

    Science.gov (United States)

    Andersen, Merethe Kousgaard; Christensen, Bo; Obel, Carsten; Søndergaard, Jens

    2012-09-01

    To evaluate general practitioners' (GPs') assessment of potential overweight among children attending the five-year preventive child health examination (PCHE) by comparing their assessment of the children's weight-for-stature with overweight defined by body mass index (BMI) according to paediatric standard definitions. A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular. The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region. Children attending the five-year PCHE in general practice, regardless of their weight status. Paediatric standard definitions for childhood overweight based on BMI were used as the gold standard for categorizing weight-for-stature. Identification of overweight was analysed with regard to sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GPs' assessment of weight-for-stature. A total of 165 GPs conducted 1138 PCHEs. GPs assessed that 171 children had a weight-for-stature above normal. Use of the Danish Standards (DS), i.e. the Danish national growth charts for BMI, as the gold standard yielded a sensitivity of 70.1% (95% CI 62.0-77.3) and a specificity of 92.4% (95% CI 90.6-93.9). The sensitivity was influenced by the GPs' use of BMI and the presence of previous notes regarding abnormal weight development. At the five-year PCHE almost one-third of overweight children were assessed to be normal weight by GPs. Use of BMI and presence of notes on abnormal weight in medical records were positively associated with a higher identification. Hence, utilization of medical record data and BMI charts may refine GPs' assessment of childhood overweight.

  19. Squamous cell carcinoma arising in previously burned or irradiated skin

    International Nuclear Information System (INIS)

    Edwards, M.J.; Hirsch, R.M.; Broadwater, J.R.; Netscher, D.T.; Ames, F.C.

    1989-01-01

    Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5, 10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation

  20. [Assessment, delivery and peripartum care in the case of a uterine rupture during labor of a woman with a previous C-section].

    Science.gov (United States)

    Parrilla-Fernández, Alberto; Manrique-Tejedor, Javier; Figuerol-Calderó, M Inmaculada; García-Romero, Verónica

    Uterine rupture is a rare but severe complication in obstetrics. A previous C-section is the most important risk factor. Its incidence during labor in women with a previous C-section is of approximately 0.3-0.47%, being potentially severe. We present the case of a pregnant women with a previous C-section who suffered uterine rupture during labor. The rapid assessment and action of the midwife and obstetric team was essential to obtain a successful obstetric outcome, avoiding maternal and fetal mortality; and nursing care given to the mother and the newborn after birth contributed to achieving a normal postpartum. It is necessary to have specific knowledge about this condition that, despite rare, can present insidiously with a potential risk for the mother and the fetus. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  1. Life-history traits in an evergreen Mediterranean oak respond differentially to previous experimental environments

    Directory of Open Access Journals (Sweden)

    J. M. Rey Benayas

    2008-06-01

    Full Text Available Living organisms respond both to current and previous environments, which can have important consequences on population dynamics. However, there is little experimental evidence based on long-term field studies of the effects of previous environments on the performance of individuals. We tested the hypothesis that trees that establish under different environmental conditions perform differently under similar post-establishment conditions. We used the slow-growing, evergreen Mediterranean oak Quercus ilex subsp. rotundifolia as target species. We analyzed the effects of previous environments, competition effects and tradeoffs among life-history traits (survival, growth, and reproduction. We enhanced seedling establishment for three years by reducing abiotic environmental harshness by means of summer irrigation and artificial shading in 12 experimental plots, while four plots remained as controls. Then these treatments were interrupted for ten years. Seedlings under ameliorated environmental conditions survived and grew faster during early establishment. During the post-management period, previous treatments 1 did not have any effect on survival, 2 experienced a slower above-ground growth, 3 decreased root biomass as indicated from reflectivity of Ground Penetration Radar, 4 increased acorn production mostly through a greater canopy volume and 5 increased acorn production effort. The trees exhibited a combination of effects related to acclimation for coping with abiotic stress and effects of intra-specific competition. In accordance with our hypothesis, tree performance overall depended on previous environmental conditions, and the response was different for different life-history traits. We recommend early management because it increased plot cover, shortened the time to attain sexual maturity and increased the amount of acorn production. Plots such as those assessed in this study may act as sources of propagules in deforested

  2. Previous Fractures at Multiple Sites Increase the Risk for Subsequent Fractures: The Global Longitudinal Study of Osteoporosis in Women

    Science.gov (United States)

    Gehlbach, Stephen; Saag, Kenneth G.; Adachi, Jonathan D.; Hooven, Fred H.; Flahive, Julie; Boonen, Steven; Chapurlat, Roland D.; Compston, Juliet E.; Cooper, Cyrus; Díez-Perez, Adolfo; Greenspan, Susan L.; LaCroix, Andrea Z.; Netelenbos, J. Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Sambrook, Philip N.; Silverman, Stuart; Siris, Ethel S.; Watts, Nelson B.; Lindsay, Robert

    2016-01-01

    Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women ≥ 55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ≥3 fractures since age 45. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no prior fractures, women with 1, 2, or ≥ 3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ≥3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio 7.3) and hip (hazard ratio 3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture; women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development. PMID:22113888

  3. Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Masood Mohd

    2012-11-01

    Full Text Available Abstract Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health Organization criteria. The rates of dental caries were recorded in prevalence and incidence density of carious lesions from baseline to final examination. Risk assessment was done to assess relative risk for caries after 5 years in children with baseline caries status. Simple and multiple logistic regression analysis were performed to identify significant independent risk factors for caries. Results The sample consisted of 1830 school children. All components of DMFT showed significant differences between baseline and final examination. Filled teeth (FT component of the DMFT showed the greatest increases. Results revealed the initial baseline caries level in permanent dentition was a strong predictor for future caries after 5 years (RR=3.78, 95% CI=3.48-4.10, P0.001. Logistic regression analysis showed significant association between caries occurrence and residence (urban/rural (OR=1.80, Pp observed from baseline and after 5 years was 5.80 persons/100 person-year of observation. The rate of new caries-affected tooth (IDt in the period from baseline and after 5-years was 0.76 teeth/100 teeth-year of observation. Conclusion The majority of 12-year-old school children (70% were caries-free and most of the caries were concentrated in only a small proportion (30% of them. We found that the presence of caries in permanent teeth at the age of 6 years was a strong predictor of future caries development in this population. The strong evidence of early permanent teeth

  4. Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years

    Directory of Open Access Journals (Sweden)

    Rafael Paschoal ESTEVES LIMA

    Full Text Available Abstract Periodontitis can contribute to the development of insulin resistance. Gestational diabetes is a risk factor for type 2 diabetes. Therefore, periodontitis, when associated with gestational diabetes, could increase the risk for the development of type 2 diabetes after pregnancy. Objective The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Material and Methods Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. Results The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. Conclusions It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.

  5. Analysis of current research addressing complementary use of life-cycle assessment and risk assessment for engineered nanomaterials: have lessons been learned from previous experience with chemicals?

    DEFF Research Database (Denmark)

    Grieger, Khara Deanne; Laurent, Alexis; Miseljic, Mirko

    2012-01-01

    of research focused on applying LCA and RA together for NM, it appears that current research efforts have taken into account some key ‘‘lessons learned’’ from previous experience with chemicals while many key challenges remain for practically applying these methods to NM. We identified two main approaches...... for using these methods together for NM: ‘‘LC-based RA’’ (traditional RA applied in a life-cycle perspective) and ‘‘RA-complemented LCA’’ (conventional LCA supplemented by RA in specific life-cycle steps). Hence, the latter is the only identified approach which genuinely combines LC- and RA-based methods......While it is generally agreed that successful strategies to address the health and environmental impacts of engineered nanomaterials (NM) should consider the well-established frameworks for conducting life-cycle assessment (LCA) and risk assessment (RA), scientific research, and specific guidance...

  6. Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency: A Concise Follow-up, at a Minimum of 10 Years, of Previous Reports.

    Science.gov (United States)

    Cuff, Derek J; Pupello, Derek R; Santoni, Brandon G; Clark, Rachel E; Frankle, Mark A

    2017-11-15

    We previously evaluated 94 patients (96 shoulders) who underwent reverse shoulder arthroplasty using a central compressive screw with 5.0-mm peripheral locking screws for baseplate fixation and a center of rotation lateral to the glenoid as treatment for end-stage rotator cuff deficiency. The purpose of this study was to report updated results at a minimum follow-up of 10 years. Forty patients (42 shoulders) were available for clinical follow-up. In the patients available for study, implant survivorship, with the end point being revision for any reason, was 90.7%. Since our 5-year report, 2 patients underwent revision surgery; 1 patient sustained a periprosthetic fracture 7 years postoperatively and 1 patient had a dislocation because of chronic shoulder instability at 8 years postoperatively. At a minimum follow-up of 10 years, the patients continued to maintain their improved outcome scores and range of motion, which were comparable with earlier follow-up evaluations. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  7. Chemoimmunotherapy with ofatumumab in combination with CHOP in previously untreated follicular lymphoma

    DEFF Research Database (Denmark)

    Czuczman, Myron S; Hess, Georg; Gadeberg, Ole V

    2012-01-01

    An international, Phase II trial was conducted to assess two doses of ofatumumab, a human CD20 monoclonal antibody, combined with cyclophosphamide (750 mg/m(2) ), doxorubicin (50 mg/m(2) ), prednisone (100 mg days 3-7) and vincristine (1·4 mg/m(2) ) (O-CHOP), as frontline treatment for follicular...... lymphoma (FL). 59 patients with previously untreated FL were randomized to ofatumumab 500 mg (n = 29) or 1000 mg (n = 30) day 1, with CHOP on day 3 every 3 weeks for six cycles. Median duration of FL was 0·1 years for both dose groups; 34% and 38% of patients had high-risk Follicular Lymphoma International...

  8. A 2-year study of patient safety competency assessment in 29 clinical laboratories.

    Science.gov (United States)

    Reed, Robyn C; Kim, Sara; Farquharson, Kara; Astion, Michael L

    2008-06-01

    Competency assessment is critical for laboratory operations and is mandated by the Clinical Laboratory Improvement Amendments of 1988. However, no previous reports describe methods for assessing competency in patient safety. We developed and implemented a Web-based tool to assess performance of 875 laboratory staff from 29 laboratories in patient safety. Question categories included workplace culture, categorizing error, prioritization of patient safety interventions, strength of specific interventions, and general patient safety concepts. The mean score was 85.0%, with individual scores ranging from 56% to 100% and scores by category from 81.3% to 88.6%. Of the most difficult questions (laboratory technologists. Computer-based competency assessments help laboratories identify topics for continuing education in patient safety.

  9. Needs assessment activity report: Fiscal year 1995

    International Nuclear Information System (INIS)

    1995-09-01

    The Needs Assessment program has assessed the packaging requirements of many U.S. Department of Energy (DOE) sites. These assessments have involved site visits and meetings with personnel involved with transportation and packaging of hazardous materials. By September 1995, 24 DOE facilities had been visited, with 14 site visits occurring in fiscal year 1995. As a result, these sites have been informed of some of the packaging activities that DOE has sponsored and is sponsoring, have been apprised of the affects of upcoming changes to transportation regulations, have discussed their near-term packaging needs, and have shared unique packaging they have developed, which may be of use to other DOE facilities. Program successes include discovery of a need for a reusable Type A liquid sample packaging and its development within another DOE task and establishing communications pathways between DOE sites that have similar transportation and packaging needs. This report recommends that the Needs Assessment activity continue to pursue the strategy of visiting DOE sites to meet with their transportation and packaging personnel. These visits will ensure that DOE needs are met, communications pathways between DOE sites are established and cultivated, and redundant packaging development is identified. The site visits should be expanded to include meetings with the long-range and strategic planners at each site, and at the DOE-Headquarters level, to ensure that all future transportation and packaging needs are identified early enough to allow adequate transportation assessment and packaging development. This activity could become a permanent conduit for information and will ensure that all future DOE transportation and packaging needs are satisfied in a cost-effective, timely, and efficient manner

  10. Field assessment of balance in 10 to 14 year old children, reproducibility and validity of the Nintendo Wii board

    DEFF Research Database (Denmark)

    Larsen, Lisbeth Runge; Jørgensen, Martin Grønbech; Junge, Tina

    2014-01-01

    and adults. When assessing static balance, it is essential to use objective, sensitive tools, and these types of measurement have previously been performed in laboratory settings. However, the emergence of technologies like the Nintendo Wii Board (NWB) might allow balance assessment in field settings....... As the NWB has only been validated and tested for reproducibility in adults, the purpose of this study was to examine reproducibility and validity of the NWB in a field setting, in a population of children. METHODS: Fifty-four 10-14 year-olds from the CHAMPS-Study DK performed four different balance tests...... of the reproducibility study. CONCLUSION: Both NWB and AMTI have satisfactory reproducibility for testing static balance in a population of children. Concurrent validity of NWB compared with AMTI was satisfactory. Furthermore, the results from the concurrent validity study were comparable to the reproducibility results...

  11. Cryptococcal meningitis in a previously healthy child | Chimowa ...

    African Journals Online (AJOL)

    An 8-year-old previously healthy female presented with a 3 weeks history of headache, neck stiffness, deafness, fever and vomiting and was diagnosed with cryptococcal meningitis. She had documented hearing loss and was referred to tertiary-level care after treatment with fluconazole did not improve her neurological ...

  12. [Prevalence of previously diagnosed diabetes mellitus in Mexico.

    Science.gov (United States)

    Rojas-Martínez, Rosalba; Basto-Abreu, Ana; Aguilar-Salinas, Carlos A; Zárate-Rojas, Emiliano; Villalpando, Salvador; Barrientos-Gutiérrez, Tonatiuh

    2018-01-01

    To compare the prevalence of previously diagnosed diabetes in 2016 with previous national surveys and to describe treatment and its complications. Mexico's national surveys Ensa 2000, Ensanut 2006, 2012 and 2016 were used. For 2016, logistic regression models and measures of central tendency and dispersion were obtained. The prevalence of previously diagnosed diabetes in 2016 was 9.4%. The increase of 2.2% relative to 2012 was not significant and only observed in patients older than 60 years. While preventive measures have increased, the access to medical treatment and lifestyle has not changed. The treatment has been modified, with an increase in insulin and decrease in hypoglycaemic agents. Population aging, lack of screening actions and the increase in diabetes complications will lead to an increase on the burden of disease. Policy measures targeting primary and secondary prevention of diabetes are crucial.

  13. A previous hamstring injury affects kicking mechanics in soccer players.

    Science.gov (United States)

    Navandar, Archit; Veiga, Santiago; Torres, Gonzalo; Chorro, David; Navarro, Enrique

    2018-01-10

    Although the kicking skill is influenced by limb dominance and sex, how a previous hamstring injury affects kicking has not been studied in detail. Thus, the objective of this study was to evaluate the effect of sex and limb dominance on kicking in limbs with and without a previous hamstring injury. 45 professional players (males: n=19, previously injured players=4, age=21.16 ± 2.00 years; females: n=19, previously injured players=10, age=22.15 ± 4.50 years) performed 5 kicks each with their preferred and non-preferred limb at a target 7m away, which were recorded with a three-dimensional motion capture system. Kinematic and kinetic variables were extracted for the backswing, leg cocking, leg acceleration and follow through phases. A shorter backswing (20.20 ± 3.49% vs 25.64 ± 4.57%), and differences in knee flexion angle (58 ± 10o vs 72 ± 14o) and hip flexion velocity (8 ± 0rad/s vs 10 ± 2rad/s) were observed in previously injured, non-preferred limb kicks for females. A lower peak hip linear velocity (3.50 ± 0.84m/s vs 4.10 ± 0.45m/s) was observed in previously injured, preferred limb kicks of females. These differences occurred in the backswing and leg-cocking phases where the hamstring muscles were the most active. A variation in the functioning of the hamstring muscles and that of the gluteus maximus and iliopsoas in the case of a previous injury could account for the differences observed in the kicking pattern. Therefore, the effects of a previous hamstring injury must be considered while designing rehabilitation programs to re-educate kicking movement.

  14. Assessment of Working Memory Components at 6 Years of Age as Predictors of Reading Achievements a Year Later

    Science.gov (United States)

    Nevo, Einat; Breznitz, Zvia

    2011-01-01

    The ability of working memory skills (measured by tasks assessing all four working memory components), IQ, language, phonological awareness, literacy, rapid naming, and speed of processing at 6 years of age, before reading was taught, to predict reading abilities (decoding, reading comprehension, and reading time) a year later was examined in 97…

  15. Process cells dismantling of EUREX pant: previous activities

    International Nuclear Information System (INIS)

    Gili, M.

    1998-01-01

    In the '98-'99 period some process cells of the EUREX pant will be dismantled, in order to place there the liquid wastes conditioning plant 'CORA'. This report resumes the previous activities (plant rinsing campaigns and inactive Cell 014 dismantling), run in the past three years and the drawn experience [it

  16. An Early Years Toolbox for Assessing Early Executive Function, Language, Self-Regulation, and Social Development: Validity, Reliability, and Preliminary Norms

    Science.gov (United States)

    Howard, Steven J.; Melhuish, Edward

    2017-01-01

    Several methods of assessing executive function (EF), self-regulation, language development, and social development in young children have been developed over previous decades. Yet new technologies make available methods of assessment not previously considered. In resolving conceptual and pragmatic limitations of existing tools, the Early Years…

  17. Tricuspid Endocarditis, in a 12 year old girl with a previously normal ...

    African Journals Online (AJOL)

    Abstract. A 12 year old girl was referred to QECH Paediatric and Child Health Department with a two week history of dry cough, fever and chills. Three days before admission she became pale and short of breath.

  18. Influence of radiation therapy on lung tissue in breast cancer patients. CT-assessed density changes 4 years after completion of radiotherapy

    International Nuclear Information System (INIS)

    Svane, G.; Rotstein, S.; Lax, I.

    1995-01-01

    CT-assessed density changes in lung tissues were measured in 22 disease-free breast cancer patients 4 years after completion of radiation therapy. All patients had previously undergone similar CT-examinations before treatment, 3 months, and 9 months after radiotherapy. In patients with visible areas of increased lung density at earlier CT-examinations a decrease of focal findings was observed at 4 years. In patients without focal findings, an increase in density relative to that before therapy was observed. The difference between the mean lung density values among those with visible radiological findings and those without was statistically significant both at 3 and 9 months after therapy. However, this difference did not persist at 4 years. These results may indicate a 2-phase development of radiation-induced lung damages - an acute phase and a late phase; the late phase emerging slowly, and in this study detectable 4 years after completion of radiation therapy. (orig.)

  19. ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes.

    LENUS (Irish Health Repository)

    Noctor, E

    2013-11-01

    Previous gestational diabetes (GDM) is associated with a significant lifetime risk of type 2 diabetes. In this study, we assessed the performance of HbA1c and fasting plasma glucose (FPG) measurements against that of 75 g oral glucose tolerance testing (OGTT) for the follow-up screening of women with previous GDM.

  20. Improving third-year medical students' competency in clinical moral reasoning : two interventions

    NARCIS (Netherlands)

    Cummins, P.J.; Mendis, K.J.; Fallar, R.; Favia, A.; Frank, L.E.; Plunkett, C.; Gligorov, N.; Rhodes, R.

    2016-01-01

    Background: This article reports on the impact of two ethics interventions implemented for third-year medical students. Previous research validated our institution's model for assessing medical students' competency in medical ethics. Confident in our assessment model, the bioethics faculty sought to

  1. Personality disorders in previously detained adolescent females: a prospective study

    NARCIS (Netherlands)

    Krabbendam, A.; Colins, O.F.; Doreleijers, T.A.H.; van der Molen, E.; Beekman, A.T.F.; Vermeiren, R.R.J.M.

    2015-01-01

    This longitudinal study investigated the predictive value of trauma and mental health problems for the development of antisocial personality disorder (ASPD) and borderline personality disorder (BPD) in previously detained women. The participants were 229 detained adolescent females who were assessed

  2. A rare case of failed healing in previously burned skin after a secondary burns.

    Science.gov (United States)

    Goldie, Stephen J; Parsons, Shaun; Menezes, Hana; Ives, Andrew; Cleland, Heather

    2017-01-01

    Patients presenting with large surface area burns are common in our practice; however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5% TBSA burn on skin scarred by a previous 40% total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings; however, they failed to heal and became infected requiring surgical management. Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

  3. Body Composition Assessment from Birth to Two Years of Age

    International Nuclear Information System (INIS)

    2013-01-01

    During infancy and early childhood, the pace and quality of growth mark the risk of ill health in the short and longer term. Measurements of body weight and its changes are frequently taken as indicators of growth, without adequate attention being paid to linear growth or body composition during this critical window of opportunity, as these measurements are more challenging to make. To better define and characterize healthy growth, there is a need for guidance on the use of standardized methodologies to assess body composition during early life to differentiate between nutrient partitioning to fat free mass and to fat mass in infants and young children. Given the necessity for an international consensus, in 2009 the IAEA initiated a review of body composition assessment techniques as the basis for efforts aimed at the standardization of body composition assessment from birth to 2 years of age. This initiative follows the IAEA's long standing tradition of providing guidance on the use of nuclear techniques in nutrition. This publication was developed by an international group of experts as an integral part of the IAEA's contribution to the transfer of technology and capacity building in this field to assist Member States in their efforts to improve the nutrition and health of infants and young children, who are among the most vulnerable population groups. This publication provides practical information on the assessment of body composition from birth up to 2 years of age and is intended for nutritionists, paediatricians and other health professionals. The body composition assessment techniques included in this publication were considered the methodologies with the highest potential for standardization globally - based on considerations such as access to equipment, cost and the training needs of staff - and include stable isotope dilution for total body water assessment as well as dual energy X ray absorptiometry and air displacement plethysmography. In addition, the

  4. Body Composition Assessment from Birth to Two Years of Age

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-15

    During infancy and early childhood, the pace and quality of growth mark the risk of ill health in the short and longer term. Measurements of body weight and its changes are frequently taken as indicators of growth, without adequate attention being paid to linear growth or body composition during this critical window of opportunity, as these measurements are more challenging to make. To better define and characterize healthy growth, there is a need for guidance on the use of standardized methodologies to assess body composition during early life to differentiate between nutrient partitioning to fat free mass and to fat mass in infants and young children. Given the necessity for an international consensus, in 2009 the IAEA initiated a review of body composition assessment techniques as the basis for efforts aimed at the standardization of body composition assessment from birth to 2 years of age. This initiative follows the IAEA's long standing tradition of providing guidance on the use of nuclear techniques in nutrition. This publication was developed by an international group of experts as an integral part of the IAEA's contribution to the transfer of technology and capacity building in this field to assist Member States in their efforts to improve the nutrition and health of infants and young children, who are among the most vulnerable population groups. This publication provides practical information on the assessment of body composition from birth up to 2 years of age and is intended for nutritionists, paediatricians and other health professionals. The body composition assessment techniques included in this publication were considered the methodologies with the highest potential for standardization globally - based on considerations such as access to equipment, cost and the training needs of staff - and include stable isotope dilution for total body water assessment as well as dual energy X ray absorptiometry and air displacement plethysmography. In addition, the

  5. Five-Year NRHP Re-Evaluation of Historic Buildings Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, R A; Heidecker, K R

    2011-09-12

    The Lawrence Livermore National Laboratory (LLNL) 'Draft Programmatic Agreement among the Department of Energy and the California State Historic Preservation Officer Regarding Operation of Lawrence Livermore National Laboratory' requires a review and re-evaluation of the eligibility of laboratory properties for the National Register of Historic Places (NRHP) every five years. The original evaluation was published in 2005; this report serves as the first five-year re-evaluation. This re-evaluation includes consideration of changes within LLNL to management, to mission, and to the built environment. it also determines the status of those buildings, objects, and districts that were recommended as NRHP-eligible in the 2005 report. Buildings that were omitted from the earlier building list, those that have reached 50 years of age since the original assessment, and new buildings are also addressed in the re-evaluation.

  6. Influence of previous experience on resistance training on reliability of one-repetition maximum test.

    Science.gov (United States)

    Ritti-Dias, Raphael Mendes; Avelar, Ademar; Salvador, Emanuel Péricles; Cyrino, Edilson Serpeloni

    2011-05-01

    The 1-repetition maximum test (1RM) has been widely used to assess maximal strength. However, to improve accuracy in assessing maximal strength, several sessions of the 1RM test are recommended. The aim of this study was to analyze the influence of previous resistance training experience on the reliability of 1RM test. Thirty men were assigned to the following 2 groups according to their previous resistance training experience: no previous resistance training experience (NOEXP) and more than 24 months of resistance training experience (EXP). All subjects performed the 1RM tests in bench press and squat in 4 sessions on distinct days. There was a significant session × group effect in bench press (F = 3.09; p reliability of the 1RM test is influenced by the subject's previous experience in resistance training. Subjects without experience in resistance training require more practice and familiarization and show greater increases in maximal strength between sessions than subjects with previous experience in resistance training.

  7. Five-year longitudinal assessment of the prognosis of apical microsurgery

    DEFF Research Database (Denmark)

    von Arx, Thomas; Jensen, Simon S; Hänni, Stefan

    2012-01-01

    Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohor...

  8. The impact of predictive genetic testing for hereditary nonpolyposis colorectal cancer: three years after testing.

    Science.gov (United States)

    Collins, Veronica R; Meiser, Bettina; Ukoumunne, Obioha C; Gaff, Clara; St John, D James; Halliday, Jane L

    2007-05-01

    To fully assess predictive genetic testing programs, it is important to assess outcomes over periods of time longer than the 1-year follow-up reported in the literature. We conducted a 3-year study of individuals who received predictive genetic test results for previously identified familial mutations in Australian Familial Cancer Clinics. Questionnaires were sent before attendance at the familial cancer clinic and 2 weeks, 4 months, 1 year, and 3 years after receiving test results. Psychological measures were included each time, and preventive behaviors were assessed at baseline and 1 and 3 years. Psychological measures were adjusted for age, gender, and baseline score. The study included 19 carriers and 54 non-carriers. We previously reported an increase in mean cancer-specific distress in carriers at 2 weeks with a return to baseline levels by 12 months. This level was maintained until 3 years. Non-carriers showed sustained decreases after testing with a significantly lower level at 3 years compared with baseline (P depression and anxiety scores did not differ between carriers and non-carriers and, at 3 years, were similar to baseline. All carriers and 7% of non-carriers had had a colonoscopy by 3 years, and 69% of 13 female carriers had undergone gynecological screening in the previous 2 years. Prophylactic surgery was rare. This report of long-term data indicates appropriate screening and improved psychological measures for non-carriers with no evidence of undue psychological distress in carriers of hereditary nonpolyposis colorectal cancer mutations.

  9. Femoral Component Revision with Use of Impaction Bone-Grafting and a Cemented Polished Stem: A Concise Follow-up, at Fifteen to Twenty Years, of a Previous Report*

    NARCIS (Netherlands)

    Te Stroet, M.A.; Gardeniers, J.W.M.; Verdonschot, N.J.; Rijnen, W.H.C.; Slooff, T.J.J.H.; Schreurs, B.W.

    2012-01-01

    We previously reported our results for thirty-three consecutive femoral component revisions with impaction bone-grafting, performed with the X-change femoral revision system and a cemented polished Exeter stem, at a minimum of eight years of follow-up. The present updated study shows the results

  10. Vaginal prostaglandin gel to induce labour in women with one previous caesarean section.

    LENUS (Irish Health Repository)

    Agnew, G

    2012-02-01

    This retrospective study reviewed the mode of delivery when vaginal prostaglandins were used to induce labour in women with a single previous lower segment caesarean section. Over a 4-year period, PGE 2 gel was used cautiously in low doses in 54 women. Induction with PGE 2 gel was associated with an overall vaginal birth after caesarean section (VBAC) rate of 74%, which compared favourably with the 74% VBAC rate in women who went into spontaneous labour (n = 1969). There were no adverse outcomes recorded after the prostaglandin inductions but the number reported are too small to draw any conclusions about the risks, such as uterine rupture. We report our results because they may be helpful in assessing the chances of a successful VBAC in the uncommon clinical circumstances where prostaglandin induction is being considered.

  11. Influence of Previous Knowledge, Language Skills and Domain-specific Interest on Observation Competency

    Science.gov (United States)

    Kohlhauf, Lucia; Rutke, Ulrike; Neuhaus, Birgit

    2011-10-01

    Many epoch-making biological discoveries (e.g. Darwinian Theory) were based upon observations. Nevertheless, observation is often regarded as `just looking' rather than a basic scientific skill. As observation is one of the main research methods in biological sciences, it must be considered as an independent research method and systematic practice of this method is necessary. Because observation skills form the basis of further scientific methods (e.g. experiments or comparisons) and children from the age of 4 years are able to independently generate questions and hypotheses, it seems possible to foster observation competency at a preschool level. To be able to provide development-adequate individual fostering of this competency, it is first necessary to assess each child's competency. Therefore, drawing on the recent literature, we developed in this study a competency model that was empirically evaluated within learners ( N = 110) from different age groups, from kindergarten to university. In addition, we collected data on language skills, domain-specific interest and previous knowledge to analyse coherence between these skills and observation competency. The study showed as expected that previous knowledge had a high impact on observation competency, whereas the influence of domain-specific interest was nonexistent. Language skills were shown to have a weak influence. By utilising the empirically validated model consisting of three dimensions (`Describing', `Scientific reasoning' and `Interpreting') and three skill levels, it was possible to assess each child's competency level and to develop and evaluate guided play activities to individually foster a child's observation competency.

  12. Japanese Language and Culture: 9-Year Program Classroom Assessment Materials, Grade 4

    Science.gov (United States)

    Alberta Education, 2008

    2008-01-01

    This document is designed to provide assessment materials for specific Grade 4 outcomes in the Japanese Language and Culture Nine-year Program, Grades 4-5-6. The assessment materials are designed for the beginner level in the context of teaching for communicative competence. Grade 4 learning outcomes from the Japanese Language and Culture…

  13. Neuropsychological Assessment at Preschool Age: Adaptation and Validation of the McCarthy Scales of Children's Abilities to 4 Year-old Basque-speaking Children.

    Science.gov (United States)

    Andiarena, Ainara; Balluerka, Nekane; Gorostiaga, Arantxa; Ibarluzea, Jesús

    2017-10-23

    Early neuropsychological assessment provides important information for clinical practice and research. As previously no tool for neuropsychological assessment has been developed in or adapted to Basque, the aim of this study was to adapt and validate the McCarthy Scales of Children's Abilities for 4 years old children. The adaptation and validation of the original instrument followed the methodological steps established by the International Test Commission. We examined the psychometric properties of the adapted instrument in 273 Basque preschool children (aged between 4 years and 4 months and 4 years and 11 months; 52.2% boys). Confirmatory factor analysis showed satisfactory fit indexes except for the General Cognitive and Memory scales. Most scales presented adequate internal consistency (Reliability coefficients ranged between .55 and .81). The Basque version also showed evidence of validity based on the relationship between neuropsychological development and sex, parental education, attention deficit hyperactivity disorder-like behaviours and early neurodevelopment (p < .05; effect sizes ranged between Cohen's d = .26 and .52 and r = .15 and 39). The Basque MSCA can be regarded as a useful tool to evaluate cognitive and psychomotor development in preschool children.

  14. Extreme fire events are related to previous-year surface moisture conditions in permafrost-underlain larch forests of Siberia

    International Nuclear Information System (INIS)

    Forkel, Matthias; Beer, Christian; Thonicke, Kirsten; Cramer, Wolfgang; Bartalev, Sergey; Schmullius, Christiane

    2012-01-01

    Wildfires are a natural and important element in the functioning of boreal forests. However, in some years, fires with extreme spread and severity occur. Such severe fires can degrade the forest, affect human values, emit huge amounts of carbon and aerosols and alter the land surface albedo. Usually, wind, slope and dry air conditions have been recognized as factors determining fire spread. Here we identify surface moisture as an additional important driving factor for the evolution of extreme fire events in the Baikal region. An area of 127 000 km 2 burned in this region in 2003, a large part of it in regions underlain by permafrost. Analyses of satellite data for 2002–2009 indicate that previous-summer surface moisture is a better predictor for burned area than precipitation anomalies or fire weather indices for larch forests with continuous permafrost. Our analysis advances the understanding of complex interactions between the atmosphere, vegetation and soil, and how coupled mechanisms can lead to extreme events. These findings emphasize the importance of a mechanistic coupling of soil thermodynamics, hydrology, vegetation functioning, and fire activity in Earth system models for projecting climate change impacts over the next century. (letter)

  15. German Language and Culture: 9-Year Program Classroom Assessment Materials, Grade 4

    Science.gov (United States)

    Alberta Education, 2008

    2008-01-01

    This document is designed to provide assessment materials for specific Grade 4 outcomes in the German Language and Culture Nine-year Program, Grades 4-5-6. The assessment materials are designed for the beginner level in the context of teaching for communicative competence. Grade 4 learning outcomes from the German Language and Culture Nine-year…

  16. Punjabi Language and Culture: 9-Year Program Classroom Assessment Materials, Grade 4

    Science.gov (United States)

    Alberta Education, 2008

    2008-01-01

    This document is designed to provide assessment materials for specific Grade 4 outcomes in the Punjabi Language and Culture Nine-year Program, Grades 4-5-6. The assessment materials are designed for the beginner level in the context of teaching for communicative competence. Grade 4 learning outcomes from the Punjabi Language and Culture Nine-year…

  17. Project W-420 Ventilation Stack Monitoring System Year 2000 Compliance Assessment Project Plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-420. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance. This assessment describes the potential Year 2000 (Y2K) problems and describes the methods for achieving Y2K Compliance for Project W-420, Ventilation Stack Monitoring Systems Upgrades. The purpose of this assessment is to give an overview of the project. This document will not be updated and any dates contained in this document are estimates and may change. The project work scope includes upgrades to ventilation stacks and generic effluent monitoring systems (GEMS) at the 244-A Double Contained Receiver Tank (DCRT), the 244-BX DCRT, the 244-CR Vault, tanks 241-C-105 and 241-C-106, the 244-S DCRT, and the 244-TX DCRT. A detailed description of system dates, functions, interfaces, potential Y2K problems, and date resolutions can not be described since the project is in the definitive design phase, This assessment will describe the methods, protocols, and practices to ensure that equipment and systems do not have Y2K problems

  18. Previous Employment and Job Satisfaction Conditions: The Case of Regional Administration

    Science.gov (United States)

    Amalia, Myronaki; Nikolaos, Antonakas

    2009-08-01

    In the present work we study the different dimensions of satisfaction and the way of constitution of satisfaction of an important sample of the employees in the Regional administration of Crete and in their connection with the variable of the previous employment. We found statistically important differences for the components of satisfaction from the life, collaboration in and outside from the department, in the social satisfaction and the variable of the years in the service (labour group with satisfaction than the other previous employment groups. In the other hand the group with many years in the service presents bigger satisfaction than the other groups. Finally, is important to note that the sample present some interesting characteristics.

  19. Project W-211 initial tank retrieval systems year 2000 compliance assessment project plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-211. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance

  20. Assessing middle school students` understanding of science relationships and processes: Year 2 - instrument validation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Schau, C.; Mattern, N.; Weber, R.; Minnick, K.

    1997-01-01

    Our overall purpose for this multi-year project was to develop an alternative assessment format measuring rural middle school students understanding of science concepts and processes and the interrelationships among them. This kind of understanding is called structural knowledge. We had 3 major interrelated goals: (1) Synthesize the existing literature and critically evaluate the actual and potential use of measures of structural knowledge in science education. (2) Develop a structural knowledge alternative assessment format. (3) Examine the validity of our structural knowledge format. We accomplished the first two goals during year 1. The structural knowledge assessment we identified and developed further was a select-and-fill-in concept map format. The goal for our year 2 work was to begin to validate this assessment approach. This final report summarizes our year 2 work.

  1. Alflutop clinical efficacy assessment in osteoarthritis (two-years study

    Directory of Open Access Journals (Sweden)

    V. N. Chodyrev

    2003-01-01

    Full Text Available Objective. To assess alflutop clinical efficacy and safety during long-term course treatment of knee osteoarthritis. Methods. 51 pts with definite knee osteoarthritis of I-III stage according to Kellgren-Lawrence classification were included in an open controlled study. 20 pts received 6 intra-articular injections of alflutop 2 ml with subsequent intramuscular treatment during 3 months. Such courses were repeated 6 months apart for 2 years. 31 pts of control group received nonsteroidal anti-inflammatory drugs (NSAID only. Pain on visual analog scale, Leken functional score, changes of NSAID treatment and radiological picture were used for assessment of efficacy. Clinical examination was performed before and after every treatment course and 3 months after the last course. Results. Every alflutop treatment course provided significant stepwise decrease of pain with improvement of mobility, reduction of NSAID requirement and absence of osteoarthritis radiological progression. Doctor and pts clinical efficacy and safety assessment coincided. Conclusion. Alflutop is an effective drug for knee osteoarthritis treatment. It has anti-inflammatory and probably chondroprotective activity with good safety.

  2. 75 FR 43197 - Public Housing Assessment System (PHAS): Asset Management Transition Year 2 Extension

    Science.gov (United States)

    2010-07-23

    ... System (PHAS): Asset Management Transition Year 2 Extension AGENCY: Office of the Assistant Secretary for...): Asset Management Transition Year 2 Information (75 FR 1632), dated January 12, 2010, for PHAs with... Assessment System (PHAS): Asset Management Transition Year Information and Uniform Financial Reporting...

  3. Assessment of working memory components at 6years of age as predictors of reading achievements a year later.

    Science.gov (United States)

    Nevo, Einat; Breznitz, Zvia

    2011-05-01

    The ability of working memory skills (measured by tasks assessing all four working memory components), IQ, language, phonological awareness, literacy, rapid naming, and speed of processing at 6years of age, before reading was taught, to predict reading abilities (decoding, reading comprehension, and reading time) a year later was examined in 97 children. Among all working memory components, phonological complex memory contributed most to predicting all three reading abilities. A capacity measure of phonological complex memory, based on passing a minimum threshold in those tasks, contributed to the explained variance of decoding and reading comprehension. Findings suggest that a minimal ability of phonological complex memory is necessary for children to attain a normal reading level. Adding assessment of phonological complex memory, before formal teaching of reading begins, to more common measures might better estimate children's likelihood of future academic success. Copyright © 2010 Elsevier Inc. All rights reserved.

  4. Books average previous decade of economic misery.

    Science.gov (United States)

    Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade.

  5. Retrospective analysis on malignant calcification previously misdiagnosed as benign on screening mammography

    International Nuclear Information System (INIS)

    Ha, Su Min; Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung

    2017-01-01

    The purpose of our study was to investigate the morphology and distribution of calcifications initially interpreted as benign or probably benign, but proven to be malignant by subsequent stereotactic biopsy, and to identify the reason for misinterpretation or underestimation at the initial diagnosis. Out of 567 women who underwent stereotactic biopsy for calcifications at our hospital between January 2012 and December 2014, 167 women were diagnosed with malignancy. Forty-six of these 167 women had previous mammography assessed as benign or probably benign which was changed to suspicious malignancy on follow-up mammography. Of these 46 women, three women with biopsy-proven benign calcifications at the site of subsequent cancer were excluded, and 43 patients were finally included. The calcifications (morphology, distribution, extent, associated findings) in the previous and follow-up mammography examinations were analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and assessment category. We classified the patients into two groups: 1) group A patients who were still retrospectively re-categorized as less than or equal to BI-RADS 3 and 2) group B patients who were re-categorized as equal to or higher than BI-RADS 4a and whose results should have prompted previous diagnostic assessment. In the follow-up mammography examinations, change in calcification morphology (n = 27, 63%) was the most frequent cause of assessment change. The most frequent previous mammographic findings of malignant calcification were amorphous morphology (n = 26, 60%) and grouped distribution (n = 36, 84%). The most frequent calcification findings at reassessment were amorphous morphology (n = 4, 9%), fine pleomorphic calcification (n = 30, 70%), grouped distribution (n = 23, 53%), and segmental calcification (n = 12, 28%). There were 33 (77%) patients in group A, and 10 patients (23%) in group B. Amorphous morphology and grouped distribution were the most frequent

  6. Retrospective analysis on malignant calcification previously misdiagnosed as benign on screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Su Min [Dept. of Radiology, Research Institute of Radiology, Chung Ang University Hospital, Seoul(Korea, Republic of); Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung [Dept. of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    The purpose of our study was to investigate the morphology and distribution of calcifications initially interpreted as benign or probably benign, but proven to be malignant by subsequent stereotactic biopsy, and to identify the reason for misinterpretation or underestimation at the initial diagnosis. Out of 567 women who underwent stereotactic biopsy for calcifications at our hospital between January 2012 and December 2014, 167 women were diagnosed with malignancy. Forty-six of these 167 women had previous mammography assessed as benign or probably benign which was changed to suspicious malignancy on follow-up mammography. Of these 46 women, three women with biopsy-proven benign calcifications at the site of subsequent cancer were excluded, and 43 patients were finally included. The calcifications (morphology, distribution, extent, associated findings) in the previous and follow-up mammography examinations were analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and assessment category. We classified the patients into two groups: 1) group A patients who were still retrospectively re-categorized as less than or equal to BI-RADS 3 and 2) group B patients who were re-categorized as equal to or higher than BI-RADS 4a and whose results should have prompted previous diagnostic assessment. In the follow-up mammography examinations, change in calcification morphology (n = 27, 63%) was the most frequent cause of assessment change. The most frequent previous mammographic findings of malignant calcification were amorphous morphology (n = 26, 60%) and grouped distribution (n = 36, 84%). The most frequent calcification findings at reassessment were amorphous morphology (n = 4, 9%), fine pleomorphic calcification (n = 30, 70%), grouped distribution (n = 23, 53%), and segmental calcification (n = 12, 28%). There were 33 (77%) patients in group A, and 10 patients (23%) in group B. Amorphous morphology and grouped distribution were the most frequent

  7. [Parathyroid cancer in a patient with previous history of hypernephroma: a clinical case].

    Science.gov (United States)

    Martín Navarro, J; Mendoza, E; Mateos, P; Cereceda, A; Coca, S

    2007-01-01

    We report the clinical case of a 55 year-old male patient, with a previous history of nephrectomy by hypernephroma sixteen years ago, first presenting hypercalcemia and rising of intact parathyroid hormone (iPTH) levels. A localization study revealed an intrathyroid nodule with cystic appearance. After undergoing a hemi-thyroidectomy, the patient is diagnosed with parathyroid carcinoma. This article analyzes previously published cases presenting parathyroidal pathologies associated with hypernephroma. A broader differential diagnosis--including the screening of parathyroidal pathologies should be considered in patients with hypercalcemia and hypernephroma.

  8. Bibliometric analysis of global environmental assessment research in a 20-year period

    Energy Technology Data Exchange (ETDEWEB)

    Li, Wei, E-mail: weili@bnu.edu.cn; Zhao, Yang

    2015-01-15

    Based on the samples of 113,468 publications on environmental assessment (EA) from the past 20 years, we used a bibliometric analysis to study the literature in terms of trends of growth, subject categories and journals, international collaboration, geographic distribution of publications, and scientific research issues. By applying thresholds to network centralities, a core group of countries can be distinguished as part of the international collaboration network. A frequently used keywords analysis found that the priority in assessment would gradually change from project environmental impact assessment (EIA) to strategic environmental assessment (SEA). Decision-theoretic approaches (i.e., environmental indicator selection, life cycle assessment, etc.), along with new technologies and methods (i.e., the geographic information system and modeling) have been widely applied in the EA research field over the past 20 years. Hot spots such as “biodiversity” and “climate change” have been emphasized in current EA research, a trend that will likely continue in the future. The h-index has been used to evaluate the research quality among countries all over the world, while the improvement of developing countries' EA systems is becoming a popular research topic. Our study reveals patterns in scientific outputs and academic collaborations and serves as an alternative and innovative way of revealing global research trends in the EA research field.

  9. Bibliometric analysis of global environmental assessment research in a 20-year period

    International Nuclear Information System (INIS)

    Li, Wei; Zhao, Yang

    2015-01-01

    Based on the samples of 113,468 publications on environmental assessment (EA) from the past 20 years, we used a bibliometric analysis to study the literature in terms of trends of growth, subject categories and journals, international collaboration, geographic distribution of publications, and scientific research issues. By applying thresholds to network centralities, a core group of countries can be distinguished as part of the international collaboration network. A frequently used keywords analysis found that the priority in assessment would gradually change from project environmental impact assessment (EIA) to strategic environmental assessment (SEA). Decision-theoretic approaches (i.e., environmental indicator selection, life cycle assessment, etc.), along with new technologies and methods (i.e., the geographic information system and modeling) have been widely applied in the EA research field over the past 20 years. Hot spots such as “biodiversity” and “climate change” have been emphasized in current EA research, a trend that will likely continue in the future. The h-index has been used to evaluate the research quality among countries all over the world, while the improvement of developing countries' EA systems is becoming a popular research topic. Our study reveals patterns in scientific outputs and academic collaborations and serves as an alternative and innovative way of revealing global research trends in the EA research field

  10. Rapid Turnover and Minimal Accretion of Mineral Soil Carbon During 60-Years of Pine Forest Growth on Previously Cultivated Land

    Science.gov (United States)

    Richter, D., Jr.; Mobley, M. L.; Billings, S. A.; Markewitz, D.

    2016-12-01

    At the Calhoun Long-Term Soil-Ecosystem field experiment (1957-present), reforestation of previously cultivated land over fifty years nearly doubled soil organic carbon (SOC) in surface soils (0 to 7.5-cm) but these gains were offset by significant SOC losses in subsoils (35 to 60-cm). Nearly all of the accretions in surface soils amounted to gains in light fraction SOC, whereas losses at depth were associated with silt and clay-sized particles. These changes are documented in the Calhoun Long-Term Soil-Ecosystem (LTSE) study that resampled soil from 16 plots about every five years and archived all soil samples from four soil layers within the upper 60-cm of mineral soil. We combined soil bulk density, density fractionation, stable isotopes, and radioisotopes to explore changes in SOC and soil organic nitrogen (SON) associated with five decades of the growth of a loblolly pine secondary forest. Isotopic signatures showed relatively large accumulations of contemporary forest-derived carbon in surface soils, and no accumulation of forest-derived carbon in subsoils. We interpret results to indicate that land-use change from cotton fields to secondary pine forests drove soil biogeochemical and hydrological changes that enhanced root and microbial activity and SOM decomposition in subsoils. As pine stands matured and are now transitioning to mixed pines and hardwoods, demands on soil organic matter for nutrients to support aboveground growth has eased due to pine mortality, and bulk SOM and SON and their isotopes in subsoils have stabilized. We anticipate major changes in the next fifty years as 1957 pine trees transition to hardwoods. This study emphasizes the importance of long-term experiments and deep soil measurements when characterizing SOC and SON responses to land use change. There is a remarkable paucity of E long-term soil data deeper than 30 cm.

  11. The Relationship of Lumbar Multifidus Muscle Morphology to Previous, Current, and Future Low Back Pain

    DEFF Research Database (Denmark)

    Hebert, Jeffrey J; Kjær, Per; Fritz, Julie M

    2014-01-01

    of LBP after five and nine years.Summary of Background Data. Although low back pain (LBP) is a major source of disease burden, the biologic determinants of LBP are poorly understood.Methods. Participants were 40-year-old adults randomly sampled from a Danish population and followed-up at ages 45 and 49....... At each time point, participants underwent magnetic resonance imaging and reported ever having had LBP, LBP in the previous year, non-trivial LBP in the previous year, or a history of pain radiating into the legs. Pixel intensity and frequencies from T1-weighted magnetic resonance images identified...

  12. Condition Assessment of a 2,500-Year-Old Mummy Coffin

    Science.gov (United States)

    Robert J. Ross; Turker Dundar

    2012-01-01

    This work was conducted to assess the condition of a 2,500-year-old mummy coffin. The coffin, part of a collection of funerary objects at the Nelson–Atkins Museum of Art in St. Louis, Missouri, is made of wood obtained from a sycamore fig tree, Ficus sycomorus. Visual and acoustic-based nondestructive testing techniques were used to inspect the...

  13. Analysis of previous screening examinations for patients with breast cancer

    International Nuclear Information System (INIS)

    Lee, Eun Hye; Cha, Joo Hee; Han, Dae Hee; Choi, Young Ho; Hwang, Ki Tae; Ryu, Dae Sik; Kwak, Jin Ho; Moon, Woo Kyung

    2007-01-01

    We wanted to improve the quality of subsequent screening by reviewing the previous screening of breast cancer patients. Twenty-four breast cancer patients who underwent previous screening were enrolled. All 24 took mammograms and 15 patients also took sonograms. We reviewed the screening retrospectively according to the BI-RADS criteria and we categorized the results into false negative, true negative, true positive and occult cancers. We also categorized the causes of false negative cancers into misperception, misinterpretation and technical factors and then we analyzed the attributing factors. Review of the previous screening revealed 66.7% (16/24) false negative, 25.0% (6/24) true negative, and 8.3% (2/24) true positive cancers. False negative cancers were caused by the mammogram in 56.3% (9/16) and by the sonogram in 43.7% (7/16). For the false negative cases, all of misperception were related with mammograms and this was attributed to dense breast, a lesion located at the edge of glandular tissue or the image, and findings seen on one view only. Almost all misinterpretations were related with sonograms and attributed to loose application of the final assessment. To improve the quality of breast screening, it is essential to overcome the main causes of false negative examinations, including misperception and misinterpretation. We need systematic education and strict application of final assessment categories of BI-RADS. For effective communication among physicians, it is also necessary to properly educate them about BI-RADS

  14. Haemophilus influenzae type f meningitis in a previously healthy boy

    DEFF Research Database (Denmark)

    Ronit, Andreas; Berg, Ronan M G; Bruunsgaard, Helle

    2013-01-01

    Non-serotype b strains of Haemophilus influenzae are extremely rare causes of acute bacterial meningitis in immunocompetent individuals. We report a case of acute bacterial meningitis in a 14-year-old boy, who was previously healthy and had been immunised against H influenzae serotype b (Hib...

  15. Iodine-131 induced hepatotoxicity in previously healthy patients with Grave's disease.

    Science.gov (United States)

    Jhummon, Navina Priya; Tohooloo, Bhavna; Qu, Shen

    2013-01-01

    To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave's disease (GD) patients after the treatment with radioactive iodine (131)I (RAI). We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine (131)I.

  16. A prospective observational cohort study to assess the incidence of acute otitis media among children 0-5 years of age in Southern Brazil.

    Science.gov (United States)

    Lanzieri, Tatiana M; Cunha, Clóvis Arns da; Cunha, Rejane B; Arguello, D Fermin; Devadiga, Raghavendra; Sanchez, Nervo; Barria, Eduardo Ortega

    To estimate acute otitis media incidence among young children and impact on quality of life of parents/caregivers in a southern Brazilian city. Prospective cohort study including children 0-5 years of age registered at a private pediatric practice. Acute otitis media episodes diagnosed by a pediatrician and impact on quality of life of parents/caregivers were assessed during a 12-month follow-up. During September 2008-March 2010, of 1,136 children enrolled in the study, 1074 (95%) were followed: 55.0% were ≤2 years of age, 52.3% males, 94.7% white, and 69.2% had previously received pneumococcal vaccine in private clinics. Acute otitis media incidence per 1000 person-years was 95.7 (95% confidence interval: 77.2-117.4) overall, 105.5 (95% confidence interval: 78.3-139.0) in children ≤2 years of age and 63.6 (95% confidence interval: 43.2-90.3) in children 3-5 years of age. Acute otitis media incidence per 1000 person-years was 86.3 (95% confidence interval: 65.5-111.5) and 117.1 (95% confidence interval: 80.1-165.3) among vaccinated and unvaccinated children, respectively. Nearly 68.9% of parents reported worsening of their overall quality of life. Acute otitis media incidence among unvaccinated children in our study may be useful as baseline data to assess impact of pneumococcal vaccine introduction in the Brazilian National Immunization Program in April 2010. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  17. Books Average Previous Decade of Economic Misery

    Science.gov (United States)

    Bentley, R. Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20th century since the Depression, we find a strong correlation between a ‘literary misery index’ derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

  18. Predictors of subjective health status 10 years post-PCI.

    Science.gov (United States)

    van den Berge, Jan C; Dulfer, Karolijn; Utens, Elisabeth M W J; Hartman, Eline M J; Daemen, Joost; van Geuns, Robert J; van Domburg, Ron T

    2016-06-01

    Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. We included a series of consecutive PCI patients (n = 573) as part of the RESEARCH registry, a Dutch single-center retrospective cohort study. These patients completed the 36-item Short-Form Health Survey (SF-36) at baseline and 10 years post-PCI. We found 6 predictors of poor subjective health status 10 years post-PCI: SF-36 at baseline, age, previous PCI, obesity, acute myocardial infarction as indication for PCI, and diabetes mellitus (arranged from most to least numbers of sub domains). SF-36 scores at baseline, age, and previous PCI were significant predictors of subjective health status 10 years post-PCI. Specifically, the SF-36 score at baseline was an important predictor. Thus assessment of subjective health status at baseline is useful as an indicator to predict long-term subjective health status. Subjective health status becomes better by optimal medical treatment, cardiac rehabilitation and psychosocial support. This is the first study determining predictors of subjective health status 10 years post-PCI.

  19. A comparison of morbidity associated with placenta previa with and without previous caesarean sections

    International Nuclear Information System (INIS)

    Baqai, S.; Siraj, A.; Noor, N.

    2018-01-01

    To compare the morbidity associated with placenta previa with and without previous caesarean sections. Study Design: Retrospective comparative study. Place and Duration of Study: From March 2014 till March 2016 in the department of Obstetrics and Gynaecology at PNS Shifa hospital Karachi. Material and Methods: After the approval from hospital ethical committee, antenatal patients with singleton pregnancy of gestational age >32 weeks, in the age group of 20-40 years diagnosed to have placenta previa included in the study. All patients with twin pregnancy less than 20 years and more than 40 years of age were excluded. The records of all patients fulfilling the inclusion criteria were reviewed. Data had been collected for demographic and maternal variables, placenta previa, history of previous lower segment caesarean section (LSCS), complications associated with placenta previa and techniques used to control blood loss were recorded. Results: During the study period, 6879 patients were delivered in PNS Shifa, out of these, 2060 (29.9%) had caesarean section out of these, 47.3% patients had previous history of LSCS. Thirty three (1.6%) patients were diagnosed to have placenta previa and frequency of placenta previa was significantly higher in patients with previous history of LSCS than previous normal delivery of LSCS i.e. 22 vs. 11 (p=0.023). It was observed that the frequency of morbidly adherent placenta (MAP) and Intensive care unit (ICU) stay were significantly higher in patients with previous history of LSCS than previous history of normal delivery. Conclusion: Frequency of placenta previa was significantly higher in patients with history of LSCS. Also placenta previa remains a major risk factor for various maternal complications. (author)

  20. Fifteen years of portfolio assessment of dental hygiene student competency: lessons learned.

    Science.gov (United States)

    Gadbury-Amyot, Cynthia C; Bray, Kimberly Krust; Austin, Kylie J

    2014-10-01

    Adoption of portfolio assessment in the educational environment is gaining attention as a means to incorporate self-assessment into the curriculum and to use evidence to support learning outcomes and to demonstrate competency. Portfolios provide a medium for students to demonstrate and document their personal and professional growth across the curriculum. The purpose of this literature review is to discuss the drivers for portfolio education, the benefits to both students and program faculty/administrators, the barriers associated with portfolio use, and suggested solutions that have been determined through several years of "lessons learned." The University of Missouri Kansas City School of Dentistry, Division of Dental Hygiene department has been utilizing portfolio assessment for over 15 years and has collected data related to portfolio performance since 2001. Results from correlational statistics calculated on the 312 dental hygiene students that graduated from 2001 to 2013 demonstrate a positive and significant relationship between portfolio performance and overall GPA as well as portfolio performance and NBDHE scores. Copyright © 2014 The American Dental Hygienists’ Association.

  1. Creating physicians of the 21st century: assessment of the clinical years

    Directory of Open Access Journals (Sweden)

    Vanderbilt AA

    2017-06-01

    Full Text Available Allison A Vanderbilt,1 Sara Q Perkins,2 Moriah K Muscaro,2 Thomas J Papadimos,3 Reginald F Baugh4 1Department of Family Medicine, 2College of Medicine and Life Sciences, University of Toledo, 3Department of Anesthesiology, 4Department of Surgery, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA Abstract: Medical education has been under a constant state of revision for the past several years. The overarching theme of the curriculum revisions for medical schools across the USA has been creating better physicians for the 21st century, with the same end result: graduating medical students at the optimal performance level when entering residency. We propose a robust, thorough assessment process that will address the needs of clerkships, residents, students, and, most importantly, medical schools to best measure and improve clinical reasoning skills that are required for the learning outcomes of our future physicians. The Accreditation Council for Graduate Medical Education (ACGME evaluates and accredits medical school graduates based on competency-based outcomes and the assessment of specialty-specific milestones; however, there is some evidence that medical school graduates do not consistently meet the Level 1 milestones prior to entering/beginning residency, thus starting their internship year underprepared and overwhelmed. Medical schools should take on the responsibility to provide competency-based assessments for their students during the clinical years. These assessments should be geared toward preparing them with the cognitive competencies and skills needed to successfully transition to residency. Then, medical schools can produce students who will ultimately be prepared for transition to their residency programs to provide quality care. Keywords: ACGME Core Competencies, milestones, clerkships, medical education, evaluation 

  2. Project W-519 TWRS privatization phase 1 infrastructure year 2000 compliance assessment project plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-519. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance

  3. Environmental assessment of PSS, feedback on 2 years of experimentation

    Science.gov (United States)

    Allais, Romain; Gobert, Julie

    2018-05-01

    This communication details the sustainability assessment of the partial transition of business model from selling products to product renting for small household equipment (SHE). Perceived by the French SHE manufacturer as a strategic opportunity to meet customers' expectations and environmental regulation, 2-years experimentation was performed on a specific territory with the support of a network of new competencies (B-to-B-to-C market). Researchers were mandated for the sustainability assessment of such a transition but this communication focuses on the environmental performance of the experimentation. The results of the comparative LCA are presented and the main environmental impacts linked to this business model transition are specified and discussed. Then, different eco-design scenarios are explored and recommendations for this specific case are proposed.

  4. High-Level Waste Tank Lay-Up Assessment - Year-End Progress Report

    International Nuclear Information System (INIS)

    Elmore, Monte R.; Henderson, Colin

    2002-01-01

    This report documents the preliminary needs assessment of high-level waste (HLW) tank lay-up requirements and considerations for the Hanford Site, Idaho National Engineering and Environmental Lab (INEEL), Savannah River Site (SRS) and Oak Ridge Reservation (ORR). This assessment includes the development of a high-level requirements and considerations list that evolved from work done for the West Valley Demonstration Project (WVDP) earlier in fiscal year (FY) 2001, and is based on individual site conditions and tank retrieval/tank closure schedules. Because schedules are continually subject to change, this assessment is considered preliminary and needs review and validation by the individual sites. The lay-up decision methodology developed for WVDP was based on standard systems engineering principles, and provided a structured framework for producing an effective, technically-defensible lay-up strategy

  5. Predicting fruit consumption: the role of habits, previous behavior and mediation effects

    NARCIS (Netherlands)

    de Vries, H.; Eggers, S.M.; Lechner, L.; van Osch, L.; van Stralen, M.M.

    2014-01-01

    Background: This study assessed the role of habits and previous behavior in predicting fruit consumption as well as their additional predictive contribution besides socio-demographic and motivational factors. In the literature, habits are proposed as a stable construct that needs to be controlled

  6. [Fatal amnioinfusion with previous choriocarcinoma in a parturient woman].

    Science.gov (United States)

    Hrgović, Z; Bukovic, D; Mrcela, M; Hrgović, I; Siebzehnrübl, E; Karelovic, D

    2004-04-01

    The case of 36-year-old tercipare is described who developed choriocharcinoma in a previous pregnancy. During the first term labour the patient developed cardiac arrest, so reanimation and sectio cesarea was performed. A male new-born was delivered in good condition, but even after intensive therapy and reanimation occurred death of parturient woman with picture of disseminate intravascular coagulopathia (DIK). On autopsy and on histology there was no sign of malignant disease, so it was not possible to connect previous choricarcinoma with amniotic fluid embolism. Maybe was place of choriocarcinoma "locus minoris resistentiae" which later resulted with failure in placentation what was hard to prove. On autopsy we found embolia of lung with a microthrombosis of terminal circulation with punctiformis bleeding in mucous, what stands for DIK.

  7. Contract 98, Appendix F self-assessment report for Fiscal Year 2003

    Energy Technology Data Exchange (ETDEWEB)

    Albert (Editor), Rich

    2003-10-15

    This report summarizes the Ernest Orlando Lawrence Berkeley National Laboratory internal assessment of Laboratory operational and administrative performance in key support functions for Fiscal Year (FY) 2003. The report provides documentation of ongoing performance-based management and oversight processes required by the Department of Energy (DOE) to monitor, measure, and evaluate Berkeley Lab work.

  8. Five years of opening the electricity market in Germany: an assessment

    International Nuclear Information System (INIS)

    Feder, A.

    2004-01-01

    In 1998, the German federal government decided to transpose in national law the principle of competition in the sector of electricity. To set up an electricity market, the new law has more or less dismantled the former system of the juxtaposed monopolies of approximately nine hundred local energy firms. The author tries to answer the following questions: How were the new market's legal and institutional modalities determined? What political choices underlie them? What benefits will consumers draw from this liberalization? What assessment has Germany made about these past five years ? What are the hopes and fears for coming years? (author)

  9. 75 FR 1632 - Public Housing Assessment System (PHAS): Asset Management Transition Year 2 Information

    Science.gov (United States)

    2010-01-12

    ... accounting under asset management, also known as ``Transition Year 2.'' FOR FURTHER INFORMATION CONTACT: The... System (PHAS): Asset Management Transition Year 2 Information AGENCY: Office of the Assistant Secretary... by HUD under the Public Housing Management Assessment Program (PHMAP), the regulations for which are...

  10. Dental status and self-assessed chewing ability in 70- and 80-year-old subjects in Sweden.

    Science.gov (United States)

    Unell, L; Johansson, A; Ekbäck, G; Ordell, S; Carlsson, G E

    2015-09-01

    The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80- than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability. © 2015 John Wiley & Sons Ltd.

  11. Motor Skills in Children Aged 7-10 Years, Diagnosed with Autism Spectrum Disorder

    Science.gov (United States)

    Whyatt, Caroline P.; Craig, Cathy M.

    2012-01-01

    This study used the Movement Assessment Battery for Children (M-ABC2) to assess motor skills in children aged 7-10 years with autism (n = 18) in comparison to two groups of age-matched typically developing children; a receptive vocabulary matched group (n = 19) and a nonverbal IQ matched group (n = 22). The results supported previous work, as…

  12. Graft Fibrosis After Pediatric Liver Transplantation : Ten Years of Follow-up

    NARCIS (Netherlands)

    Scheenstra, Rene; Peeters, Paul M. G. J.; Verkade, Henkjan J.; Gouw, Annette S. H.

    Previously we reported the presence of portal fibrosis in 31% (n = 84) of the grafts in protocol biopsies I year after pediatric liver transplantation (LTx). To assess the natural history of graft fibrosis after pediatric liver transplantation, we extended the analysis of graft histology in

  13. Rhabdomyosarcoma Arising in a Previously Irradiated Field: An Analysis of 43 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Dang, Nguyen D. [Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas (United States); Teh, Bin S. [Department of Radiation Oncology, The Methodist Hospital and Methodist Hospital Research Institute, Houston, Texas (United States); Paulino, Arnold C., E-mail: apaulino@tmhs.org [Department of Radiation Oncology, The Methodist Hospital and Methodist Hospital Research Institute, Houston, Texas (United States)

    2013-03-01

    Patients with soft tissue sarcomas that arise from previously irradiated fields have traditionally been reported to have a poor prognosis. In this report, we examined the characteristics and outcomes of patients who developed a rhabdomyosarcoma in a previously irradiated field (RMS-RIF); we hypothesize that these patients should have a better outcome compared to other postradiation soft tissue sarcomas as these tumors are chemosensitive and radiosensitive. A PubMed search of the literature from 1961-2010 yielded 33 studies with data for patients with RMS-RIF. The study included 43 patients with a median age of 6.5 years at the time of radiation therapy (RT) for the initial tumor. The median RT dose was 48 Gy. The median latency period, the time from RT to development of RMS-RIF, was 8 years. The 3-year overall survival for RMS-RIF was 42%. The 3-year overall survival was 66% for patients receiving chemotherapy and local treatment (surgery and/or RT) compared to 29% for those who had systemic treatment only or local treatment only (P=.049). Other factors associated with increased 3-year overall survival included retinoblastoma initial diagnosis (P<.001), age ≤18 years at diagnosis of RMS-RIF (P=.003), favorable site (P=.008), and stage 1 disease (P=.002). Age at time of RMS-RIF, retinoblastoma initial tumor, favorable site, stage 1 disease, and use of both systemic and local treatment were found to be favorable prognostic factors for 3-year overall survival.

  14. Pertussis-associated persistent cough in previously vaccinated children.

    Science.gov (United States)

    Principi, Nicola; Litt, David; Terranova, Leonardo; Picca, Marina; Malvaso, Concetta; Vitale, Cettina; Fry, Norman K; Esposito, Susanna

    2017-11-01

    To evaluate the role of Bordetella pertussis infection, 96 otherwise healthy 7- to 17-year-old subjects who were suffering from a cough lasting from 2 to 8 weeks were prospectively recruited. At enrolment, a nasopharyngeal swab and an oral fluid sample were obtained to search for pertussis infection by the detection of B. pertussis DNA and/or an elevated titre of anti-pertussis toxin IgG. Evidence of pertussis infection was found in 18 (18.7 %; 95 % confidence interval, 11.5-28.0) cases. In 15 cases, the disease occurred despite booster administration. In two cases, pertussis was diagnosed less than 2 years after the booster injection, whereas in the other cases it was diagnosed between 2 and 9 years after the booster dose. This study used non-invasive testing to show that pertussis is one of the most important causes of long-lasting cough in school-age subjects. Moreover, the protection offered by acellular pertussis vaccines currently wanes more rapidly than previously thought.

  15. Adult or not? Accuracy of Cameriere's cut-off value for third molar in assessing 18 years of age for legal purposes.

    Science.gov (United States)

    Cameriere, R; Pacifici, A; Viva, S; Carbone, D; Pacifici, L; Polimeni, A

    2014-09-01

    The discovery of reliable means to determine the age of an individual is a fundamental objective in forensic medicine, in consideration of the constant increase of illegal immigration into the European community. In 2008 Cameriere et al. developed a method based on the relationship between age and the third molar index (I3m), which assesses the degree of maturation of the third molar through measurements made on orthopantomography. The purpose of this work was to test the accuracy of Cameriere's cut-off for I3m as a tool to assess full age (18) on a new sample of living subjects. Orthopantomographs of 287 Italian living subjects aged between 13 and 22 years have been randomly selected and included in the study. Identification number, gender, date of birth and date of execution of the radiograph were recorded for each patient on a Microsoft Excel® spreadsheet. Radiographs were digitalized and analyzed using a computerized image-processing program (Adobe® Photoshop® CS4). The results show that the sensitivity of the test was 84.1% and the specificity was 92.5%. The estimated post-test probability was 90.1%, with a confidence interval of 95% (83.6%, 95.2%). Thus, the probability that a person being positive to the test has 18 or more years of age was 90.1%. The results highlight the contribution of Cameriere's cut-off value for the I3m in the assessment of full age, always remembering that the simultaneous employment of previously introduced complementary methods is essential for the purpose.

  16. Fresh osteochondral allografts in the knee: comparison of primary transplantation versus transplantation after failure of previous subchondral marrow stimulation.

    Science.gov (United States)

    Gracitelli, Guilherme C; Meric, Gokhan; Briggs, Dustin T; Pulido, Pamela A; McCauley, Julie C; Belloti, João Carlos; Bugbee, William D

    2015-04-01

    In most treatment algorithms, osteochondral allograft (OCA) transplantation is regarded as an alternative salvage procedure when other, previous reparative treatments have failed. To compare the outcomes of a retrospective matched-pair cohort of (1) primary OCA transplantation and (2) OCA transplantation after failure of previous subchondral marrow stimulation. Cohort study; Level of evidence, 3. An OCA database was used to identify 46 knees that had OCA transplantation performed as a primary treatment (group 1) and 46 knees that underwent OCA transplantation after failure of previous subchondral marrow stimulation (group 2). All patients had a minimum of 2 years' follow-up. Patients in each group were matched for age (±5 years), diagnosis (osteochondral lesion, degenerative chondral lesion, traumatic chondral injury), and graft size (small, 10 cm2). The groups had similar body mass indexes, sex distributions, and graft locations (femoral condyle, patella, and trochlea. The number and type of further surgeries after the OCA transplantation were assessed; failure was defined as any reoperation resulting in removal of the graft. Functional outcomes were evaluated by use of the modified Merle d'Aubigné-Postel (18-point) scale, International Knee Documentation Committee (IKDC) subjective knee evaluation form, Knee injury and Osteoarthritis Outcomes Score (KOOS), and the Knee Society function (KS-F) scale. Patient satisfaction, according to a 5-point scale from "extremely satisfied" to "dissatisfied," was recorded at the latest follow-up. Eleven of 46 knees (24%) in group 1 had reoperations, compared with 20 of 46 knees (44%) in group 2 (P = .04). The OCA was classified as a failure in 5 knees (11%) in group 1 and 7 knees (15%) in group 2 (P = .53). At 10 years of follow-up, survivorship of the graft was 87.4% and 86% in groups 1 and 2, respectively. Both groups showed improvement in pain and function on all subjective scores from preoperatively to the latest follow

  17. Reliability and validity of measures used in assessing dental anxiety in 5- to 15-year-old Croatian children.

    Science.gov (United States)

    Majstorovic, M; Veerkamp, J S; Skrinjaric, I

    2003-12-01

    The aim of the study was to evaluate reliability and validity of different questionnaires and predict related causes, as concomitant factors in assessing different aspects of children's dental anxiety. Children were interviewed on dental anxiety, dispositional risk factors and satisfaction with the dentist after dental treatment had been accomplished. Parents were interviewed on dental anxiety as well. The study population included 165 children (91 boys) aged 5 to 15 years, referred to a university dental clinic by general dental practitioners because of a history of fear and uncooperative behaviour during previous dental visits. Children were treated by two dentists, both experienced in treating fearful children. Statistical analysis was performed in Statistics for Windows, Release 5.5 and Release 7.5. Pearson's correlation coefficients were calculated for validity and Cronbach alpha for reliability of the measures. Spearman Brown prophecy formula was used for correction of the alpha scores. Results The children's total average CFSS-DS score was 27.02, with no significant difference with respect to gender. The highest Cronbach alpha scores regarding reliability were obtained for the S-DAI, the CFSS-DS and the PDAS. Pearson's correlations regarding validity presented significant correlations between the CMFQ, the CDAS and the S-DAI, between the OAS, the CDAS and the S-DAI, as well as between the OAS and the DVSS-SV. Previous negative medical experience had significant influence on children's dental anxiety, supporting Rachman's conditioning theory. Anxious children were more likely to show behaviour problems (aggression) and more introvert in expressing their judgement regarding the dentist. Both the S-DAI and the CFSS-DS, which were standardized in the Croatian population sample, showed the highest reliability in assessment of children's dental anxiety.

  18. Iodine-131 induced hepatotoxicity in previously healthy patients with Grave’s disease

    Science.gov (United States)

    2013-01-01

    Objective To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave’s disease (GD) patients after the treatment with radioactive iodine 131I (RAI). Case presentation We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. Conclusion To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine 131I. PMID:23497434

  19. AECB staff annual assessment of the Bruce B Nuclear Generating Station for the year 1994

    International Nuclear Information System (INIS)

    1995-06-01

    AECB staff believes Ontario Hydro operated Bruce B safely in 1994. The Bruce B reactors will remain limited to 88% full power until Ontario Hydro is able to demonstrate that it is safe to operate at higher powers. Ontario Hydro's compliance with AECB regulations and the Operating Licence was satisfactory. AECB found no major violations. The station performance was similar to previous years. Radiation doses to workers and the public were well below the legal limits and also remained below Ontario Hydro's internal targets. Worker radiation doses increased slightly but were comparable to previous years. Inspection of pressure tubes and steam generator tubes by Ontario Hydro showed continuing tube degradation. However, we believe that Ontario Hydro made progress in correcting and managing these problems. Ontario Hydro carried out a full-scale fire drill at Bruce B in 1994. AECB witnessed the drill and were pleased to observe a significant improvement in the station's fire-fighting capability. 7 tabs., 4 figs

  20. The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble. A 15-year follow-up study of risk indicators for self-reported sick-listing caused by low back trouble.

    Science.gov (United States)

    Müller, C F; Monrad, T; Biering-Sørensen, F; Darre, E; Deis, A; Kryger, P

    1999-08-01

    A 15-year follow-up study. To find risk indicators for self-reported sick-listing because of low back trouble and to evaluate which variables were the most important indicators of work incapacity resulting from low back trouble during the follow-up period of 15 years. The initial data were obtained from a health survey conducted in a general population from the Municipality of Glostrup, Denmark. The follow-up data included information from the Central Person Register, the Early Retirement Pension Register, and a postal questionnaire regarding self-reported sick-listing because of low back trouble. An epidemiologic study, in which logistic regression analyses were used for evaluation of the data. The model used consisted of the variable in question, age, gender, and previous experience of low back trouble, along with interactions. It was found that 22 of 37 variables were risk indicators for later self-reported sick-listing because of low back trouble during the preceding year or the 7 years before the date of follow-up evaluation. In analyzing the most significant variables simultaneously, it was found that information from the initial investigation about sick-listing in general during the previous 10 years, sciatic pain, use of analgesics for low back trouble, previous sick-listing because of low back trouble, and occupation were the most important risk indicators for self-reported work incapacity resulting from low back trouble during the follow-up period of 15 years. Findings showed that the strongest prognostic indicators of later sick-listing because of low back trouble involve information from the person about previous sick-listing behavior in general and previous experience of low back trouble episodes, especially if these had been accompanied by sciatic pain, use of analgesics, or previous low back trouble sick-listing.

  1. Origin of choriocarcinoma in previous molar pregnancy proved by DNA analysis

    International Nuclear Information System (INIS)

    Vojtassak, J.; Repiska, V.; Konecna, B.; Zajac, V.; Korbel, M.; Danihel, L.

    1996-01-01

    A 17-year old woman had in a short time period (seven months) a very exciting reproduction history. Molar pregnancy in December 1993, choriocarcinoma in January 1994 and induced abortion in June 1994. DNA analysis proved the origin of the choriocarcinoma in the previous molar pregnancy. (author)

  2. Antimetabolites in cataract surgery to prevent failure of a previous trabeculectomy.

    Science.gov (United States)

    Thomas, Roger E; Crichton, Andrew; Thomas, Bennett C

    2014-07-28

    Patients having cataract surgery have often earlier undergone a trabeculectomy for glaucoma. However, cataract surgery may be associated with failure of the previous glaucoma surgery and antimetabolites may be used with cataract surgery to prevent such failure. There is no systematic review on whether antimetabolites with cataract surgery prevent failure of a previous trabeculectomy. To assess the effects of antimetabolites with cataract surgery on functioning of a previous trabeculectomy. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2014), EMBASE (January 1980 to June 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to June 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 10 June 2014. We also searched the Science Citation Index database (July 2013) and reference lists of potentially relevant studies. Randomised controlled trials (RCTs) of antimetabolites with cataract surgery in people with a functioning trabeculectomy. Two review authors independently reviewed the titles and abstracts from the electronic searches. Two review authors independently assessed relevant full-text articles and entered data. We identified no RCTs to test the effectiveness of antimetabolites with cataract surgery in individuals with the intention of preventing failure of a previous trabeculectomy. There are no RCTs of antimetabolites with cataract surgery in people with a functioning trabeculectomy. Appropriately powered RCTs

  3. The pathogenicity of genetic variants previously associated with left ventricular non-compaction

    DEFF Research Database (Denmark)

    Abbasi, Yeganeh; Jabbari, Javad; Jabbari, Reza

    2016-01-01

    BACKGROUND: Left ventricular non-compaction (LVNC) is a rare cardiomyopathy. Many genetic variants have been associated with LVNC. However, the number of the previous LVNC-associated variants that are common in the background population remains unknown. The aim of this study was to provide...... an updated list of previously reported LVNC-associated variants with biologic description and investigate the prevalence of LVNC variants in healthy general population to find false-positive LVNC-associated variants. METHODS AND RESULTS: The Human Gene Mutation Database and PubMed were systematically...... searched to identify all previously reported LVNC-associated variants. Thereafter, the Exome Sequencing Project (ESP) and the Exome Aggregation Consortium (ExAC), that both represent the background population, was searched for all variants. Four in silico prediction tools were assessed to determine...

  4. Prevalent musculoskeletal pain as a correlate of previous exposure to torture

    DEFF Research Database (Denmark)

    Olsen, Dorte Reff; Montgomery, Edith; Bojholm, S

    2006-01-01

    AIM: To research possible associations between previous exposure to specific torture techniques and prevalent pain in the head and face, back, and feet. METHODS: 221 refugees, 193 males and 28 females, previously exposed to torture in their home country, were subject to a clinical interview...... was general abuse of the whole body (OR 5.64, 95% CI 1.93-16.45). CONCLUSION: In spite of many factors being potentially co-responsible for prevalent pain, years after the torture took place it presents itself as strongly associated with specific loci of pain, with generalized effects, and with somatizing....

  5. Bilateral orbital infarction and retinal detachment in a previously undiagnosed sickle cell hemoglobinopathy African child

    Science.gov (United States)

    Helen, Onakpoya Oluwatoyin; Ajite, K. O.; Oyelami, O. A.; Asaleye, C. M.; Adeoye, A. O.

    2013-01-01

    Bone infarction involving the orbit in sickle cell disease is not common. Bilateral orbital infarction in a previously undiagnosed sickle cell hemoglobinopathy has not been previously reported. In this report, we present a case of an 11-year-old previously undiagnosed sickle cell disease Nigerian girl with severe acute bilateral orbital infarction and retinal detachment to highlight that hemoglobinopathy induced orbital infarction should be considered in African children with acute onset proptosis with or without previous history of sickle cell hemoglobinopathy. PMID:23901183

  6. Prognostic factors for recurrences in neck pain patients up to 1 year after chiropractic care.

    Science.gov (United States)

    Langenfeld, Anke; Humphreys, B Kim; Swanenburg, Jaap; Peterson, Cynthia K

    2015-09-01

    Information about recurrence and prognostic factors is important for patients and practitioners to set realistic expectations about the chances of full recovery and to reduce patient anxiety and uncertainty. Therefore, the purpose of this study was to assess recurrence and prognostic factors for neck pain in a chiropractic patient population at 1 year from the start of the current episode. Within a prospective cohort study, 642 neck pain patients were recruited by chiropractors in Switzerland. After a course of chiropractic therapy, patients were followed up for 1 year regarding recurrence of neck pain. A logistic regression analysis was used to assess prognostic factors for recurrent neck pain. The independent variables age, pain medication usage, sex, work status, duration of complaint, previous episodes of neck pain and trauma onset, numerical rating scale, and Bournemouth questionnaire for neck pain were analyzed. Prognostic factors that have been identified in previous studies to influence recovery of neck pain are psychologic distress, poor general health at baseline, and a previous history of pain elsewhere. Five hundred forty five patients (341 females), with a mean age of 42.1 years (SD, 13.1) completed the 1-year follow-up period. Fifty-four participants (11%) were identified as "recurrent." Prognostic factors associated with recurrent neck pain were previous episodes of neck pain and increasing age. The results of this study suggest that recurrence of neck pain within 1 year after chiropractic intervention in Swiss chiropractic patients presenting from varied onsets is low. This study found preliminary findings that older age and a previous episode of neck may be useful predictors of neck pain recurrence within 1 year. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  7. Project W-151 Tank 101-AZ Waste Retrieval System Year 2000 Compliance Assessment Project Plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-151. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance

  8. Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia.

    Science.gov (United States)

    Kuenzli, Esther; Juergensen, David; Kling, Kerstin; Jaeger, Veronika K; DeCrom, Susan; Steffen, Robert; Widmer, Andreas F; Battegay, Manuel; Hatz, Christoph; Neumayr, Andreas

    2017-09-01

    Travellers' diarrhoea is the most common health problem in travellers. Depending on the region visited, up to 40% of travellers develop diarrhoea during a 2-week trip. The aim of this study was to assess risk factors for TD among travellers to the Indian subcontinent. An observational prospective multicentre cohort study investigated travellers to the Indian subcontinent. Participants completed questionnaires assessing the incidence of travellers' diarrhoea and identifying potential risk factors. Covariates were assessed univariately, followed by a multivariate regression. Two-hundred and twenty-six travellers were enrolled into the study, 178 filled in both pre- and post-travel questionnaires. Overall, the attack rate of travellers' diarrhoea was 38.2%. Travel destination is a key risk factor for the occurrence of TD. Travelling to India or Nepal vs Bhutan is associated with an increased risk for TD (OR 6.68 and 6.62, respectively). A length of stay of more than 3 weeks compared to less than 2 weeks is also associated with a significantly increased risk (OR 5.45). Having stayed in a high-risk area for travellers' diarrhoea within the past year before the current trip is associated with a significantly decreased risk (OR 0.19). No association was found between consumption of high risk food (i.e. tap water, ice cream, raw meat and hamburgers) and travellers' diarrhoea. Travellers' diarrhoea is a frequent problem in travellers to the Indian subcontinent. Previous exposure in a high-risk area for travellers' diarrhoea within the past year appears to have a significant protective effect. Furthermore, an association between the occurrence of travellers' diarrhoea and travel destination and length of stay, respectively, was observed. Consumption of risk food did not confer a TD risk in our study. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  9. Numerical simulation of the shot peening process under previous loading conditions

    International Nuclear Information System (INIS)

    Romero-Ángeles, B; Urriolagoitia-Sosa, G; Torres-San Miguel, C R; Molina-Ballinas, A; Benítez-García, H A; Vargas-Bustos, J A; Urriolagoitia-Calderón, G

    2015-01-01

    This research presents a numerical simulation of the shot peening process and determines the residual stress field induced into a component with a previous loading history. The importance of this analysis is based on the fact that mechanical elements under shot peening are also subjected to manufacturing processes, which convert raw material into finished product. However, material is not provided in a virgin state, it has a previous loading history caused by the manner it is fabricated. This condition could alter some beneficial aspects of the residual stress induced by shot peening and could accelerate the crack nucleation and propagation progression. Studies were performed in beams subjected to strain hardening in tension (5ε y ) before shot peening was applied. Latter results were then compared in a numerical assessment of an induced residual stress field by shot peening carried out in a component (beam) without any previous loading history. In this paper, it is clearly shown the detrimental or beneficial effect that previous loading history can bring to the mechanical component and how it can be controlled to improve the mechanical behavior of the material

  10. Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, P.; Kühl, C.; Bertelsen, Aksel

    1992-01-01

    OBJECTIVES: The purpose of this study was to determine the incidence of diabetes in women with previous dietary-treated gestational diabetes mellitus and to identify predictive factors for development of diabetes. STUDY DESIGN: Two to 11 years post partum, glucose tolerance was investigated in 241...... women with previous dietary-treated gestational diabetes mellitus and 57 women without previous gestational diabetes mellitus (control group). RESULTS: Diabetes developed in 42 (17.4%) women with previous gestational diabetes mellitus (3.7% insulin-dependent diabetes mellitus and 13.7% non...... of previous patients with gestational diabetes mellitus in whom plasma insulin was measured during an oral glucose tolerance test in late pregnancy a low insulin response at diagnosis was found to be an independent predictive factor for diabetes development. CONCLUSIONS: Women with previous dietary...

  11. Regional-scale assessment of soil salinity in the Red River Valley using multi-year MODIS EVI and NDVI.

    Science.gov (United States)

    Lobell, D B; Lesch, S M; Corwin, D L; Ulmer, M G; Anderson, K A; Potts, D J; Doolittle, J A; Matos, M R; Baltes, M J

    2010-01-01

    The ability to inventory and map soil salinity at regional scales remains a significant challenge to scientists concerned with the salinization of agricultural soils throughout the world. Previous attempts to use satellite or aerial imagery to assess soil salinity have found limited success in part because of the inability of methods to isolate the effects of soil salinity on vegetative growth from other factors. This study evaluated the use of Moderate Resolution Imaging Spectroradiometer (MODIS) imagery in conjunction with directed soil sampling to assess and map soil salinity at a regional scale (i.e., 10-10(5) km(2)) in a parsimonious manner. Correlations with three soil salinity ground truth datasets differing in scale were made in Kittson County within the Red River Valley (RRV) of North Dakota and Minnesota, an area where soil salinity assessment is a top priority for the Natural Resource Conservation Service (NRCS). Multi-year MODIS imagery was used to mitigate the influence of temporally dynamic factors such as weather, pests, disease, and management influences. The average of the MODIS enhanced vegetation index (EVI) for a 7-yr period exhibited a strong relationship with soil salinity in all three datasets, and outperformed the normalized difference vegetation index (NDVI). One-third to one-half of the spatial variability in soil salinity could be captured by measuring average MODIS EVI and whether the land qualified for the Conservation Reserve Program (a USDA program that sets aside marginally productive land based on conservation principles). The approach has the practical simplicity to allow broad application in areas where limited resources are available for salinity assessment.

  12. Investigating Key Psychometric Properties of the French Version of the Early Years Evaluation-Teacher Assessment

    Science.gov (United States)

    Laurie, Robert; Sloat, Elizabeth

    2016-01-01

    This research investigates key psychometric properties of the French Early Years Evaluation-Teacher Assessment measure designed to systematically assess kindergarten children across five social and academic developmental domains: awareness of self and environment, social skills and behaviour, cognitive abilities, language and communication, and…

  13. Immunogenicity and Safety of the HZ/su Adjuvanted Herpes Zoster Subunit Vaccine in Adults Previously Vaccinated With a Live Attenuated Herpes Zoster Vaccine.

    Science.gov (United States)

    Grupping, Katrijn; Campora, Laura; Douha, Martine; Heineman, Thomas C; Klein, Nicola P; Lal, Himal; Peterson, James; Vastiau, Ilse; Oostvogels, Lidia

    2017-12-12

    Protection against herpes zoster (HZ) induced by the live attenuated zoster vaccine Zostavax (ZVL) wanes within 3-7 years. Revaccination may renew protection. We assessed whether (re)vaccination with the adjuvanted HZ subunit vaccine candidate (HZ/su) induced comparable immune responses in previous ZVL recipients and ZVL-naive individuals (HZ-NonVac). In an open-label, multicenter study, adults ≥65 years of age, vaccinated with ZVL ≥5 years previously (HZ-PreVac), were matched to ZVL-naive adults (HZ-NonVac). Participants received 2 doses of HZ/su 2 months apart. The primary objective of noninferiority of the humoral immune response 1 month post-dose 2 was considered demonstrated if the upper limit of the 95% confidence interval (CI) of the adjusted anti-glycoprotein E geometric mean concentration (GMC) ratio of HZ-NonVac over HZ-PreVac was <1.5. HZ/su cellular immunogenicity, reactogenicity, and safety were also assessed. In 430 participants, humoral immune response to HZ/su was noninferior in HZ-PreVac compared with HZ-NonVac (adjusted GMC ratio, 1.04 [95% CI, .92-1.17]). Cellular immunogenicity, reactogenicity, and safety appeared to be comparable between groups. HZ/su was well-tolerated, with no safety concerns raised within 1 month post-dose 2. HZ/su induces a strong immune response irrespective of prior vaccination with ZVL, and may be an attractive option to revaccinate prior ZVL recipients. NCT02581410. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  14. Outcomes With Edoxaban Versus Warfarin in Patients With Previous Cerebrovascular Events

    DEFF Research Database (Denmark)

    Rost, Natalia S; Giugliano, Robert P; Ruff, Christian T

    2016-01-01

    BACKGROUND AND PURPOSE: Patients with atrial fibrillation and previous ischemic stroke (IS)/transient ischemic attack (TIA) are at high risk of recurrent cerebrovascular events despite anticoagulation. In this prespecified subgroup analysis, we compared warfarin with edoxaban in patients with ver......BACKGROUND AND PURPOSE: Patients with atrial fibrillation and previous ischemic stroke (IS)/transient ischemic attack (TIA) are at high risk of recurrent cerebrovascular events despite anticoagulation. In this prespecified subgroup analysis, we compared warfarin with edoxaban in patients...... with versus without previous IS/TIA. METHODS: ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) was a double-blind trial of 21 105 patients with atrial fibrillation randomized to warfarin (international normalized ratio......). Because only HDER is approved, we focused on the comparison of HDER versus warfarin. RESULTS: Of 5973 (28.3%) patients with previous IS/TIA, 67% had CHADS2 (congestive heart failure, hypertension, age, diabetes, prior stroke/transient ischemic attack) >3 and 36% were ≥75 years. Compared with 15 132...

  15. Relationship of deer and moose populations to previous winters' snow

    Science.gov (United States)

    Mech, L.D.; McRoberts, R.E.; Peterson, R.O.; Page, R.E.

    1987-01-01

    (1) Linear regression was used to relate snow accumulation during single and consecutive winters with white-tailed deer (Odocoileus virginianus) fawn:doe ratios, mosse (Alces alces) twinning rates and calf:cow ratios, and annual changes in deer and moose populations. Significant relationships were found between snow accumulation during individual winters and these dependent variables during the following year. However, the strongest relationships were between the dependent variables and the sums of the snow accumulations over the previous three winters. The percentage of the variability explained was 36 to 51. (2) Significant relationships were also found between winter vulnerability of moose calves and the sum of the snow accumulations in the current, and up to seven previous, winters, with about 49% of the variability explained. (3) No relationship was found between wolf numbers and the above dependent variables. (4) These relationships imply that winter influences on maternal nutrition can accumulate for several years and that this cumulative effect strongly determines fecundity and/or calf and fawn survivability. Although wolf (Canis lupus L.) predation is the main direct mortality agent on fawns and calves, wolf density itself appears to be secondary to winter weather in influencing the deer and moose populations.

  16. Corneal perforation after conductive keratoplasty with previous refractive surgery.

    Science.gov (United States)

    Kymionis, George D; Titze, Patrik; Markomanolakis, Marinos M; Aslanides, Ioannis M; Pallikaris, Ioannis G

    2003-12-01

    A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.

  17. Consultants' opinion on a new practice-based assessment programme for first-year residents in anaesthesiology

    DEFF Research Database (Denmark)

    Ringsted, C; ØStergaard, D; Scherpbier, A

    2002-01-01

    for first-year residency in anaesthesiology appears to be appropriate regarding the range of competencies assessed, the appropriateness as a basis for pass/fail decisions, and regarding the content of the tests used for pass/fail decisions. Further studies are needed to assess the feasibility...

  18. Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer: single center experience

    International Nuclear Information System (INIS)

    Ocvirk, Janja; Moltara, Maja Ebert; Mesti, Tanja; Boc, Marko; Rebersek, Martina; Volk, Neva; Benedik, Jernej; Hlebanja, Zvezdana

    2016-01-01

    Metastatic colorectal cancer (mCRC) is mainly a disease of elderly, however, geriatric population is underrepresented in clinical trials. Patient registries represent a tool to assess and follow treatment outcomes in this patient population. The aim of the study was with the help of the patients’ register to determine the safety and efficacy of bevacizumab plus chemotherapy in elderly patients who had previously untreated metastatic colorectal cancer. The registry of patients with mCRC was designed to prospectively evaluate the safety and efficacy of bevacizumab-containing chemotherapy as well as selection of patients in routine clinical practice. Patient baseline clinical characteristics, pre-specified bevacizumab-related adverse events, and efficacy data were collected, evaluated and compared according to the age categories. Between January 2008 and December 2010, 210 patients with mCRC (median age 63, male 61.4%) started bevacizumab-containing therapy in the 1 st line setting. Majority of the 210 patients received irinotecan-based chemotherapy (68%) as 1 st line treatment and 105 patients (50%) received bevacizumab maintenance therapy. Elderly (≥ 70 years) patients presented 22.9% of all patients and they had worse performance status (PS 1/2, 62.4%) than patients in < 70 years group (PS 1/2, 35.8%). Difference in disease control rate was mainly due to inability to assess response in elderly group (64.6% in elderly and 77.8% in < 70 years group, p = 0.066). The median progression free survival was 10.2 (95% CI, 6.7–16.2) and 11.3 (95% CI, 10.2–12.6) months in elderly and < 70 years group, respectively (p = 0.58). The median overall survival was 18.5 (95% CI, 12.4–28.9) and 27.4 (95% CI, 22.7–31.9) months for elderly and < 70 years group, respectively (p = 0.03). Three-year survival rate was 26% and 37.6% in elderly vs. < 70 years group (p = 0.03). Overall rates of bevacizumab-related adverse events were similar in both groups: proteinuria 21

  19. Assessing diets of 3-year-old children: evaluation of an FFQ.

    Science.gov (United States)

    Jarman, Megan; Fisk, Catherine M; Ntani, Georgia; Crozier, Sarah R; Godfrey, Keith M; Inskip, Hazel M; Cooper, Cyrus; Robinson, Sian M

    2014-05-01

    To evaluate the use of an administered eighty-item FFQ to assess nutrient intake and diet quality in 3-year-old children. Frequency of consumption and portion size of the foods listed on the FFQ during the 3 months preceding the interview were reported by the child's main caregiver; after the interview a 2 d prospective food diary (FD) was completed on behalf of the child. Nutrient intakes from the FFQ and FD were estimated using UK food composition data. Diet quality was assessed from the FFQ and FD according to the child's scores for a principal component analysis-defined dietary pattern ('prudent' pattern), characterised by high consumption of fruit, vegetables, water and wholemeal cereals. Southampton, UK. Children (n 892) aged 3 years in the Southampton Women's Survey. Intakes of all nutrients assessed by the FFQ were higher than FD estimates, but there was reasonable agreement in terms of ranking of children (range of Spearman rank correlations for energy-adjusted nutrient intakes, r s = 0·41 to 0·59). Prudent diet scores estimated from the FFQ and FD were highly correlated (r = 0·72). Some family and child characteristics appeared to influence the ability of the FFQ to rank children, most notably the number of child's meals eaten away from home. The FFQ provides useful information to allow ranking of children at this age with respect to nutrient intake and quality of diet, but may overestimate absolute intakes. Dietary studies of young children need to consider family and child characteristics that may impact on reporting error associated with an FFQ.

  20. Angiographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid artery

    International Nuclear Information System (INIS)

    Na, Dong Gyu; Han, Moon Hee; Chang, Kee Hyun; Han, Gi Seok; Yeon, Kung Mo

    1995-01-01

    The purpose of this study is to describe the angiographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid arteries and to evaluate the extent of angiographic assessment needed before embolization. We retrospectively reviewed 10 cervicofacial vascular lesions with previously ligated carotid artery, which were 6 cases of arteriovenous malformation, 2 cases of carotid cavernous fistula, 1 case of hemangioma and 1 case of arteriovenous malformation with carotid cavernous fistula. The previously ligated arteries are proximal external carotid artery (n = 5), branches of external carotid artery (n = 2) and common carotid artery (n = 3). Common carotid artery or internal carotid artery (n = 9), vertebral artery (n = 5), ipsilateral external carotid artery (n = 4), contralateral external carotid artery (n = 5), costocervical trunk (n = 2), thyrocervical trunk (n = 2) were assessed by conventional angiography. Angiography of both carotid and vertebral arteries was performed in 5 cases. The collateral vascular channels were inferolateral trunk of internal carotid artery (n = 8), vertebral artery (n = 5), contralateral external carotid artery (n = 5), ipsilateral external carotid artery (n = 4), deep cervical artery (n = 2) and ascending cervical artery (n = 1). Embolization were performed in 9 cases with operative cannulation (n = 4), embolization via collateral branches of ipsilateral external carotid artery (n = 1), embolization via collateral branches of contralateral external carotid artery (n = 3) and balloon occlusion via direct puncture (n = 1). The collateral channels in cervicofacial vascular lesions with previously ligated carotid artery were inferolateral trunk of internal carotid artery, contralateral or ipsilateral external carotid artery, vertebral artery, deep cervical artery and ascending cervical artery on angiography. Complete angiographic assessment of possible collateral channels is mandatory for the

  1. An Example of Large-group Drama and Cross-year Peer Assessment for Teaching Science in Higher Education

    Science.gov (United States)

    Sloman, Katherine; Thompson, Richard

    2010-09-01

    Undergraduate students pursuing a three-year marine biology degree programme (n = 86) experienced a large-group drama aimed at allowing them to explore how scientific research is funded and the associated links between science and society. In the drama, Year 1 students played the "general public" who decided which environmental research areas should be prioritised for funding, Year 2 students were the "scientists" who had to prepare research proposals which they hoped to get funded, and Year 3 students were the "research panel" who decided which proposals to fund with input from the priorities set by the "general public". The drama, therefore, included an element of cross-year peer assessment where Year 3 students evaluated the research proposals prepared by the Year 2 students. Questionnaires were distributed at the end of the activity to gather: (1) student perceptions on the cross-year nature of the exercise, (2) the use of peer assessment, and (3) their overall views on the drama. The students valued the opportunity to interact with their peers from other years of the degree programme and most were comfortable with the use of cross-year peer assessment. The majority of students felt that they had increased their knowledge of how research proposals are funded and the perceived benefits of the large-group drama included increased critical thinking ability, confidence in presenting work to others, and enhanced communication skills. Only one student did not strongly advocate the use of this large-group drama in subsequent years.

  2. Team health, an assessment approach to engage first year students in cross-cultural and cross-discipline teams towards more effective team-working

    Directory of Open Access Journals (Sweden)

    Kathy Egea

    Full Text Available Specialists who work in a globalised environment, need to work in teams, if they are to be continuously effective. The challenge for IT educators is to design and implement inter-cultural teamwork practices into their curriculum. Investigating this challenge, this case study describes Team Health, an assessment approach designed to skill students to be more effective in team working in cross-cultural and cross-discipline teams. The educational context is teamwork practice within a first year introductory web design course. Framed by Saunders\\'s virtual team lifecycle model (relationship building and team processes and Hofstede\\'s cultural dimensions (communication and working cross-culturally, the assessment approach utilises reflective and iterative strategies to support team working. At three points in the semester, students complete a survey on these four concepts, identify team strengths and weaknesses from the results of the surveys and work towards addressing one team weakness. The final assessment activity requires students to reflect on team working for the semester. Key attributes for effective team working are identified from the three surveys and the final reflective summaries. This paper compares course outcomes such as team cohesion and student grades to the previous course offering and shows that with the introduction of Team Health, the more complex student cohorts under this study achieve equally well. It is concluded that the guided reflective practices underpinning Team Health can prepare students for first year approaches to teamwork, and thereby provide starting points for working in future global teams where members are both culturally diverse and from different discipline areas.

  3. Modeling and risk assessment of a 30-Year-old subsurface radioactive-liquid drain field

    Science.gov (United States)

    Dawson, Lon A.; Pohl, Phillip I.

    1997-11-01

    The contamination from a 30-year-old radioactive liquid drain field was assessed for movement in the subsurface and potential risks to humans. This assessment included determining field concentrations of cesium 137 (137Cs) and other inorganic contaminants and modeling of the flow and transport of the liquid waste that was sent to the drain field. The field investigation detected no contamination deeper than 15 feet (4.6 m) from the bottom of the drain field. Prediction of the water content of the vadose zone showed no saturated conditions for times greater than 10 years after the known infiltration. Sensitivity analysis of the modeling parameters showed the equilibrium sorption coefficient to be the most important factor in predicting the contaminant plumes. Calibration of modeling results with field data gave a 137Cs sorption coefficient that is within the range of values found in the literature. The risk assessment for the site showed that the contamination poses no significant risk to human health.

  4. Burden of sudden cardiac death in persons aged 1 to 49 years

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

    2014-01-01

    : All deaths in persons aged 1 to 49 years were included in 2007 to 2009. Death certificates were reviewed by 2 physicians. History of previous admissions to hospital was assessed, and discharge summaries were read. Sudden unexpected death cases were identified and autopsy reports were collected...

  5. Response to health insurance by previously uninsured rural children.

    Science.gov (United States)

    Tilford, J M; Robbins, J M; Shema, S J; Farmer, F L

    1999-08-01

    To examine the healthcare utilization and costs of previously uninsured rural children. Four years of claims data from a school-based health insurance program located in the Mississippi Delta. All children who were not Medicaid-eligible or were uninsured, were eligible for limited benefits under the program. The 1987 National Medical Expenditure Survey (NMES) was used to compare utilization of services. The study represents a natural experiment in the provision of insurance benefits to a previously uninsured population. Premiums for the claims cost were set with little or no information on expected use of services. Claims from the insurer were used to form a panel data set. Mixed model logistic and linear regressions were estimated to determine the response to insurance for several categories of health services. The use of services increased over time and approached the level of utilization in the NMES. Conditional medical expenditures also increased over time. Actuarial estimates of claims cost greatly exceeded actual claims cost. The provision of a limited medical, dental, and optical benefit package cost approximately $20-$24 per member per month in claims paid. An important uncertainty in providing health insurance to previously uninsured populations is whether a pent-up demand exists for health services. Evidence of a pent-up demand for medical services was not supported in this study of rural school-age children. States considering partnerships with private insurers to implement the State Children's Health Insurance Program could lower premium costs by assembling basic data on previously uninsured children.

  6. A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style

    Directory of Open Access Journals (Sweden)

    Alex Ghanouni

    2017-04-01

    Full Text Available Abstract Background There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. Methods A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and ‘decision-making styles’ (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent. The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. Results After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009. Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively. Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008

  7. A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

    Science.gov (United States)

    Ghanouni, Alex; Renzi, Cristina; Waller, Jo

    2017-04-18

    There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively). Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008) and bowel (OR: 2.58, p = .015) information; an

  8. Outcome of the use of tension-free vaginal tape in women with mixed urinary incontinence, previous failed surgery, or low valsalva pressure.

    Science.gov (United States)

    Abdel-Hady, El-Said; Constantine, Glyn

    2005-02-01

    To assess the safety and efficacy of the use of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with mixed incontinence, previous failed incontinence surgery or low valsalva leak point pressure (VLPP). Six hundred and fifty-eight women with SUI underwent the TVT procedure. These included women with mixed stress and urge incontinence (n=128), previous surgery for SUI (n=118), low VLPP (n=80), and those over 70 years old (n=68). The procedure was carried out under spinal anesthetic and operative and immediate postoperative data was collected for all women. Six-month follow-up data was available on 454 women, with the first 300 women completing a quality of life (QOL) questionnaire before and after surgery. The overall subjective cure rate at 6 months was 91%, with 8% of women reporting significant (>50%) improvement in their symptoms. Subgroups with a body mass index > 30, age > 70 years, coexisting instability, previous failed surgery, and low VLPP showed cure rates of 81-89%. QOL improvements for all groups were highly significant. Significant complications included voiding difficulties in 29 women (4.4%), retropubic hematomas in four (0.6%), and thromboembolic episodes in three (0.5%). The simplicity and high efficacy of the TVT makes it the first choice for the treatment of women with SUI, including those with more complex problems or coexisting risk factors.

  9. Two Years into the Journey: AACSB Assessment of Learning in a "Principles of Marketing" Course

    Science.gov (United States)

    Clinton, Steven R.; Marco, Gayle; Chu, Yun

    2009-01-01

    Using a "Principles of Marketing" course, the authors demonstrate how compliance with AACSB standards and assessment of learning has been undertaken at Robert Morris University over a two-year period. Learning goals and objectives are tied to a specific assessment instrument to provide an illustration of how broad conceptual ideas are…

  10. Current role of endovascular therapy in Marfan patients with previous aortic surgery

    Directory of Open Access Journals (Sweden)

    Ibrahim Akin

    2008-02-01

    Full Text Available Ibrahim Akin, Stephan Kische, Tim C Rehders, Tushar Chatterjee, Henrik Schneider, Thomas Körber, Christoph A Nienaber, Hüseyin InceDepartment of Medicine, Division of Cardiology at the University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057 Rostock, GermanyAbstract: The Marfan syndrome is a heritable disorder of the connective tissue which affects the cardiovascular, ocular, and skeletal system. The cardiovascular manifestation with aortic root dilatation, aortic valve regurgitation, and aortic dissection has a prevalence of 60% to 90% and determines the premature death of these patients. Thirty-four percent of the patients with Marfan syndrome will have serious cardiovascular complications requiring surgery in the first 10 years after diagnosis. Before aortic surgery became available, the majority of the patients died by the age of 32 years. Introduction in the aortic surgery techniques caused an increase of the 10 year survival rate up to 97%. The purpose of this article is to give an overview about the feasibility and outcome of stent-graft placement in the descending thoracic aorta in Marfan patients with previous aortic surgery.Keywords: Marfan syndrome, aortic dissection, root replacement, stent-graft, previous aortic surgery

  11. Assessing Physicians' Intentions to Talk about Sex when They Vaccinate Nine-Year-Old to 15-Year-Old Girls against HPV

    Science.gov (United States)

    Askelson, Natoshia M.; Campo, Shelly; Smith, Sandi; Lowe, John B.; Dennis, Leslie; Andsager, Julie

    2011-01-01

    The human papillomavirus (HPV) vaccine provides physicians with an opportunity to have conversations with girls about sex and sex-related topics. Current research suggests that these conversations are not happening. This study was designed to assess whether physicians would use the HPV vaccination as an opening to communicate with nine-year-old to…

  12. Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires.

    Science.gov (United States)

    Seo, Yu Ri; Kim, Jong Sung; Kim, Sung Soo; Yoon, Seok Joon; Suh, Won Yoon; Youn, Kwangmi

    2016-01-01

    This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires. This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires. Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850-0.915) and 0.862 (0.824-0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934-0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC. The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.

  13. Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

    Directory of Open Access Journals (Sweden)

    Stella Maris Costa Castro

    2013-07-01

    Full Text Available Objective It was to investigate visual field (VF abnormalities in a group of multiple sclerosis (MS patients in the remission phase and the presence of magnetic resonance imaging (MRI lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years: 35 relapsing-remitting MS patients [20 optic neuritis (+, 15 optic neuritis (-] and 25 controls. MRI (3-Tesla was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

  14. High-Grade Leiomyosarcoma Arising in a Previously Replanted Limb

    Directory of Open Access Journals (Sweden)

    Tiffany J. Pan

    2015-01-01

    Full Text Available Sarcoma development has been associated with genetics, irradiation, viral infections, and immunodeficiency. Reports of sarcomas arising in the setting of prior trauma, as in burn scars or fracture sites, are rare. We report a case of a leiomyosarcoma arising in an arm that had previously been replanted at the level of the elbow joint following traumatic amputation when the patient was eight years old. He presented twenty-four years later with a 10.8 cm mass in the replanted arm located on the volar forearm. The tumor was completely resected and pathology examination showed a high-grade, subfascial spindle cell sarcoma diagnosed as a grade 3 leiomyosarcoma with stage pT2bNxMx. The patient underwent treatment with brachytherapy, reconstruction with a free flap, and subsequently chemotherapy. To the best of our knowledge, this is the first case report of leiomyosarcoma developing in a replanted extremity. Development of leiomyosarcoma in this case could be related to revascularization, scar formation, or chronic injury after replantation. The patient remains healthy without signs of recurrence at three-year follow-up.

  15. The persistence of predictors of wellbeing among refugee youth eight years after resettlement in Melbourne, Australia.

    Science.gov (United States)

    Correa-Velez, Ignacio; Gifford, Sandra M; McMichael, Celia

    2015-10-01

    This short report assesses the predictors of subjective health and happiness among a cohort of refugee youth over their first eight years in Australia. Five waves of data collection were conducted between 2004 (n = 120) and 2012-13 (n = 51) using mixed methods. Previous schooling, self-esteem, moving house in the previous year, a supportive social environment, stronger ethnic identity and perceived discrimination were significant predictors of wellbeing after adjusting for demographic and pre-migration factors. When compared with a previous analysis of this cohort over their first three years of settlement, experiences of social exclusion still have a significant impact on wellbeing eight years after arriving in Australia. This study contributes to mounting evidence in support of policies that discourage discrimination and promote social inclusion and cultural diversity and which underpin the wellbeing of resettled refugee youth. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Impulsivity moderates the relationship between previous quit failure and cue-induced craving.

    Science.gov (United States)

    Erblich, Joel; Michalowski, Alexandra

    2015-12-01

    Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Intellectual Curiosity in Action: A Framework to Assess First-Year Seminars in Liberal Arts Settings

    Science.gov (United States)

    Kolb, Kenneth H.; Longest, Kyle C.; Barnett, Jenna C.

    2014-01-01

    Fostering students' intellectual curiosity is a common goal of first-year seminar programs--especially in liberal arts settings. The authors propose an alternative method to assess this ambiguous, value-laden concept. Relying on data gathered from pre- and posttest in-depth interviews of 34 students enrolled in first-year seminars, they construct…

  18. Maternal Fish Oil Supplementation in Pregnancy: A 12 Year Follow-Up of a Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Suzanne Meldrum

    2015-03-01

    Full Text Available A number of trials have been undertaken to assess whether the intake of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA during pregnancy can influence the neurological development of the offspring, yet no consensus from these trials has been reached. We aimed to investigate the long-term effects (12 years of fish oil supplementation in pregnancy on neurodevelopment, including cognition, language and fine motor skills. In a follow up of a previously published randomised controlled trial of 98 pregnant women, their children were assessed at 12 years of age using a battery of neurodevelopmental assessments. Fifty participants were assessed at 12 years, with 25 participant’s mothers receiving fish oil supplementation, and 25 receiving control capsules. There were no significant differences for any of the assessment measures completed. Our data indicate that fish oil supplementation during pregnancy does not influence the cognition, language or fine motor skills of children in late primary school (12 years of age.

  19. Maternal fish oil supplementation in pregnancy: a 12 year follow-up of a randomised controlled trial.

    Science.gov (United States)

    Meldrum, Suzanne; Dunstan, Janet A; Foster, Jonathan K; Simmer, Karen; Prescott, Susan L

    2015-03-20

    A number of trials have been undertaken to assess whether the intake of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) during pregnancy can influence the neurological development of the offspring, yet no consensus from these trials has been reached. We aimed to investigate the long-term effects (12 years) of fish oil supplementation in pregnancy on neurodevelopment, including cognition, language and fine motor skills. In a follow up of a previously published randomised controlled trial of 98 pregnant women, their children were assessed at 12 years of age using a battery of neurodevelopmental assessments. Fifty participants were assessed at 12 years, with 25 participant's mothers receiving fish oil supplementation, and 25 receiving control capsules. There were no significant differences for any of the assessment measures completed. Our data indicate that fish oil supplementation during pregnancy does not influence the cognition, language or fine motor skills of children in late primary school (12 years of age).

  20. Immunogenicity and Safety of a Trivalent Inactivated Influenza Vaccine in Children 6 Months to 17 Years of Age, Previously Vaccinated with an AS03-Adjuvanted A(H1N1)Pdm09 Vaccine: Two Open-label, Randomized Trials.

    Science.gov (United States)

    Vesikari, Timo; Richardus, Jan Hendrik; Berglund, Johan; Korhonen, Tiina; Flodmark, Carl-Erik; Lindstrand, Ann; Silfverdal, Sven Arne; Bambure, Vinod; Caplanusi, Adrian; Dieussaert, Ilse; Roy-Ghanta, Sumita; Vaughn, David W

    2015-07-01

    During the influenza pandemic 2009-2010, an AS03-adjuvanted A(H1N1)pdm09 vaccine was used extensively in children 6 months of age and older, and during the 2010-2011 influenza season, the A(H1N1)pdm09 strain was included in the seasonal trivalent inactivated influenza vaccine (TIV) without adjuvant. We evaluated the immunogenicity and safety of TIV in children previously vaccinated with the AS03-adjuvanted A(H1N1)pdm09 vaccine. Healthy children were randomized (1:1) to receive TIV or a control vaccine. Children were aged 6 months to 9 years (n = 154) and adolescents 10-17 years (n = 77) when they received AS03-adjuvanted A(H1N1)pdm09 vaccine at least 6 months before study enrolment. Hemagglutination inhibition (HI) and neutralizing antibody responses against the A(H1N1)pdm09 strain were evaluated before (day 0) and at day 28 and month 6 after study vaccination. Reactogenicity was assessed during the 7 day postvaccination period, and safety was assessed for 6 months. At day 0, >93.9% of all children had HI titers ≥1:40 for the A(H1N1)pdm09 strain, which increased to 100% at both day 28 and month 6 in the TIV group. Between days 0 and 28, HI antibody geometric mean titers against A(H1N1)pdm09 increased by 9-fold and 4-fold in children 6 months to 9 years of age and 10-17 years of age, respectively. AS03-adjuvanted A(H1N1)pdm09 vaccine-induced robust immune responses in children that persisted into the next season, yet were still boosted by TIV containing A(H1N1)pdm09. The reactogenicity and safety profile of TIV did not appear compromised by prior receipt of AS03-adjuvanted A(H1N1)pdm09 vaccine.

  1. Classifying previously undefined days from eleven years of aerosol-particle-size distribution data from the SMEAR II station, Hyytiälä, Finland

    Directory of Open Access Journals (Sweden)

    S. Buenrostro Mazon

    2009-01-01

    Full Text Available Studies of secondary aerosol-particle formation depend on identifying days in which new particle formation occurs and, by comparing them to days with no signs of particle formation, identifying the conditions favourable for formation. Continuous aerosol size distribution data has been collected at the SMEAR II station in a boreal forest in Hyytiälä, Finland, since 1996, making it the longest time series of aerosol size distributions available worldwide. In previous studies, the data have been classified as particle-formation event, nonevent, and undefined days, with almost 40% of the dataset classified as undefined. In the present study, eleven years (1996–2006 of undefined days (1630 days were reanalyzed and subdivided into three new classes: failed events (37% of all previously undefined days, ultrafine-mode concentration peaks (34%, and pollution-related concentration peaks (19%. Unclassified days (10% comprised the rest of the previously undefined days. The failed events were further subdivided into tail events (21%, where a tail of a formation event presumed to be advected to Hyytiälä from elsewhere, and quasi events (16% where new particles appeared at sizes 3–10 nm, but showed unclear growth, the mode persisted for less than an hour, or both. The ultrafine concentration peaks days were further subdivided into nucleation-mode peaks (24% and Aitken-mode peaks (10%, depending on the size range where the particles occurred. The mean annual distribution of the failed events has a maximum during summer, whereas the two peak classes have maxima during winter. The summer minimum previously found in the seasonal distribution of event days partially offsets a summer maximum in failed-event days. Daily-mean relative humidity and condensation sink values are useful in discriminating the new classes from each other. Specifically, event days had low values of relative humidity and condensation sink relative to nonevent days. Failed-event days

  2. [Comparison of the present and previously used protocol of risk stratification in children with acute lymphoblastic leukemia].

    Science.gov (United States)

    Glodkowska, Eliza; Bialas, Agnieszka; Jackowska, Teresa

    2007-01-01

    Acute lymphoblastic leukaemia (ALL) is one of the most common cancers in children. In Poland, since November 2002 a new protocol of risk stratification has been recommended for assessment of risk factors and for choosing therapy regimens. assessment of accuracy of protocol ALL-IC 2002 in comparison to previously used risk stratification protocols. ALL was diagnosed in 100 children (44 girls, 56 boys; 1-18 years of age) in the Department of Pediatric Hematology and Oncology, Warsaw Medical University, over the period from November 2002 to November 2006. According to the ALL-IC 2002 protocol the patients were divided into three risk groups: SR-standard, IR-intermediate and HR-high. The stratification was by age, leukocyte count, cytogenetic changes, early response to prednisone therapy and bone marrow remission. In the previously used risk stratification protocols-BFM-90, only hepatosplenomegaly and the number of blasts in peripheral blood (PB) were considered, and the patients were divided into three risk groups: low (LRG1.2). out of the 100 patients qualified for treatment regimens according to the ALL-IC 2002 protocol, 97 entered remission, 11 died and 3 had a relapse. Under the ALL-IC 2002 protocol these children were stratified into the following groups: SR-31%, IR-44% and HR-25%. In the previously used stratification, there would be 26% children in low, 46% in the medium and 28% in the high risk group. According to the BFM-90 protocol 18/31 (58%) and 16/44 (36%) patients from the SR and IR groups respectively would be given more intensive treatment. On the other hand 11/44 (25%) and 14/25 (56%) patients from the IR and HR groups respectively would be given less intensive treatment. 1. ALL-IC 2002 protocol in comparison with the previously used protocol BFM-90, changes the qualification of children with ALL for the SR, IR and HR risk groups. This is linked to basic change of treatment protocol, adequate to severity of disease. 2. Children with ALL qualified

  3. Natural gas market assessment ten years after deregulation

    International Nuclear Information System (INIS)

    1996-11-01

    Changes which have taken place in the Canadian natural gas market in the ten years since the gas market was de-regulated, were reviewed. A 1985 agreement created conditions for a competitive natural gas market. However, the National Energy Board ensured that the pipeline transmission sector of the gas industry would continue to be regulated because of its natural monopoly characteristics. Open non-discriminatory access was to be provided to all shippers on inter-provincial gas pipelines. One objective of this report was to provide the Board with the means of assuring itself that the market was operating in such a way that Canadian requirements for natural gas were being met at fair market prices. The report also provided a review of the major changes in the gas producing and transmission sector, and reviewed developments in gas markets and sales practices. The overall assessment was that the natural gas industry was efficient and responsive to the demands of the marketplace. 5 tabs., 30 figs

  4. The Impact of Subcortical Band Heterotopia and Associated Complications on the Neuropsychological Functioning of a 13-Year-Old Child

    Science.gov (United States)

    Beaudoin, Beata S.; Hill, James M.; Ming, Sue X.

    2007-01-01

    Motor impairment in children with Asperger syndrome (AS) or high functioning autism (HFA) has been reported previously. This study presents results of a quantitative assessment of neuromotor skills in 14-22 year old HFA/AS. Sixteen HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA). The HFA/AS group showed…

  5. Sensory assessment of normal adolescents between 11 and 18 years old

    Directory of Open Access Journals (Sweden)

    Nara Suemi Shishido

    2013-04-01

    Full Text Available Tactile sensibility allows for adequate neuropsychomotor development. In addition, it enables the understanding of the subject’s own body, actions and explorations of objects, people and the environment. Previous studies have evaluated 3 to 10 year-old children. Herein, we evaluate the tactile sensibility in adolescents. The aim of this study was to verify whether the rapid growth of the body changes the normal pattern of tactile sensibility in adolescents. Furthermore, we provide evaluation material that is easy to use, simple, and secure to handle, designed to attend the specific age range studied. Thirty-two young participants between 11 and 18 years old, sixteen males and sixteen females, were evaluated. The adolescents go to public school and present normal development patterns. Graphesthesia, stereognosia, and Semmes-Weinstein monofilament tests were performed to evaluate the sensibility on the ventral and dorsal sides of the right and left hands. A questionnaire was used to identify the relevant activities performed with the hands during the studied period. The adolescents tested were collaborative during the research and presented curiosity regarding the boxes used in the experiment. Results indicated alterations in the tactile sensibility on the dorsal side of the hands from 13-year- old males. The major activities indicated by the adolescents were writing and sports for males and writing and cleaning for females. First evidences of possible changes in the normal tactile sensibility during adolescence were observed in this study.

  6. Does previous abdominal surgery affect the course and outcomes of laparoscopic bariatric surgery?

    Science.gov (United States)

    Major, Piotr; Droś, Jakub; Kacprzyk, Artur; Pędziwiatr, Michał; Małczak, Piotr; Wysocki, Michał; Janik, Michał; Walędziak, Maciej; Paśnik, Krzysztof; Hady, Hady Razak; Dadan, Jacek; Proczko-Stepaniak, Monika; Kaska, Łukasz; Lech, Paweł; Michalik, Maciej; Duchnik, Michał; Kaseja, Krzysztof; Pastuszka, Maciej; Stepuch, Paweł; Budzyński, Andrzej

    2018-03-26

    Global experiences in general surgery suggest that previous abdominal surgery may negatively influence different aspects of perioperative care. As the incidence of bariatric procedures has recently increased, it is essential to assess such correlations in bariatric surgery. To assess whether previous abdominal surgery influences the course and outcomes of laparoscopic bariatric surgery. Seven referral bariatric centers in Poland. We conducted a retrospective analysis of 2413 patients; 1706 patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) matched the inclusion criteria. Patients with no history of abdominal surgery were included as group 1, while those who had undergone at least 1 abdominal surgery were included as group 2. Group 2 had a significantly prolonged median operation time for RYGB (P = .012), and the longest operation time was observed in patients who had previously undergone surgeries in both the upper and lower abdomen (P = .002). Such a correlation was not found in SG cases (P = .396). Groups 1 and 2 had similar rates of intraoperative adverse events and postoperative complications (P = .562 and P = .466, respectively). Group 2 had a longer median duration of hospitalization than group 1 (P = .034), while the readmission rate was similar between groups (P = .079). There was no significant difference between groups regarding the influence of the long-term effects of bariatric treatment on weight loss (percentage of follow-up was 55%). Previous abdominal surgery prolongs the operative time of RYGB and the duration of postoperative hospitalization, but does not affect the long-term outcomes of bariatric treatment. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  7. Assessment of fire-damaged mesquite trees 8 years following an illegal burn

    Science.gov (United States)

    Gerald J. Gottfried; Peter F. Ffolliott; Pablo Garcia; Diego Valdez-Zamudio; Akram Al-Khouri

    2003-01-01

    Effects of an illegal burn on the Santa Rita Experimental Range on mesquite (Prosopis velutina) survival in the semidesert grass-shrub ecosystem was initially assessed in terms of firedamage classes 18 months after the fire and again 8 years after the burn. While many of the mesquite trees on the burned site were damaged by the fire, some of the trees appear to have...

  8. Assessment of nutrition knowledge and related aspects among first-year Kuwait University students.

    Science.gov (United States)

    El-Sabban, Farouk; Badr, Hanan E

    2011-01-01

    Assessing nutrition knowledge of populations assists in drawing strategies for education programs. Nutrition-related problems are common in Kuwait, thus data on nutrition knowledge are needed. This study involved administration of a questionnaire to 1,037 first-year Kuwait University students. The overall nutrition knowledge score was rated as fair, with deficiency in specific areas of knowledge. Students' dietary habits, attitudes, and interest in nutrition information were assessed as fair. Our findings will aid in building a nutrition knowledge database in Kuwait. A simplified course on aspects of healthy nutrition and lifestyle to all Kuwait University students is highly recommended.

  9. A 20-Year High-Resolution Wave Resource Assessment of Japan with Wave-Current Interactions

    Science.gov (United States)

    Webb, A.; Waseda, T.; Kiyomatsu, K.

    2016-02-01

    Energy harvested from surface ocean waves and tidal currents has the potential to be a significant source of green energy, particularly for countries with extensive coastlines such as Japan. As part of a larger marine renewable energy project*, The University of Tokyo (in cooperation with JAMSTEC) has conducted a state-of-the-art wave resource assessment (with uncertainty estimates) to assist with wave generator site identification and construction in Japan. This assessment will be publicly available and is based on a large-scale NOAA WAVEWATCH III (version 4.18) simulation using NCEP and JAMSTEC forcings. It includes several key components to improve model skill: a 20-year simulation to reduce aleatory uncertainty, a four-nested-layer approach to resolve a 1 km shoreline, and finite-depth and current effects included in all wave power density calculations. This latter component is particularly important for regions near strong currents such as the Kuroshio. Here, we will analyze the different wave power density equations, discuss the model setup, and present results from the 20-year assessment (with a focus on the role of wave-current interactions). Time permitting, a comparison will also be made with simulations using JMA MSM 5 km winds. *New Energy and Industrial Technology Development Organization (NEDO): "Research on the Framework and Infrastructure of Marine Renewable Energy; an Energy Potential Assessment"

  10. Neurological condition assessed with the Hempel examination and cognition and behaviour at 4 years

    NARCIS (Netherlands)

    Schendelaar, Pamela; Seggers, Jorien; Heineman, Maas Jan; Hadders-Algra, Mijna

    Aim: To investigate associations between neurological condition, assessed with the Hempel examination, in terms of minor neurological dysfunction (MND) and neurological optimality, and cognition and behaviour at 4 years. Study design: Cross-sectional analyses within a prospective, assessor-blinded

  11. A new method for assessment of skeletal maturity in the first 2 years of life

    International Nuclear Information System (INIS)

    Hernandez, M.; Sanchez, E.; Sobradillo, B.; Rincon, J.M.; Narvaiza, J.L.

    1988-01-01

    We present an original scoring method for assessing skeletal maturity in the first 2 years of life. We propose a lateral radiograph of the ankle and foot. Five different bony centers were examined: The calcaneus, the cuboid, the third cuneiform, the distal tibial epiphysis and the distal fibular epiphysis. The maturity scores given to the different stages of each bony center were calculated in proportion to the coefficients of regression between the skeletal maturity and a factor that expresses the influence of weight and head circumference as high multiple correlation coefficients of skeletal maturity with the factor obtained (0.920 for boys ad 0.929 for girls). Our method was standardized in a children population of less than two years of life in Biscaye, where 1,164 radiographs were taken. The distribution of scores in this study shows the discriminative ability of our method and its validity as an adequate method for skeletal maturity assessment in children less than 2 years of age. (orig.)

  12. Emergency Preparedness Hazards Assessment for solid waste management facilities in E-area not previously evaluated

    International Nuclear Information System (INIS)

    Hadlock, D.J.

    1999-01-01

    This report documents the facility Emergency Preparedness Hazards Assessment (EPHA) for the Solid Waste Management Department (SWMD) activities located on the Department of Energy (DOE) Savannah River Site (SRS) within E Area that are not described in the EPHAs for Mixed Hazardous Waste storage, the TRU Waste Storage Pads or the E-Area Vaults. The hazards assessment is intended to identify and analyze those hazards that are significant enough to warrant consideration in the SWMD operational emergency management program

  13. A comprehensive special educational diagnostic assessment of five-year-old children with developmental coordination disorder (case studies

    Directory of Open Access Journals (Sweden)

    Tjasa Filipcic

    2016-07-01

    Full Text Available Developmental coordination disorder (DCD is a neurodevelopmental disorder which affects different areas of an individual's everyday living and learning. Children with DCD are often diagnosed late, at school age, when difficulties with writing, organization and executive functions arise, even though one could have seen signs of probable DCD very early in childhood. The aim of this study was to further assess five-year-old, preschool children recognized as children with DCD, and develop a model for a comprehensive special educational diagnostic assessment of abilities and skills in five-year-old children with DCD. The comprehensive diagnostic assessment comprised observations and assessments of children’s everyday skills in their kindergartens. It also included semi-structured interviews with children, their parents and their preschool teachers. Further, children’s skills and abilities in all developmental domains (sensory and motor skills, cognitive abilities, social and emotional development, speech and language development, including emerging literacy skills, and early maths skills were assessed. A qualitative analysis was undertaken to compare individual children’s comprehensive assessments. The developed model included both the strengths and weaknesses of the assessed children.

  14. Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): results after one year.

    Science.gov (United States)

    Artac, Macide; Dalton, Andrew R H; Majeed, Azeem; Car, Josip; Millett, Christopher

    2013-08-01

    We aimed to assess whether the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program, was associated with reduction in CVD risk in attendees after one year. We extracted data from patients aged 40-74 years, with high estimated CVD risk, who were registered with general practices in a deprived, culturally diverse setting in England. We included 4748 patients at baseline (July 2008-November 2009), with 3712 at follow-up (December 2009-March 2011). We used a pre-post study design to assess changes in global CVD risk, individual CVD risk factors and statin prescription in patients with a complete and partial Health Check. There were significant reductions in mean CVD risk score (28.2%; 95% confidence interval (CI)=27.3-29.1 to 26.2%; 95% CI, 25.4-27.1), diastolic blood pressure, total cholesterol levels and lipid ratios after one year in patients with a complete Health Check. Statin prescription increased from 14.0% (95% CI=11.9-16.0) to 60.6% (95% CI=57.7-63.5). The introduction of NHS Health Check was associated with significant but modest reductions in CVD risk among screened high-risk individuals. Further cost-effectiveness analysis and work accounting for uptake is required to assess whether the program can make significant changes to population health. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Radiation environmental monitoring and assessment of plant-221 site ten years after decommissioning

    International Nuclear Information System (INIS)

    Li Yang; Gu Zhijie; Pan Wei; Ren Xiaona; Hu Xiaolin; She Haiqiang

    2011-01-01

    More than 10 years have passed since nuclear facility decommissioning practice for Plant-221 finished. Environmental radiation monitoring and post assessment of the decommissioning site of Plant-221 was carried out during 2003-2006, which was organized by Department of Environmental Protection and executed by China Institute for Radiation Protection, Environmental Radiation Monitoring station of Qinghai Province, etc. It shows that the decommissioning practice for Plant-221 complied with relevant limits for decommissioning, and its environmental radiation situation has not had significant change in general after 10 years, and the potential impact to the public and the environmental is acceptable. (authors)

  16. Reirradiation, surgery and IORT for recurrent rectal cancer in previously irradiated patients

    International Nuclear Information System (INIS)

    Vermaas, Maarten; Nuyttens, Joost J.M.E.; Ferenschild, Floris T.J.; Verhoef, Cornelis; Eggermont, Alexander M.M.; Wilt, Johannes H.W. de

    2008-01-01

    A total of 11 patients with recurrent rectal cancer who had been previously irradiated were treated with preoperative reirradiation (median dose 30 Gy), surgery and IORT. This treatment was related with high morbidity, a short pain-free survival (5 months) and poor local control (27% after 3 years), although some patients have long-term distant control and survival

  17. Do emotional intelligence and previous caring experience influence student nurse performance? A comparative analysis.

    Science.gov (United States)

    Stenhouse, Rosie; Snowden, Austyn; Young, Jenny; Carver, Fiona; Carver, Hannah; Brown, Norrie

    2016-08-01

    Reports of poor nursing care have focused attention on values based selection of candidates onto nursing programmes. Values based selection lacks clarity and valid measures. Previous caring experience might lead to better care. Emotional intelligence (EI) might be associated with performance, is conceptualised and measurable. To examine the impact of 1) previous caring experience, 2) emotional intelligence 3) social connection scores on performance and retention in a cohort of first year nursing and midwifery students in Scotland. A longitudinal, quasi experimental design. Adult and mental health nursing, and midwifery programmes in a Scottish University. Adult, mental health and midwifery students (n=598) completed the Trait Emotional Intelligence Questionnaire-short form and Schutte's Emotional Intelligence Scale on entry to their programmes at a Scottish University, alongside demographic and previous caring experience data. Social connection was calculated from a subset of questions identified within the TEIQue-SF in a prior factor and Rasch analysis. Student performance was calculated as the mean mark across the year. Withdrawal data were gathered. 598 students completed baseline measures. 315 students declared previous caring experience, 277 not. An independent-samples t-test identified that those without previous caring experience scored higher on performance (57.33±11.38) than those with previous caring experience (54.87±11.19), a statistically significant difference of 2.47 (95% CI, 0.54 to 4.38), t(533)=2.52, p=.012. Emotional intelligence scores were not associated with performance. Social connection scores for those withdrawing (mean rank=249) and those remaining (mean rank=304.75) were statistically significantly different, U=15,300, z=-2.61, p$_amp_$lt;0.009. Previous caring experience led to worse performance in this cohort. Emotional intelligence was not a useful indicator of performance. Lower scores on the social connection factor were associated

  18. Economic impact of feeding a phenylalanine-restricted diet to adults with previously untreated phenylketonuria.

    Science.gov (United States)

    Brown, M C; Guest, J F

    1999-02-01

    The aim of the present study was to estimate the direct healthcare cost of managing adults with previously untreated phenylketonuria (PKU) for one year before any dietary restrictions and for the first year after a phenylalanine- (PHE-) restricted diet was introduced. The resource use and corresponding costs were estimated from medical records and interviews with health care professionals experienced in caring for adults with previously untreated PKU. The mean annual cost of caring for a client being fed an unrestricted diet was estimated to be 83 996 pound silver. In the first year after introducing a PHE-restricted diet, the mean annual cost was reduced by 20 647 pound silver to 63 348 pound silver as a result of a reduction in nursing time, hospitalizations, outpatient clinic visits and medications. However, the economic benefit of the diet depended on whether the clients were previously high or low users of nursing care. Nursing time was the key cost-driver, accounting for 79% of the cost of managing high users and 31% of the management cost for low users. In contrast, the acquisition cost of a PHE-restricted diet accounted for up to 6% of the cost for managing high users and 15% of the management cost for low users. Sensitivity analyses showed that introducing a PHE-restricted diet reduces the annual cost of care, provided that annual nursing time was reduced by more than 8% or more than 5% of clients respond to the diet. The clients showed fewer negative behaviours when being fed a PHE-restricted diet, which may account for the observed reduction in nursing time needed to care for these clients. In conclusion, feeding a PHE-restricted diet to adults with previously untreated PKU leads to economic benefits to the UK's National Health Service and society in general.

  19. Is Previous Respiratory Disease a Risk Factor for Lung Cancer?

    Science.gov (United States)

    Denholm, Rachel; Schüz, Joachim; Straif, Kurt; Stücker, Isabelle; Jöckel, Karl-Heinz; Brenner, Darren R.; De Matteis, Sara; Boffetta, Paolo; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Ahrens, Wolfgang; Pohlabeln, Hermann; Zaridze, David; Field, John K.; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kendzia, Benjamin; Peters, Susan; Behrens, Thomas; Vermeulen, Roel; Brüning, Thomas; Kromhout, Hans

    2014-01-01

    Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case–control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20–1.48 and OR, 1.50; 95% CI, 1.21–1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33–4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis “only.” Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. Conclusions: Findings from this large international case–control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer. PMID:25054566

  20. A randomized, double-blind study of continuation treatment for attention-deficit/hyperactivity disorder after 1 year.

    NARCIS (Netherlands)

    Buitelaar, J.K.; Michelson, D.; Danckaerts, M.; Gillberg, C.; Spencer, T.J.; Zuddas, A.; Faries, D.E.; Zhang, S.; Biederman, J.

    2007-01-01

    BACKGROUND: The efficacy of atomoxetine in maintaining symptom response following 1 year of treatment was assessed in children and adolescents (n = 163) with DSM-IV defined attention-deficit/hyperactivity disorder (ADHD). METHODS: Subjects had previously responded to atomoxetine acutely and had

  1. Maternal condition and previous reproduction interact to affect offspring sex in a wild mammal.

    Science.gov (United States)

    Douhard, Mathieu; Festa-Bianchet, Marco; Pelletier, Fanie

    2016-08-01

    Trivers and Willard proposed that offspring sex ratio should vary with maternal condition when condition, meant as maternal capacity to care, has different fitness consequences for sons and daughters. In polygynous and dimorphic species, mothers in good condition should preferentially produce sons, whereas mothers in poor condition should produce more daughters. Despite its logical appeal, support for this hypothesis has been inconsistent. Sex-ratio variation may be influenced by additional factors, such as environmental conditions and previous reproduction, which are often ignored in empirical studies. We analysed 39 years of data on bighorn sheep (Ovis canadensis) that fit all the assumptions of the Trivers-Willard hypothesis. Production of sons increased with maternal condition only for mothers that weaned a son the previous year. This relationship likely reflects a mother's ability to bear the higher reproductive costs of sons. The interaction between maternal condition and previous weaning success on the probability of producing a son was independent of the positive effect of paternal reproductive success. Maternal and paternal effects accounted for similar proportions of the variance in offspring sex. Maternal reproductive history should be considered in addition to current condition in studies of sex allocation. © 2016 The Author(s).

  2. A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology.

    Science.gov (United States)

    Zappacosta, Roberta; Lattanzio, Giuseppe; Viola, Patrizia; Ianieri, Manuel Maria; Gatta, Daniela Maria Pia; Rosini, Sandra

    2014-01-01

    The introduction of organized cervical cancer (CC) screening programs has drastically reduced the prevalence of CC. However the incidence is still too high, especially among elderly women. All guidelines strongly recommend a regular Papanicolaou (Pap) testing for young and middle-aged patients. On the other hand, many international professional societies no longer advise screening in women who have undergone hysterectomy, and in women aged 65 years and above, who have a previous history of regular Pap smears. Here we report the case of poorly differentiated CC, involving the pelvic lymph nodes and urinary bladder, occurring in a 79-year-old woman who regularly underwent Pap tests, with no reported cytological abnormalities. In this very rare case, the CC cells, as well as cells from metastatic lymph nodes and cells from urinary specimens, molecularly showed human papilloma virus (HPV)-53. With the limitations of a single case, this report brings important information to prevent CC in elderly patients: the utility of molecular tests to increase sensitivity of Pap smears in postmenopausal women; the importance of HPV-53 as one of the four "emergent" genotypes having a possible role in oncogenesis; and the presence of HPV-53 in lymph node metastases from cervical carcinoma, which would support the role of this virus in the maintenance of malignant status.

  3. Parents' Ability to Assess Dental Fear in their Six- to 10-year-old Children.

    Science.gov (United States)

    Klein, Ulrich; Manangkil, Rochelle; DeWitt, Peter

    2015-01-01

    To investigate parents' ability to assess dental anxiety of their six- to 10-year-old children and to determine how parents' and children's fear assessments correlate with patient behavior during dental treatment. From a continuous convenience sample, 184 child/parent dyads were recruited to complete the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire prior to dental treatment. One provider treated all children, assessed their behavior, and assigned a Frankl score rating to them. Parent/child anxiety scores were compared to each other and to the behavior children presented during dental treatment. The mean dental anxiety score reported by the children was 30.30; the score reported by their parents was 2.94 points higher (P=.0016). There was poor consistency within parent/child pairs when precisely assessing dental anxiety. Parental assessments of their children's dental anxiety were a poor to fair predictor for observed behavior, whereas the children's self-assessments were fair to good. Child age was not associated with ability to assess anxiety. Parents of children with low anxiety overestimated their children's anxiety, whereas parents of children with high anxiety underestimated their children's anxiety. Parents and children showed moderate agreement assessing dental anxiety measured by the CFSS-DS. The child's score is preferable for predicting behavior.

  4. Incidence of Acneform Lesions in Previously Chemically Damaged Persons-2004

    Directory of Open Access Journals (Sweden)

    N Dabiri

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Chemical gas weapons especially nitrogen mustard which was used in Iraq-Iran war against Iranian troops have several harmful effects on skin. Some other chemical agents also can cause acne form lesions on skin. The purpose of this study was to compare the incidence of acneform in previously chemically damaged soldiers and non chemically damaged persons. Materials & Methods: In this descriptive and analytical study, 180 chemically damaged soldiers, who have been referred to dermatology clinic between 2000 – 2004, and forty non-chemically damaged people, were chosen randomly and examined for acneform lesions. SPSS software was used for statistic analysis of the data. Results: The mean age of the experimental group was 37.5 ± 5.2 and that of the control group was 38.7 ± 5.9 years. The mean percentage of chemical damage in cases was 31 percent and the time after the chemical damage was 15.2 ± 1.1 years. Ninety seven cases (53.9 percent of the subjects and 19 people (47.5 percent of the control group had some degree of acne. No significant correlation was found in incidence, degree of lesions, site of lesions and age of subjects between two groups. No significant correlation was noted between percentage of chemical damage and incidence and degree of lesions in case group. Conclusion: Incidence of acneform lesions among previously chemically injured peoples was not higher than the normal cases.

  5. Visual Working Memory Supports the Inhibition of Previously Processed Information: Evidence from Preview Search

    Science.gov (United States)

    Al-Aidroos, Naseem; Emrich, Stephen M.; Ferber, Susanne; Pratt, Jay

    2012-01-01

    In four experiments we assessed whether visual working memory (VWM) maintains a record of previously processed visual information, allowing old information to be inhibited, and new information to be prioritized. Specifically, we evaluated whether VWM contributes to the inhibition (i.e., visual marking) of previewed distractors in a preview search.…

  6. The previous Common Agricultural Policy (2003-2013) reduced french agricultural emissions. Climate Brief no. 49

    International Nuclear Information System (INIS)

    Baudrier, Mathilde; Foucherot, Claudine; Bellassen, Valentin

    2015-04-01

    In September 2013, European institutions ratified the reform of the Common Agricultural Policy for 2014-2020 with new targets for combating climate change, making these an official goal for the Common Agricultural Policy (CAP). However the CAP's impact on greenhouse gas (GHG) emissions did not begin in 2014, even if it was previously ancillary to measures focusing on other targets. This Climate Report assesses emissions avoided and induced by the 2003-2013 CAP based on CAP measures modified in France over the period. A list of 20 major measures was drawn up. These met the following three criteria: The measure potentially has an impact on GHG emissions; The annual budget allocated to the measure is more than euro 20 million a year; The measure was created or modified between 2003 and 2013 Their positive or negative impact on GHG emissions was then estimated at a unitary level (per hectare, animal, square metre of greenhouse, etc.), on a national scale (MtCO 2 e per year) and relative to the quantity produced (tCO 2 e per litre of milk, quintal of wheat, etc.). Almost all these measures encourage emissions reduction, whatever the metric considered: tCO 2 e per hectare or per quantity of product. In just under half of cases, however, the incentive is not considered to be effective, with the data (e.g. surface area of grasslands, quantity of animals, etc.) moving in the opposite direction from the expected effects of the measure. The effects from the other half of measures is estimated at more than 2 million tCO 2 e per year, or around 2% of emissions from the agri-supply, agriculture and agri-food (AAA) sectors in 2011. Two-thirds of these reductions can be attributed to three types of measures: incentives for sustainable use of inputs (green environment plan, energy performance plan, training, etc.), agri-environmental grassland premium and coupled support for grain legumes. The main purpose of these calculations is to spark a debate. The assumptions underlying

  7. Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients

    Energy Technology Data Exchange (ETDEWEB)

    Haddock, M G; Gunderson, L L; Nelson, H; Cha, S; Devine, R M; Dozois, R R; Wolff, B G

    1995-07-01

    Purpose/Objective: Little information exists in the literature on salvage treatment for patients with pelvic recurrences of colorectal cancer who have previously received high dose radiation therapy (RT). A retrospective review of such patients treated aggressively with surgical resection and intraoperative electrons (IOERT) was undertaken. Material and Methods: From 1981 through 1994, 52 previously irradiated patients with recurrent locally advanced colorectal cancer without evidence of distant metastatic disease were treated with surgical resection and intraoperative electrons (IOERT) {+-} additional external beam RT. Every attempt was made to achieve a gross total resection prior to IOERT if it could be safely accomplished. IOERT doses ranged from 1000-3000 cGy with a median of 2000 cGy. 37 patients received additional external beam radiotherapy either pre- or post-operatively with doses ranging from 500-5040 cGy (median 2520 cGy). 20 patients received 5FU {+-} leukovorin during external beam RT. Three patients received 5FU+leukovorin after completion of RT. Results: 31 males and 21 females with a median age of 55 years (range 31-73 years) were treated. 71% of patients have been followed until death or for > 2 years. The median, 2-year and 5-year actuarial overall survival is 23 months, 48% and 13%, respectively. Actuarial central disease control (IOERT field) at 2 and 4 years is 72 and 57%; pelvic control at 2 and 4 years is 60 and 34%. Pelvic control rates are better in patients who received {>=} 3000 cGy external beam RT in addition to IOERT as compared to patients who received no external beam RT or < 3000 cGy, with 2 year pelvic control rates of 81% vs. 54%. 25 patients have developed distant metastases. The actuarial rate of appearance of distant metastatic disease at 2 and 4 years is 60 and 80%. Late complications attributable to IOERT include neuropathies in 13 patients (5 mild, 5 moderate, 3 severe) and narrowing or obstruction of the ureter in four

  8. Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients

    International Nuclear Information System (INIS)

    Haddock, M.G.; Gunderson, L.L.; Nelson, H.; Cha, S.; Devine, R.M.; Dozois, R.R.; Wolff, B.G.

    1995-01-01

    Purpose/Objective: Little information exists in the literature on salvage treatment for patients with pelvic recurrences of colorectal cancer who have previously received high dose radiation therapy (RT). A retrospective review of such patients treated aggressively with surgical resection and intraoperative electrons (IOERT) was undertaken. Material and Methods: From 1981 through 1994, 52 previously irradiated patients with recurrent locally advanced colorectal cancer without evidence of distant metastatic disease were treated with surgical resection and intraoperative electrons (IOERT) ± additional external beam RT. Every attempt was made to achieve a gross total resection prior to IOERT if it could be safely accomplished. IOERT doses ranged from 1000-3000 cGy with a median of 2000 cGy. 37 patients received additional external beam radiotherapy either pre- or post-operatively with doses ranging from 500-5040 cGy (median 2520 cGy). 20 patients received 5FU ± leukovorin during external beam RT. Three patients received 5FU+leukovorin after completion of RT. Results: 31 males and 21 females with a median age of 55 years (range 31-73 years) were treated. 71% of patients have been followed until death or for > 2 years. The median, 2-year and 5-year actuarial overall survival is 23 months, 48% and 13%, respectively. Actuarial central disease control (IOERT field) at 2 and 4 years is 72 and 57%; pelvic control at 2 and 4 years is 60 and 34%. Pelvic control rates are better in patients who received ≥ 3000 cGy external beam RT in addition to IOERT as compared to patients who received no external beam RT or < 3000 cGy, with 2 year pelvic control rates of 81% vs. 54%. 25 patients have developed distant metastases. The actuarial rate of appearance of distant metastatic disease at 2 and 4 years is 60 and 80%. Late complications attributable to IOERT include neuropathies in 13 patients (5 mild, 5 moderate, 3 severe) and narrowing or obstruction of the ureter in four patients

  9. Method for assessment of skeletal maturity in children below one year of age

    Energy Technology Data Exchange (ETDEWEB)

    Erasmie, U.; Ringertz, H.

    1980-07-01

    Although there is a continuing clinical interest in the radiological determination of skeletal development in children below one year of age, none of the existing methods is particularly appropriate. We have therefore developed a new and simple method of assessment. This takes into account the dose of radiation and the two aspects of size and maturity of the skeleton; and so we choose to study the lateral view of the tarsus. The calcaneous and talus are ossification centers appearing before birth. The sum of length and height of these centers constitutes the first part of the assessment. The second part of our evaluation includes an appraisal of the cuboid, the third cuneiform and the distal epiphyses of tibia and fibula. For practical purposes we have chosen to relate the two different aspects of skeletal maturity which we have assessed to the weight of the baby.

  10. The influence of general anesthesia on the brain in aged patients with previous ischemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Kokubo, Yasuaki; Kayama, Takamasa; Kondo, Rei; Oki, Masato; Takaoka, Seiji

    2008-01-01

    Whenever we discuss the overall results of surgical treatment for unruptured cerebral aneurysms, especially in aged patients, we tend to consider advanced age or general anesthesia as causes for unfavorable results. There are no reports concerning ischemic stroke events following general anesthesia in aged patients with a prior history of cerebrovascular disease. The purpose of this study is to clarify the influence of general anesthesia on the brats in aged patients with a previous history of ischemic cerebrovascular disease. The subjects were 30 consecutive patients over 70 years of age with previous ischemic cerebrovascular disease who underwent various surgeries except brain and cardiac surgery under general anesthesia. The patients were 70 to 85 years old, with a mean age of 76. Twenty-three were men and 7 were women. Surgical procedures were 12 gastrointestinal, 6 orthopedic and 4 urogenital and others. The type of cerebrovascular disease evaluated by neuroradiologist and anesthesiologist based on MR imaging was devided as follows: 16 patients had minor stroke, 7 had transient ischemic attack/reversible ischemic neurological deficit (TIA/RIND) and 7 had asymptomatic cerebral infarction. MR angiography was also assessed to evaluate the main artery in the brain. Blood pressure and arterial blood gas (PaCO 2 ) during general anesthesia were analyzed, and the rate of systemic and neurological complications following general anesthesia were evaluated. MR angiography revealed no occlusion or severe stenosis of the main artery in the brain of any of the patients. The minimum systolic blood pressure showed less than 100 mmHg transiently for 5-20 minutes in 28 of 30 patients during general anesthesia. The minimum value was 65 mmHg maintained for 5 minutes. The minimum PaCO 2 during general anesthesia was as follows: 1 case 36 mmHg. There were no neurological complications following general anesthesia in this study. One of 30 patients (3.3%) had suffered from pneumonia

  11. The relationship between body composition and femoral neck osteoporosis or osteopenia in adults with previous poliomyelitis.

    Science.gov (United States)

    Chang, Kwang-Hwa; Tseng, Sung-Hui; Lin, Yu-Ching; Lai, Chien-Hung; Hsiao, Wen-Tien; Chen, Shih-Ching

    2015-04-01

    Articles in the literature describing the association between body composition and osteoporosis in subjects with poliomyelitis are scarce. To assess the relationship between body composition and femoral neck osteoporosis or osteopenia in adults with previous polio. After excluding postmenopausal women, 44 polio (mean age ± standard deviation, 46.1 ± 3.3 years) and 44 able-bodied control volunteers (47.0 ± 4.0 years) participated in the study. Each participant's femoral neck bone mineral density (FNBMD) and whole body composition were measured using dual-energy X-ray absorptiometry. With local reference BMD values of normal young adults installed in the instrument, we obtained T-score values that depended on each FNBMD value. A T-score value of ≤-1.0 indicated decreased T-score, including osteoporosis (T-score ≤ -2.5) and osteopenia (-1.0 to -2.5). This study conducted logistic regression analyses to find factors associated with osteoporosis and osteopenia. Based on the FNBMD T-score values, 60.0% of middle-aged men with polio had osteoporosis. In adjusted logistic regression analyses, total lean tissue mass (Adjusted odds ratio [95% confidence interval], 0.74 [0.56-0.99], P < 0.05) and male gender (947.16 [6.02-148,926.16], P < 0.01) were important factors associated with decreased T-score in polio group. Osteoporosis or osteopenia is a common medical problem for middle-aged men with polio. Reduced total lean tissue mass seems to be one of the important factors associated with osteoporosis or osteopenia among subjects with polio. Further research for a clinical tool to assess lean tissue mass for subjects with polio is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Dietary self-efficacy predicts AHEI diet quality in women with previous gestational diabetes.

    Science.gov (United States)

    Ferranti, Erin Poe; Narayan, K M Venkat; Reilly, Carolyn M; Foster, Jennifer; McCullough, Marjorie; Ziegler, Thomas R; Guo, Ying; Dunbar, Sandra B

    2014-01-01

    The purpose of this study was to examine the association of intrapersonal influences of diet quality as defined by the Health Belief Model constructs in women with recent histories of gestational diabetes. A descriptive, correlational, cross-sectional design was used to analyze relationships between diet quality and intrapersonal variables, including perceptions of threat of type 2 diabetes mellitus development, benefits and barriers of healthy eating, and dietary self-efficacy, in a convenience sample of 75 community-dwelling women (55% minority; mean age, 35.5 years; SD, 5.5 years) with previous gestational diabetes mellitus. Diet quality was defined by the Alternative Healthy Eating Index (AHEI). Multiple regression was used to identify predictors of AHEI diet quality. Women had moderate AHEI diet quality (mean score, 47.6; SD, 14.3). Only higher levels of education and self-efficacy significantly predicted better AHEI diet quality, controlling for other contributing variables. There is a significant opportunity to improve diet quality in women with previous gestational diabetes mellitus. Improving self-efficacy may be an important component to include in nutrition interventions. In addition to identifying other important individual components, future studies of diet quality in women with previous gestational diabetes mellitus are needed to investigate the scope of influence beyond the individual to potential family, social, and environmental factors. © 2014 The Author(s).

  13. Gastrointestinal tolerability with ibandronate after previous weekly bisphosphonate treatment.

    Science.gov (United States)

    Derman, Richard; Kohles, Joseph D; Babbitt, Ann

    2009-01-01

    Data from two open-label trials (PRIOR and CURRENT) of women with postmenopausal osteoporosis or osteopenia were evaluated to assess whether monthly oral and quarterly intravenous (IV) ibandronate dosing improved self-reported gastrointestinal (GI) tolerability for patients who had previously experienced GI irritation with bisphosphonate (BP) use. In PRIOR, women who had discontinued daily or weekly BP treatment due to GI intolerance received monthly oral or quarterly IV ibandronate for 12 months. The CURRENT subanalysis included women receiving weekly BP treatment who switched to monthly oral ibandronate for six months. GI symptom severity and frequency were assessed using the Osteoporosis Patient Satisfaction Questionnaire. In PRIOR, mean GI tolerability scores increased significantly at month 1 from screening for both treatment groups (oral: 79.3 versus 54.1; IV: 84.4 versus 51.0; p 90% at Month 10). In the CURRENT subanalysis >60% of patients reported improvements in heartburn or acid reflux and >70% indicated improvement in other stomach upset at month 6. Postmenopausal women with GI irritability with daily or weekly BPs experienced improvement in symptoms with extended dosing monthly or quarterly ibandronate compared with baseline.

  14. [The Octabaix study. Baseline assessment and 5 years of follow-up].

    Science.gov (United States)

    Ferrer, Assumpta; Formiga, Francesc; Padrós, Gloria; Badia, Teresa; Almeda, Jesús; Octabaix, Grupo Estudio

    This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Value and reliability of findings from previous epidemiologic studies in the assessment of radiation-related cancer risks. Pt. 3

    International Nuclear Information System (INIS)

    Frasch, G.; Martignoni, K.

    1990-01-01

    The theories put forward here are predominantly based on pooled data from previous studies in a number of cohorts made up by mostly non-average individuals. These studies were carried out by various researchers and differed in procedures and aims. Factors of major importance to the validity and reliability of the conclusions drawn from this study are pointed out. In one chapter some light is thrown on factors known to bear a relation to the incidence of radiation-induced cancer of the breast, even though at present this can only very vaguely be described on a quantitative basis. These factors include fractionated dose regimens, pregnancies and parturitions, menarche, menopause, synergisms as well as secondary cancer of the breast. The available body of evidence suggests that exposure of each of 1 million women to a dose of 10 mGy (rad) can be linked with approx. 3 additional cases of mammary cancer reported on an average per year after the latency period. The fact that there is some statistical scatter around this value is chiefly attributable to age-related causes at the beginning of exposure. Differences in ethnic and cultural characteristics between the populations investigated appeared to be less important here. (orig./MG) [de

  16. Survival after early-stage breast cancer of women previously treated for depression

    DEFF Research Database (Denmark)

    Suppli, Nis Frederik Palm; Johansen, Christoffer; Kessing, Lars Vedel

    2017-01-01

    treatment of depression and risk of receiving nonguideline treatment of breast cancer were assessed in multivariable logistic regression analyses. We compared the overall survival, breast cancer-specific survival, and risk of death by suicide of women who were and were not treated for depression before......Purpose The aim of this nationwide, register-based cohort study was to determine whether women treated for depression before primary early-stage breast cancer are at increased risk for receiving treatment that is not in accordance with national guidelines and for poorer survival. Material...... and Methods We identified 45,325 women with early breast cancer diagnosed in Denmark from 1998 to 2011. Of these, 744 women (2%) had had a previous hospital contact (as an inpatient or outpatient) for depression and another 6,068 (13%) had been treated with antidepressants. Associations between previous...

  17. Are previous episodes of bacterial vaginosis a predictor for vaginal symptoms in breast cancer patients treated with aromatase inhibitors?

    DEFF Research Database (Denmark)

    Gade, Malene R; Goukasian, Irina; Panduro, Nathalie

    2018-01-01

    Objective To estimate the prevalence of vaginal symptoms in postmenopausal women with breast cancer exposed to aromatase inhibitors, and to investigate if the risk of vaginal symptoms is associated with previous episodes of bacterial vaginosis. Methods Patients from Rigshospitalet and Herlev...... University Hospital, Denmark, were identified through the register of Danish Breast Cancer Cooperation Group and 78 patients participated in the study. Semiquantitave questionnaires and telephone interview were used to assess the prevalence of vaginal symptoms and previous episode(s) of bacterial vaginosis....... Multivariable logistic regression models were used to assess the association between vaginal symptoms and previous episodes of bacterial vaginosis. Results Moderate to severe symptoms due to vaginal itching/irritation were experienced by 6.4% (95% CI: 2.8-14.1%), vaginal dryness by 28.4% (95% CI: 19...

  18. Deep brain stimulation of the subthalamic nucleus: effectiveness in advanced Parkinson's disease patients previously reliant on apomorphine

    OpenAIRE

    Varma, T; Fox, S; Eldridge, P; Littlechild, P; Byrne, P; Forster, A; Marshall, A; Cameron, H; McIver, K; Fletcher, N; Steiger, M

    2003-01-01

    Objectives: To assess the efficacy of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with advanced Parkinson's disease previously reliant on apomorphine as their main antiparkinsonian medication.

  19. DIEP flap customization using Fluobeam® indocyanine green tissue perfusion assessment with large previous abdominal scar

    Directory of Open Access Journals (Sweden)

    Michael A. Fallucco

    2017-06-01

    Full Text Available The Fluobeam® is a portable, near-infrared camera that is held and controlled by the surgeon to visualize tissue perfusion using indocyanine green (ICG fluorescence imaging. This case report describes how data obtained from ICG imaging allows intraoperative customization in a previously surgically scarred abdomen during autologous Deep Inferior Epigastric Artery Perforator (DIEP flap bilateral breast reconstruction. The outcome was successful breast mound recreation without fat necrosis.

  20. Body mass index, Mini Nutritional Assessment, and their association with five-year mortality in very old people.

    Science.gov (United States)

    Burman, M; Säätelä, S; Carlsson, M; Olofsson, B; Gustafson, Y; Hörnsten, C

    2015-04-01

    to investigate the prevalence of malnutrition and the association between Body Mass Index (BMI), Mini Nutritional Assessment (MNA) and five-year mortality in a representative population of very old (>85 years) people. A prospective cohort study. A population-based study of very old people in northern Sweden and western Finland, living in institutional care or in the community. Out of 1195 potential participants, 832 were included (mean age 90.2±4.6 years). Nutritional status was assessed using BMI and MNA and the association of those two variables with five-year mortality was analyzed. The mean BMI value for the whole population was 25.1±4.5 kg/m2, with no difference between genders (P=0.938). The mean MNA score was 22.5±4.6 for the whole sample, and it was lower for women than for men (Ppeople, and BMI might be misleading and could underestimate the prevalence of malnutrition, especially in women.

  1. A case report: mixed thrombus formation in a previously sutured right atrium.

    Science.gov (United States)

    Yunfei, Ling; Dongxu, Li; Shuhua, Luo; Yabo, Wang; San, Deep; Changping, Gan; Ke, Lin; Qi, An

    2014-08-01

    We describe the case of a 19-year-old Chinese woman who nine months prior underwent repair of an atrial septal defect and came to our hospital with a right atrial mass attached to the anterior wall of the right atrium on transthoracic echocardiography. Pathologic examination revealed the mass was a mixed-type thrombosis with some unusual organization, which previously was not described in literature.

  2. [Prospective assessment of children with pervasive developmental disorder after 2 years of day-hospital treatment].

    Science.gov (United States)

    Poinso, F; Dubois, B; Chatel, C; Viellard, M; Bastard-Rosset, D; Girardot, A-M; Grandgeorge, P; De Martino, S; Sokolowsky, M; Salle-Collemiche, X; Da Fonseca, D

    2013-01-01

    The treatment of children with pervasive developmental disorders (PDD) has not been systematically assessed in French day-care units. In this prospective study, 11 children with a diagnosis of PDD were followed up for 2years in a day-care unit in the Marseille university hospital. The treatment they received is based on an initial assessment by the "Centre Ressources Autisme" (CRA PACA) and further included a continued observation of the child and an assessment of the child's abilities and needs. This treatment used various therapeutic approaches 10h weekly and also included parental counseling and coordinated work with schools. Treatment in our day-care unit can be categorized as eclectic, non-intensive therapy. It is based on methods such as TEACCH (Treatment and Education of Autistic and related Communication handicapped Children), Floor Time Play, speech and language therapy, developmental therapy, and psychotherapy. International studies on intensive behavioral therapies suggest that this treatment is superior to non-behavioral and/or non-intensive treatment. They suggest its efficiency is due both to the nature of the treatment (behavioral) and to its intensity (more than 25h a week). In this study, the CRA diagnosed children using the ADI and ADOS. The 11 children (mean age, 3years 5months) were tested twice, with the Vineland and CARS scales. The first assessment was on admission to the day hospital and the second was 2years later. The results showed developmental progress with a mean increase of 13.5 months at the Vineland Scale, and a decrease of the autism severity score on the CARS. The treatment presented here proves to be efficient; if compared to similar results in international studies, we obtained better results than their eclectic intensive or non-intensive treatment comparison group. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  3. Tails from previous exposures: a general problem in setting reference levels for the assessment of internal contamination

    International Nuclear Information System (INIS)

    Breuer, F.; Frittelli, L.

    1988-01-01

    Reference levels for retention and excretion are evaluated for routine and special monitoring following the intake of a fraction of ICRP annual limits (ALIs) or of a unit activity. Methodologies are also suggested for taking into account the contribution by previous intakes to excretion or retention

  4. Project W-420 Ventilation Stack Monitoring System Year 2000 Compliance Assessment Project Plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This assessment describes the potential Year 2000 (Y2K) problems and describes the methods for achieving Y2K Compliance for Project W-420, Ventilation Stack Monitoring Systems Upgrades. The purpose of this assessment is to give an overview of the project. This document will not be updated and any dates contained in this document are estimates and may change. The project work scope includes upgrades to ventilation stacks and generic effluent monitoring systems (GEMS) at the 244-A Double Contained Receiver Tank (DCRT), the 244-BX DCRT, the 244-CR Vault, tanks 241-C-105 and 241-C-106, the 244-S DCRT, and the 244-TX DCRT. A detailed description of system dates, functions, interfaces, potential Y2K problems, and date resolutions can not be described since the project is in the definitive design phase, This assessment will describe the methods, protocols, and practices to ensure that equipment and systems do not have Y2K problems

  5. Pushing the boundaries in liver graft utilisation in transplantation: Case report of a donor with previous bile duct injury repair.

    Science.gov (United States)

    Sultana, Asma; Powell, James J; Oniscu, Gabriel C

    2017-01-01

    Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation. The liver was successfully recovered and transplanted into a 56-year-old male recipient with end stage liver disease consequent to alpha 1 antitrypsin deficiency. The graft continues to function well 36 months post-transplant, with normal liver function tests and imaging revealing a patent hepaticojejunostomy. The potential associated vascular injuries should be identified during bench preparation whilst the management of biliary reconstruction at the time of transplant should follow the principles of biliary reconstruction in cases with biliary injuries, extending the hilar opening into the left duct. This case highlights the successful utilisation of a post bile duct injury repair liver, employing an experienced procurement team and careful bench assessment and reconstruction. Copyright © 2017. Published by Elsevier Ltd.

  6. Effects of previous ovarian surgery for endometriosis on the outcome of assisted reproduction treatment.

    Science.gov (United States)

    Geber, Selmo; Ferreira, Daniela Parreiras; Spyer Prates, Luis Felipe Víctor; Sales, Liana; Sampaio, Marcos

    2002-01-01

    Endometriosis affects 2-50% of women at reproductive age. Surgery is an option for treatment, but there is no convincing evidence that it promotes a significant improvement in fertility. Also, the removal of ovarian endometrioma might lead to a reduction in the follicular reserve and response to stimulation. Therefore, the aim of this study was to evaluate the effect of previous ovarian surgery for endometriosis on the ovarian response in assisted reproduction treatment cycles and its pregnancy outcome. A total of 61 women, with primary infertility and previously having undergone ovarian surgery for endometriosis, who had received 74 IVF/intracytoplasmic sperm injection (ICSI) cycles, were studied (study group). A further 74 patients with primary infertility who underwent 77 IVF/ICSI cycles within#10; the same period of time, at the same clinic and without previous ovarian surgery or endometriosis were studied as a control group. Patients were matched for age and treatment performed. Patients 35 years with previous ovarian surgery needed more ampoules for ovulation induction (P = 0.017) and had fewer follicles and oocytes than women in the control group (P = 0.001). Duration of folliculogenesis was similar in both groups, as was fertilization rate. A total of 10 patients achieved pregnancy in the study group (34.5%) and 14 (48.3%) in the control group. Although a lower pregnancy rate was observed in patients who had undergone previous ovarian surgery, this difference was not statistically significant (P = 0.424). In conclusion, ovarian surgery for the treatment of endometriosis reduces the ovarian outcome in IVF/ICSI cycles in women >35 years old, and might also decrease pregnancy rates. Therefore, for infertile patients, non-surgical treatment might be a better option to avoid reduction of the ovarian response.

  7. A Phase 3, multicenter, open-label, switchover trial to assess the safety and efficacy of taliglucerase alfa, a plant cell-expressed recombinant human glucocerebrosidase, in adult and pediatric patients with Gaucher disease previously treated with imiglucerase.

    Science.gov (United States)

    Pastores, Gregory M; Petakov, Milan; Giraldo, Pilar; Rosenbaum, Hanna; Szer, Jeffrey; Deegan, Patrick B; Amato, Dominick J; Mengel, Eugen; Tan, Ee Shien; Chertkoff, Raul; Brill-Almon, Einat; Zimran, Ari

    2014-12-01

    Taliglucerase alfa is a β-glucosidase enzyme replacement therapy (ERT) approved in the US and other countries for the treatment of Gaucher disease (GD) in adults and is approved in pediatric and adult patients in Australia and Canada. It is the first approved plant cell-expressed recombinant human protein. A Phase 3, multicenter, open-label, 9-month study assessed safety and efficacy of switching to taliglucerase alfa in adult and pediatric patients with GD treated with imiglucerase for at least the previous 2years. Patients with stable disease were offered taliglucerase alfa treatment using the same dose (9-60U/kg body weight) and regimen of administration (every 2weeks) as imiglucerase. This report summarizes results from 26 adult and 5 pediatric patients who participated in the trial. Disease parameters (spleen and liver volumes, hemoglobin concentration, platelet count, and biomarker levels) remained stable through 9months of treatment in adults and children following the switch from imiglucerase. All treatment-related adverse events were mild or moderate in severity and transient in nature. Exploratory parameters of linear growth and development showed positive outcomes in pediatric patients. These findings provide evidence of the efficacy and safety profile of taliglucerase alfa as an ERT for GD in patients previously treated with imiglucerase. This trial was registered at www.clinicaltrials.gov as # NCT00712348. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Second malignancies in high-dose areas of previous tumor radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Welte, Birgitta; Suhr, Peter; Bottke, Dirk; Bartkowiak, Detlef; Wiegel, Thomas [Dept. of Radiotherapy and Radiation Oncology, Univ. of Ulm (Germany); Doerr, Wolfgang [Dept. of Radiotherapy and Radiation Oncology, Radiobiology Lab., Univ. of Technology Dresden (Germany); Trott, Klaus Ruediger [UCL Cancer Centre, Univ. Coll. London (United Kingdom)

    2010-03-15

    Purpose: To characterize second tumors that developed in or near the high-dose areas of a previous radiotherapy, regarding their frequency, entities, latency, and dose dependence. Patients and Methods: 9,995/15,449 tumor patients of the Radiation Oncology Department in Ulm, Germany, treated between 1981 and 2003, survived at least 1 year after radiotherapy. By long-term follow-up and review of treatment documentation, 100 of them were identified who developed an independent second cancer in or near the irradiated first tumor site. Results: Major primary malignancies were breast cancer (27%), lymphoma (24%), and pelvic gynecologic tumors (17%). Main second tumors were carcinomas of the upper (18%) and lower (12%) gastrointestinal tract, head and neck tumors (10%), lymphoma (10%), breast cancer (9%), sarcoma (9%), and lung cancer (8%). Overall median second tumor latency was 7.4 years (1-42 years). For colorectal cancer it was 3.5 and for leukemia 4.3 years, but for sarcoma 11.7 and for breast cancer 17.1 years. The relatively frequent second tumors of the upper gastrointestinal tract were associated with median radiation doses of 24 Gy. By contrast, second colorectal cancer and sarcoma developed after median doses of 50 Gy. Conclusion: The 5- and 15-year probability to develop a histopathologically independent second tumor in or near the irradiated first tumor site, i.e., after intermediate or high radiation doses, was 0.5% and 2.2%, respectively. To identify potentially radiogenic second malignancies, a follow-up far beyond 5 years is mandatory. The incidence and potential dose-response relationship intermediate will be analyzed by a case-case and a case-control study of the Ulm data. (orig.)

  9. Outcome of trial of scar in patients with previous caesarean section

    International Nuclear Information System (INIS)

    Khan, B.; Bashir, R.; Khan, W.

    2016-01-01

    Medical evidence indicates that 60-80% of women can achieve vaginal delivery after a previous lower segment caesarean section. Proper selection of patients for trial of scar and vigilant monitoring during labour will achieve successful maternal and perinatal outcome. The objective of our study is to establish the fact that vaginal delivery after one caesarean section has a high success rate in patients with previous one caesarean section for non-recurrent cause. Methods: The study was conducted in Ayub Teaching Abbottabad, Gynae-B Unit. All labouring patients, during the study period of five years, with previous one caesarean section and between 37 weeks to 41 weeks of gestation for a non-recurrent cause were included in the study. Data was recorded on special proforma designed for the purpose. Patients who had previous classical caesarean section, more than one caesarean section, and previous caesarean section with severe wound infection, transverse lie and placenta previa in present pregnancy were excluded. Foetal macrosomia (wt>4 kg) and severe IUGR with compromised blood flow on Doppler in present pregnancy were also not considered suitable for the study. Patients who had any absolute contraindication for vaginal delivery were also excluded. Results: There were 12505 deliveries during the study period. Total vaginal deliveries were 8790 and total caesarean sections were 3715. Caesarean section rate was 29.7%. Out of these 8790 patients, 764 patients were given a trial of scar and 535 patients delivered successfully vaginally (70%). Women who presented with spontaneous onset of labour were more likely to deliver vaginally (74.8%) as compared to induction group (27.1%). Conclusion: Trial of vaginal birth after caesarean (VBAC) in selected cases has great importance in the present era of the rising rate of primary caesarean section. (author)

  10. Recommendations for a trans-European dietary assessment method in children between 4 and 14 years

    DEFF Research Database (Denmark)

    Andersen, L. F.; Lioret, S.; Brants, H.

    2011-01-01

    Background/Objectives: The main objective of European Food Consumption Validation (EFCOVAL)-child Project is to define and evaluate a trans-European methodology for undertaking national representative dietary surveys among children in the age group of 4-14 years. In the process of identifying...... was to investigate whether the method (two non-consecutive 24-h dietary recalls (24-HDRs)) suggested for the adults in European Food Consumption Survey Method (EFCOSUM) would be usable for children in the age group between 4 and 14 years. However, all available dietary assessment methods were included...... of 4-14 years. Nevertheless, on the basis of the literature, the recommendations were separated for preschoolers (4-6 years) and schoolchildren (7-14 years). Conclusion: For preschoolers, two non-consecutive days of a structured food record are recommended, using a (for children adapted) picture...

  11. Characteristic of cognitive decline in Parkinson's disease: a 1-year follow-up.

    Science.gov (United States)

    McKinlay, Audrey; Grace, Randolph C

    2011-10-01

    The aim of this study was to track the evolution of cognitive decline in Parkinson's disease (PD) patients 1 year after baseline testing. Thirty-three PD patients, divided according to three previously determined subgroups based on their initial cognitive performance, and a healthy comparison group were reassessed after a 1-year interval. Participants were assessed in the following five domains: Executive Function, Problem Solving, Working Memory/Attention, Memory, and Visuospatial Ability. The PD groups differed on the domains of Executive Function, Problem Solving, and Working Memory, with the most severe deficits being evident for the group that had previously shown the greatest level of impairment. Increased cognitive problems were also associated with decreased functioning in activities of daily living. The most severely impaired group had evidence of global cognitive decline, possibly reflecting a stage of preclinical dementia.

  12. Progress Testing for Medical Students at the University of Auckland: Results from the First Year of Assessments

    Directory of Open Access Journals (Sweden)

    Steven Lillis

    2014-01-01

    Full Text Available Background Progress testing is a method of assessing longitudinal progress of students using a single best answer format pitched at the standard of a newly graduated doctor. Aim To evaluate the results of the first year of summative progress testing at the University of Auckland for Years 2 and 4 in 2013. SUBJECTS: Two cohorts of medical students from Years 2 and 4 of the Medical Program. Methods A survey was administered to all involved students. Open text feedback was also sought. Psychometric data were collected on test performance, and indices of reliability and validity were calculated. Results The three tests showed increased mean scores over time. Reliability of the assessments was uniformly high. There was good concurrent validity. Students believe that progress testing assists in integrating science with clinical knowledge and improve learning. Year 4 students reported improved knowledge retention and deeper understanding. Conclusion Progress testing has been successfully introduced into the Faculty for two separate year cohorts and results have met expectations. Other year cohorts will be added incrementally. Recommendation Key success factors for introducing progress testing are partnership with an experienced university, multiple and iterative briefings with staff and students as well as demonstrating the usefulness of progress testing by providing students with detailed feedback on performance.

  13. Communication skills assessment in the final postgraduate years to established practice: a systematic review.

    Science.gov (United States)

    Gillis, Amy E; Morris, Marie C; Ridgway, Paul F

    2015-01-01

    Communication breakdown is a factor in the majority of all instances of medical error. Despite the importance, a relative paucity of time is invested in communication skills in postgraduate curricula. Our objective is to systematically review the literature to identify the current tools used to assess communication skills in postgraduate trainees in the latter 2 years of training and in established practice. Two reviewers independently reviewed the literature identifying communication skill assessment tools, for postgraduate trainees in the latter 2 years of training and in established practice following Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, and inclusion/exclusion criteria from January 1990 to 15 August 2014. PubMed/CINAHL/ERIC/EMBASE/PsycInfo/Psyc Articles/Cochrane. 222 articles were identified; after review, 34 articles fulfilled criteria for complete evaluation; the majority (26) had a high level of evidence scoring 3 or greater on the Best Evidence Medical Education guide. 22 articles used objective structured clinical examination/standardised patient (SP)-based formats in an assessment or training capacity. Evaluation tools included author-developed questionnaires and validated tools. Nineteen articles demonstrated an educational initiative. The reviewed literature is heterogeneous for objectives and measurement techniques for communication. Observed interactions, with patients or SPs, is the current favoured method of evaluation using author-developed questionnaires. The role of self-evaluation of skill level is questioned. The need for a validated assessment tool for communication skills is highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Gastrointestinal tolerability with ibandronate after previous weekly bisphosphonate treatment

    Directory of Open Access Journals (Sweden)

    Richard Derman

    2009-09-01

    Full Text Available Richard Derman1, Joseph D Kohles2, Ann Babbitt31Department of Obstetrics and Gynecology, Christiana Hospital, Newark, DE, USA; 2Roche, Nutley, NJ, USA; 3Greater Portland Bone and Joint Specialists, Portland, ME, USAAbstract: Data from two open-label trials (PRIOR and CURRENT of women with postmenopausal osteoporosis or osteopenia were evaluated to assess whether monthly oral and quarterly intravenous (IV ibandronate dosing improved self-reported gastrointestinal (GI tolerability for patients who had previously experienced GI irritation with bisphosphonate (BP use. In PRIOR, women who had discontinued daily or weekly BP treatment due to GI intolerance received monthly oral or quarterly IV ibandronate for 12 months. The CURRENT subanalysis included women receiving weekly BP treatment who switched to monthly oral ibandronate for six months. GI symptom severity and frequency were assessed using the Osteoporosis Patient Satisfaction Questionnaire™. In PRIOR, mean GI tolerability scores increased significantly at month 1 from screening for both treatment groups (oral: 79.3 versus 54.1; IV: 84.4 versus 51.0; p < 0.001 for both. Most patients reported improvement in GI symptom severity and frequency from baseline at all post-screening assessments (>90% at Month 10. In the CURRENT subanalysis >60% of patients reported improvements in heartburn or acid reflux and >70% indicated improvement in other stomach upset at month 6. Postmenopausal women with GI irritability with daily or weekly BPs experienced improvement in symptoms with extended dosing monthly or quarterly ibandronate compared with baseline.Keywords: ibandronate, osteoporosis, bisphosphonate, gastrointestinal

  15. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up.

    Science.gov (United States)

    Walczak, Monika; Esbjørn, Barbara H; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise

    2017-06-01

    Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.

  16. MR findings of primary bone lymphoma in a 15-year-old girl: emphasis on diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Garrett, Kevin M.; Kim, Hee Kyung; Emery, Kathleen H. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Stanek, Jerzy [Cincinnati Children' s Hospital Medical Center, Department of Pathology, Cincinnati, OH (United States)

    2011-05-15

    We report a case of primary bone lymphoma (PBL) in a 15-year-old girl assessed by MR imaging with diffusion-weighted imaging (DWI). DWI has been shown to help characterize the cellularity of solid tumors and this case correlates well with previous data. (orig.)

  17. COMPARATIVE ASSESSMENT OF LEARNING OUTCOMES OF SECOND YEAR STUDENTS IN THEIR FPD EDUCATION

    Directory of Open Access Journals (Sweden)

    Mariana Dimova-Gabrovska

    2017-06-01

    Full Text Available The objective of the authors is to analyse the results of students in their second year of study in Dental Medicine in regards to their fixed partial dentures (FPD education. Material and Methods: The article is based on an analysis of the work of94 students in second year in the Faculty of dental medicine Sofia (56 females, 38 males, who were rated using a test and practical work marks during the submission of the FPD’s that they fabricated during the 4th semester practices. Results: The analysis indicates that only 2% of the students that were assessed with a mark “average 3” or “good 4” have found up to four correct answers in their tests. The percentage of students who’s practical work was assessed with marks “very good 5” or “excellent 6” and gave five or more correct answers to the test is 83%. With 15% of the student, a major discrepancy between their theoretical knowledge and practical results was noticed. Conclusion: Further researches are needed regarding the introduction in the educational program in Introduction of Prosthetic Dentistry in the Faculty of Dental Medicine of brief test examination in the specific topics.

  18. Objectively assessed physical activity and aerobic fitness in a population-based sample of Norwegian 9- and 15-year-olds

    DEFF Research Database (Denmark)

    Kolle, E; Steene-Johannessen, J; Andersen, Lars Bo

    2010-01-01

    The present study described current physical activity, determined compliance with physical activity guidelines and assessed aerobic fitness in a nationally representative sample of 9- and 15-year-olds in Norway. In 2005-2006, 2299 children and adolescents were randomly recruited. The participation...... rate was 89% and 74% among the 9- and 15-year-olds, respectively. Physical activity was assessed objectively by accelerometry, and aerobic fitness was measured directly as peak oxygen uptake during a cycle ergometry test. Boys were more physically active than girls, and 9-year-olds were substantially......, 48.2 (7.1) mL/min/kg; 9-year-old girls, 42.9 (6.7) mL/min/kg; and 15-year-old girls 41.1 (6.0) mL/min/kg and 15-year-old boys 51.9 (8.0) mL/min/kg. Because of the high participation rate, this study provides a good description of the physical activity and aerobic fitness in the young population...

  19. Concurrent Chemoradiotherapy Followed by Consolidation Chemotherapy With Bi-Weekly Docetaxel and Carboplatin for Stage III Unresectable, Non-Small-Cell Lung Cancer: Clinical Application of a Protocol Used in a Previous Phase II Study

    International Nuclear Information System (INIS)

    Saitoh, Jun-Ichi; Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro; Sakai, Hiroshi; Kurimoto, Futoshi; Kato, Shingo; Shibuya, Kei

    2012-01-01

    Purpose: To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC). Methods and Materials: Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m 2 , and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy. Results: The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade ≥3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade ≥3 severity were observed in 2.6% and 1.7% of patients, respectively. Conclusions: The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

  20. Concurrent Chemoradiotherapy Followed by Consolidation Chemotherapy With Bi-Weekly Docetaxel and Carboplatin for Stage III Unresectable, Non-Small-Cell Lung Cancer: Clinical Application of a Protocol Used in a Previous Phase II Study

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, Jun-Ichi, E-mail: junsaito@sannet.ne.jp [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Sakai, Hiroshi; Kurimoto, Futoshi [Division of Respiratory Disease, Saitama Cancer Center, Saitama (Japan); Kato, Shingo [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Shibuya, Kei [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan)

    2012-04-01

    Purpose: To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC). Methods and Materials: Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m{sup 2}, and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy. Results: The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade {>=}3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade {>=}3 severity were observed in 2.6% and 1.7% of patients, respectively. Conclusions: The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

  1. Nuclear thermal rocket clustering: 1, A summary of previous work and relevant issues

    International Nuclear Information System (INIS)

    Buksa, J.J.; Houts, M.G.

    1991-01-01

    A general review of the technical merits of nuclear thermal rocket clustering is presented. A summary of previous analyses performed during the Rover program is presented and used to assess clustering in the context of projected Space Exploration Initiative missions. A number of technical issues are discussed including cluster reliability, engine-out operation, neutronic coupling, shutdown core power generation, shutdown reactivity requirements, reactor kinetics, and radiation shielding. 7 refs., 3 figs., 2 tabs

  2. Long-term safety and outcome of fludarabine, cyclophosphamide and mitoxantrone (FCM) regimen in previously untreated patients with advanced follicular lymphoma: 12 years follow-up of a phase 2 trial.

    Science.gov (United States)

    Magnano, Laura; Montoto, Silvia; González-Barca, Eva; Briones, Javier; Sancho, Juan Manuel; Muntañola, Ana; Salar, Antonio; Besalduch, Joan; Escoda, Lourdes; Moreno, Carol; Domingo-Domenech, Eva; Estany, Cristina; Oriol, Albert; Altés, Albert; Pedro, Carmen; Gardella, Santiago; Asensio, Antoni; Vivancos, Pilar; Fernández de Sevilla, Alberto; Ribera, Josep María; Colomer, Dolors; Campo, Elias; López-Guillermo, Armando

    2017-04-01

    Fludarabine combinations are very affective in follicular lymphoma (FL) with high rates of complete response and prolonged survival. However, late toxicities could be a concern. The aim of the present study was to analyze the long-term impact on survival, relapse and late toxicities of a trial of treatment with fludarabine, mitoxantrone and cyclophosphamide (FCM regimen) for untreated patients with advanced stage FL. One hundred and twenty patients enrolled in a phase 2 trial of treatment with FCM regimen between 2000 and 2003 were evaluated. After a median follow-up of 12 years, 52 patients eventually relapsed/progressed with 10 year progression-free survival (PFS) of 46 %. Ten patients showed histological transformation to aggressive lymphoma with a risk of transformation of 2 and 9 % at 5 and 10 years, respectively. Three patients developed therapy-related myelodysplastic syndrome/acute myeloid leukaemia (MDS/AML) and seven solid neoplasms with an overall risk of 3 and 8 % at 5 and 10 years, respectively. Twenty-six patients eventually died during the follow-up. Overall survival at 10 years was 83 %. In conclusion, FCM regimen allows excellent long-lasting response in previously untreated patients with FL. The incidence of late events including histological transformation and secondary neoplasia is low but not negligible.

  3. Assessing undergraduate nursing students in clinical practice: do preceptors use assessment strategies?

    Science.gov (United States)

    McCarthy, Bridie; Murphy, Siobhan

    2008-04-01

    Health care organisations such as the World Health Organisation (WHO) and An Bord Altranais (ABA, The Irish Nursing Registration Board) demand higher standards of new graduate nurses than heretofore. This is in conjunction with the implementation of degree programmes for undergraduate nurse education. These organisations stipulate that graduates must be well-educated, accountable, and can demonstrate the skills of a safe, caring and competent decision-making practitioner. The Bachelor of Science (BSc) four-year degree programme for undergraduate nurse education was introduced in Ireland in 2002, and is provided in universities and colleges of higher education throughout The Republic of Ireland. During the implementation process, each university and college of higher education developed a range of assessment strategies to clinically assess students. Preceptor nurses were subsequently assigned the responsibility of clinically assessing students, a remit previously undertaken by Clinical Ward/Unit Nurse Managers. Preceptors are qualified nurses, working in clinical units who are specially prepared to support BSc students during clinical placements. The purpose of this study was to explore to what extent preceptor nurses use the devised assessment strategies to clinically assess BSc students in one university in The Republic of Ireland. Data were collected by using a questionnaire distributed to all known preceptors in General, Psychiatric and Intellectual Disability nursing, during year four of the first cycle of the BSc programme. Findings from this descriptive study revealed that many preceptors were inexperienced, did not fully comprehend the assessment process and were not applying all of the recommended assessment strategies when assessing students in clinical practice. In light of these findings suggestions are made in the context of further research, management and education.

  4. Pain and functional impairment 6 years after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Bay-Nielsen, Morten; Kehlet, Henrik

    2006-01-01

    2002 and June 2003 (n=1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224...... and subsequent sexual dysfunction represent a clinically significant problem in about 3% of younger male patients with a previous inguinal herniorrhaphy. Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors.......To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation...

  5. Student Acceptance and Application of Peer Assessment in a Final Year Genetics Undergraduate Oral Presentation

    Science.gov (United States)

    Verkade, Heather; Bryson-Richardson, Robert J.

    2013-01-01

    Undergraduate students benefit from observation of each other's oral presentations through both exposure to content and observation of presentation style. In order to increase the engagement and reflection of final year students in an oral presentation task, a peer assessment component was introduced using a rubric that emphasised scientific…

  6. 49 CFR 173.23 - Previously authorized packaging.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Previously authorized packaging. 173.23 Section... REQUIREMENTS FOR SHIPMENTS AND PACKAGINGS Preparation of Hazardous Materials for Transportation § 173.23 Previously authorized packaging. (a) When the regulations specify a packaging with a specification marking...

  7. Fine tuning the teaching methods used for second year university mathematics

    Science.gov (United States)

    Lim, L. L.; Thiel, D. V.; Searles, Debra J.

    2012-01-01

    Second year mathematics is a compulsory course for all students enrolled in engineering and mathematics programmes at the university, and it is taken by approximately 120 students each year. The pass rate of the course had been below expectations in the past years. In order to improve the predicament, quizzes which provided a mark incentive were introduced in 2009 as a pilot study. The pass rate was improved compared to the previous year. Hence, quizzes were added to the course assessment in 2010. This article compares and reports the outcome to the 2009 and 2010 quizzes based on the students' feedback and results at the end of the course. From the data of the surveys, students welcomed the regular quizzes, although the pass rate still did not meet the expectation.

  8. Development of Attention to Faces during the First 3 Years: Influences of Stimulus Type

    Directory of Open Access Journals (Sweden)

    Klaus Libertus

    2017-11-01

    Full Text Available The development of attention toward faces was explored during the first 3 years of life in 54 children aged between 3 and 36 months. In contrast to previous research, attention to faces was assessed using both static images and a dynamic video sequence in the same participants. Separate analyses at each age and exploratory longitudinal analyses indicate a preference for faces during the first year, followed by a decline during the second year. These results suggest that attention to faces does not follow a linear increasing pattern over development, and that social attention patterns are influenced by stimulus characteristics.

  9. Assessment of China's renewable energy contribution during the 12th Five Year Plan

    International Nuclear Information System (INIS)

    Hong, Lixuan; Zhou, Nan; Fridley, David; Raczkowski, Chris

    2013-01-01

    In recent years, China has been ambitious in investing and developing renewable energy technologies, aiming to enhance its energy security, mitigate its energy-related CO 2 emissions and develop renewable energy industry. The 12th Five Year Plan (2011–2015) has set clear targets on installed capacities of different renewable energy technologies. This study aimed to assess the possible contribution of 12th Five Year Plan for China's future energy system and identify factors that might influence its impacts. First, current status of renewable energy development in China has been reviewed. Then several energy scenarios have been developed in an hourly simulation using an energy system analysis tool EnergyPLAN. It was identified that existing grid bottleneck would greatly reduce the potential contribution of renewable installations in terms of share of renewable electricity generation, share of non-fossil fuels in primary energy and system CO 2 emissions. In contrast, improving technical performance of renewable energy technologies and sectoral energy efficiency plays an important role in increasing the share of renewables and promoting China’s energy system transition. Finally, some policy suggestions were drawn to facilitate a better implementation of the renewable energy plan. - Highlights: • China's renewable energy contribution during the 12th Five Year Plan was assessed. • Non-fossil fuel targets in primary energy for 2015 and 2020 could be easily achieved. • Grid bottlenecks severely decrease the share of RES-E in electricity generation through the 12th Five Year Period. • Improved technical performance of renewable technologies and sectoral energy efficiency are extremely important for achieving higher RES-E share. • Several policy suggestions were drawn

  10. The Impact of Multi-Year Math Response to Intervention as Measured by Smarter Balanced Assessments

    Science.gov (United States)

    Park, Maysoon Mohamad

    2017-01-01

    This quantitative study evaluated how two consecutive years of math Response to Intervention (RtI) demonstrated its effectiveness on 995 fifth grade students within the School District A (SDA) on Smarter Balanced (SB) assessments. Research questions: "What is the relationship between the duration of math RtI implementation and math…

  11. International Space Station Environmental Control and Life Support System Previous Year Status for 2013 - 2014

    Science.gov (United States)

    Williams, David E.; Gentry, Gregory J.

    2015-01-01

    The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the past year and the impacts of the international partners' activities on them, covering the period of time between March 2013 and February 2014. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the commercial crew vehicles, and work to try and extend ISS service life.

  12. 78 FR 52761 - Proposed Information Collection; Comment Request; One Year Assessment of the Social and Economic...

    Science.gov (United States)

    2013-08-26

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; One Year Assessment of the Social and Economic Impacts of Hurricane Sandy on New... Atmospheric Administration, Commerce. ACTION: Notice. SUMMARY: The Department of Commerce, as part of its...

  13. Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack

    DEFF Research Database (Denmark)

    Easton, J Donald; Lopes, Renato D; Bahit, M Cecilia

    2012-01-01

    In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk of stroke. We therefore aimed to assess the efficacy ...

  14. If First-Year Students Are Afraid of Public Speaking Assessments What Can Teachers Do to Alleviate Such Anxiety?

    Science.gov (United States)

    Nash, Gregory; Crimmins, Gail; Oprescu, Florin

    2016-01-01

    Public speaking and oral assessments are common in higher education, and they can be a major cause of anxiety and stress for students. This study was designed to measure the student experience of public speaking assessment tasks in a mandatory first-year course at a regional Australian university. The research conducted was an instrumental case…

  15. Setting Them up for Success: Assessing a Pre-Research Assignment for First-Year International Students

    Science.gov (United States)

    Avery, Susan

    2017-01-01

    As the international student population continues to grow, librarians must adjust their instruction to meet the needs of students who are adapting to a new country, culture, and language. This study assesses first-year international students as they engage in the research process through the completion of concept maps that precede database…

  16. Differential effects of two types of formative assessment in predicting performance of first-year medical students.

    Science.gov (United States)

    Krasne, Sally; Wimmers, Paul F; Relan, Anju; Drake, Thomas A

    2006-05-01

    Formative assessments are systematically designed instructional interventions to assess and provide feedback on students' strengths and weaknesses in the course of teaching and learning. Despite their known benefits to student attitudes and learning, medical school curricula have been slow to integrate such assessments into the curriculum. This study investigates how performance on two different modes of formative assessment relate to each other and to performance on summative assessments in an integrated, medical-school environment. Two types of formative assessment were administered to 146 first-year medical students each week over 8 weeks: a timed, closed-book component to assess factual recall and image recognition, and an un-timed, open-book component to assess higher order reasoning including the ability to identify and access appropriate resources and to integrate and apply knowledge. Analogous summative assessments were administered in the ninth week. Models relating formative and summative assessment performance were tested using Structural Equation Modeling. Two latent variables underlying achievement on formative and summative assessments could be identified; a "formative-assessment factor" and a "summative-assessment factor," with the former predicting the latter. A latent variable underlying achievement on open-book formative assessments was highly predictive of achievement on both open- and closed-book summative assessments, whereas a latent variable underlying closed-book assessments only predicted performance on the closed-book summative assessment. Formative assessments can be used as effective predictive tools of summative performance in medical school. Open-book, un-timed assessments of higher order processes appeared to be better predictors of overall summative performance than closed-book, timed assessments of factual recall and image recognition.

  17. Youth suicide: an insight into previous hospitalisation for injury and sociodemographic conditions from a nationwide cohort study.

    Science.gov (United States)

    Zambon, Francesco; Laflamme, Lucie; Spolaore, Paolo; Visentin, Cristiana; Hasselberg, Marie

    2011-06-01

    This study investigates the degree to which a previous hospitalisation for injury of any intent is a risk of subsequent youth suicide and whether this association is influenced by family socioeconomic status or economic stress. A nationwide register-based cohort study was conducted covering all Swedish subjects born between January 1977 and December 1991 (N=1,616,342, male/female ratio=1.05). The cohort subjects were followed-up from January 1998 to December 2003, when aged 7-26 years. Poisson regression and the likelihood ratio test (95% CI) were used to assess the age-adjusted effect of hospitalisation for injuries of various intent on youth suicide and its effect once adjusted for family sociodemographic and social circumstances. Each set of exposures was associated independently and significantly with suicide mortality. Being hospitalised for self-inflicted injuries or injuries of undetermined intent was associated with a risk of suicide 36 to 47 times, respectively, that of subjects never hospitalised in the period under study (95% CI 28.36 to 45.58 and 26.67 to 83.87 for self-inflicted injuries and for events of undetermined intent, respectively; overall psuicide (RR 3.08; 95% CI 2.26 to 4.19). These effects were solid and not substantially altered after adjustment for family demographic and socioeconomic circumstances. A strong association exists between previous hospitalisation for injury of any intent and youth suicide. The association is robust and unaltered by family socioeconomic circumstances.

  18. Anxiety and Depression in Tinnitus Patients: 5-Year Follow-Up Assessment after Completion of Habituation Therapy

    Directory of Open Access Journals (Sweden)

    Eva-Signe Falkenberg

    2012-01-01

    Full Text Available Treatment programs based on a neurophysiological model have shown a positive effect on anxiety and depression in tinnitus patients. The aim of this paper was to assess the long-term effect of tinnitus habituation therapy. Sixty-eight individuals were treated with a comprehensive therapy program. The degree of anxiety and depression was assessed before, after, and five years after intervention using the Hospital Anxiety and Depression Scale. The positive and significant changes achieved after habituation therapy (pre = 1.10, post = 0.92 for anxiety and pre = 0.77, post = 0.62 for depression were maintained five years after treatment ended (0.87 for anxiety and 0.52 for depression. A regression analysis revealed that individual evaluation of the treatment lectures, self-reported health condition, individual experiences of hyperacusis, and hearing loss could explain 44.3% of the variation in anxiety and 30.5% of the variation in depression posttreatment. Five years after, individual evaluation of the treatment lectures and self-reported health condition explained 22.2% of the variation in anxiety. These factors and individual experiences of hyperacusis could further explain 34.9% of the variation in depression. The effect of a neurophysiologic-based management treatment was maintained five years after treatment ended, indicating that the patients continued the improvement process without becoming dependent on professionals.

  19. PARS risk charts: A 10-year study of risk assessment for cardiovascular diseases in Eastern Mediterranean Region.

    Directory of Open Access Journals (Sweden)

    Nizal Sarrafzadegan

    Full Text Available This study was designed to develop a risk assessment chart for the clinical management and prevention of the risk of cardiovascular disease (CVD in Iranian population, which is vital for developing national prevention programs. The Isfahan Cohort Study (ICS is a population-based prospective study of 6504 Iranian adults ≥35 years old, followed-up for ten years, from 2001 to 2010. Behavioral and cardiometabolic risk factors were examined every five years, while biennial follow-ups for the occurrence of the events was performed by phone calls or by verbal autopsy. Among these participants, 5432 (2784 women, 51.3% were CVD free at baseline examination and had at least one follow-up. Cox proportional hazard regression was used to predict the risk of ischemic CVD events, including sudden cardiac death due to unstable angina, myocardial infarction, and stroke. The model fit statistics such as area under the receiver-operating characteristic (AUROC, calibration chi-square and the overall bias were used to assess the model performance. We also tested the Framingham model for comparison. Seven hundred and five CVD events occurred during 49452.8 person-years of follow-up. The event probabilities were calculated and presented color-coded on each gender-specific PARS chart. The AUROC and Harrell's C indices were 0.74 (95% CI, 0.72-0.76 and 0.73, respectively. In the calibration, the Nam-D'Agostino χ2 was 10.82 (p = 0.29. The overall bias of the proposed model was 95.60%. PARS model was also internally validated using cross-validation. The Android app and the Web-based risk assessment tool were also developed as to have an impact on public health. In comparison, the refitted and recalibrated Framingham models, estimated the CVD incidence with the overall bias of 149.60% and 128.23% for men, and 222.70% and 176.07% for women, respectively. In conclusion, the PARS risk assessment chart is a simple, accurate, and well-calibrated tool for predicting a 10-year

  20. Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization.

    Science.gov (United States)

    Pikwer, Andreas; Acosta, Stefan; Kölbel, Tilo; Åkeson, Jonas

    2010-01-01

    This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization. Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively. Sixteen patients aged 48 years (range 0.5-76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for hemodialysis had had significantly fewer individual catheters inserted compared with 5 patients cannulated for nutritional support (mean 3.6 vs. 10.2, pvenous occlusions. Patients were subjected to recanalization (n=2), recanalization and percutaneous transluminal angioplasty (n=5), or stenting for vena cava superior syndrome (n=1) prior to catheter insertion. The remaining 8 patients were cannulated by avoiding the occluded route. Central venous occlusion occurs particularly in patients under hemodialysis and with a history of multiple central venous catheterizations with large-diameter catheters and/or long total indwelling time periods. Patients with central venous occlusion verified by CT or MRT venography and need for central venous access should be referred for endovascular intervention.

  1. Increased risk of default among previously treated tuberculosis cases in the Western Cape Province, South Africa.

    Science.gov (United States)

    Marx, F M; Dunbar, R; Hesseling, A C; Enarson, D A; Fielding, K; Beyers, N

    2012-08-01

    To investigate, in two urban communities with high tuberculosis (TB) incidence and high rates of TB recurrence, whether a history of previous TB treatment is associated with treatment default. Retrospective cohort study of TB cases with an episode of treatment recorded in the clinic-based treatment registers between 2002 and 2007. Probabilistic record linkage was used to ascertain treatment history of TB cases back to 1996. Based on the outcome of their most recent previous treatment episode, previously treated cases were compared to new cases regarding their risk of treatment default. Previous treatment success (adjusted odds ratio [aOR] 1.79; 95%CI 1.17-2.73), previous default (aOR 6.18, 95%CI 3.68-10.36) and previous failure (aOR 9.72, 95%CI 3.07-30.78) were each independently associated with treatment default (P default were male sex (P = 0.003) and age 19-39 years (P risk of treatment default, even after previous successful treatment. This finding is of particular importance in a setting where recurrent TB is very common. Adherence to treatment should be ensured in new and retreatment cases to increase cure rates and reduce transmission of TB in the community.

  2. Underestimation of Severity of Previous Whiplash Injuries

    Science.gov (United States)

    Naqui, SZH; Lovell, SJ; Lovell, ME

    2008-01-01

    INTRODUCTION We noted a report that more significant symptoms may be expressed after second whiplash injuries by a suggested cumulative effect, including degeneration. We wondered if patients were underestimating the severity of their earlier injury. PATIENTS AND METHODS We studied recent medicolegal reports, to assess subjects with a second whiplash injury. They had been asked whether their earlier injury was worse, the same or lesser in severity. RESULTS From the study cohort, 101 patients (87%) felt that they had fully recovered from their first injury and 15 (13%) had not. Seventy-six subjects considered their first injury of lesser severity, 24 worse and 16 the same. Of the 24 that felt the violence of their first accident was worse, only 8 had worse symptoms, and 16 felt their symptoms were mainly the same or less than their symptoms from their second injury. Statistical analysis of the data revealed that the proportion of those claiming a difference who said the previous injury was lesser was 76% (95% CI 66–84%). The observed proportion with a lesser injury was considerably higher than the 50% anticipated. CONCLUSIONS We feel that subjects may underestimate the severity of an earlier injury and associated symptoms. Reasons for this may include secondary gain rather than any proposed cumulative effect. PMID:18201501

  3. Effectiveness of a 2-year menopause medicine curriculum for obstetrics and gynecology residents.

    Science.gov (United States)

    Christianson, Mindy S; Washington, Chantel I; Stewart, Katherine I; Shen, Wen

    2016-03-01

    Previous work has shown American obstetrics and gynecology (OB/GYN) residents are lacking in menopause training. Our objective was to assess the effectiveness of a 2-year menopause medicine curriculum in improving OB/GYN residents' knowledge and self-assessed competency in menopause topics. We developed a menopause medicine-teaching curriculum for OB/GYN residents at our academic hospital-based residency program. The 2-year curriculum was composed of year 1: four 1-hour lectures and one 2-hour lab with cases presentations, and year 2: three 1-hour lectures and one 2-hour lab. Core topics included menopause physiology, hormone therapy, breast health, bone health, cardiovascular disease, and autoimmune disease. Pre- and posttests assessed resident knowledge and comfort in core topics, and a pre- and postcurriculum survey assessed utility and learning satisfaction. From July 2011 to June 2013, 34 OB/GYN residents completed the menopause curriculum annually with an average attendance at each module of 23 residents. Pre-/posttest scores improved from a mean pretest score of 57.3% to a mean posttest score of 78.7% (P menopause patients with 75.8% reporting feeling "barely comfortable" and 8.4% feeling "not at all comfortable." After the 2-year curriculum, 85.7% reported feeling "comfortable/very comfortable" taking care of menopause patients. The majority of residents (95.2%) reported the menopause curriculum was "extremely useful." A 2-year menopause medicine curriculum for OB/GYN residents utilizing lectures and a lab with case studies is an effective modality to improve resident knowledge required to manage menopause patients.

  4. The impact of previous knee injury on force plate and field-based measures of balance.

    Science.gov (United States)

    Baltich, Jennifer; Whittaker, Jackie; Von Tscharner, Vinzenz; Nettel-Aguirre, Alberto; Nigg, Benno M; Emery, Carolyn

    2015-10-01

    Individuals with post-traumatic osteoarthritis demonstrate increased sway during quiet stance. The prospective association between balance and disease onset is unknown. Improved understanding of balance in the period between joint injury and disease onset could inform secondary prevention strategies to prevent or delay the disease. This study examines the association between youth sport-related knee injury and balance, 3-10years post-injury. Participants included 50 individuals (ages 15-26years) with a sport-related intra-articular knee injury sustained 3-10years previously and 50 uninjured age-, sex- and sport-matched controls. Force-plate measures during single-limb stance (center-of-pressure 95% ellipse-area, path length, excursion, entropic half-life) and field-based balance scores (triple single-leg hop, star-excursion, unipedal dynamic balance) were collected. Descriptive statistics (mean within-pair difference; 95% confidence intervals) were used to compare groups. Linear regression (adjusted for injury history) was used to assess the relationship between ellipse-area and field-based scores. Injured participants on average demonstrated greater medio-lateral excursion [mean within-pair difference (95% confidence interval); 2.8mm (1.0, 4.5)], more regular medio-lateral position [10ms (2, 18)], and shorter triple single-leg hop distances [-30.9% (-8.1, -53.7)] than controls, while no between group differences existed for the remaining outcomes. After taking into consideration injury history, triple single leg hop scores demonstrated a linear association with ellipse area (β=0.52, 95% confidence interval 0.01, 1.01). On average the injured participants adjusted their position less frequently and demonstrated a larger magnitude of movement during single-limb stance compared to controls. These findings support the evaluation of balance outcomes in the period between knee injury and post-traumatic osteoarthritis onset. Copyright © 2015 Elsevier Ltd. All rights

  5. A 10-Year Assessment of Information and Communication Technology Tasks Required in Undergraduate Agriculture Courses

    Science.gov (United States)

    Edgar, Leslie D.; Johnson, Donald M.; Cox, Casandra

    2012-01-01

    This study sought to assess required information and communication technology (ICT) tasks in selected undergraduate agriculture courses in a land-grant university during a 10-year period. Selected agriculture faculty members in the fall 1999 (n = 63), 2004 (n = 55), and 2009 (n = 64) semesters were surveyed to determine the ICT tasks they required…

  6. Assess Yourself! How Did You Do This Year?

    Science.gov (United States)

    Easton, Lois Brown

    2011-01-01

    Most teachers look back on their first year (or years) of teaching with humility, many with some regret. The author stresses that teachers are always learners, especially so in their first years. At the beginning of each year, they start over again with new students. A learning teacher takes risks and makes mistakes but derives new information,…

  7. Exercise induced ST elevation and residual myocardial ischemia in previous myocardial infarction

    International Nuclear Information System (INIS)

    Shimonagata, Tsuyoshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Saito, Muneyasu; Sumiyoshi, Tetsuya

    1987-01-01

    The purpose of this study was to evaluate the clinical significance of stress induced ST elevation on infarcted area in 65 patients with previous myocardial infarction (single vessel disease) who had stress thallium scan. Stress induced ST changes on infarcted area were compared with quantitative assessment of myocardial ischemia (thallium ischemic score; TIS) and extent of myocardial infarction (defect score; DS) derived from circumferential profile analysis. In patients with previous myocardial infarction in less than 3 month from the onset (n = 36), left ventricular ejection fraction (LVEF) and extent of abnormal LV wall motion were not significantly different between patients with stress induced ST elevation ( ≥ 2 mm, n = 26) and those with stress induced ST elevation ( < 2 mm, n = 10), while, in patients with previous myocardial infarction in more than 3 month (n = 29), patients with stress induced ST elevation ( ≥ 2 mm, n = 15) showed left ventricular dyskinesis more frequently than those with ST elevation ( < 2 mm, n = 14). In addition, the former showed significantly higher DS and significantly lower TIS than the latter. In patients with previous myocardial infarction in less than 3 month, patients with ST elevation ( ≥ 2 mm, n = 15) with prominent upright T wave (n = 15) had transient thallium defect in infarcted area in 73 % and they had significantly higher LVEF and TIS than those with ST elevation ( < 2 mm, n = 11). These results indicated that ST elevation in infarcted area reflect different significance according to the recovery of injured myocardium and stress induced ST elevation with prominent upright T wave in infarcted area reflect residual myocardial ischemia in less than 3 month from the onset of myocardial infarction. (author)

  8. Survival of dental implants placed in sites of previously failed implants.

    Science.gov (United States)

    Chrcanovic, Bruno R; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    2017-11-01

    To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure. Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated. 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents. Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. A diagnostic dilemma: Left-sided appendicitis in a 10 year old boy with previously undiagnosed intestinal malrotation. A case report

    Directory of Open Access Journals (Sweden)

    Ashvini Shekhar

    2015-01-01

    Conclusion: Left sided acute appendicitis is a diagnostic dilemma, thus often leading to management delays. It is pertinent to remember that malrotation of the gut is more common than previously thought, and not just a disease of infancy. It is advisable to consider imaging studies while balancing the risk-benefit-ratio of radiation exposure, especially in paediatric cases to cinch the diagnosis.

  10. The Next Generation of Risk Assessment Multi-Year Study—Highlights of Findings, Applications to Risk Assessment, and Future Directions

    Science.gov (United States)

    Cote, Ila; Andersen, Melvin E.; Ankley, Gerald T.; Barone, Stanley; Birnbaum, Linda S.; Boekelheide, Kim; Bois, Frederic Y.; Burgoon, Lyle D.; Chiu, Weihsueh A.; Crawford-Brown, Douglas; Crofton, Kevin M.; DeVito, Michael; Devlin, Robert B.; Edwards, Stephen W.; Guyton, Kathryn Z.; Hattis, Dale; Judson, Richard S.; Knight, Derek; Krewski, Daniel; Lambert, Jason; Maull, Elizabeth Anne; Mendrick, Donna; Paoli, Gregory M.; Patel, Chirag Jagdish; Perkins, Edward J.; Poje, Gerald; Portier, Christopher J.; Rusyn, Ivan; Schulte, Paul A.; Simeonov, Anton; Smith, Martyn T.; Thayer, Kristina A.; Thomas, Russell S.; Thomas, Reuben; Tice, Raymond R.; Vandenberg, John J.; Villeneuve, Daniel L.; Wesselkamper, Scott; Whelan, Maurice; Whittaker, Christine; White, Ronald; Xia, Menghang; Yauk, Carole; Zeise, Lauren; Zhao, Jay; DeWoskin, Robert S.

    2016-01-01

    Background: The Next Generation (NexGen) of Risk Assessment effort is a multi-year collaboration among several organizations evaluating new, potentially more efficient molecular, computational, and systems biology approaches to risk assessment. This article summarizes our findings, suggests applications to risk assessment, and identifies strategic research directions. Objective: Our specific objectives were to test whether advanced biological data and methods could better inform our understanding of public health risks posed by environmental exposures. Methods: New data and methods were applied and evaluated for use in hazard identification and dose–response assessment. Biomarkers of exposure and effect, and risk characterization were also examined. Consideration was given to various decision contexts with increasing regulatory and public health impacts. Data types included transcriptomics, genomics, and proteomics. Methods included molecular epidemiology and clinical studies, bioinformatic knowledge mining, pathway and network analyses, short-duration in vivo and in vitro bioassays, and quantitative structure activity relationship modeling. Discussion: NexGen has advanced our ability to apply new science by more rapidly identifying chemicals and exposures of potential concern, helping characterize mechanisms of action that influence conclusions about causality, exposure–response relationships, susceptibility and cumulative risk, and by elucidating new biomarkers of exposure and effects. Additionally, NexGen has fostered extensive discussion among risk scientists and managers and improved confidence in interpreting and applying new data streams. Conclusions: While considerable uncertainties remain, thoughtful application of new knowledge to risk assessment appears reasonable for augmenting major scope assessments, forming the basis for or augmenting limited scope assessments, and for prioritization and screening of very data limited chemicals. Citation: Cote I

  11. Assessing third-year medical students' ability to address a patient's spiritual distress using an OSCE case.

    Science.gov (United States)

    McEvoy, Mimi; Schlair, Sheira; Sidlo, Zsuzsanna; Burton, William; Milan, Felise

    2014-01-01

    To inform curricular development by assessing the ability of third-year medical students to address a patient's spiritual distress during an acute medical crisis in the context of an objective structured clinical examination (OSCE) case. During March and April 2010, 170 third-year medical students completed an eight-station videotaped OSCE at Albert Einstein College of Medicine of Yeshiva University. One of the standardized patients (SPs) was a 65-year-old man with acute chest pain who mentioned his religious affiliation and fear of dying. If prompted, he revealed his desire to speak with a chaplain. The SP assessed students' history taking, physical examination, and communication skills. In a postencounter written exercise, students reported their responses to the patient's distress via four open-ended questions. Analysis of the postencounter notes was conducted by three coders for emergent themes. Clinical skills performance was compared between students who reported making chaplain referral and those who did not. A total of 108 students (64%) reported making a chaplain referral; 4 (2%) directly addressed the patient's religious/spiritual beliefs. Students' clinical performance scores showed no significant association with whether they made a chaplain referral. Findings suggest that the majority of medical students without robust training in addressing patients' spiritual needs can make a chaplain referral when faced with a patient in spiritual crisis. Yet, few students explicitly engaged the patient in a discussion of his beliefs. Thus, future studies are needed to develop more precise assessment measures that can inform development in spirituality and medicine curricula.

  12. Ultrasound evaluation of liver disease in cystic fibrosis as part of an annual assessment clinic: A 9-year review

    International Nuclear Information System (INIS)

    Williams, Stuart M.; Goodman, Robin; Thomson, Anne; McHugh, Kieran; Lindsell, David R.M.

    2002-01-01

    AIM: To review 9 years of annual assessment data in cystic fibrosis (CF) and evaluate the frequency of hepatobiliary abnormalities and the correlation between ultrasound and biochemical findings. MATERIALS AND METHODS: Over a 9-year period (1990-99), 168 children (age range 1-18 years) with CF have undergone an annual assessment which has included clinical, biochemical and ultrasonographic evaluation of the hepatobiliary system. We have retrospectively reviewed the sequential ultrasound reports and correlated them with the contemporaneous biochemical results. RESULTS: A total of 725 ultrasound examinations were performed over the review period. Sixty patients had at least one examination showing an abnormality of liver echo texture and in 39 patients this was a persisting finding. Seven patients (4.2%) developed frank cirrhotic change on ultrasound criteria, while 15 patients (8.9%) had evidence of persistent splenomegaly. Gall-bladder calculi were present in 4.8%. In 176 examinations (24%) there was disparity between the ultrasound findings and aspartate aminotransferase (AST) levels. In 3.0% of cases (five patients) there were persisting abnormalities of liver echo texure and persisting splenomegaly with a normal range AST value. CONCLUSION: No perfect method of assessing hepatobiliary involvement in CF is currently available. Ultrasonographic and biochemical assessment may reflect different aspects of disease progression. Routine use of ultrasound in annual assessment allows identification of a minority of patients with liver changes but with normal biochemistry. Williams, S.M. et al. (2002)

  13. [Assessment of the nutritional status of a group of people older than 50 years by means of dietary and body composition parameters].

    Science.gov (United States)

    Martínez Roldán, C; Veiga Herreros, P; Cobo Sanz, J Ma; Carbajal Azcona, A

    2011-01-01

    To assess the nutritional status of elder adults by means of dietary and body composition parameters. The sample comprised 49 adults, older than 50 years (23 men and 26 women) with a mean age of 54.84±4.56 years, working at a private university. The body composition was analyzed by using anthropometric parameters. The energy and nutrients intake was gathered by means of a registry of all the foods and beverages consumed during 3 days that was filled-up by each (previously instructed) participant and estimating the amounts through photographic models. Total energy requirements were estimated by the Harris-Benedict and FAO/WHO calculations. The body mass index was similar (p=0.018) in both men and women (26.1±1.9 and 24.4±2.8 kg/m²). The percentage of fat obtained by anthropometrics was 29.6±3.6 and 36.8±3.1% (p=0.000) in men and women, respectively. The level of physical activity was very light to light. Daily energy intake was appropriate for total energy demands when these were calculated by the calculations proposed by FAO/WHO. The caloric profile indicated an unbalance with high proteins and lipids and low carbohydrates intake. As for the micronutrients, the diets assessed indicated a deficient intake of folic acid and vitamins D and E, in both genders, and zinc and selenium also in women. We have found overweight problems according to the BMI and the waist circumference, and obesity according to the body fat percentage, with the potential risk for the development of an associated complication. It would be advisable to improve the quality of the diets consumed by increasing the amount of some micronutrients and fiber, and by promoting an increase in the physical activity.

  14. Cost-effectiveness of abiraterone treatment in patients with castration-resistant prostate cancer who previously received docetaxel therapy

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2014-01-01

    Full Text Available Background. Therapy for metastatic castration-resistant prostate cancer (CRPC is a serious problem that requires significant public health care expenditures.Objective: to evaluate the cost-effectiveness of abiraterone treatment in patients with metastatic CRPC who previously received docetaxel under the conditions of the budgetary public health system of the Russian Federation.Material and methods. Markovian simulation based on the COU-AA-301 randomized placebo-controlled Phase III study was used. Survival analysis was made in 70-year-old patients. The cost of abiraterone therapy corresponded to that of the 2013 auctions.Results. Abiraterone therapy in patients who have previously received docetaxel therapy causes an increase in average life expectancy by an average of 4.6 months and progression-free survival by 2.0 months. Moreover, the cost calculated with reference to one year of additional life will account for about 3.6 million rubles and that to one additional quality-adjusted life year will be about 5.45 million rubles.Conclusion. The cost-effectiveness of abiraterone therapy for metastatic CRPC in patients who have previously received docetaxel therapy is similar to that of other medicaments used in oncological practice under the conditions of the budgetary public health system of the Russian Federation. In this connection, abiraterone may be considered as an economically acceptable medical intervention in this clinical situation.

  15. Cost-effectiveness of abiraterone treatment in patients with castration-resistant prostate cancer who previously received docetaxel therapy

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2014-11-01

    Full Text Available Background. Therapy for metastatic castration-resistant prostate cancer (CRPC is a serious problem that requires significant public health care expenditures.Objective: to evaluate the cost-effectiveness of abiraterone treatment in patients with metastatic CRPC who previously received docetaxel under the conditions of the budgetary public health system of the Russian Federation.Material and methods. Markovian simulation based on the COU-AA-301 randomized placebo-controlled Phase III study was used. Survival analysis was made in 70-year-old patients. The cost of abiraterone therapy corresponded to that of the 2013 auctions.Results. Abiraterone therapy in patients who have previously received docetaxel therapy causes an increase in average life expectancy by an average of 4.6 months and progression-free survival by 2.0 months. Moreover, the cost calculated with reference to one year of additional life will account for about 3.6 million rubles and that to one additional quality-adjusted life year will be about 5.45 million rubles.Conclusion. The cost-effectiveness of abiraterone therapy for metastatic CRPC in patients who have previously received docetaxel therapy is similar to that of other medicaments used in oncological practice under the conditions of the budgetary public health system of the Russian Federation. In this connection, abiraterone may be considered as an economically acceptable medical intervention in this clinical situation.

  16. Smoking Patterns, Attitudes and Motives: Unique Characteristics among 2-Year versus 4-Year College Students

    Science.gov (United States)

    Berg, C. J.; An, L. C.; Thomas, J. L.; Lust, K. A.; Sanem, J. R.; Swan, D. W.; Ahluwalia, J. S.

    2011-01-01

    Given the previously documented higher rates of smoking among 2-year college students in comparison with 4-year university students, this study compares smoking patterns, attitudes and motives among 2-year and 4-year college students. Two thousand two hundred and sixty-five undergraduate students aged 18-25 years at a 2-year college and a 4-year…

  17. PHACES syndrome: a review of eight previously unreported cases with late arterial occlusions

    International Nuclear Information System (INIS)

    Bhattacharya, J.J.; Luo, C.B.; Alvarez, H.; Rodesch, G.; Lasjaunias, P.L.; Pongpech, S.

    2004-01-01

    PHACE and PHACES are acronyms for a syndrome of variable expression comprising posterior cranial fossa malformations, facial haemangiomas, arterial anomalies, aortic coarctation and other cardiac disorders, ocular abnormalities and stenotic arterial disease. We review five girls and three boys aged 1 month-14 years with disorders from this spectrum. Six had large facial haemangiomas but recent reports suggest that small haemangiomas may occur; hence our inclusion of two possible cases. We also focus on the recently recognised feature of progressive intracranial arterial occlusions, present in four of our patients, later than previously recognised, from 4 to 14 years of age. We suggest that many elements of this disorder could reflect an abnormality of cell proliferation and apoptosis. (orig.)

  18. [Vaccinovigilance: Reports of adverse reactions in the year 2016].

    Science.gov (United States)

    Albrecht, N; Ottiger, H

    2017-08-01

    In the year 2016, 107 reports of adverse reactions following the application of various authorized vaccines were received and evaluated by the IVI (Institute of Virology and Immunology). The notifications were submitted primarily by marketing authorization holders (81) or veterinarians and private persons (26). The aim of the Vigilance System is the identification of rare events to assess the individual risks of the vaccine application. During the last year, the correlation between reaction and vaccination was considered probable in 34% of the cases. As in previous years, companion animals were involved in most of the adverse effects (48% dogs, 21% cats), followed by cattle (13%). In dogs, approximately half of the reports concern the combination vaccines against distemper, hepatitis, parvovirus, parainfluenza and leptospirosis. The reported symptoms, such as itching, facial edema, acute vomiting and diarrhea, usually indicated forms of hypersensitivity. In cats, apathy was most frequently observed regardless of the vaccination.

  19. AECB staff annual assessment of the Point Lepreau Nuclear Generating Station for the year 1994

    International Nuclear Information System (INIS)

    1995-06-01

    This report is the Atomic Energy Control Board assessment of safety at Point Lepreau Generating Station for 1994. AECB on-site Project Officers, and Ottawa based specialists monitored the station throughout the year. The station operated safely during 1994. Performance of the special safety systems was very good, and NB Power made important progress improving the safety management of these systems. NB Power staff failed to comply with the conditions of our Operating Licence seven times during 1994. This is an improvement from last year, but the number of compliance problems is still too high. NB Power introduced safety culture training for its staff last year. AECB is optimistic that this will help to improve compliance. The station fully met the radiation safety requirements during the year. Releases of radioactive material to the environment are well below the limits set. Radiation exposure to workers are being well controlled, and AECB believe that NB Power is maintaining these exposures 'As Low As Reasonably Achievable' for this reactor type

  20. Cardiorespiratory fitness and body mass index values in 9-year-old rural Norwegian children

    DEFF Research Database (Denmark)

    Resaland, G K; Mamen, A; Anderssen, S A

    2009-01-01

    AIM: To describe cardiorespiratory fitness and body mass index (BMI) values in a representative population of 9-year-old Norwegian children in two rural communities and compare present values with previous findings. METHODS: Two hundred and fifty-nine 9-year-old children were invited, and 256......, children's BMI values seem to have increased substantially. This increase is most pronounced in girls. When assessing these differences using the PI, this increase is less marked. Comparing maximal oxygen uptake data with that in earlier Nordic studies, there is no evidence that fitness has declined among...... 9-year olds. However, the limitations of the few earlier studies make reliable comparisons difficult....

  1. AbobotulinumtoxinA Efficacy and Safety in Children With Equinus Foot Previously Treated With Botulinum Toxin.

    Science.gov (United States)

    Dabrowski, Edward; Bonikowski, Marcin; Gormley, Mark; Volteau, Magali; Picaut, Philippe; Delgado, Mauricio R

    2018-05-01

    The effects of botulinum toxin are transient, and repeat injections are required in children with lower-limb spasticity. However, the efficacy of botulinum toxin in patients who have received previous injections has remained largely unexplored. We present subgroup analyses of a phase III study conducted in ambulatory children (aged two to 17) with spastic equinus foot. Patients were randomized to single doses of abobotulinumtoxinA 10 U/kg/leg, 15 U/kg/leg, or placebo injected into the gastrocnemius-soleus complex (one or both legs). The first analysis was prespecified to review the effect of abobotulinumtoxinA in children previously treated with botulinum toxin versus those children new to the treatment; a second post hoc analysis evaluated the effect of abobotulinumtoxinA in children who changed botulinum toxin formulation. Of the 241 randomized patients, 113 had previously received botulinum toxin, including 86 who had been treated with another formulation. In both analyses, muscle tone (Modified Ashworth Scale) and the Physicians Global Assessment, at week 4, improved with abobotulinumtoxinA treatment versus placebo, regardless of baseline botulinum toxin status. Placebo responses in patients new to treatment were consistently higher than in the previously treated group. These results demonstrate similar abobotulinumtoxinA efficacy and safety profiles in children with spasticity who are new to botulinum toxin treatment and those children who were previously treated. The efficacy and safety of abobotulinumtoxinA treatment in these previously treated patients were comparable with the overall trial population, indicating that doses of 10 and 15 U/kg/leg are suitable starting doses for children with spasticity regardless of the previous botulinum toxin preparation used. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Impact of vocational interests, previous academic experience, gender and age on Situational Judgement Test performance.

    Science.gov (United States)

    Schripsema, Nienke R; van Trigt, Anke M; Borleffs, Jan C C; Cohen-Schotanus, Janke

    2017-05-01

    Situational Judgement Tests (SJTs) are increasingly implemented in medical school admissions. In this paper, we investigate the effects of vocational interests, previous academic experience, gender and age on SJT performance. The SJT was part of the selection process for the Bachelor's degree programme in Medicine at University of Groningen, the Netherlands. All applicants for the academic year 2015-2016 were included and had to choose between learning communities Global Health (n = 126), Sustainable Care (n = 149), Intramural Care (n = 225), or Molecular Medicine (n = 116). This choice was used as a proxy for vocational interest. In addition, all graduate-entry applicants for academic year 2015-2016 (n = 213) were included to examine the effect of previous academic experience on performance. We used MANCOVA analyses with Bonferroni post hoc multiple comparisons tests for applicant performance on a six-scenario SJT. The MANCOVA analyses showed that for all scenarios, the independent variables were significantly related to performance (Pillai's Trace: 0.02-0.47, p performance on three scenarios (p performance on two scenarios (p performance, as was previous academic experience. Gender and age were related to performance on SJT scenarios in different settings. Especially the first effect might be helpful in selecting appropriate candidates for areas of health care in which more professionals are needed.

  3. Impact of Availability and Use of ART/PMTCT Services on Fertility Desires of Previously Pregnant Women in Rakai, Uganda: A Retrospective Cohort Study.

    Science.gov (United States)

    Litwin, Lindsay E; Makumbi, Frederick E; Gray, Ronald; Wawer, Maria; Kigozi, Godfrey; Kagaayi, Joseph; Nakigozi, Gertrude; Lutalo, Tom; Serwada, David; Brahmbhatt, Heena

    2015-07-01

    To assess fertility desires by availability and use of antiretroviral therapy and prevention of mother-to-child transmission (ART/PMTCT) services in Rakai, Uganda. Retrospective analyses of longitudinal data from the Rakai Community Cohort Study. Study participants were retrospectively identified and categorized by HIV status. Availability of ART/PMTCT services in Rakai was defined in three periods: (1) pre-ART/PMTCT (ART/PMTCT rollout (2005-2006), and (3) universal ART/PMTCT (>2006); and use of ART/PMTCT was coded as yes if the woman received services. Trends in fertility desires were assessed by χ. "Modified" Poisson regression was performed using generalized linear models with a log link and Poisson family to estimate prevalence rate ratios (PRRs) and 95% confidence intervals (CIs) of desire for another child among previously and currently pregnant women; PRRs were adjusted for demographic and behavioral factors. A total of 4227 sexually active women in Rakai, including 436 HIV+ women, contributed 13,970 observations over 5 survey rounds. Fertility desires increased in the population in the ART/PMTCT rollout [adjusted (adj.) PRR: 1.08, 95% CI: 1.04 to 1.13] and the universal availability periods (adj. PRR: 1.11, 95% CI: 1.08 to 1.14) compared with pre-ART/PMTCT period. A total of 862 woman observations used ART/PMTCT services. Fertility desires were similar among ART/PMTCT service users and nonusers in cross-sectional analysis (adj. PRR: 0.84, 95% CI: 0.62 to 1.14) and 1 year after ART/PMTCT use (adj. PRR: 1.27, 95% CI: 0.83 to 1.94). Availability of ART/PMTCT may increase fertility desires of previously pregnant women in Rakai, Uganda. Use of ART/PMTCT services was not correlated with fertility desires of previously or current pregnant women.

  4. Peer-Mediated Multimodal Intervention Program for the Treatment of Children with ADHD in India: One-Year Followup

    Science.gov (United States)

    Mehta, Sagar; Shah, Devesh; Shah, Kushal; Mehta, Sanjiv; Mehta, Neelam; Mehta, Vivek; Mehta, Vijay; Mehta, Vaishali; Motiwala, Smita; Mehta, Naina; Mehta, Devendra

    2012-01-01

    The objective was to assess the efficacy of a one-year, peer-mediated interventional program consisting of yoga, meditation and play therapy maintained by student volunteers in a school in India. The population consisted of 69 students between the ages of 6 and 11 years, previously identified as having attention deficit hyperactivity disorder (ADHD). A program, known as Climb-Up, was initially embedded in the school twice weekly. Local high school student volunteers were then trained to continue to implement the program weekly over the period of one year. Improvements in ADHD symptoms and academic performance were assessed using Vanderbilt questionnaires completed by both parents and teachers. The performance impairment scores for ADHD students assessed by teachers improved by 6 weeks and were sustained through 12 months in 46 (85%) of the enrolled students. The improvements in their Vanderbilt scores assessed by parents were also seen in 92% (P < 0.0001, Wilcoxon). The Climb-Up program resulted in remarkable improvements in the students' school performances that were sustained throughout the year. These results show promise for a cost-effective program that could easily be implemented in any school. PMID:23316384

  5. Predictive Validity of the HKT-R Risk Assessment Tool: Two and 5-Year Violent Recidivism in a Nationwide Sample of Dutch Forensic Psychiatric Patients.

    Science.gov (United States)

    Bogaerts, Stefan; Spreen, Marinus; Ter Horst, Paul; Gerlsma, Coby

    2018-06-01

    This study has examined the predictive validity of the Historical Clinical Future [ Historisch Klinisch Toekomst] Revised risk assessment scheme in a cohort of 347 forensic psychiatric patients, which were discharged between 2004 and 2008 from any of 12 highly secure forensic centers in the Netherlands. Predictive validity was measured 2 and 5 years after release. Official reconviction data obtained from the Dutch Ministry of Security and Justice were used as outcome measures. Violent reoffending within 2 and 5 years after discharge was assessed. With regard to violent reoffending, results indicated that the predictive validity of the Historical domain was modest for 2 (area under the curve [AUC] = .75) and 5 (AUC = .74) years. The predictive validity of the Clinical domain was marginal for 2 (admission: AUC = .62; discharge: AUC = .63) and 5 (admission: AUC = .69; discharge: AUC = .62) years after release. The predictive validity of the Future domain was modest (AUC = .71) for 2 years and low for 5 (AUC = .58) years. The total score of the instrument was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .68) years. Finally, the Final Risk Judgment was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .63) years time at risk. It is concluded that this risk assessment instrument appears to be a satisfactory instrument for risk assessment.

  6. The formation of pollen in male flowers and yearly atmospheric pollen counts of Cryptomeria japonica in the following year

    Directory of Open Access Journals (Sweden)

    Hideaki Taira

    1998-01-01

    Full Text Available Prediction of yearly atmospheric pollen counts is a very important component in the prevention of allergenic symptoms. We investigated the relationship between atomspheric pollen counts and the formation of male flowers of Cryptomeriajaponica D. Don (C. japonica. An atmospheric pollen survey of C. japonica was conducted from 1983 to 1996 using a Durham’s sampler. A regression analysis was performed between the total pollen count and July temperature in previous years. The atmospheric pollen counts of C. japonica had a high positive correlation with the mean temperature in July of the previous year. However, the predicted using average mean July temperature records of the previous year were insufficient, especially in years following high pollen count. In experimental conditions, using 60 C. japonica trees in pots, the formation of male flowers was shown to increase with a rise in incubation temperature. In a forest of C. japonica, our results showed that the length and weight of new needle growth from old needles, which produced many flowers in the previous year, were shorter and lighter, respectively. These aerobiological and plant physiological studies provide evidence that a smaller number of pollen counts are a common result in a year following one in which many male flowers are produced, even if the mean July temperature of that year was high.

  7. FEEDING DIFFICULTIES IN PRESCHOOL CHILDREN, PREVIOUS FEEDING PRACTICES, AND NUTRITIONAL STATUS.

    Science.gov (United States)

    Maranhão, Hélcio de Sousa; Aguiar, Renata Cunha de; Lira, Débora Teixeira Jales de; Sales, Mônica Úrsula Figuerêdo; Nóbrega, Nathalia Ávila do Nascimento

    2018-01-01

    To identify the prevalence of feeding difficulties in preschoolers, its association with epidemiological factors and previous eating habits, and repercussion on nutritional status. Cross-sectional study with a questionnaire given to the mothers of 301 children aged 2-6 years enrolled in public and private kindergartens in Natal, Northeast Brazil, conducted in 2014-2015. Feeding difficulty was assessed according to Kerzner's criteria, resulting in the profiles "highly selective intake", "active child with small appetite", "fear of feeding", and "child with psychological disorder or neglected". Association with the following independent variables was analyzed by logistic regression: breastfeeding time, age of cows' milk and complementary feeding introduction, age range, family income, type of school, mothers' profile (responsive or nonresponsive), and body mass index (BMI). Feeding difficulty was found in 37.2% of cases, with predominance of "highly selective intake" (25.4%). It was not associated with infancy feeding practices, family income or type of school. There were no differences between the BMI Z score means for the groups with and without feeding difficulty (1.0±1.5 SD and 1.1±1.4 SD, respectively). The five-to-six age range had more occurrences (OR 1.8; 95%CI 1.1-2.9). Children of responsive mothers were less likely to have feeding difficulties (OR 0.4; 95%CI 0.2-0.8). Feeding difficulties were very frequent. Nutritional status was not impacted by it, and infancy eating habits were not associated with it. Responsive mothers' profile is a protective factor against eating difficulties and reinforces the importance of behavioral factors and mother-child interaction.

  8. A retrospective tiered environmental assessment of the Mount Storm Wind Energy Facility, West Virginia,USA

    Energy Technology Data Exchange (ETDEWEB)

    Efroymson, Rebecca Ann [ORNL; Day, Robin [No Affiliation; Strickland, M. Dale [Western EcoSystems Technology

    2012-11-01

    Bird and bat fatalities from wind energy projects are an environmental and public concern, with post-construction fatalities sometimes differing from predictions. Siting facilities in this context can be a challenge. In March 2012 the U.S. Fish and Wildlife Service (USFWS) released Land-based Wind Energy Guidelines to assess collision fatalities and other potential impacts to species of concern and their habitats to aid in siting and management. The Guidelines recommend a tiered approach for assessing risk to wildlife, including a preliminary site evaluation that may evaluate alternative sites, a site characterization, field studies to document wildlife and habitat and to predict project impacts, post construction studies to estimate impacts, and other post construction studies. We applied the tiered assessment framework to a case study site, the Mount Storm Wind Energy Facility in Grant County, West Virginia, USA, to demonstrate the use of the USFWS assessment approach, to indicate how the use of a tiered assessment framework might have altered outputs of wildlife assessments previously undertaken for the case study site, and to assess benefits of a tiered ecological assessment framework for siting wind energy facilities. The conclusions of this tiered assessment for birds are similar to those of previous environmental assessments for Mount Storm. This assessment found risk to individual migratory tree-roosting bats that was not emphasized in previous preconstruction assessments. Differences compared to previous environmental assessments are more related to knowledge accrued in the past 10 years rather than to the tiered structure of the Guidelines. Benefits of the tiered assessment framework include good communication among stakeholders, clear decision points, a standard assessment trajectory, narrowing the list of species of concern, improving study protocols, promoting consideration of population-level effects, promoting adaptive management through post

  9. Evolution Of USDOE Performance Assessments Over 20 Years

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, Roger R. [Savannah River Site (SRS), Aiken, SC (United States); Suttora, Linda C. [U.S. Department of Energy, Office of Site Restoration, Germantown, MD (United States)

    2013-02-26

    Performance assessments (PAs) have been used for many years for the analysis of post-closure hazards associated with a radioactive waste disposal facility and to provide a reasonable expectation of the ability of the site and facility design to meet objectives for the protection of members of the public and the environment. The use of PA to support decision-making for LLW disposal facilities has been mandated in United States Department of Energy (USDOE) directives governing radioactive waste management since 1988 (currently DOE Order 435.1, Radioactive Waste Management). Prior to that time, PAs were also used in a less formal role. Over the past 20+ years, the USDOE approach to conduct, review and apply PAs has evolved into an efficient, rigorous and mature process that includes specific requirements for continuous improvement and independent reviews. The PA process has evolved through refinement of a graded and iterative approach designed to help focus efforts on those aspects of the problem expected to have the greatest influence on the decision being made. Many of the evolutionary changes to the PA process are linked to the refinement of the PA maintenance concept that has proven to be an important element of USDOE PA requirements in the context of supporting decision-making for safe disposal of LLW. The PA maintenance concept represents the evolution of the graded and iterative philosophy and has helped to drive the evolution of PAs from a deterministic compliance calculation into a systematic approach that helps to focus on critical aspects of the disposal system in a manner designed to provide a more informed basis for decision-making throughout the life of a disposal facility (e.g., monitoring, research and testing, waste acceptance criteria, design improvements, data collection, model refinements). A significant evolution in PA modeling has been associated with improved use of uncertainty and sensitivity analysis techniques to support efficient

  10. Evolution Of USDOE Performance Assessments Over 20 Years

    International Nuclear Information System (INIS)

    Seitz, Roger R.; Suttora, Linda C.

    2013-01-01

    Performance assessments (PAs) have been used for many years for the analysis of post-closure hazards associated with a radioactive waste disposal facility and to provide a reasonable expectation of the ability of the site and facility design to meet objectives for the protection of members of the public and the environment. The use of PA to support decision-making for LLW disposal facilities has been mandated in United States Department of Energy (USDOE) directives governing radioactive waste management since 1988 (currently DOE Order 435.1, Radioactive Waste Management). Prior to that time, PAs were also used in a less formal role. Over the past 20+ years, the USDOE approach to conduct, review and apply PAs has evolved into an efficient, rigorous and mature process that includes specific requirements for continuous improvement and independent reviews. The PA process has evolved through refinement of a graded and iterative approach designed to help focus efforts on those aspects of the problem expected to have the greatest influence on the decision being made. Many of the evolutionary changes to the PA process are linked to the refinement of the PA maintenance concept that has proven to be an important element of USDOE PA requirements in the context of supporting decision-making for safe disposal of LLW. The PA maintenance concept represents the evolution of the graded and iterative philosophy and has helped to drive the evolution of PAs from a deterministic compliance calculation into a systematic approach that helps to focus on critical aspects of the disposal system in a manner designed to provide a more informed basis for decision-making throughout the life of a disposal facility (e.g., monitoring, research and testing, waste acceptance criteria, design improvements, data collection, model refinements). A significant evolution in PA modeling has been associated with improved use of uncertainty and sensitivity analysis techniques to support efficient

  11. Impact of previously disadvantaged land-users on sustainable ...

    African Journals Online (AJOL)

    Impact of previously disadvantaged land-users on sustainable agricultural ... about previously disadvantaged land users involved in communal farming systems ... of input, capital, marketing, information and land use planning, with effect on ...

  12. Postpartum IGF-I and IGFBP-2 levels are prospectively associated with the development of type 2 diabetes in women with previous gestational diabetes mellitus.

    Science.gov (United States)

    Lappas, M; Jinks, D; Shub, A; Willcox, J C; Georgiou, H M; Permezel, M

    2016-12-01

    Women with previous gestational diabetes mellitus (GDM) are at greater risk of developing type 2 diabetes. In the general population, the insulin-like growth factor (IGF) system has been implicated in the development of type 2 diabetes. The aim of this study was to determine if circulating IGF-I, IGF-II, IGFBP-1 and IGFBP-2 levels 12weeks following a GDM pregnancy are associated with an increased risk of developing type 2 diabetes. IGF-I, IGF-II, IGFBP-1 and IGFBP-2 levels were measured in 98 normal glucose tolerant women, 12weeks following an index GDM pregnancy using enzyme immunoassay. Women were assessed for up to 10years for the development of overt type 2 diabetes. Among the 98 women with previous GDM, 21 (21%) developed diabetes during the median follow-up period of 8.5years. After adjusting for age and BMI, IGF-I and IGFBP-2 were significantly associated with the development of type 2 diabetes. In a clinical model of prediction of type 2 diabetes that included age, BMI, pregnancy fasting glucose and postnatal fasting glucose, the addition of IGF-I and IGFBP-2 resulted in an improvement in the net reclassification index of 17.8%. High postpartum IGF-I and low postpartum IGFBP-2 levels are a significant risk factor for the development of type 2 diabetes in women with a previous history of GDM. This is the first report that identifies IGF-I and IGFBP-2 as a potential biomarker for the prediction of type 2 diabetes in women with a history of GDM. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Quantifying restoration success and recovery in a metal-polluted stream: A 17-year assessment of physicochemical and biological responses

    Science.gov (United States)

    Clements, W.H.; Vieira, N.K.M.; Church, S.E.

    2010-01-01

    Evaluating the effectiveness of stream restoration is often challenging because of the lack of pre-treatment data, narrow focus on physicochemical measures and insufficient post-restoration monitoring. Even when these fundamental elements are present, quantifying restoration success is difficult because of the challenges associated with distinguishing treatment effects from seasonal variation, episodic events and long-term climatic changes.2. We report results of one of the most comprehensive and continuous records of physical, chemical and biological data available to assess restoration success for a stream ecosystem in North America. Over a 17 year period we measured seasonal and annual changes in metal concentrations, physicochemical characteristics, macroinvertebrate communities, and brown trout Salmo trutta populations in the Arkansas River, a metal-contaminated stream in Colorado, USA.3. Although we observed significant improvements in water quality after treatment, the effectiveness of restoration varied temporally, spatially and among biological response variables. The fastest recovery was observed at stations where restoration eliminated point sources of metal contamination. Recovery of macroinvertebrates was significantly delayed at some stations because of residual sediment contamination and because extreme seasonal and episodic variation in metal concentrations prevented recolonization by sensitive species. Synthesis and applications. Because recovery trajectories after the removal of a stressor are often complex or nonlinear, long-term studies are necessary to assess restoration success within the context of episodic events and changes in regional climate. The observed variation in recovery among chemical and biological endpoints highlights the importance of developing objective criteria to assess restoration success. Although the rapid response of macroinvertebrates to reduced metal concentrations is encouraging, we have previously demonstrated that

  14. Upon Further Review: V. An Examination of Previous Lightcurve Analysis from the Palmer Divide Observatory

    Science.gov (United States)

    Warner, Brian D.

    2011-01-01

    Updated results are given for nine asteroids previously reported from the Palmer Divide Observatory (PDO). The original images were re-measured to obtain new data sets using the latest version of MPO Canopus photometry software, analysis tools, and revised techniques for linking multiple observing runs covering several days to several weeks. Results that were previously not reported or were moderately different were found for 1659 Punkajarju, 1719 Jens, 1987 Kaplan, 2105 Gudy, 2961 Katsurahama, 3285 Ruth Wolfe, 3447 Burckhalter, 7816 Hanoi, and (34817) 2000 SE116. This is one in a series of papers that will examine results obtained during the initial years of the asteroid lightcurve program at PDO.

  15. A Study to Assess the Knowledge on Risk for Fall among Geriatric People Above 60 Years at Selected Oldage Home at Karaikal

    OpenAIRE

    R.G. Padmapriya; E. Kalaivani

    2017-01-01

    A study to assess the risk for fall among geriatric people above 60 years of age in selected old age home at karaikal. The research approach was adopted for this study was quantitative approach. The research design used for this study is descriptive design. A simple random sampling technique adopted to select the desired sample. Sample size is 50. Donna conley fall risk assessment scale was used to assess the risk for fall among geriatric people above 60 years of age . The collected data was...

  16. Effect of the Duration of Meteorological Data Collection on the Atmospheric Dispersion Assessment

    International Nuclear Information System (INIS)

    Choi, Yoo-mi; Kim, Eun-hee

    2017-01-01

    This study regards the duration of meteorological data record for a prospective assessment of the environmental impact of gas release from Kori nuclear power plant under normal operation. We compared the atmospheric dispersion factors obtained by employing the meteorological data from 2- and 5-year durations with the corresponding values obtained by employing yearly meteorological data in the period of 2001 to 2008. Influence of the duration of meteorological data collection on short-term atmospheric dispersion factors was previously studied. In this study, long-term dispersion factors were assessed to investigate the influence of the duration of meteorological data collection on the assessment of environmental impact by gas release from Kori nuclear power plant under normal operation. We counted how many yearly meteorological conditions would be represented by 2 or 5 years of long-term data collection. The distribution of shaded cells in Tables I and II indicated that some of the yearly meteorological condition could be properly represented by the conditions averaged over 2- or 5-year durations.

  17. Effect of a change in selection year on success in male soccer players.

    Science.gov (United States)

    Helsen, Werner F.; Starkes, Janet L.; Van Winckel, Jan

    2000-11-01

    Since 1997 and following the guidelines of the International Football Association, the Belgian Soccer Federation has used January 1st as the start of the selection year. Previously, August 1 was the start. This shift prompted an investigation of changes in birth-date distributions throughout youth categories for 1996-1997 compared to the 1997-1998 competitive years. Birth dates were considered for national youth league players, ages 10-12, 12-14, 14-16, and 16-18 years. Kolmogorov Smirnov tests assessed differences between observed and expected birth-date distributions. Regression analyses examined the relationship between month of birth and number of participants both before and after the August to January shift. Results indicated that from 1996 to 1997, youth players born from January to March (the early part of the new selection year) were more likely to be identified as "talented" and to be exposed to higher levels of coaching. In comparison, players born late in the new selection year (August to October) were assessed as "talented" in significantly lower proportions. Specific suggestions are presented to reduce the relative age effect. Am. J. Hum. Biol. 12:729-735, 2000. Copyright 2000 Wiley-Liss, Inc.

  18. Cognitive functioning in children and adolescents in their first episode of psychosis: differences between previous cannabis users and nonusers.

    Science.gov (United States)

    de la Serna, Elena; Mayoral, María; Baeza, Inmaculada; Arango, Celso; Andrés, Patricia; Bombin, Igor; González, Cristina; Rapado, Marta; Robles, Olalla; Rodríguez-Sánchez, Jose Manuel; Zabala, Arantzazu; Castro-Fornieles, Josefina

    2010-02-01

    To investigate the relationship between cognition and prior cannabis use in children and adolescents presenting a first episode of psychosis. A total of 107 patients with first episode of psychosis and 96 healthy controls, aged 9 to 17 years, were interviewed about their previous substance use and to assess their cognitive functions. Patients were assessed while not using cannabis by means of a comprehensive neuropsychological battery. They were divided into 2 groups depending on the history of prior cannabis use: cannabis users (CU) and cannabis nonusers (CNU). Significant differences were found in all areas evaluated between the 3 groups. Both CU and CNU patients obtained lower scores than controls on verbal learning and memory and working memory. Patients with prior cannabis use performed better on some tests of attention (Continuous performance test (CPT) number of correct responses, p = 0.002; CPT average reaction time, p < 0.001) and executive functions (Trail Making Test, part B (TMT-B) number of mistakes, p < 0.001; Wisconsin Card Sorting Test (WCST) number of categories completed, p < 0.001) than CNU patients. CU patients performed better than CNU subjects on some cognitive measures. This may indicate lower individual vulnerability for psychosis in CU patients in whom cannabis use can be a precipitating factor of psychotic episodes.

  19. A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology

    Directory of Open Access Journals (Sweden)

    Zappacosta R

    2014-04-01

    Full Text Available Roberta Zappacosta,1 Giuseppe Lattanzio,2 Patrizia Viola,2 Manuel Maria Ianieri,3 Daniela Maria Pia Gatta,1 Sandra Rosini11Cytopathology Unit, Experimental and Clinical Sciences Department, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy; 2Surgical Pathology Unit, 3Obstetrics and Gynecology Unit, SS Annunziata Hospital, Chieti, ItalyAbstract: The introduction of organized cervical cancer (CC screening programs has drastically reduced the prevalence of CC. However the incidence is still too high, especially among elderly women. All guidelines strongly recommend a regular Papanicolaou (Pap testing for young and middle-aged patients. On the other hand, many international professional societies no longer advise screening in women who have undergone hysterectomy, and in women aged 65 years and above, who have a previous history of regular Pap smears. Here we report the case of poorly differentiated CC, involving the pelvic lymph nodes and urinary bladder, occurring in a 79-year-old woman who regularly underwent Pap tests, with no reported cytological abnormalities. In this very rare case, the CC cells, as well as cells from metastatic lymph nodes and cells from urinary specimens, molecularly showed human papilloma virus (HPV-53. With the limitations of a single case, this report brings important information to prevent CC in elderly patients: the utility of molecular tests to increase sensitivity of Pap smears in postmenopausal women; the importance of HPV-53 as one of the four “emergent” genotypes having a possible role in oncogenesis; and the presence of HPV-53 in lymph node metastases from cervical carcinoma, which would support the role of this virus in the maintenance of malignant status.Keywords: old women, molecular tests, cervical cancer screening, HPV-DNA test, HPV genotypingA Letter to the editor has been received and published for this articleCorrigendum for this paper has been published

  20. Jumping performance differences among elite professional handball players with or without previous ACL reconstruction.

    Science.gov (United States)

    Setuain, I; Millor, N; Alfaro, J; Gorostiaga, E; Izquierdo, M

    2015-10-01

    Handball is one of the most challenging sports for the knee joint. Persistent strength and jumping capacity alterations may be observed among athletes who have suffered anterior cruciate ligament (ACL) injury. The aim of this study was to examine unilateral and bilateral jumping ability differences between previously ACL-reconstructed rehabilitated elite handball athletes and sex, age and uninjured sport activity level-pairs of control players. It was a Cross-sectional study with one factor: previous ACL injury. We recruited 22 male (6 ACL-reconstructed and 16 uninjured control players) and 21 female (6 ACL-reconstructed and 15 uninjured control players) elite handball players who were evaluated 6.2±3.4 years after surgical ACL reconstruction. A battery of jump tests, including both bilateral and unilateral maneuvers, was performed. Two-tailed unpaired (intergroup comparison) and paired (intragroup comparison) t-tests were performed for mean comparisons. The P-value cut-off for significance was set at handball athletes demonstrated both lower vertical bilateral drop jump (VBDJ) contact times and lower UTHD scores for the injured leg several years after injury. These deficits could contribute to an increase in ACL re-injury risk.

  1. The association between subjective memory complaint and objective cognitive function in older people with previous major depression.

    Science.gov (United States)

    Chu, Chung-Shiang; Sun, I-Wen; Begum, Aysha; Liu, Shen-Ing; Chang, Ching-Jui; Chiu, Wei-Che; Chen, Chin-Hsin; Tang, Hwang-Shen; Yang, Chia-Li; Lin, Ying-Chin; Chiu, Chih-Chiang; Stewart, Robert

    2017-01-01

    The goal of this study is to investigate associations between subjective memory complaint and objective cognitive performance in older people with previous major depression-a high-risk sample for cognitive impairment and later dementia. A cross-sectional study was carried out in people aged 60 or over with previous major depression but not fulfilling current major depression criteria according to DSM-IV-TR. People with dementia or Mini-Mental State Examination score less than 17 were excluded. Subjective memory complaint was defined on the basis of a score ≧4 on the subscale of Geriatric Mental State schedule, a maximum score of 8. Older people aged equal or over 60 without any psychiatric diagnosis were enrolled as healthy controls. Cognitive function was evaluated using a series of cognitive tests assessing verbal memory, attention/speed, visuospatial function, verbal fluency, and cognitive flexibility in all participants. One hundred and thirteen older people with previous major depression and forty-six healthy controls were enrolled. Subjective memory complaint was present in more than half of the participants with depression history (55.8%). Among those with major depression history, subjective memory complaint was associated with lower total immediate recall and delayed verbal recall scores after adjustment. The associations between subjective memory complaint and worse memory performance were stronger in participants with lower depressive symptoms (Hamilton Depression Rating Scale scorememory complaint may be a valid appraisal of memory performance in older people with previous major depression and consideration should be given to more proactive assessment and follow-up in these clinical samples.

  2. Five-year quality of life assessment after carbon ion radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Maruyama, Katsuya; Tsuji, Hiroshi; Nomiya, Takuma; Katoh, Hiroyuki; Ishikawa, Hitoshi; Kamada, Tadashi; Wakatsuki, Masaru; Akakura, Koichiro; Shimazaki, Jun; Aoyama, Hidefumi; Tsujii, Hirohiko

    2017-01-01

    The aim of this study was to prospectively assess 5-year health-related quality of life (HRQOL) of patients treated with carbon ion radiotherapy (C-ion RT) for clinically localized prostate cancer. A total of 417 patients received carbon ion radiotherapy at a total dose of 63–66 Gray-equivalents (GyE) in 20 fractions over 5 weeks, and neoadjuvant and adjuvant androgen deprivation therapy (ADT) were administered for intermediate and high-risk patients. A HRQOL assessment was performed at five time points (immediately before the initiation of C-ion RT, immediately after, and at 12, 36 and 60 months after completion of C-ion RT) using Functional Assessment of Cancer Therapy (FACT) questionnaires. FACT-G and FACT-P scores were significantly decreased; however, the absolute change after 60 months was minimal. The transient decreases in the Trial Outcome Index (TOI) score returned to their baseline levels. Use of ADT, presence of adverse events, and biochemical failure were related to lower scores. Scores of subdomains of FACT instruments indicated characteristic changes. The pattern of HRQOL change after C-ion RT was similar to that of other modalities. Further controlled studies focusing on a HRQOL in patients with prostate cancer are warranted.

  3. Determining root correspondence between previously and newly detected objects

    Science.gov (United States)

    Paglieroni, David W.; Beer, N Reginald

    2014-06-17

    A system that applies attribute and topology based change detection to networks of objects that were detected on previous scans of a structure, roadway, or area of interest. The attributes capture properties or characteristics of the previously detected objects, such as location, time of detection, size, elongation, orientation, etc. The topology of the network of previously detected objects is maintained in a constellation database that stores attributes of previously detected objects and implicitly captures the geometrical structure of the network. A change detection system detects change by comparing the attributes and topology of new objects detected on the latest scan to the constellation database of previously detected objects.

  4. Maternal morbidity in the first year after childbirth in Mombasa Kenya; a needs assessment

    Directory of Open Access Journals (Sweden)

    Luchters Stanley MF

    2009-11-01

    Full Text Available Abstract Background In sub-Saharan Africa, few services specifically address the needs of women in the first year after childbirth. By assessing the health status of women in this period, key interventions to improve maternal health could be identified. There is an underutilised opportunity to include these interventions within the package of services provided for woman-child pairs attending child-health clinics. Methods This needs assessment entailed a cross-sectional survey with 500 women attending a child-health clinic at the provincial hospital in Mombasa, Kenya. A structured questionnaire, clinical examination, and collection of blood, urine, cervical swabs and Pap smear were done. Women's health care needs were compared between the early (four weeks to two months after childbirth, middle (two to six months and late periods (six to twelve months since childbirth. Results More than one third of women had an unmet need for contraception (39%, 187/475. Compared with other time intervals, women in the late period had more general health symptoms such as abdominal pain, fever and depression, but fewer urinary or breast problems. Over 50% of women in each period had anaemia (Hb Trichomonas vaginalis and 11% (54/496 HIV infection. Conclusion Throughout the first year after childbirth, women had high levels of morbidity. Interface with health workers at child health clinics should be used for treatment of anaemia, screening and treatment of reproductive tract infections, and provision of family planning counselling and contraception. Providing these services during visits to child health clinics, which have high coverage both early and late in the year after childbirth, could make an important contribution towards improving women's health.

  5. Formative assessment to develop oral communication competency using YouTube: self- and peer assessment in engineering

    Science.gov (United States)

    Nikolic, Sasha; Stirling, David; Ros, Montserrat

    2018-07-01

    Obtaining oral communication competency is an important skill for engineering students to prepare them for interacting and working in any professional setting. For engineers, it is also important to be able to present technical information to non-technical audiences. To ensure oral competency, a non-graded formative assessment approach using video with self- and peer assessment was introduced into a final-year engineering thesis course. A low workload approach was used due to growing student numbers and higher pressures on academic staff. A quasi-experimental design was used to investigate the differences between traditional delivery, self-assessment and combined self-assessment with peer feedback. The study found that the formative models were seen by students to help develop their presentation skills. However, the results showed no significant improvement compared to the traditional method. This could be due to previous presentation practice within the degree or more probable, the lack of incentive for weaker students to engage and improve due to the ungraded nature of the activity.

  6. Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial

    DEFF Research Database (Denmark)

    Aguilar, David; Solomon, Scott D; Køber, Lars

    2004-01-01

    cardiovascular events associated with previously known and newly diagnosed diabetes by studying 14,703 patients with acute MI enrolled in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Patients were grouped by diabetic status: previously known diabetes (insulin use or diagnosis of diabetes before...

  7. Infliximab therapy in pediatric patients 7 years of age and younger.

    Science.gov (United States)

    Kelsen, Judith R; Grossman, Andrew B; Pauly-Hubbard, Helen; Gupta, Kernika; Baldassano, Robert N; Mamula, Petar

    2014-12-01

    Infliximab (IFX) is efficacious for induction and maintenance of remission in pediatric patients with moderate-to-severe inflammatory bowel disease (IBD). It has, however, not been studied in patients 7 years old and younger. Our aim was to characterize efficacy and safety of IFX therapy in this cohort. This was a retrospective study of patients with IBD ages 7 years and younger, treated with IFX between 1999 and 2011. Medical records were reviewed for age of diagnosis, disease phenotype, therapy, surgery, IFX infusion dates, dose, and intervals. Outcome measures included physician global assessment, corticosteroid requirement, and adverse events. Thirty-three children (ages 2.4-7 years) were included. Twenty patients had Crohn disease, 4 had ulcerative colitis, and 9 had indeterminate colitis. Maintenance of IFX therapy at 1, 2, and 3 years was 36%, 18%, and 12%, respectively. Patients of age 5 years and younger had the lowest rates of maintenance of therapy at 25% at year 1, and 10% at years 2 and 3 combined. Nine percent of all of the patients demonstrated response measured by the physician global assessment and were steroid free at 1 year. There were 8 infusion reactions. There were no malignancies, serious infections, or deaths. IFX demonstrated a modest response rate and a low steroid-sparing effect in patients with IBD 7 years old and younger. Although this is a limited study, there appears to be a trend for decreased sustained efficacy with IFX in this age group, particularly in children 5 years old and younger, when compared with the previously published literature in older children.

  8. A Ten-Year Assessment of a Biomedical Engineering Summer Research Internship within a Comprehensive Cancer Center

    Science.gov (United States)

    Wright, A. S.; Wu, X.; Frye, C. A.; Mathur, A. B.; Patrick, C. W., Jr.

    2007-01-01

    A Biomedical Engineering Internship Program conducted within a Comprehensive Cancer Center over a 10 year period was assessed and evaluated. Although this is a non-traditional location for an internship, it is an ideal site for a multidisciplinary training program for science, technology, engineering, and mathematics (STEM) students. We made a…

  9. FDG-PET and CT patterns of bone metastases and their relationship to previously administered anti-cancer therapy

    International Nuclear Information System (INIS)

    Israel, Ora; Bar-Shalom, Rachel; Keidar, Zohar; Goldberg, Anat; Nachtigal, Alicia; Militianu, Daniela; Fogelman, Ignac

    2006-01-01

    To assess 18 F-fluorodeoxyglucose (FDG) uptake in bone metastases in patients with and without previous treatment, and compare positive positron emission tomography (PET) with osteolytic or osteoblastic changes on computed tomography (CT). One hundred and thirty-one FDG-PET/CT studies were reviewed for bone metastases. A total of 294 lesions were found in 76 patients, 81 in untreated patients and 213 in previously treated patients. PET was assessed for abnormal FDG uptake localised by PET/CT to the skeleton. CT was evaluated for bone metastases and for blastic or lytic pattern. The relationship between the presence and pattern of bone metastases on PET and CT, and prior treatment was statistically analysed using the chi-square test. PET identified 174 (59%) metastases, while CT detected 280 (95%). FDG-avid metastases included 74/81 (91%) untreated and 100/213 (47%) treated lesions (p<0.001). On CT there were 76/81 (94%) untreated and 204/213 (96%) treated metastases (p NS). In untreated patients, 85% of lesions were seen on both PET and CT (26 blastic, 43 lytic). In treated patients, 53% of lesions were seen only on CT (95 blastic, 18 lytic). Of the osteoblastic metastases, 65/174 (37%) were PET positive and 98/120 (82%), PET negative (p<0.001). The results of the present study indicate that when imaging bone metastases, prior treatment can alter the relationship between PET and CT findings. Most untreated bone metastases are PET positive and lytic on CT, while in previously treated patients most lesions are PET negative and blastic on CT. PET and CT therefore appear to be complementary in the assessment of bone metastases. (orig.)

  10. Dabrafenib plus trametinib in patients with previously untreated BRAFV600E-mutant metastatic non-small-cell lung cancer: an open-label, phase 2 trial.

    Science.gov (United States)

    Planchard, David; Smit, Egbert F; Groen, Harry J M; Mazieres, Julien; Besse, Benjamin; Helland, Åslaug; Giannone, Vanessa; D'Amelio, Anthony M; Zhang, Pingkuan; Mookerjee, Bijoyesh; Johnson, Bruce E

    2017-10-01

    BRAF V600E mutation occurs in 1-2% of lung adenocarcinomas and acts as an oncogenic driver. Dabrafenib, alone or combined with trametinib, has shown substantial antitumour activity in patients with previously treated BRAF V600E -mutant metastatic non-small-cell lung cancer (NSCLC). We aimed to assess the activity and safety of dabrafenib plus trametinib treatment in previously untreated patients with BRAF V600E -mutant metastatic NSCLC. In this phase 2, sequentially enrolled, multicohort, multicentre, non-randomised, open-label study, adults (≥18 years of age) with previously untreated metastatic BRAF V600E -mutant NSCLC were enrolled into cohort C from 19 centres in eight countries within North America, Europe, and Asia. Patients received oral dabrafenib 150 mg twice per day plus oral trametinib 2 mg once per day until disease progression, unacceptable adverse events, consent withdrawal, or death. The primary endpoint was investigator-assessed overall response, defined as the percentage of patients who achieved a confirmed complete response or partial response per Response Evaluation Criteria In Solid Tumors version 1.1. The primary and safety analyses were by intention to treat in the protocol-defined population (previously untreated patients). The study is ongoing, but no longer recruiting patients. This trial is registered with ClinicalTrials.gov, number NCT01336634. Between April 16, 2014, and Dec 28, 2015, 36 patients were enrolled and treated with first-line dabrafenib plus trametinib. Median follow-up was 15·9 months (IQR 7·8-22·0) at the data cutoff (April 28, 2017). The proportion of patients with investigator-assessed confirmed overall response was 23 (64%, 95% CI 46-79), with two (6%) patients achieving a complete response and 21 (58%) a partial response. All patients had one or more adverse event of any grade, and 25 (69%) had one or more grade 3 or 4 event. The most common (occurring in more than two patients) grade 3 or 4 adverse events were

  11. Unexpected finding of T-cell lymphoma in a previously healthy 16-year-old patient after a thorax trauma: a case report

    DEFF Research Database (Denmark)

    Bach Okholm-Hansen, Anna; Brorson, Stig

    2014-01-01

    INTRODUCTION: We describe the clinical course and emphasize the difficulties in diagnosing T-cell lymphoblastic lymphoma. The differential diagnostic difficulties have previously been described in regard to pneumonia, but to the best of the authors' knowledge this is the first case report to desc...... relevant to pediatricians, surgeons, anesthesiologists, and general practitioners....

  12. Improved reliability in skeletal age assessment using a pediatric hand MR scanner with a 0.3T permanent magnet.

    Science.gov (United States)

    Terada, Yasuhiko; Kono, Saki; Uchiumi, Tomomi; Kose, Katsumi; Miyagi, Ryo; Yamabe, Eiko; Fujinaga, Yasunari; Yoshioka, Hiroshi

    2014-01-01

    The purpose of this study was to improve the reliability and validity of skeletal age assessment using an open and compact pediatric hand magnetic resonance (MR) imaging scanner. We used such a scanner with 0.3-tesla permanent magnet to image the left hands of 88 healthy children (aged 3.4 to 15.7 years, mean 8.8 years), and 3 raters (2 orthopedic specialists and a radiologist) assessed skeletal age using those images. We measured the strength of agreement in ratings by values of weighted Cohen's κ and the proportion of cases excluded from rating because of motion artifact and inappropriate positioning. We compared the current results with those of a previous study in which 93 healthy children (aged 4.1 to 16.4 years, mean 9.7 years) were examined with an adult hand scanner. The κ values between raters exceeded 0.80, which indicates almost perfect agreement, and most were higher than those of the previous study. The proportion of cases excluded from rating because of motion artifact or inappropriate positioning was also reduced. The results indicate that use of the compact pediatric hand scanner improved the reliability and validity of skeletal age assessments.

  13. Repeat immigration: A previously unobserved source of heterogeneity?

    Science.gov (United States)

    Aradhya, Siddartha; Scott, Kirk; Smith, Christopher D

    2017-07-01

    Register data allow for nuanced analyses of heterogeneities between sub-groups which are not observable in other data sources. One heterogeneity for which register data is particularly useful is in identifying unique migration histories of immigrant populations, a group of interest across disciplines. Years since migration is a commonly used measure of integration in studies seeking to understand the outcomes of immigrants. This study constructs detailed migration histories to test whether misclassified migrations may mask important heterogeneities. In doing so, we identify a previously understudied group of migrants called repeat immigrants, and show that they differ systematically from permanent immigrants. In addition, we quantify the degree to which migration information is misreported in the registers. The analysis is carried out in two steps. First, we estimate income trajectories for repeat immigrants and permanent immigrants to understand the degree to which they differ. Second, we test data validity by cross-referencing migration information with changes in income to determine whether there are inconsistencies indicating misreporting. From the first part of the analysis, the results indicate that repeat immigrants systematically differ from permanent immigrants in terms of income trajectories. Furthermore, income trajectories differ based on the way in which years since migration is calculated. The second part of the analysis suggests that misreported migration events, while present, are negligible. Repeat immigrants differ in terms of income trajectories, and may differ in terms of other outcomes as well. Furthermore, this study underlines that Swedish registers provide a reliable data source to analyze groups which are unidentifiable in other data sources.

  14. Age Effects on Upper Limb Kinematics Assessed by the REAplan Robot in Healthy Subjects Aged 3 to 93 Years.

    Science.gov (United States)

    Gilliaux, Maxime; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine

    2016-04-01

    Kinematics is recommended for the quantitative assessment of upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish normative values in healthy subjects. Three hundred and seventy healthy subjects, aged 3-93 years, participated in the study. They performed two unidirectional and two geometrical tasks ten consecutive times with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-six kinematic indices were computed for the four tasks. For the four tasks, nineteen of the computed kinematic indices showed an age effect. Seventeen indices (the accuracy, speed and smoothness indices and the reproducibility of the accuracy, speed and smoothness) improved in young subjects aged 3-30 years, showed stabilization in adults aged 30-60 years and declined in elderly subjects aged 60-93 years. Additionally, for both geometrical tasks, the speed index exhibited a decrease throughout life. Finally, a principal component analysis provided the relations between the kinematic indices, tasks and subjects' age. This study is the first to assess age effects on upper limb kinematics and establish normative values in subjects aged 3-93 years.

  15. Conservation assessment of the endemic plants from Kosovo

    Directory of Open Access Journals (Sweden)

    Millaku Fadil

    2017-06-01

    Full Text Available Sixteen endemic plant taxa were selected from Kosovo, according to the IUCN standards and for each taxon the risk assessment and threat category has been assigned. The taxa were compared with their previous status from fifteen years ago. From sixteen plant taxa, which were included in this work, four are Balkan endemics, whereas, eight of them are local endemics and four of the taxa are stenoendemics. Six of the taxa are grown exclusively on serpentine soils, five of them on limestone substrate, four of them in carbonate substrate, yet only one in silicate substrate. The work has been done based on the standard working methodologies of the IUCN (Guidelines for Using the IUCN Red List Categories and Criteria – Version 8.1. The most threatened plant taxa is Solenanthus krasniqii – which after its observance has only 20 mature individuals. As a result of the wild collection of the medicinal and aromatic plants, from the local population, Sideritis scardica is about to be completely go extinct. The aim of this study was to assess the state of endemics in the threats possessed to them during the previous times, present and predicting the trends for the upcoming years.

  16. A Clinical Assessment Tool for Advanced Theory of Mind Performance in 5 to 12 Year Olds

    Science.gov (United States)

    O'Hare, Anne E.; Bremner, Lynne; Nash, Marysia; Happe, Francesca; Pettigrew, Luisa M.

    2009-01-01

    One hundred forty typically developing 5- to 12-year-old children were assessed with a test of advanced theory of mind employing Happe's strange stories. There was no significant difference in performance between boys and girls. The stories discriminated performance across the different ages with the lowest performance being in the younger…

  17. [A brief history of resuscitation - the influence of previous experience on modern techniques and methods].

    Science.gov (United States)

    Kucmin, Tomasz; Płowaś-Goral, Małgorzata; Nogalski, Adam

    2015-02-01

    Cardiopulmonary resuscitation (CPR) is relatively novel branch of medical science, however first descriptions of mouth-to-mouth ventilation are to be found in the Bible and literature is full of descriptions of different resuscitation methods - from flagellation and ventilation with bellows through hanging the victims upside down and compressing the chest in order to stimulate ventilation to rectal fumigation with tobacco smoke. The modern history of CPR starts with Kouwenhoven et al. who in 1960 published a paper regarding heart massage through chest compressions. Shortly after that in 1961Peter Safar presented a paradigm promoting opening the airway, performing rescue breaths and chest compressions. First CPR guidelines were published in 1966. Since that time guidelines were modified and improved numerously by two leading world expert organizations ERC (European Resuscitation Council) and AHA (American Heart Association) and published in a new version every 5 years. Currently 2010 guidelines should be obliged. In this paper authors made an attempt to present history of development of resuscitation techniques and methods and assess the influence of previous lifesaving methods on nowadays technologies, equipment and guidelines which allow to help those women and men whose life is in danger due to sudden cardiac arrest. © 2015 MEDPRESS.

  18. Psychological reactions after multifetal pregnancy reduction: a 2-year follow-up study.

    Science.gov (United States)

    Garel, M; Stark, C; Blondel, B; Lefebvre, G; Vauthier-Brouzes, D; Zorn, J R

    1997-03-01

    This study had two objectives. Firstly we assessed the effects of multifetal pregnancy reduction on the mothers' emotional well-being and the relationship with the children during the 2 years following intervention. Secondly at 2 years we compared mothers who had a reduction with mothers who had not and had delivered triplets. The comparisons focused on the mothers' health and their relationship with the children. Women having had a reduction in two hospitals in Paris, between May 1992 and June 1993, were contacted just after intervention for a prospective study. In all, 18 women were included. At 1 and 2 years, 10 women participated. At 2 years, 10 additional women were included. The answers of these 20 mothers were compared to those of 11 consecutive mothers of 2 year old triplets, assessed by the same psychologist in a previous prospective study. Semi-structured interviews were conducted at home. The mothers' social characteristics, their parity, the children's condition at birth and 4 months were very similar between the reduction and triplet groups. One year after birth one-third of the women in the reduction group reported persistent depressive symptoms related to the reduction, mainly sadness and guilt. The others made medical and rational comments expressing no emotion. At 2 years all but two women seemed to have overcome the emotional pain associated with the reduction. The comparison with mothers of triplets indicated that the mothers' anxiety and depression, and difficult relationship with the children were less acute in the reduction group. These results presented some limitations, since a high number of women who miscarried or refused to participate in the follow-up were not assessed at 1 and 2 years. However, a majority of women who participated in the study 2 years after intervention seemed able to accept a multifetal pregnancy reduction to achieve parental goals.

  19. Assessment of first-year medical students' perceptions of teaching and learning through team-based learning sessions.

    Science.gov (United States)

    Obad, Adam S; Peeran, Ahmed A; Shareef, Mohammad Abrar; Alsheikh, Wissal J; Kalagi, Dana A; AlAmodi, Abdulhadi A; Khan, Tehreem A; Shaikh, Abdul Ahad; Ganguly, Paul; Yaqinuddin, Ahmed

    2016-12-01

    Team-based learning (TBL) is an emerging teaching and learning strategy being employed in medical schools. The College of Medicine at Alfaisal University has adopted a TBL approach as an instructional method for first-year medical students. The aim of the present study was to describe the TBL method employed at Alfaisal University College of Medicine and to assess first-year medical students' perceptions of this learning modality for the anatomy- and physiology-based blocks/courses in organ systems form of curriculum. A five-point Likert scale questionnaire was structured based on Kirkpatrick's theory and assessed three major domains: reaction, learning, and behavior. Confirmatory factor analysis (CFA) and Cronbach's α-coefficient tests were used to assess the validity and reliability of the construct, respectively. CFA showed an adequate validity of the survey and Cronbach's α revealed an acceptable internal uniformity (0.69). A total of 185 respondents rated reaction, learning, and behavior toward introduction of TBL as 3.53 ± 1.01, 3.59 ± 1.12, and 3.57 ± 1.12, respectively. Excellent students rated TBL highly in all major domains compared with borderline students (reaction, behavior, and learning domains with P values of teaching and learning strategy for functional anatomy, and prior involvement in teamwork and academic performance correlates with higher ratings of TBL. Copyright © 2016 the American Physiological Society.

  20. Intra- and inter-observer agreement in MRI assessment of rotator cuff healing using the Sugaya classification 10years after surgery.

    Science.gov (United States)

    Niglis, L; Collin, P; Dosch, J-C; Meyer, N; Kempf, J-F

    2017-10-01

    The long-term outcomes of rotator cuff repair are unclear. Recurrent tears are common, although their reported frequency varies depending on the type and interpretation challenges of the imaging method used. The primary objective of this study was to assess the intra- and inter-observer reproducibility of the MRI assessment of rotator cuff repair using the Sugaya classification 10years after surgery. The secondary objective was to determine whether poor reproducibility, if found, could be improved by using a simplified yet clinically relevant classification. Our hypothesis was that reproducibility was limited but could be improved by simplifying the classification. In a retrospective study, we assessed intra- and inter-observer agreement in interpreting 49 magnetic resonance imaging (MRI) scans performed 10years after rotator cuff repair. These 49 scans were taken at random among 609 cases that underwent re-evaluation, with imaging, for the 2015 SoFCOT symposium on 10-year and 20-year clinical and anatomical outcomes of rotator cuff repair for full-thickness tears. Each of three observers read each of the 49 scans on two separate occasions. At each reading, they assessed the supra-spinatus tendon according to the Sugaya classification in five types. Intra-observer agreement for the Sugaya type was substantial (κ=0.64) but inter-observer agreement was only fair (κ=0.39). Agreement improved when the five Sugaya types were collapsed into two categories (1-2-3 and 4-5) (intra-observer κ=0.74 and inter-observer κ=0.68). Using the Sugaya classification to assess post-operative rotator cuff healing was associated with substantial intra-observer and fair inter-observer agreement. A simpler classification into two categories improved agreement while remaining clinically relevant. II, prospective randomised low-power study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Theory of mind deficit in bipolar disorder: is it related to a previous history of psychotic symptoms?

    Science.gov (United States)

    Lahera, Guillermo; Montes, José Manuel; Benito, Adolfo; Valdivia, María; Medina, Elena; Mirapeix, Isabel; Sáiz-Ruiz, Jerónimo

    2008-12-15

    It has been hypothesized that a Theory of Mind (ToM) deficit could be a vulnerability marker for psychosis. Recent studies, however, have shown ToM deficits in affective relapses of bipolar disorder as well as in the euthymic phase. This study analyzes the relationship between ToM and a previous history of psychotic symptoms in bipolar disorder. ToM, sustained attention and executive functions were analyzed in 75 bipolar euthymic patients with three or more previous relapses (42 of them had a history of psychotic symptoms and 33 did not) and 48 healthy subjects. ToM was assessed with the Advanced Test by Happé. ToM performance was similar in bipolar patients with or without a history of psychotic symptoms, and in both cases it was significantly reduced as compared with the healthy control group. Similarly, both bipolar groups showed impaired sustained attention and executive functions. This general cognitive deficit partially explains the differences obtained in ToM. The ToM instrument used shows low sensitivity for assessing ToM in bipolar patients and it could partially reflect general cognitive functioning rather than a specific deficit in psychosis. ToM deficit is not a trait marker for psychosis, given that it is present in bipolar disorder regardless of a previous history of psychotic symptoms.

  2. Revisiting restored river reaches - Assessing change of aquatic and riparian communities after five years.

    Science.gov (United States)

    Lorenz, Armin W; Haase, Peter; Januschke, Kathrin; Sundermann, Andrea; Hering, Daniel

    2018-02-01

    Hydromorphological restructuring of river sections, i.e. river restoration measures, often has little effects on aquatic biota, even in case of strong habitat alterations. It is often supposed that the biotic response is simply delayed as species require additional time to recolonize the newly generated habitats and to establish populations. To identify and specify the supposed lag time between restoration and biotic response, we investigated 19 restored river reaches twice in a five-year interval. The sites were restored one to ten years prior to the first sampling. We sampled three aquatic (fish, benthic invertebrates, macrophytes) and two riparian organism groups (ground beetles and riparian vegetation) and analyzed changes in assemblage composition and biotic metrics. With the exception of ground beetle assemblages, we observed no significant changes in richness and abundance metrics or metrics used for biological assessment. However, indicator taxa for near-natural habitat conditions in the riparian zone (indicators for regular inundation in plants and river bank specialists in beetles) improved significantly in the five-year interval. Contrary to general expectations in river restoration planning, we neither observed a distinct succession of aquatic communities nor a general trend towards "good ecological status" over time. Furthermore, multiple linear regression models revealed that neither the time since restoration nor the morphological status had a significant effect on the biological metrics and the assessment results. Thus, the stability of aquatic assemblages is strong, slowing down restoration effects in the aquatic zone, while riparian assemblages improve more rapidly. When defining restoration targets, the different timelines for ecological recovery after restoration should be taken into account. Furthermore, restoration measures should not solely focus on local habitat conditions but also target stressors acting on larger spatial scales and take

  3. The association between subjective memory complaint and objective cognitive function in older people with previous major depression.

    Directory of Open Access Journals (Sweden)

    Chung-Shiang Chu

    Full Text Available The goal of this study is to investigate associations between subjective memory complaint and objective cognitive performance in older people with previous major depression-a high-risk sample for cognitive impairment and later dementia. A cross-sectional study was carried out in people aged 60 or over with previous major depression but not fulfilling current major depression criteria according to DSM-IV-TR. People with dementia or Mini-Mental State Examination score less than 17 were excluded. Subjective memory complaint was defined on the basis of a score ≧4 on the subscale of Geriatric Mental State schedule, a maximum score of 8. Older people aged equal or over 60 without any psychiatric diagnosis were enrolled as healthy controls. Cognitive function was evaluated using a series of cognitive tests assessing verbal memory, attention/speed, visuospatial function, verbal fluency, and cognitive flexibility in all participants. One hundred and thirteen older people with previous major depression and forty-six healthy controls were enrolled. Subjective memory complaint was present in more than half of the participants with depression history (55.8%. Among those with major depression history, subjective memory complaint was associated with lower total immediate recall and delayed verbal recall scores after adjustment. The associations between subjective memory complaint and worse memory performance were stronger in participants with lower depressive symptoms (Hamilton Depression Rating Scale score<7. The results suggest subjective memory complaint may be a valid appraisal of memory performance in older people with previous major depression and consideration should be given to more proactive assessment and follow-up in these clinical samples.

  4. [Relationship between previous severity of illness and outcome of in-hospital cardiac arrest].

    Science.gov (United States)

    Serrano, M; Rodríguez, J; Espejo, A; del Olmo, R; Llanos, S; Del Castillo, J; López-Herce, J

    2014-07-01

    To analyze the relationship between previous severity of illness, lactic acid, creatinine and inotropic index with mortality of in-hospital cardiac arrest (CA) in children, and the value of a prognostic index designed for adults. The study included total of 44 children aged from 1 month to 18 years old who suffered a cardiac arrest while in hospital. The relationship between previous severity of illness scores (PRIMS and PELOD), lactic acid, creatinine, treatment with vasoactive drugs, inotropic index with return of spontaneous circulation and survival at hospital discharge was analyzed. The large majority (90.3%) of patients had a return of spontaneous circulation, and 59% survived at hospital discharge. More than two-thirds (68.2%) were treated with inotropic drugs at the time of the CA. The patients who died had a higher lactic acid before the CA (3.4 mmol/L) than survivors (1.4 mmol/L), P=.04. There were no significant differences in PRIMS, PELOD, creatinine, inotropic drugs, and inotropic index before CA between patients who died and survivors. A high lactic acid previous to cardiac arrest could be a prognostic factor of in-hospital cardiac arrest in children. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  5. Automatic electromagnetic valve for previous vacuum

    International Nuclear Information System (INIS)

    Granados, C. E.; Martin, F.

    1959-01-01

    A valve which permits the maintenance of an installation vacuum when electric current fails is described. It also lets the air in the previous vacuum bomb to prevent the oil ascending in the vacuum tubes. (Author)

  6. Gender, Previous Knowledge, Personality Traits and Subject-Specific Motivation as Predictors of Students' Math Grade in Upper-Secondary School

    Science.gov (United States)

    Peklaj, Cirila; Podlesek, Anja; Pecjak, Sonja

    2015-01-01

    The aim of the study was to examine the relationships between gender, previous knowledge, different personality traits, subject-specific motivational dimensions and students' math grade in secondary school. A total of 386 first-year students (142 boys and 244 girls) from secondary schools in Slovenia (mean age was 15.7 years) participated in the…

  7. Proficiency Assessment of Male Volleyball Teams of the 13-15-Year Age Group at Estonian Championships

    Science.gov (United States)

    Stamm, Meelis; Stamm, Raini; Koskel, Sade

    2008-01-01

    Study aim: Assessment of feasibility of using own computer software "Game" at competitions. Material and methods: The data were collected during Estonian championships in 2006 for male volleyball teams of the 13-15-years age group (n = 8). In all games, the performance of both teams was recorded in parallel with two computers. A total of…

  8. Wheat Response to a Soil Previously Irrigated with Saline Water

    Directory of Open Access Journals (Sweden)

    Marco Antonio Russo

    2009-12-01

    Full Text Available A research was conducted aimed at assessing the response of rainfed, lysimeter-grown wheat to various levels of soil salinity, in terms of dry mass production, inorganic and organic components, sucrose phosphate synthase (SPS and sucrose synthase (SS activity. One additional scope was the assessment of soil ability to recover from applied salts by means of winter precipitations. The results confirmed the relatively high salt tolerance of wheat, as demonstrated by the mechanisms enacted by plants to contrast salinity at root and leaf level. Some insight was gained in the relationships between salinity and the various inorganic and organic components, as well as with SPS and SS activity. It was demonstrated that in a year with precipitations well below the average values (305 mm vs 500 the leaching action of rain was sufficient to eliminate salts accumulated during summer irrigation with saline water.

  9. Wheat Response to a Soil Previously Irrigated with Saline Water

    Directory of Open Access Journals (Sweden)

    Vito Sardo

    2011-02-01

    Full Text Available A research was conducted aimed at assessing the response of rainfed, lysimeter-grown wheat to various levels of soil salinity, in terms of dry mass production, inorganic and organic components, sucrose phosphate synthase (SPS and sucrose synthase (SS activity. One additional scope was the assessment of soil ability to recover from applied salts by means of winter precipitations. The results confirmed the relatively high salt tolerance of wheat, as demonstrated by the mechanisms enacted by plants to contrast salinity at root and leaf level. Some insight was gained in the relationships between salinity and the various inorganic and organic components, as well as with SPS and SS activity. It was demonstrated that in a year with precipitations well below the average values (305 mm vs 500 the leaching action of rain was sufficient to eliminate salts accumulated during summer irrigation with saline water.

  10. Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction

    International Nuclear Information System (INIS)

    Berek, J.S.; Hacker, N.F.; Lagasse, L.D.; Smith, M.L.

    1983-01-01

    Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery

  11. Congenital costo-vertebral fibrous band and congenital kyphoscoliosis: a previously unreported combination.

    Science.gov (United States)

    Eid, Tony; Ghostine, Bachir; Kreichaty, Gaby; Daher, Paul; Ghanem, Ismat

    2013-05-01

    Congenital kyphoscoliosis (CKS) results from abnormal vertebral chondrification. Congenital fibrous bands occur in several locations with variable impact on vertebral development. We report a previously unreported case of a female infant with CKS presenting with an L2 hypoplastic vertebra and a costo-vertebral fibrous band extending to the skin in the form of a dimple. We also describe the therapeutic approach, consisting of surgical excision of the fibrous band and postoperative fulltime bracing, with a 7-year follow-up. We recommend a high index of suspicion in any unusual presentation of CKS and insist on case by case management in such cases.

  12. Crotalaria trifoliolata (Leguminosae: Papilionoideae), a previously incompletely known Ethiopian endemic rediscovered after 120 years

    DEFF Research Database (Denmark)

    Friis, Ib; Weber, Odile

    2014-01-01

    . rhynchocarpa Polhill, C. saltiana Andrews, C. thomasii Harms) in having the inside of the pod densely packed with long, white hairs. C. trifoliolata was observed at the edge of and in glades inside dry Juniperus-Olea forest, in which the canopy is dominated by J. procera Endl. and the undergrowth by Barbeya...... oleoides Schweinf. and other species characteristic of dry Afromontane forest and bushland. The species is found only in a limited area near the eastern Ethiopian escarpment at Sheik Hussein. It is documented with images and maps, its potential distribution is modelled and a conservation assessment...

  13. Performance of USGS one-year earthquake hazard map for natural and induced seismicity in the central and eastern United States

    Science.gov (United States)

    Brooks, E. M.; Stein, S.; Spencer, B. D.; Salditch, L.; Petersen, M. D.; McNamara, D. E.

    2017-12-01

    Seismicity in the central United States has dramatically increased since 2008 due to the injection of wastewater produced by oil and gas extraction. In response, the USGS created a one-year probabilistic hazard model and map for 2016 to describe the increased hazard posed to the central and eastern United States. Using the intensity of shaking reported to the "Did You Feel It?" system during 2016, we assess the performance of this model. Assessing the performance of earthquake hazard maps for natural and induced seismicity is conceptually similar but has practical differences. Maps that have return periods of hundreds or thousands of years— as commonly used for natural seismicity— can be assessed using historical intensity data that also span hundreds or thousands of years. Several different features stand out when assessing the USGS 2016 seismic hazard model for the central and eastern United States from induced and natural earthquakes. First, the model can be assessed as a forecast in one year, because event rates are sufficiently high to permit evaluation with one year of data. Second, because these models are projections from the previous year thus implicitly assuming that fluid injection rates remain the same, misfit may reflect changes in human activity. Our results suggest that the model was very successful by the metric implicit in probabilistic hazard seismic assessment: namely, that the fraction of sites at which the maximum shaking exceeded the mapped value is comparable to that expected. The model also did well by a misfit metric that compares the spatial patterns of predicted and maximum observed shaking. This was true for both the central and eastern United States as a whole, and for the region within it with the highest amount of seismicity, Oklahoma and its surrounding area. The model performed least well in northern Texas, over-stating hazard, presumably because lower oil and gas prices and regulatory action reduced the water injection volume

  14. Thyroid abnormalities in patients previously treated with irradiation for acne vulgaris

    International Nuclear Information System (INIS)

    Thomson, D.B.; Grammes, C.F.; Starkey, R.H.; Monsaert, R.P.; Sunderlin, F.S.

    1984-01-01

    Of 1203 patients who received radiation treatment for acne vulgaris between 1940 and 1968, 302 were recalled and examined, 121 at Geisinger Medical Center and the remainder by their local physicians. Radiation records were reviewed on all patients. Lead-rubber and cones had been used as shielding. Mean age at the time of exposure was 21 years and mean total exposure was 692 R. Palpable nodular thyroid disease was found in eight patients (2.6%). Of these, thyroid carcinoma was detected in two patients (0.66%). Although the number of patients examined was small, the incidence of carcinomas was unexpectedly high. The authors conclude that follow-up examination is worthwhile for patients previously treated by irradiation for acne vulgaris

  15. Is Cup Positioning Challenged in Hips Previously Treated With Periacetabular Osteotomy?

    DEFF Research Database (Denmark)

    Hartig-Andreasen, Charlotte; Stilling, Maiken; Søballe, Kjeld

    2014-01-01

    After periacetabular osteotomy (PAO), some patients develop osteoarthritis with need of a total hip arthroplasty (THA). We evaluated the outcome of THA following PAO and explored factors associated with inferior cup position and increased polyethylene wear. Follow-up were performed 4 to 10years...... after THA in 34 patients (38 hips) with previous PAO. Computer analysis evaluated cup position and wear rates. No patient had dislocations or revision surgery. Median scores were: Harris hip 96, Oxford hip 38 and WOMAC 78. Mean cup anteversion and abduction angles were 22(o) (range 7°-43°) and 45......° (range 28°-65°). Outliers of cup abduction were associated with persisting dysplasia (CE...

  16. Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment.

    Science.gov (United States)

    Garcia-Lopez, Luis-Joaquin; Olivares, Jose; Beidel, Deborah; Albano, Anne-Marie; Turner, Samuel; Rosa, Ana I

    2006-01-01

    Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed.

  17. Impact of previous vascular burden on in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Consuegra-Sánchez, Luciano; Melgarejo-Moreno, Antonio; Galcerá-Tomás, José; Alonso-Fernández, Nuria; Díaz-Pastor, Angela; Escudero-García, Germán; Jaulent-Huertas, Leticia; Vicente-Gilabert, Marta

    2014-06-01

    Patients with a current acute coronary syndrome and previous ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease are reported to have a poorer outcome than those without these previous conditions. It is uncertain whether this association with outcome is observed at long-term follow-up. Prospective observational study, including 4247 patients with ST-segment elevation myocardial infarction. Detailed clinical data and information on previous ischemic heart disease, peripheral arterial disease, and cerebrovascular disease ("vascular burden") were recorded. Multivariate models were performed for in-hospital and long-term (median, 7.2 years) all-cause mortality. One vascular territory was affected in 1131 (26.6%) patients and ≥ 2 territories in 221 (5.2%). The total in-hospital mortality rate was 12.3% and the long-term incidence density was 3.5 deaths per 100 patient-years. A background of previous ischemic heart disease (odds ratio = 0.83; P = .35), peripheral arterial disease (odds ratio = 1.30; P = .34), or cerebrovascular disease (stroke) (odds ratio = 1.15; P = .59) was not independently predictive of in-hospital death. In an adjusted model, previous cerebrovascular disease and previous peripheral arterial disease were both predictors of mortality at long-term follow-up (hazard ratio = 1.57; P cerebrovascular disease and peripheral arterial disease were predictors of mortality at long-term after hospital discharge. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  18. Longitudinal study of iris concavity, corneal biomechanics, and correlations to ocular biometry in a cohort of 10- to 12-year-old UK schoolboys: 2-year follow-up data.

    Science.gov (United States)

    Shah, Ameet; Lascaratos, Gerassimos; Garway-Heath, David F; Foster, Paul J; Barton, Keith

    2014-06-10

    To explore changes in iris curvature over a 2-year period. To investigate associations between iris curvature and ocular biometric parameters. To explore relationships between a number of nonocular measurements and ocular biometric parameters. Schoolboys enrolled 2 years previously were invited to return for anterior segment optical coherence tomography, corneal hysteresis (CH), corneal resistance factor (CRF), and axial biometric measurements. Refractive error was assessed and measures of height, weight, waist circumference, digit ratio, and percentage body fat taken. Mean spherical equivalent refraction reduced by 0.76 diopters and mean iris concavity, defined as a measurement of less than or equal to -0.1 mm, increased by 0.018 mm at distance fixation and 0.04 mm on accommodation. Compared with 2 years previously, the prevalence of iris concavity increased from 24% to 32% on distance fixation and from 65% to 84% on accommodation. Variables significantly associated with nonaccommodating iris curvature were anterior chamber depth (ACD, P = 0.029) and mean scleral spur angle (P = 0.0001). Variables significantly associated with accommodating iris curvature were ACD (P = 0.02), lens vault (P = 0.047), and scleral spur angle (P Iris concavity was more prevalent in this cohort of schoolboys than 2 years earlier. The degree of concavity remains related to ACD and lens vault. The association between spur-to-spur distance and CH was similar at baseline and after 2 years. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  19. Assessing the Environmental Risks of Nanomaterials

    DEFF Research Database (Denmark)

    Grieger, Khara Deanne; Hansen, Steffen Foss; Baun, Anders

    to a wide range of technical limitations. For instance, serious knowledge gaps remain within e.g. the detection of NM in the environment, developing adequate testing equipment and protocols, and toxicity endpoints (Grieger et al., 2009). In the past few years, many scientists and organizations have...... considered. Furthermore, we recommend the use of biomonitoring in some environmental ‘hot spots’ to serve as early warning detectors while the field of NM environmental risk assessment matures, as recommended in our previous work. Ultimately, this analysis may aid the advancement of environmental risk...

  20. The Affordable Care Act, Insurance Coverage, and Health Care Utilization of Previously Incarcerated Young Men: 2008-2015.

    Science.gov (United States)

    Winkelman, Tyler N A; Choi, HwaJung; Davis, Matthew M

    2017-05-01

    To estimate health insurance and health care utilization patterns among previously incarcerated men following implementation of the Affordable Care Act's (ACA's) Medicaid expansion and Marketplace plans in 2014. We performed serial cross-sectional analyses using data from the National Survey of Family Growth between 2008 and 2015. Our sample included men aged 18 to 44 years with (n = 3476) and without (n = 8702) a history of incarceration. Uninsurance declined significantly among previously incarcerated men after ACA implementation (-5.9 percentage points; 95% confidence interval [CI] = -11.5, -0.4), primarily because of an increase in private insurance (6.8 percentage points; 95% CI = 0.1, 13.3). Previously incarcerated men accounted for a large proportion of the remaining uninsured (38.6%) in 2014 to 2015. Following ACA implementation, previously incarcerated men continued to be significantly less likely to report a regular source of primary care and more likely to report emergency department use than were never-incarcerated peers. Health insurance coverage improved among previously incarcerated men following ACA implementation. However, these men account for a substantial proportion of the remaining uninsured. Previously incarcerated men continue to lack primary care and frequently utilize acute care services.

  1. Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy.

    Science.gov (United States)

    Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Mafe, Juan Jose; Rivera, Maria Jesus; Roca, Joaquin; Baschwitz, Benno

    2014-09-01

    Surgical resection of a contralateral recurrence of non-small cell lung cancer (NSCLC) is indicated in patients without evidence of disseminated disease and considered functionally operable. General anesthesia and double-lumen intubation involves one lobe ventilation in a patient treated with a previous lobectomy, thus increasing the risks of ventilator-induced injuries and the morbidity. Awake procedures facilitate the surgery decreasing the anesthetic and surgical times, keeping the diaphragm motion and diminishing the ventilator-induced injuries into the remaining contralateral lobe. We present a 43-year-old woman with a previous left-lower lobectomy for a 3.1-cm mucinous adenocarcinoma 15 months before without nodal involvement, who presents a right-lower lobe 8-mm cavitated nodule, with evident radiological growth and fine-needle aspiration concordant with mucinous adenocarcinoma. We suggest an awake procedure with locoregional epidural anesthesia.

  2. The external quality assessment scheme: Five years experience as a participating laboratory

    Directory of Open Access Journals (Sweden)

    Chaudhary Rajendra

    2010-01-01

    Full Text Available Background and Aim : Quality assurance in blood banking includes active participation in the external quality program. Such a program offers valuable benefits to patient care, their safety, and an overall quality of laboratory practices. In the year 2002, we participated in the External Quality Assessment Scheme (EQAS under the World Health Organization (WHO, Bureau of Laboratory Quality Standards, Thailand. Materials and Methods: In the current study we evaluated our EQAS test result of the past five years, from 2003 to 2007. Test results of all blood samples such as ABO grouping, D typing, antibody screening, antibody identification, and transfusion transmitted infection (TTI testing were analyzed and documented. Results: Discordant results in one or more instances were observed with antibody identification, weak D testing, and tests for anti-HIV1/2 and HBsAg. Twice we failed to detect the ′anti-Mia′ antibody in the issued sample and that could be attributed to the absence of the corresponding antigen in the used cell panel. HBsAg was missed due to its critically low titer in the serum and the comparatively low sensitivity of our Enzyme-Linked Immunosorbent Assay (ELISA test kit. Conclusion: All these failures in the last five years have helped us to significantly improve our transfusion service in terms of performance evaluation, patient care and safety issues, and the overall quality of laboratory practices. We therefore recommend all laboratories and hospitals to participate in the EQAS program, which will definitely help them to improve from what they learn.

  3. Gefitinib plus cisplatin and radiotherapy in previously untreated head and neck squamous cell carcinoma: A phase II, randomized, double-blind, placebo-controlled study

    International Nuclear Information System (INIS)

    Gregoire, Vincent; Hamoir, Marc; Chen Changhu; Kane, Madeleine; Kawecki, Andrzej; Julka, Pramod K.; Wang, Hung-Ming; Prasad, Srihari; D'Cruz, Anil K.; Radosevic-Jelic, Ljiljana; Kumar, Rejnish R.; Korzeniowski, Stanislaw; Fijuth, Jacek; Machiels, Jean-Pascal; Sellers, Mark V.; Tchakov, Ilian; Raben, David

    2011-01-01

    Background and purpose: To assess the efficacy and safety of gefitinib given concomitantly and/or as maintenance therapy to standard cisplatin/radiotherapy for previously untreated, unresected, stage III/IV non-metastatic SCCHN. Materials and methods: In this phase II, double-blind, study, 226 patients were randomized to gefitinib 250 mg/day, 500 mg/day or placebo in two phases: a concomitant phase (gefitinib or placebo with chemoradiotherapy), followed by a maintenance phase (gefitinib or placebo alone). Primary endpoint was local disease control rate (LDCR) at 2 years; secondary endpoints were LDCR at 1 year, objective response rate, progression-free survival, overall survival, and safety and tolerability. Results: Gefitinib (250 and 500 mg/day) did not improve 2-year LDCR compared with placebo either when given concomitantly with chemoradiotherapy (32.7% vs. 33.6%, respectively; OR 0.921, 95% CI 0.508, 1.670 [1-sided p = 0.607]) or as maintenance therapy (28.8% vs. 37.4%, respectively; OR 0.684, 95% CI 0.377, 1.241 [1-sided p = 0.894]). Secondary efficacy outcomes were broadly consistent with the 2-year LDCR results. In both doses, gefitinib was well-tolerated and did not adversely affect the safety and tolerability of concomitant chemoradiotherapy. Conclusion: Gefitinib was well-tolerated, but did not improve efficacy compared with placebo when given concomitantly with chemoradiotherapy, or as maintenance therapy alone.

  4. Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach.

    Science.gov (United States)

    Batterham, Philip J; Christensen, Helen; Mackinnon, Andrew J

    2009-11-22

    Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

  5. Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach

    Directory of Open Access Journals (Sweden)

    Christensen Helen

    2009-11-01

    Full Text Available Abstract Background Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. Methods The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. Results The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. Conclusion The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

  6. Pulmonary disease in cystic fibrosis: assessment with chest CT at chest radiography dose levels.

    Science.gov (United States)

    Ernst, Caroline W; Basten, Ines A; Ilsen, Bart; Buls, Nico; Van Gompel, Gert; De Wachter, Elke; Nieboer, Koenraad H; Verhelle, Filip; Malfroot, Anne; Coomans, Danny; De Maeseneer, Michel; de Mey, Johan

    2014-11-01

    To investigate a computed tomographic (CT) protocol with iterative reconstruction at conventional radiography dose levels for the assessment of structural lung abnormalities in patients with cystic fibrosis ( CF cystic fibrosis ). In this institutional review board-approved study, 38 patients with CF cystic fibrosis (age range, 6-58 years; 21 patients 18 years) underwent investigative CT (at minimal exposure settings combined with iterative reconstruction) as a replacement of yearly follow-up posteroanterior chest radiography. Verbal informed consent was obtained from all patients or their parents. CT images were randomized and rated independently by two radiologists with use of the Bhalla scoring system. In addition, mosaic perfusion was evaluated. As reference, the previous available conventional chest CT scan was used. Differences in Bhalla scores were assessed with the χ(2) test and intraclass correlation coefficients ( ICC intraclass correlation coefficient s). Radiation doses for CT and radiography were assessed for adults (>18 years) and children (chest CT protocol can replace the two yearly follow-up chest radiographic examinations without major dose penalty and with similar diagnostic quality compared with conventional CT.

  7. Assessment of the pivot shift using inertial sensors

    OpenAIRE

    Zaffagnini, Stefano; Signorelli, Cecilia; Grassi, Alberto; Yue, Han; Raggi, Federico; Urrizola, Francisco; Bonanzinga, Tommaso; Marcacci, Maurilio

    2016-01-01

    The pivot shift test is an important clinical tool used to assess the stability of the knee following an injury to the anterior cruciate ligament (ACL). Previous studies have shown that significant variability exists in the performance and interpretation of this manoeuvre. Accordingly, a variety of techniques aimed at standardizing and quantifying the pivot shift test have been developed. In recent years, inertial sensors have been used to measure the kinematics of the pivot shift. The goal o...

  8. Assessment of the global intelligence and selective cognitive capacities in preterm 8-year-old children.

    Science.gov (United States)

    Begega, Azucena; Méndez López, Magdalena; de Iscar, María Jesús; Cuesta-Izquierdo, Marcelino; Solís, Gonzalo; Fernández-Colomer, Belén; Álvarez, Luis; Méndez, Marta; Arias, Jorge L

    2010-11-01

    The aim of this study was to assess various cognitive abilities such as attention, IQ, reasoning, and memory related to academic achievement in 8- and 9-year-old preterm children. A total of 141 children were assessed. The preterm group (=37 weeks) comprised 63 children and was compared to 78 full-term children. Attention was evaluated using the d2 Selective Attention test, and the IQ by the L-M form of the Stanford-Binet Intelligence Scale, establishing a profile of abilities: perception, memory, comprehension, reasoning, and verbal fluency. Significant differences in IQ were found between the preterm and full-term children. Of the cognitive abilities assessed, the only significant differences were found in verbal fluency, with preterm boys showing lower verbal fluency scores than full-term children. In conclusion, all preterm groups have attention ability similar to that of full-term children. However, preterm children obtain lower scores in intelligence measures. In addition, preterm boys have verbal fluency difficulties. Taking into account the increase in preterm births, suitable intervention programs must be planned to attend the difficulties found.

  9. Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients

    International Nuclear Information System (INIS)

    Haddock, Michael G.; Gunderson, Leonard L.; Nelson, Heidi; Cha, Stephen S.; Devine, Richard M.; Dozois, Roger R.; Wolff, Bruce G.

    2001-01-01

    Purpose: Information in the literature regarding salvage treatment for patients with locally recurrent colorectal cancer who have previously been treated with high or moderate dose external beam irradiation (EBRT) is scarce. A retrospective review was therefore performed in our institution to determine disease control, survival, and tolerance in patients treated aggressively with surgical resection and intraoperative electron irradiation (IOERT) ± additional EBRT and chemotherapy. Methods and Materials: From 1981 through 1994, 51 previously irradiated patients with recurrent locally advanced colorectal cancer without evidence of distant metastatic disease were treated at Mayo Clinic Rochester with surgical resection and IOERT ± additional EBRT. An attempt was made to achieve a gross total resection before IOERT if it could be safely accomplished. The median IOERT dose was 20 Gy (range, 10-30 Gy). Thirty-seven patients received additional EBRT either pre- or postoperatively with doses ranging from 5 to 50.4 Gy (median 25.2 Gy). Twenty patients received 5-fluorouracil ± leucovorin during EBRT. Three patients received additional cycles of 5-fluorouracil ± leucovorin as maintenance chemotherapy. Results: Thirty males and 21 females with a median age of 55 years (range 31-73 years) were treated. Thirty-four patients have died; the median follow-up in surviving patients is 21 months. The median, 2-yr, and 5-yr actuarial overall survivals are 23 months, 48% and 12%, respectively. The 2-yr actuarial central control (within IOERT field) is 72%. Local control at 2 years has been maintained in 60% of patients. There is a trend toward improved local control in patients who received ≥30 Gy EBRT in addition to IOERT as compared to those who received no EBRT or <30 Gy with 2-yr local control rates of 81% vs. 54%. Distant metastatic disease has developed in 25 patients, and the actuarial rate of distant progression at 2 and 4 years is 56% and 76%, respectively. Peripheral

  10. Assessing students' performance in first-year university ...

    African Journals Online (AJOL)

    Students and tutor evaluations suggested that the tool developed, met the first two criteria successfully. Achieving the third criterion proved challenging for two reasons: (1) the difficulties involved in making the assessment criteria explicit and (2) the inconsistency across tutors when converting the criterion-referenced ...

  11. Does parental divorce moderate the heritability of body dissatisfaction? An extension of previous gene-environment interaction effects.

    Science.gov (United States)

    O'Connor, Shannon M; Klump, Kelly L; VanHuysse, Jessica L; McGue, Matt; Iacono, William

    2016-02-01

    Previous research suggests that parental divorce moderates genetic influences on body dissatisfaction. Specifically, the heritability of body dissatisfaction is higher in children of divorced versus intact families, suggesting possible gene-environment interaction effects. However, prior research is limited to a single, self-reported measure of body dissatisfaction. The primary aim of this study was to examine whether these findings extend to a different dimension of body dissatisfaction: body image perceptions. Participants were 1,534 female twins from the Minnesota Twin Family Study, aged 16-20 years. The Body Rating Scale (BRS) was used to assess body image perceptions. Although BRS scores were heritable in twins from divorced and intact families, the heritability estimates in the divorced group were not significantly greater than estimates in the intact group. However, there were differences in nonshared environmental effects, where the magnitude of these environmental influences was larger in the divorced as compared with the intact families. Different dimensions of body dissatisfaction (i.e., negative self-evaluation versus body image perceptions) may interact with environmental risk, such as parental divorce, in discrete ways. Future research should examine this possibility and explore differential gene-environment interactions using diverse measures. © 2015 Wiley Periodicals, Inc.

  12. Assessing Executive Function components in 9 years old children

    Directory of Open Access Journals (Sweden)

    Sandra Reyes

    2014-05-01

    Full Text Available Executive Function (EF is a multidimensional construct. It includes a set of abilities that allows to execute actions with a purpose, aimed to a goal, in an efficient way. The objective of this work is to explore some of the cognitive abilities that constitute a common factor for EF in 9 years-old children. The chosen instruments: Batería de Evaluación Neuropsicológica de la Función Ejecutiva en niños (ENFEN (Battery of Neuropsychological Assessment for Executive Function in Children, along with the Backward Digits Subtestfrom the WISC-III, were administered to 101 children from private schools of Buenos Aires State, Argentina. The ENFEN consists on EF tasks, including Phonological and Semantic Fluency, Trail Making Test versions for children (gray and colored sets, Interference Task, and Planning disc movements according to a model. An initial confirmatory factor analysis didn’t show significant fit indexes, being the Inhibitory control the variable with the lower and non significant factorial weight. A second model excluding the Inhibitory control measure was conducted, and it showed excellent fit indexes. Therefore, it can be concluded that at this age, some of the cognitive abilities included on the EF are: Phonological and Semantic Fluency, Sustained and Selective attention, Planning and Working memory; which is not the case for Inhibitory Control (measured by the Interference Task in the ENFEN.

  13. Assessing HITECH Implementation and Lessons: 5 Years Later.

    Science.gov (United States)

    Gold, Marsha; McLAUGHLIN, Catherine

    2016-09-01

    The expansive goals of the Health Information Technology for Economic and Clinical Health (HITECH) Act required the simultaneous development of a complex and interdependent infrastructure and a wide range of relationships, generating points of vulnerability. While federal legislation can be a powerful stimulus for change, its effectiveness also depends on its ability to accommodate state and local policies and private health care markets. Ambitious goals require support over a long time horizon, which can be challenging to maintain. The future of health information technology (health IT) support nationally is likely to depend on the ability of the technology to satisfy its users that its functionalities address the interests policymakers and other stakeholders have in using technology to promote better care, improved outcomes, and reduced costs. The Health Information Technology for Economic and Clinical Health (HITECH) Act set ambitious goals for developing electronic health information as one tool to reform health care delivery and improve health outcomes. With HITECH's grant funding now mostly exhausted but statutory authority for standards remaining, this article looks back at HITECH's experience in the first 5 years to assess its implementation, remaining challenges, and lessons learned. This review derives from a global assessment of the HITECH Act. Earlier, we examined the logic of HITECH and identified interdependencies critical to its ultimate success. In this article, we build on that framework to review what has and has not been accomplished in building the infrastructure authorized by HITECH since it was enacted. The review incorporates quantitative and qualitative evidence of progress from the global assessment and from the evaluations funded by the Office of the National Coordinator for Health Information Technology (ONC) of individual programs authorized by the HITECH Act. Our review of the evidence provides a mixed picture. Despite HITECH

  14. Urinary tract infections in hospital pediatrics: many previous antibiotherapy and antibiotics resistance, including fluoroquinolones.

    Science.gov (United States)

    Garraffo, A; Marguet, C; Checoury, A; Boyer, S; Gardrat, A; Houivet, E; Caron, F

    2014-02-01

    We studied antibiotic resistance in pediatric UTIs and we evaluated the impact of antibiotic exposure in the previous 12 months, very little French data being available for this population. We conducted a multicenter prospective study including children consulting for, or admitted in 2 hospitals. Prior antibiotic exposure was documented from their health record. One hundred and ten patients (73 girls), 11 days to 12 years of age, were included in 10 months. Ninety-six percent presented with pyelonephritis, associated to uropathy for 25%. Escherichia coli was predominant (78%), followed by Proteus spp. and Enterococcus spp. The antibiotic resistance rate of E. coli was high and close to that reported for adults with complicated UTIs: amoxicillin 60%, amoxicillin-clavulanate 35%, cefotaxim 5%, trimethoprim-sulfametoxazole 26%, nalidixic acid 9%, ciprofloxacin 7%, gentamycin 1%, nitrofurantoin and fosfomycin 0%. The antibiotic exposure in the previous 12 months involved 62 children (56%) most frequently with β-lactams (89%) for a respiratory tract infection (56%). A clear relationship between exposure and resistance was observed for amoxicillin (71% vs. 46%), first generation (65% vs. 46%) and third generation (9% vs. 3%) cephalosporins, or trimethoprim-sulfamethoxazole (36% vs. 15%). However, antibiotic exposure could not account alone for the results, as suggested by the 7% of ciprofloxacin resistance, observed without any identified previous treatment. Bacterial species and antibiotic resistance level in children are similar to those reported for adults. Antibiotic exposure in the previous 12 months increases the risk of resistance but other factors are involved (previous antibiotic therapies and fecal-oral or mother-to-child transmission). Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. A 14-year longitudinal study of the impact of clean indoor air legislation on state smoking prevalence, USA, 1997-2010.

    Science.gov (United States)

    Becker, Craig M; Lee, Joseph G L; Hudson, Suzanne; Hoover, Jeanne; Civils, Donald

    2017-06-01

    While clean indoor air legislation at the state level is an evidence-based recommendation, only limited evidence exists regarding the impact of clean indoor air policies on state smoking prevalence. Using state smoking prevalence data from 1997 to 2010, a repeated measures observational analysis assessed the association between clean indoor air policies (i.e., workplace, restaurant, and bar) and state smoking prevalence while controlling for state cigarette taxes and year. The impacts from the number of previous years with any clean indoor air policy, the number of policies in effect during the current year, and the number of policies in effect the previous year were analyzed. Findings indicate a smoking prevalence predicted decrease of 0.13 percentage points (p=0.03) for each additional year one or more clean indoor air policies were in effect, a predicted decrease of 0.12 percentage points (p=0.09) for each policy in effect in the current year, and a predicted decrease of 0.22 percentage points (p=0.01) for each policy in effect in the previous year on the subsequent year. Clean indoor air policies show measurable associations with reductions in smoking prevalence within a year of implementation above and beyond taxes and time trends. Further efforts are needed to diffuse clean indoor air policies across states and provinces that have not yet adopted such policies. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. 75 FR 50036 - Petition To Modify an Exemption of a Previously Approved Antitheft Device; Ford Motor Company

    Science.gov (United States)

    2010-08-16

    ... Exemption of a Previously Approved Antitheft Device; Ford Motor Company AGENCY: National Highway Traffic..., the National Highway Traffic Safety Administration (NHTSA) granted in full Ford Motor Company's (Ford... Prevention Standard for the Ford Focus vehicle line beginning with model year (MY 2006). On June 18, 2010...

  17. 77 FR 35112 - Petition To Modify an Exemption of a Previously Approved Antitheft Device; Ford Motor Company

    Science.gov (United States)

    2012-06-12

    ... Exemption of a Previously Approved Antitheft Device; Ford Motor Company AGENCY: National Highway Traffic... Traffic Safety Administration (NHTSA) granted in full Ford Motor Company's (Ford) petition for an... Standard for the Ford Fusion vehicle line beginning with its model year (MY) 2012 vehicles. On February 16...

  18. Adolescents at Risk for Drug Abuse: A 3-Year Dual Process Analysis

    Science.gov (United States)

    Ames, S.L.; Xie, B.; Shono, Y.; Stacy, A.W.

    2016-01-01

    Aims To test longitudinal additive and synergistic dual process models in youth at documented risk for drug use. The specific dual process approach examined suggests that engaging in drug use behaviors results from a dynamic interplay between automatically-activated associative memory processes and executive reflective/control processes. Design This 3-year, three-wave population-based prospective study used mobile computer-based assessments. Setting Self-directed computer assessments were completed in school settings in the Los Angeles metropolitan area, California, USA. Participants 725 at-risk adolescents (44% female) in continuation high schools were recruited during 9th grade (age at recruitment, 14 to 16). Measurements Key outcome measures included past year alcohol, marijuana and cigarette use at each assessment. Predictors included working memory capacity (WMC), associative memory, the interaction term WMC by associative memory, sex, age, ethnicity, and acculturation. Findings A significant cross-sectional interaction revealed tobacco-relevant associations were weaker predictors of cigarette use among males with higher WMC than among those with lower WMC (p<0.004). Alternatively, drug-relevant associations were stronger predictors of past year alcohol (p<0.001) and marijuana use (p=0.02) among females with higher WMC than among those with lower WMC. Longitudinal analyses revealed no significant interactions after adjusting for predictive effects of previous drug use. With respect to WMC, females with higher WMC were less likely to use marijuana at two-year follow-up (p=0.03). First-order effects of drug-related associations prospectively predicted greater alcohol and marijuana use in males at one and two-year follow up (p≤0.03), and greater past year alcohol and marijuana use in females at one-year follow up (p≤0.03). Conclusions Drug-relevant memory associations play a key role in drug use behavior in at-risk youth. PMID:28010052

  19. Adolescents at risk for drug abuse: a 3-year dual-process analysis.

    Science.gov (United States)

    Ames, Susan L; Xie, Bin; Shono, Yusuke; Stacy, Alan W

    2017-05-01

    To test longitudinal additive and synergistic dual-process models in youth at documented risk for drug use. The specific dual-process approach examined suggests that engaging in drug use behaviors results from a dynamic interplay between automatically activated associative memory processes and executive reflective/control processes. This 3-year, three-wave population-based prospective study used mobile computer-based assessments. Self-directed computer assessments were completed in school settings in the Los Angeles metropolitan area, California, USA. Seven hundred and twenty-five at-risk adolescents (44% female) in continuation high schools were recruited during 9th grade (age at recruitment, 14-16). Key outcome measures included past year alcohol, marijuana and cigarette use at each assessment. Predictors included working memory capacity (WMC), associative memory, the interaction term WMC by associative memory, sex, age, ethnicity and acculturation. A significant cross-sectional interaction revealed tobacco-relevant associations were weaker predictors of cigarette use among males with higher WMC than among those with lower WMC (P < 0.004). Alternatively, drug-relevant associations were stronger predictors of past year alcohol (P < 0.001) and marijuana use (P = 0.02) among females with higher WMC than among those with lower WMC. Longitudinal analyses revealed no significant interactions after adjusting for predictive effects of previous drug use. With respect to WMC, females with higher WMC were less likely to use marijuana at 2-year follow-up (P = 0.03). First-order effects of drug-related associations predicted greater alcohol and marijuana use prospectively in males at 1- and 2-year follow up (P ≤ 0.03), and greater past year alcohol and marijuana use in females at 1-year follow up (P ≤ 0.03). Drug-relevant memory associations play a key role in drug use behavior in at-risk youth. © 2016 Society for the Study of Addiction.

  20. Ochratoxin A: Previous risk assessments and issues arising

    DEFF Research Database (Denmark)

    Walker, R.; Larsen, John Christian

    2005-01-01

    and mammalian cells, but produced DNA damage and chromosomal aberrations in mammalian cells in vitro, and in mice in vivo. DNA adducts found in the kidneys of mice and rats dosed with OTA, did not contain fragments of OTA. OTA in food has been evaluated by the Joint FAO/WHO Expert Committee on Food Additives...... (JECFA), and by the EC Scientific Committee on Food (SCF). JECFA established a provisional tolerable weekly intake (PTWI) of 100 ng/kg bw based on the LOEL for renal effects in pigs. Conversely, SCF recommended reducing exposure to OTA as much as possible, e.g. below 5 ng/kg bw per day. Both committees...... recommended further studies to clarify the mechanism by which OTA induces nephrotoxicity and carcinogenicity....

  1. Empirically based assessment and taxonomy of psychopathology for ages 1½-90+ years: Developmental, multi-informant, and multicultural findings.

    Science.gov (United States)

    Achenbach, Thomas M; Ivanova, Masha Y; Rescorla, Leslie A

    2017-11-01

    Originating in the 1960s, the Achenbach System of Empirically Based Assessment (ASEBA) comprises a family of instruments for assessing problems and strengths for ages 1½-90+ years. To provide an overview of the ASEBA, related research, and future directions for empirically based assessment and taxonomy. Standardized, multi-informant ratings of transdiagnostic dimensions of behavioral, emotional, social, and thought problems are hierarchically scored on narrow-spectrum syndrome scales, broad-spectrum internalizing and externalizing scales, and a total problems (general psychopathology) scale. DSM-oriented and strengths scales are also scored. The instruments and scales have been iteratively developed from assessments of clinical and population samples of hundreds of thousands of individuals. Items, instruments, scales, and norms are tailored to different kinds of informants for ages 1½-5, 6-18, 18-59, and 60-90+ years. To take account of differences between informants' ratings, parallel instruments are completed by parents, teachers, youths, adult probands, and adult collaterals. Syndromes and Internalizing/Externalizing scales derived from factor analyses of each instrument capture variations in patterns of problems that reflect different informants' perspectives. Confirmatory factor analyses have supported the syndrome structures in dozens of societies. Software displays scale scores in relation to user-selected multicultural norms for the age and gender of the person being assessed, according to ratings by each type of informant. Multicultural norms are derived from population samples in 57 societies on every inhabited continent. Ongoing and future research includes multicultural assessment of elders; advancing transdiagnostic progress and outcomes assessment; and testing higher order structures of psychopathology. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2012-01-31

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  3. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2011-01-01

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  4. Benthic prey fish assessment, Lake Ontario 2013

    Science.gov (United States)

    Weidel, Brian C.; Walsh, Maureen; Connerton, Michael J.

    2014-01-01

    The 2013 benthic fish assessment was delayed and shortened as a result of the U.S. Government shutdown, however the assessment collected 51 of the 62 planned bottom trawls. Over the past 34 years, Slimy Sculpin abundance in Lake Ontario has fluctuated, but ultimately decreased by two orders of magnitude, with a substantial decline occurring in the past 10 years. The 2013 Slimy Sculpin mean bottom trawl catch density (0.001 ind.·m-2, s.d.= 0.0017, n = 52) and mean biomass density (0.015 g·m-2 , s.d.= 0.038, n = 52) were the lowest recorded in the 27 years of sampling using the original bottom trawl design. From 2011-2013, the Slimy Sculpin density and biomass density has decreased by approximately 50% each year. Spring bottom trawl catches illustrate Slimy Sculpin and Round Goby Neogobius melanostoma winter habitat overlaps for as much as 7 months out of a year, providing opportunities for competition and predation. Invasive species, salmonid piscivory, and declines in native benthic invertebrates are likely all important drivers of Slimy Sculpin population dynamics in Lake Ontario. Deepwater Sculpin Myoxocephalus thompsonii, considered rare or absent from Lake Ontario for 30 years, have generally increased over the past eight years. For the first time since they were caught in this assessment, Deepwater Sculpin density and biomass density estimates declined from the previous year. The 2013 abundance and density estimates for trawls covering the standard depths from 60m to 150m was 0.0001 fish per square meter and 0.0028 grams per square meter. In 2013, very few small (recruitment. Nonnative Round Gobies were first detected in the USGS/NYSDEC Lake Ontario spring Alewife assessment in 2002. Since that assessment, observations indicate their population has expanded and they are now found along the entire south shore of Lake Ontario, with the highest densities in U.S. waters just east of the Niagara River confluence. In the 2013 spring-based assessment, both the

  5. [ANTITHROMBOTIC MEDICATION IN PREGNANT WOMEN WITH PREVIOUS INTRAUTERINE GROWTH RESTRICTION].

    Science.gov (United States)

    Neykova, K; Dimitrova, V; Dimitrov, R; Vakrilova, L

    2016-01-01

    To analyze pregnancy outcome in patients who were on antithrombotic medication (AM) because of previous pregnancy with fetal intrauterine growth restriction (IUGR). The studied group (SG) included 21 pregnancies in 15 women with history of previous IUGR. The patients were on low dose aspirin (LDA) and/or low molecular weight heparin (LMWH). Pregnancy outcome was compared to the one in two more groups: 1) primary group (PG) including the previous 15 pregnancies with IUGR of the same women; 2) control group (CG) including 45 pregnancies of women matched for parity with the ones in the SG, with no history of IUGR and without medication. The SG, PG and CG were compared for the following: mean gestational age (g.a.) at birth, mean birth weight (BW), proportion of cases with early preeclampsia (PE), IUGR (total, moderate, and severe), intrauterine fetal death (IUFD), neonatal death (NND), admission to NICU, cesarean section (CS) because of chronic or acute fetal distress (FD) related to IUGR, PE or placental abruption. Student's t-test was applied to assess differences between the groups. P values < 0.05 were considered statistically significant. The differences between the SG and the PG regarding mean g. a. at delivery (33.7 and 29.8 w.g. respectively) and the proportion of babies admitted to NICU (66.7% vs. 71.4%) were not statistically significant. The mean BW in the SG (2114,7 g.) was significantly higher than in the PG (1090.8 g.). In the SG compared with the PG there were significantly less cases of IUFD (14.3% and 53.3% respectively), early PE (9.5% vs. 46.7%) moderate and severe IUGR (10.5% and 36.8% vs. 41.7% and 58.3%). Neonatal mortality in the SG (5.6%) was significantly lower than in the PG (57.1%), The proportion of CS for FD was not significantly different--53.3% in the SG and 57.1% in the PG. On the other hand, comparison between the SG and the CG demonstrated significantly lower g.a. at delivery in the SG (33.7 vs. 38 w.g.) an lower BW (2114 vs. 3094 g

  6. Assessment and classification of psychopathology in epidemiological research of children 0-3 years of age: a review of the literature

    DEFF Research Database (Denmark)

    Skovgaard, A M; Houmann, T; Landorph, S L

    2004-01-01

    , such as the Bayley Scales, and relationship assessments, such as the Early Relational Assessment (ERA). The classification of psychopathology in young children can be approved by the Diagnostic Classification 0-3. The reliability and validity of DC 0-3 have not yet been established, but preliminary results seem...... promising. The demands made on diagnostic assessment procedures in epidemiological research of children 0-3 years of age can be met by a combination of well-established research instruments, such as the CBCL, with in-depth clinical assessment procedures, such as the Bayley Scales and the ERA, and diagnostic...... classification by DC 0-3....

  7. Writing and Pseudo-Writing from Internet-Based Sources: Implications for Learning and Assessment

    Science.gov (United States)

    Skaar, Håvard

    2015-01-01

    In recent years, plagiarism has been on the increase across the Western world. This article identifies Internet access as a contributory cause of this trend and addresses the implications of readily available Internet sources for the teaching and assessment of writing in schools. The basis for the article is a previous study showing a wide…

  8. Field assessment of balance in 10 to 14 year old children, reproducibility and validity of the Nintendo Wii board.

    Science.gov (United States)

    Larsen, Lisbeth Runge; Jørgensen, Martin Grønbech; Junge, Tina; Juul-Kristensen, Birgit; Wedderkopp, Niels

    2014-06-10

    Because body proportions in childhood are different to those in adulthood, children have a relatively higher centre of mass location. This biomechanical difference and the fact that children's movements have not yet fully matured result in different sway performances in children and adults. When assessing static balance, it is essential to use objective, sensitive tools, and these types of measurement have previously been performed in laboratory settings. However, the emergence of technologies like the Nintendo Wii Board (NWB) might allow balance assessment in field settings. As the NWB has only been validated and tested for reproducibility in adults, the purpose of this study was to examine reproducibility and validity of the NWB in a field setting, in a population of children. Fifty-four 10-14 year-olds from the CHAMPS-Study DK performed four different balance tests: bilateral stance with eyes open (1), unilateral stance on dominant (2) and non-dominant leg (3) with eyes open, and bilateral stance with eyes closed (4). Three rounds of the four tests were completed with the NWB and with a force platform (AMTI). To assess reproducibility, an intra-day test-retest design was applied with a two-hour break between sessions. Bland-Altman plots supplemented by Minimum Detectable Change (MDC) and concordance correlation coefficient (CCC) demonstrated satisfactory reproducibility for the NWB and the AMTI (MDC: 26.3-28.2%, CCC: 0.76-0.86) using Centre Of Pressure path Length as measurement parameter. Bland-Altman plots demonstrated satisfactory concurrent validity between the NWB and the AMTI, supplemented by satisfactory CCC in all tests (CCC: 0.74-0.87). The ranges of the limits of agreement in the validity study were comparable to the limits of agreement of the reproducibility study. Both NWB and AMTI have satisfactory reproducibility for testing static balance in a population of children. Concurrent validity of NWB compared with AMTI was satisfactory. Furthermore, the

  9. Value of computed tomography pelvimetry in patients with a previous cesarean section

    International Nuclear Information System (INIS)

    Yamani, Tarik Y.; Rouzi, Abdulrahim A.

    1998-01-01

    A case-control study was conducted at the Department of Obstetrics and Gynaecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia to determine the value of computed tomography pelivimetry in patients with a previous cesarean section. Between January 1993 and December 1995, 219 pregnant women with one previous cesarean had antenatal CT pelvimetry for assessment of the pelvis. One hundred and nineteen women did not have CT pelvimetry and served as control. Fifty-one women (51%) in the CT pelvimetry group were delivered by cesarean section. Twenty-three women (23%) underwent elective cesarean section for contracted pelvis based upon the findings of CT pelvimetry and 28 women (28%) underwent emergency cesarean section after trial of labor. In the group who did not have CT pelvimetry, 26 women (21.8%) underwent emergency cesarean section. This was a statistically significant difference (P=0.02). There were no statistically significant differences in birthweight and Apgar scores either group. There was no prenatal or maternal mortality in this study. Computed tomography pelvimetry increased the rate of cesarean delivery without any benefit in the immediate delivery outcomes. Therefore, the practice of documenting the adequacy of the pelvis by CT pelvimetry before vaginal birth after cesarean should be abandoned. (author)

  10. Thyroid abnormalities in patients previously treated with irradiation for acne vulgaris

    International Nuclear Information System (INIS)

    Thomson, D.B.; Grammes, C.F.; Starkey, R.H.; Monsaert, R.P.; Sunderlin, F.S.

    1984-01-01

    Of 1,203 patients who received radiation treatment for acne vulgaris between 1940 and 1968, 302 patients were recalled and examined, 121 at Geisinger Medical Center and the remainder by their local physicians. Radiation records were reviewed on all patients. Lead-rubber and cones had been used as shielding. Mean age at the time of exposure was 21 years and mean total exposure was 692 R. Palpable nodular thyroid disease was found in eight patients (2.6%). Of these, thyroid carcinoma was detected in two patients (0.66%). Although the number of patients examined was small, the incidence of carcinomas was unexpectedly high. We conclude that follow-up examination is worthwhile for patients previously treated by irradiation for acne vulgaris

  11. Distributed road assessment system

    Science.gov (United States)

    Beer, N. Reginald; Paglieroni, David W

    2014-03-25

    A system that detects damage on or below the surface of a paved structure or pavement is provided. A distributed road assessment system includes road assessment pods and a road assessment server. Each road assessment pod includes a ground-penetrating radar antenna array and a detection system that detects road damage from the return signals as the vehicle on which the pod is mounted travels down a road. Each road assessment pod transmits to the road assessment server occurrence information describing each occurrence of road damage that is newly detected on a current scan of a road. The road assessment server maintains a road damage database of occurrence information describing the previously detected occurrences of road damage. After the road assessment server receives occurrence information for newly detected occurrences of road damage for a portion of a road, the road assessment server determines which newly detected occurrences correspond to which previously detected occurrences of road damage.

  12. Reoperative sentinel lymph node biopsy after previous mastectomy.

    Science.gov (United States)

    Karam, Amer; Stempel, Michelle; Cody, Hiram S; Port, Elisa R

    2008-10-01

    Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in breast cancer, but many clinical scenarios questioning the validity of SLN biopsy remain. Here we describe our experience with reoperative-SLN (re-SLN) biopsy after previous mastectomy. Review of the SLN database from September 1996 to December 2007 yielded 20 procedures done in the setting of previous mastectomy. SLN biopsy was performed using radioisotope with or without blue dye injection superior to the mastectomy incision, in the skin flap in all patients. In 17 of 20 patients (85%), re-SLN biopsy was performed for local or regional recurrence after mastectomy. Re-SLN biopsy was successful in 13 of 20 patients (65%) after previous mastectomy. Of the 13 patients, 2 had positive re-SLN, and completion axillary dissection was performed, with 1 having additional positive nodes. In the 11 patients with negative re-SLN, 2 patients underwent completion axillary dissection demonstrating additional negative nodes. One patient with a negative re-SLN experienced chest wall recurrence combined with axillary recurrence 11 months after re-SLN biopsy. All others remained free of local or axillary recurrence. Re-SLN biopsy was unsuccessful in 7 of 20 patients (35%). In three of seven patients, axillary dissection was performed, yielding positive nodes in two of the three. The remaining four of seven patients all had previous modified radical mastectomy, so underwent no additional axillary surgery. In this small series, re-SLN was successful after previous mastectomy, and this procedure may play some role when axillary staging is warranted after mastectomy.

  13. The Relationship of Maternal Prepregnancy Body Mass Index and Pregnancy Weight Gain to Neurocognitive Function at Age 10 Years among Children Born Extremely Preterm

    NARCIS (Netherlands)

    Jensen, Elizabeth T; van der Burg, Jelske W; O'Shea, Thomas M; Joseph, Robert M; Allred, Elizabeth N; Heeren, Tim; Leviton, Alan; Kuban, Karl C K

    OBJECTIVE: To assess the association between maternal prepregnancy body mass index and adequacy of pregnancy weight gain in relation to neurocognitive function in school-aged children born extremely preterm. STUDY DESIGN: Study participants were 535 ten-year-old children enrolled previously in the

  14. Survival and quality of life of patients with oral and oropharyngeal cancer at 1-year follow-up of tumor resection

    Directory of Open Access Journals (Sweden)

    Maria Gabriela Haye Biazevic

    2010-06-01

    Full Text Available OBJECTIVE: This study aimed to assess the survival and life quality evolution of patients subjected to surgical excision of oral and oropharyngeal squamous cell carcinoma. MATERIAL AND METHODS: Forty-seven patients treated at a Brazilian healthcare unit specialized in head and neck surgery between 2006 and 2007 were enrolled in the study. The gathering of data comprised reviewing hospital files and applying the University of Washington Quality of Life (UW-QOL questionnaire previously and 1 year after the surgery. Comparative analysis used Poisson regression to assess factors associated with survival and a paired t-test to compare preoperative and 1-year postoperative QOL ratings. RESULTS: 1 year after surgery, 7 patients were not found (dropout of the cohort; 15 had died and 25 fulfilled the UW-QOL again. The risk of death was associated with having regional metastasis previously to surgery (relative risk=2.18; 95% confidence interval=1.09-5.17 and tumor size T3 or T4 (RR=2.30; 95%CI=1.05-5.04. Survivors presented significantly (p<0.05 poorer overall and domain-specific ratings of quality of life. Chewing presented the largest reduction: from 74.0 before surgery to 34.0 one year later. Anxiety was the only domain whose average rating increased (from 36.0 to 70.7. CONCLUSIONS: The prospective assessment of survival and quality of life may contribute to anticipate interventions aimed at reducing the incidence of functional limitations in patients with oral and oropharyngeal cancer.

  15. Parental Retrospective Assessment of Development and Behavior in Asperger Syndrome during the First 2 Years of Life

    Science.gov (United States)

    Dewrang, Petra; Sandberg, Annika Dahlgren

    2010-01-01

    Development and behavior during the first 2 years of life was assessed retrospectively by the parents to 23 adolescents and young adults with Asperger syndrome and 13 typically developing adolescents and young adults. The groups were matched on chronological age and the participants were within the normal range of intelligence. The questionnaire,…

  16. Evaluation of general practitioners' assessment of overweight among children attending the five-year preventive child health examination

    DEFF Research Database (Denmark)

    Andersen, Merethe Kousgaard; Christensen, Bo; Obel, Carsten

    2012-01-01

    . Subjects. Children attending the five-year PCHE in general practice, regardless of their weight status. Main outcome measures. Paediatric standard definitions for childhood overweight based on BMI were used as the gold standard for categorizing weight-for-stature. Identification of overweight was analysed......), i.e. the Danish national growth charts for BMI, as the gold standard yielded a sensitivity of 70.1% (95% CI 62.0-77.3) and a specificity of 92.4% (95% CI 90.6-93.9). The sensitivity was influenced by the GPs' use of BMI and the presence of previous notes regarding abnormal weight development......) according to paediatric standard definitions. Design. A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular. Setting. The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region...

  17. Quantitative and Qualitative Criteria for Assessing Endurance in Women over 60 Years of Age – Findings from a Pilot Study

    Directory of Open Access Journals (Sweden)

    Kortas Jakub

    2016-09-01

    Full Text Available Introduction. If it is to be effective, health training needs to be monitored based on regular and periodic assessment. The norms that have been proposed for standardised endurance tests for the 60-plus age group, particularly for women, still require evaluation. In light of the above, we have undertaken to design quantitative and qualitative criteria for assessing the level of endurance. Such criteria are urgently needed by persons working with this age group. Material and methods. We developed a quantitative and qualitative system for evaluating endurance based on Zatsiorky’s model, and we verified it in a group of 90 women aged over 60 years. We analysed data measured directly during a 2-km walk test. Results. We developed a set of quantitative and qualitative criteria for assessing endurance in women aged over 60 years based on the results of a 2-km walk test, measured on a scale ranging from 24:18 to 15:52 min:s. Conclusion. The pilot study has proven that a scale based on Zatsiorsky’s model can be an effective tool for assessing endurance in women aged over 60 years. We can thus recommend that it be widely used in practice. It is important to compare these results with the norms for the group in question and to establish comprehensive norms that could be useful for persons who organise physical activity for older adults.

  18. 76 FR 60801 - Assessment of Fees for Dairy Import Licenses for the 2012 Tariff-Rate Import Quota Year

    Science.gov (United States)

    2011-09-30

    ... for the 2012 calendar year. Notice: The total cost to USDA of administering the licensing system for... administering the licensing system, and $125,280 represents other miscellaneous costs, including travel, postage... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Assessment of Fees for Dairy Import...

  19. An approach to handling timescales in post-closure safety assessment

    International Nuclear Information System (INIS)

    Bailey, L.; Littleboy, A.

    2002-01-01

    Previous Nirex post-closure assessments of deep geological disposal have been based on the use of probabilistic safety analysis covering many millions of years. However, Nirex has also published an assessment methodology in which the assessment timescale is divided into a number of discrete periods of time (time frames). Nirex is currently at the stage of planning the next update to its generic post-closure performance assessment and is considering the merits of using an assessment methodology based on time frames, in order to improve links with operational assessments and the provision of advice on the packaging of wastes, and to encourage stakeholder dialogue. This paper has been prepared as part of Nirex's aim, wherever possible, to 'preview', or seek input from others on, its ideas for new work to generate discussion and feedback. It describes an evolution of Nirex's published assessment methodology and outlines how it could be applied in an updated post-closure performance assessment of the Nirex generic phased disposal concept. (authors)

  20. Local recurrence risk after previous salvage mastectomy.

    Science.gov (United States)

    Tanabe, M; Iwase, T; Okumura, Y; Yoshida, A; Masuda, N; Nakatsukasa, K; Shien, T; Tanaka, S; Komoike, Y; Taguchi, T; Arima, N; Nishimura, R; Inaji, H; Ishitobi, M

    2016-07-01

    Breast-conserving surgery is a standard treatment for early breast cancer. For ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery, salvage mastectomy is the current standard surgical procedure. However, it is not rare for patients with IBTR who have received salvage mastectomy to develop local recurrence. In this study, we examined the risk factors of local recurrence after salvage mastectomy for IBTR. A total of 118 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent salvage mastectomy without irradiation for IBTR between 1989 and 2008 were included from eight institutions in Japan. The risk factors of local recurrence were assessed. The median follow-up period from salvage mastectomy for IBTR was 4.6 years. Patients with pN2 or higher on diagnosis of the primary tumor showed significantly poorer local recurrence-free survival than those with pN0 or pN1 at primary tumor (p mastectomy for IBTR. Further research and validation studies are needed. (UMIN-CTR number UMIN000008136). Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery.

    Science.gov (United States)

    Newman, M F; Grocott, H P; Mathew, J P; White, W D; Landolfo, K; Reves, J G; Laskowitz, D T; Mark, D B; Blumenthal, J A

    2001-12-01

    The importance of perioperative cognitive decline has long been debated. We recently demonstrated a significant correlation between perioperative cognitive decline and long-term cognitive dysfunction. Despite this association, some still question the importance of these changes in cognitive function to the quality of life of patients and their families. The purpose of our investigation was to determine the association between cognitive dysfunction and long-term quality of life after cardiac surgery. After institutional review board approval and patient informed consent, 261 patients undergoing cardiac surgery with cardiopulmonary bypass were enrolled and followed for 5 years. Cognitive function was measured with a battery of tests at baseline, discharge, and 6 weeks and 5 years postoperatively. Quality of life was assessed with well-validated, standardized assessments at the 5-year end point. Our results demonstrate significant correlations between cognitive function and quality of life in patients after cardiac surgery. Lower 5-year overall cognitive function scores were associated with lower general health and a less productive working status. Multivariable logistic and linear regression controlling for age, sex, education, and diabetes confirmed this strong association in the majority of areas of quality of life. Five years after cardiac surgery, there is a strong relationship between neurocognitive functioning and quality of life. This has important social and financial implications for preoperative evaluation and postoperative care of patients undergoing cardiac surgery.

  2. Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial.

    Science.gov (United States)

    Shaverdian, Narek; Lisberg, Aaron E; Bornazyan, Krikor; Veruttipong, Darlene; Goldman, Jonathan W; Formenti, Silvia C; Garon, Edward B; Lee, Percy

    2017-07-01

    Preclinical studies have found radiotherapy enhances antitumour immune responses. We aimed to assess disease control and pulmonary toxicity in patients who previously received radiotherapy for non-small-cell lung cancer (NSCLC) before receiving pembrolizumab. We assessed patients with advanced NSCLC treated on the phase 1 KEYNOTE-001 trial at a single institution (University of California, Los Angeles, CA, USA). Patients were aged 18 years or older, had an Eastern Cooperative Oncology Group performance status of 1 or less, had adequate organ function, and no history of pneumonitis. Patients received pembrolizumab at a dose of either 2 mg/kg of bodyweight or 10 mg/kg every 3 weeks, or 10 mg/kg every 2 weeks, until disease progression, unacceptable toxicity, or other protocol-defined reasons for discontinuation. Disease response and pulmonary toxicity were prospectively assessed by Immune-related Response Criteria and Common Terminology Criteria for Adverse Events version 4.0. The primary objective of the KEYNOTE-001 trial was to assess the safety, side-effect profile, and antitumour activity of pembrolizumab. For our secondary analysis, patients were divided into subgroups to compare patients who previously received radiotherapy with patients who had not. Our primary objective was to determine whether previous radiotherapy affected progression-free survival, overall survival, and pulmonary toxicity in the intention-to-treat population. The KEYNOTE-001 trial was registered with ClinicalTrials.gov, number NCT01295827. Between May 22, 2012, and July 11, 2014, 98 patients were enrolled and received their first cycle of pembrolizumab. One patient was lost to follow-up. 42 (43%) of 97 patients had previously received any radiotherapy for the treatment of NSCLC before the first cycle of pembrolizumab. 38 (39%) of 97 patients received extracranial radiotherapy and 24 (25%) of 97 patients received thoracic radiotherapy. Median follow-up for surviving patients was 32·5

  3. 77 FR 70176 - Previous Participation Certification

    Science.gov (United States)

    2012-11-23

    ... participants' previous participation in government programs and ensure that the past record is acceptable prior... information is designed to be 100 percent automated and digital submission of all data and certifications is... government programs and ensure that the past record is acceptable prior to granting approval to participate...

  4. Association between maternal diet quality and offspring diet quality assessed at age 14 years: longitudinal study in a large contemporary cohort

    DEFF Research Database (Denmark)

    Bjerregaard, Anne Ahrendt; Halldorsson, Thorhallur I.; Tetens, Inge

    2017-01-01

    -pregnancy BMI, level of education, and maternal smoking. Interpretation  This is the first study, to our knowledge, to examine associations between maternal dietary habits during pregnancy and offspring dietary habits during adolescent years in a large contemporary cohort. Diet quality during pregnancy......Background  Emerging evidence suggests that exposures in fetal life may have an impact many years later on the individual's susceptibility to diseases. Study of diet–disease associations over long time-spans is a major methodological challenge. We examined whether overall diet quality during...... pregnancy was associated with adolescent diet quality 15 years later in a prospective cohort representing a typical high-income population. Methods  Dietary intake assessed with a 360-item food frequency questionnaire during mid-pregnancy (1996–2003) was matched with offspring dietary intake assessed...

  5. Formative assessment: a student perspective.

    Science.gov (United States)

    Hill, D A; Guinea, A I; McCarthy, W H

    1994-09-01

    An educator's view would be that formative assessment has an important role in the learning process. This study was carried out to obtain a student perspective of the place of formative assessment in the curriculum. Final-year medical students at Royal Prince Alfred Hospital took part in four teaching sessions, each structured to integrate teaching with assessment. Three assessment methods were used; the group objective structured clinical examination (G-OSCE), structured short answer (SSA) questions and a pre/post-test multiple choice questionnaire (MCQ). Teaching sessions were conducted on the subject areas of traumatology, the 'acute abdomen', arterial disorders and cancer. Fifty-five students, representing 83% of those who took part in the programme, responded to a questionnaire where they were asked to rate (on a 5-point Likert scale) their response to general questions about formative assessment and 13 specific questions concerning the comparative value of the three assessment modalities. Eighty-nine per cent of respondents felt that formative assessment should be incorporated into the teaching process. The SSA assessment was regarded as the preferred modality to reinforce previous teaching and test problem-solving skills. The MCQ was the least favoured assessment method. The effect size variable between the total scores for the SSA and MCQ was 0.64. The variable between G-OSCE and SSA/MCQ was 0.26 and 0.33 respectively. Formative assessment is a potentially powerful method to direct learning behaviour. Students should have input into the methods used.

  6. Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes.

    Science.gov (United States)

    Sokup, Alina; Góralczyk, Barbara; Góralczyk, Krzysztof; Rość, Danuta

    2012-02-01

    To investigate whether baseline triglyceride levels are associated with early glucose dysregulation and/or cardiovascular risk in women with a previous history of gestational diabetes. Prospective postpregnancy cohort study. Polish university hospitals. Participants included 125 women with previous gestational diabetes and 40 women with normal glucose regulation during pregnancy. All women were studied 2-24 months (mean 12 ± 10 months) after the index pregnancy. Women with previous gestational diabetes were divided into tertiles in accordance with baseline triglyceride levels. We assessed glucose regulation (oral glucose tolerance test), insulin resistance (homeostasis model assessment), markers of endothelial dysfunction (soluble: intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, tissue plasminogen activator antigen, von Willebrand factor antigen), fibrinolysis (plasminogen activator inhibitor antigen), inflammation (high-sensitivity C-reactive protein) and lipid levels. Women with previous gestational diabetes (78% normal glucose regulation, 22% impaired glucose tolerance) had a high cardiometabolic risk profile compared with control women (100% normal glucose regulation). Baseline triglycerides >0.83 mmol/l were associated with a higher prevalence of impaired glucose tolerance, higher high-sensitivity C-reactive protein and triglyceride/high-density lipoprotein-cholesterol ratio. Triglycerides >1.22 mmol/l were associated with higher body fat indexes, higher insulin resistance, higher levels of endothelial dysfunction biomarkers, higher plasminogen activator inhibitor antigen and dyslipidemia. Only E-selectin was independently associated with triglyceride levels. Baseline triglyceride levels are a cardiovascular risk marker as well as a pathophysiological parameter independently associated with endothelial dysfunction in nondiabetic women with previous gestational diabetes at 2-24 months after an index pregnancy. Normalization of

  7. Assessment of Compliance to Treatment of Diabetes and Hypertension amongst Previously Diagnosed Patients from Rural Community of Raigad District of Maharashtra.

    Science.gov (United States)

    Kakumani, Kiranmayi Venkata; Waingankar, Prasad

    2016-12-01

    Substantial burden of diabetes and hypertension is on rise in India, leading to a twin epidemic. India, being a rural country, has unique problems regarding the treatment compliance which is a serious risk for morbidity and mortality. To assess the compliance to treatment of hypertension and diabetes amongst the diagnosed patients from rural area and to study reasons of non-compliance and knowledge and attitude. Community based, cross sectional, observational study conducted in the rural communities of Tara and Barapada villages of Raigad district of Maharashtra. Survey was conducted covering population of 2115 across 360 families, 250 at Barapada and 110 at Tara. All the cases of diabetes and hypertension diagnosed for more than one year were included. A structured and pre-tested questionnaire was administered including details on demography, medical documentation, treatment details and factors assessing the compliance, knowledge and attitude towards the diseases. When reviewed the treatment adherence pattern based on documentary evidence and interview of the patient, on history of taking medication strictly since the detection illness, it was found that more than 70% of the Diabetics and more than 75% of the Hypertensive have discontinued the treatment in between. The most common reasons of non-compliance is the lack of sufficient motivation for treatment adherence as many mentioned (61.4% diabetics, 55.8% hypertensives) difficulty to remember to take daily medication due to work or forgetfulness. This is followed by lack of money (50%diabetics, 55.8% hypertensives) and living far away from doctor in city (43% diabetics and 46% hypertensives). The study findings are only tip of iceberg and the non-adherence to the treatment of diabetes and hypertension in rural population is at alarmingly high. Illiteracy, lack of faith in treatment and motivation, unawareness and self-neglect as well as financial constraints and lack of specialist care in rural area is playing

  8. [Meningitis and white matter lesions due to Streptococcus mitis in a previously healthy child].

    Science.gov (United States)

    Yiş, Reyhan; Yüksel, Ciğdem Nükhet; Derundere, Umit; Yiş, Uluç

    2011-10-01

    Streptococcus mitis, an important member of viridans streptococci, is found in the normal flora of the oropharynx, gastrointestinal tract, female genital tract and skin. Although it is of low pathogenicity and virulence, it may cause serious infections in immunocompromised patients. Meningitis caused by S.mitis has been described in patients with previous spinal anesthesia, neurosurgical procedure, malignancy, bacterial endocarditis with neurological complications and alcoholics, but it is rare in patients who are previously healthy. In this report, a rare case of meningoencephalitis caused by S.mitis developed in a previously healthy child has been presented. A previously healthy eight-year-old girl who presented with fever, altered state of consciousness, and headache was hospitalized in intensive care unit with the diagnosis of meningitis. Past history revealed that she was treated with amoxicillin-clavulanate for acute sinusitis ten days before her admission. Whole blood count revealed the followings: hemoglobin 13 g/dl, white blood cell count 18.6 x 109/L (90% neutrophils), platelet count 200 x 109/L and 150 leucocytes were detected on cerebrospinal fluid (CSF) examination. Protein and glucose levels of CSF were 80 mg/dl and 40 mg/dl (concomitant blood glucose 100 mg/dl), respectively. Brain magnetic resonance imaging (MRI) revealed widespread white matter lesions, and alpha-hemolytic streptococci were grown in CSF culture. The isolate was identified as S.mitis with conventional methods, and also confirmed by VITEK2 (bioMerieux, France) and API 20 STREP (bioMerieux, France) systems. Isolate was found susceptible to penicillin, erythromycin, clindamycin, tetracycline, cefotaxime, vancomycin and chloramphenicol. Regarding the etiology, echocardiography revealed no vegetation nor valve pathology, and peripheral blood smear showed no abnormality. Immunoglobulin and complement levels were within normal limits. Ongoing inflammation in maxillary sinuses detected in

  9. Neuropsychological alterations in mercury intoxication persist several years after exposure.

    Science.gov (United States)

    Zachi, Elaine Cristina; Taub, Anita; Faria, Marcília de Araújo Medrado; Ventura, Dora Fix

    2008-01-01

    Elemental mercury is a liquid toxic metal widely used in industry. Occupational exposure occurs mainly via inhalation. Previously, neuropsychological assessment detected deficits in former workers of a fluorescent lamp plant who had been exposed to elemental mercury vapor and were away from exposure for several years at the time of examination. The purpose of this work was to reexamine these functions after 18 months in order to evaluate their progression. Thirteen participants completed tests of attention, inhibitory control, verbal/visual memory, psychomotor speed, verbal fluency, visuomotor ability, executive function, semantic knowledge, and depression and anxiety inventories on 2 separate occasions. At baseline, the former workers indicated slower psychomotor and information processing speed, verbal spontaneous recall memory impairment, and increased depression and anxiety symptoms compared to controls (Precovery of functions, the neuropsychological effects related to mercury exposure are found to persist for many years.

  10. Psychiatric disorders revealing multiple sclerosis after 20 years of evolvement

    Directory of Open Access Journals (Sweden)

    Aicha Slassi Sennou

    2014-01-01

    Full Text Available Previous research indicates that the onset of psychiatric disorders is sometimes associated with multiple sclerosis (MS evolving several years later. However, information on why this might occur, and on the outcomes of such patients, is still lacking. We aim to discuss these limitations with the current paper. We describe a 51-year-old female who demonstrated severe anxiety disorder and depression years before developing MS neurological symptoms. The patient was treated for these psychiatric disorders over 20 years. In the last 3 years of her treatment, the patient demonstrated a choreic-type of movement disorder in all her limbs. This disorder is consistent with relapsing-remitting MS. Clinical and magnetic resonance imaging (MRI examinations demonstrated aspects of MS, without MS being diagnosed conclusively. The visual evoked potential indicated a diagnosis of conduction abnormalities. The established diagnosis was slow relapsing MS. The patient underwent methylprednisolone bolus (1 g/day. This case-study suggests that health professionals should conduct a full neurological assessment when they find atypical psychiatric symptoms in a patient. This would make sure that patients receive a better standard of care, and thus experience a better quality of life.

  11. Can Touch Screen Tablets be Used to Assess Cognitive and Motor Skills in Early Years Primary School Children? A Cross-Cultural Study.

    Science.gov (United States)

    Pitchford, Nicola J; Outhwaite, Laura A

    2016-01-01

    Assessment of cognitive and motor functions is fundamental for developmental and neuropsychological profiling. Assessments are usually conducted on an individual basis, with a trained examiner, using standardized paper and pencil tests, and can take up to an hour or more to complete, depending on the nature of the test. This makes traditional standardized assessments of child development largely unsuitable for use in low-income countries. Touch screen tablets afford the opportunity to assess cognitive functions in groups of participants, with untrained administrators, with precision recording of responses, thus automating the assessment process. In turn, this enables cognitive profiling to be conducted in contexts where access to qualified examiners and standardized assessments are rarely available. As such, touch screen assessments could provide a means of assessing child development in both low- and high-income countries, which would afford cross-cultural comparisons to be made with the same assessment tool. However, before touch screen tablet assessments can be used for cognitive profiling in low-to-high-income countries they need to be shown to provide reliable and valid measures of performance. We report the development of a new touch screen tablet assessment of basic cognitive and motor functions for use with early years primary school children in low- and high-income countries. Measures of spatial intelligence, visual attention, short-term memory, working memory, manual processing speed, and manual coordination are included as well as mathematical knowledge. To investigate if this new touch screen assessment tool can be used for cross-cultural comparisons we administered it to a sample of children ( N = 283) spanning standards 1-3 in a low-income country, Malawi, and a smaller sample of children ( N = 70) from first year of formal schooling from a high-income country, the UK. Split-half reliability, test-retest reliability, face validity, convergent

  12. Can touch screen tablets be used to assess cognitive and motor skills in early years primary school children? A cross-cultural study

    Directory of Open Access Journals (Sweden)

    Nicola Pitchford

    2016-10-01

    Full Text Available Assessment of cognitive and motor functions is fundamental for developmental and neuropsychological profiling. Assessments are usually conducted on an individual basis, with a trained examiner, using standardised paper and pencil tests, and can take up to an hour or more to complete, depending on the nature of the test. This makes traditional standardised assessments of child development largely unsuitable for use in low-income countries. Touch screen tablets afford the opportunity to assess cognitive functions in groups of participants, with untrained administrators, with precision recording of responses, thus automating the assessment process. In turn, this enables cognitive profiling to be conducted in contexts where access to qualified examiners and standardised assessments are rarely available. As such, touch screen assessments could provide a means of assessing child development in both low- and high-income countries, which would afford cross-cultural comparisons to be made with the same assessment tool. However, before touch screen tablet assessments can be used for cognitive profiling in low-to-high-income countries they need to be shown to provide reliable and valid measures of performance. We report the development of a new touch screen tablet assessment of basic cognitive and motor functions for use with early years primary school children in low- and high-income countries. Measures of spatial intelligence, visual attention, short-term memory, working memory, manual processing speed, and manual coordination are included as well as mathematical knowledge. To investigate if this new touch screen assessment tool can be used for cross-cultural comparisons we administered it to a sample of children (N=283 spanning standards 1-3 in a low-income country, Malawi, and a smaller sample of children (N=70 from first year of formal schooling from a high-income country, the UK. Split-half reliability, test-retest reliability, face validity

  13. Skeletal maturity assessment using mandibular canine calcification stages

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    Vildana Džemidžić

    2016-11-01

    Full Text Available Objective. The aims of this study were: to investigate the relationship between mandibular canine calcification stages and skeletal maturity; and to evaluate whether the mandibular canine calcification stages may be used as a reliable diagnostic tool for skeletal maturity assessment. Materials and methods. This study included 151 subjects: 81 females and 70 males, with ages ranging from 9 to 16 years (mean age: 12.29±1.86 years. The inclusion criteria for subjects were as follows: age between 9 and 16 years; good general health without any hormonal, nutritional, growth or dental development problems. Subjects who were undergoing or had previously received orthodontic treatment were not included in this study. The calcification stages of the left permanent mandibular canine were assessed according to the method of Demirjian, on panoramic radiographs. Assessment of skeletal maturity was carried out using the cervical vertebral maturation index (CVMI, as proposed by the Hassel-Farman method, on lateral cephalograms. The correlation between the calcification stages of mandibular canine and skeletal maturity was estimated separately for male and female subjects. Results. Correlation coefficients between calcification stages of mandibular canine and skeletal maturity were 0.895 for male and 0.701 for female subjects. Conclusions. A significant correlation was found between the calcification stages of the mandibular canine and skeletal maturity. The calcification stages of the mandibular canine show a satisfactory diagnostic performance only for assessment of pre-pubertal growth phase.

  14. Prediction of successful trial of labour in patients with a previous caesarean section

    International Nuclear Information System (INIS)

    Shaheen, N.; Khalil, S.; Iftikhar, P.

    2014-01-01

    Objective: To determine the prediction rate of success in trial of labour after one previous caesarean section. Methods: The cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Cantonment General Hospital, Rawalpindi, from January 1, 2012 to January 31, 2013, and comprised women with one previous Caesarean section and with single alive foetus at 37-41 weeks of gestation. Women with more than one Caesarean section, unknown site of uterine scar, bony pelvic deformity, placenta previa, intra-uterine growth restriction, deep transverse arrest in previous labour and non-reassuring foetal status at the time of admission were excluded. Intrapartum risk assessment included Bishop score at admission, rate of cervical dilatation and scar tenderness. SPSS 21 was used for statistical analysis. Results: Out of a total of 95 women, the trial was successful in 68 (71.6%). Estimated foetal weight and number of prior vaginal deliveries had a high predictive value for successful trial of labour after Caesarean section. Estimated foetal weight had an odds ratio of 0.46 (p<0.001), while number of prior vaginal deliveries had an odds ratio of 0.85 with (p=0.010). Other factors found to be predictive of successful trial included Bishop score at the time of admission (p<0.037) and rate of cervical dilatation in the first stage of labour (p<0.021). Conclusion: History of prior vaginal deliveries, higher Bishop score at the time of admission, rapid rate of cervical dilatation and lower estimated foetal weight were predictive of a successful trial of labour after Caesarean section. (author)

  15. Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma

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    Antonio Biroli

    2012-01-01

    Full Text Available Brain metastases arise in 10%–40% of all cancer patients. Up to one third of the patients do not have previous cancer history. We report a case of a 67-years-old male patient who presented with confusion, tremor, and apraxia. A brain MRI revealed an isolated right temporal lobe lesion. A thorax-abdomen-pelvis CT scan showed no primary lesion. The patient underwent a craniotomy with gross-total resection. Histopathology revealed an intestinal-type adenocarcinoma. A colonoscopy found no primary lesion, but a PET-CT scan showed elevated FDG uptake in the appendiceal nodule. A right hemicolectomy was performed, and the specimen showed a moderately differentiated mucinous appendiceal adenocarcinoma. Whole brain radiotherapy was administrated. A subsequent thorax-abdomen CT scan revealed multiple lung and hepatic metastasis. Seven months later, the patient died of disease progression. In cases of undiagnosed primary lesions, patients present in better general condition, but overall survival does not change. Eventual identification of the primary tumor does not affect survival. PET/CT might be a helpful tool in detecting lesions of the appendiceal region. To the best of our knowledge, such a case was never reported in the literature, and an appendiceal malignancy should be suspected in patients with brain metastasis from an undiagnosed primary tumor.

  16. Factitious aortic dissection leading to thoracotomy in a 20-year-old man.

    Science.gov (United States)

    Chambers, Elise; Yager, Joel; Apfeldorf, William; Camps-Romero, Eduardo

    2007-01-01

    A 20-year-old man presented to an emergency department with dramatic, sudden-onset, tearing chest pain. He also claimed to have been previously diagnosed with Ehler-Danlos syndrome and a previous Type I aortic dissection (intimal tear of ascending aorta), rapidly increasing his treating physician's suspicion of an emergent aortic dissection. The patient was quickly transferred to a large university hospital, where he underwent a median sternotomy and thoracotomy, with no aortic pathology found on operation and biopsy. After the patient's postoperative recovery, he was treated at a mental health facility, where he remained ambivalent about his psychiatric condition and did not respond well to treatment. This case report describes a unique case of factitious disorder that led to a serious operative intervention and subsequent psychiatric care and assesses factors that might have contributed to his hospital course.

  17. Nivolumab Versus Docetaxel in Previously Treated Patients With Advanced Non-Small-Cell Lung Cancer: Two-Year Outcomes From Two Randomized, Open-Label, Phase III Trials (CheckMate 017 and CheckMate 057).

    Science.gov (United States)

    Horn, Leora; Spigel, David R; Vokes, Everett E; Holgado, Esther; Ready, Neal; Steins, Martin; Poddubskaya, Elena; Borghaei, Hossein; Felip, Enriqueta; Paz-Ares, Luis; Pluzanski, Adam; Reckamp, Karen L; Burgio, Marco A; Kohlhäeufl, Martin; Waterhouse, David; Barlesi, Fabrice; Antonia, Scott; Arrieta, Oscar; Fayette, Jérôme; Crinò, Lucio; Rizvi, Naiyer; Reck, Martin; Hellmann, Matthew D; Geese, William J; Li, Ang; Blackwood-Chirchir, Anne; Healey, Diane; Brahmer, Julie; Eberhardt, Wilfried E E

    2017-12-10

    Purpose Nivolumab, a programmed death-1 inhibitor, prolonged overall survival compared with docetaxel in two independent phase III studies in previously treated patients with advanced squamous (CheckMate 017; ClinicalTrials.gov identifier: NCT01642004) or nonsquamous (CheckMate 057; ClinicalTrials.gov identifier: NCT01673867) non-small-cell lung cancer (NSCLC). We report updated results, including a pooled analysis of the two studies. Methods Patients with stage IIIB/IV squamous (N = 272) or nonsquamous (N = 582) NSCLC and disease progression during or after prior platinum-based chemotherapy were randomly assigned 1:1 to nivolumab (3 mg/kg every 2 weeks) or docetaxel (75 mg/m 2 every 3 weeks). Minimum follow-up for survival was 24.2 months. Results Two-year overall survival rates with nivolumab versus docetaxel were 23% (95% CI, 16% to 30%) versus 8% (95% CI, 4% to 13%) in squamous NSCLC and 29% (95% CI, 24% to 34%) versus 16% (95% CI, 12% to 20%) in nonsquamous NSCLC; relative reductions in the risk of death with nivolumab versus docetaxel remained similar to those reported in the primary analyses. Durable responses were observed with nivolumab; 10 (37%) of 27 confirmed responders with squamous NSCLC and 19 (34%) of 56 with nonsquamous NSCLC had ongoing responses after 2 years' minimum follow-up. No patient in either docetaxel group had an ongoing response. In the pooled analysis, the relative reduction in the risk of death with nivolumab versus docetaxel was 28% (hazard ratio, 0.72; 95% CI, 0.62 to 0.84), and rates of treatment-related adverse events were lower with nivolumab than with docetaxel (any grade, 68% v 88%; grade 3 to 4, 10% v 55%). Conclusion Nivolumab provides long-term clinical benefit and a favorable tolerability profile compared with docetaxel in previously treated patients with advanced NSCLC.

  18. Previous hepatitis a virus infection is related to slower psychomotor speed in elderly adults.

    Science.gov (United States)

    Hsieh, Cheng-Fang; Liu, Ching-Kuan; Fang, Tzu-Jung; Yu, Yau-Hua; Lai, Chiou-Lian; Kuo, Hsu-Ko

    2009-10-01

    Patients with chronic viral hepatitis are at a higher risk for cognitive dysfunction. Little is known about the association between hepatitis A virus (HAV) infection and cognitive function. From the National Health and Nutrition Examination Survey, 1999-2002, we selected study participants (> or =60 years, n = 1,529) without hepatitis B, C, or D virus infection; without previous hepatitis A vaccination; and without abnormal liver function. HAV-seropositive participants represented people with previous HAV infection. Psychomotor speed and executive functioning domain of cognitive function were measured by the Digit Symbol Substitution Test (DSST). HAV-seropositive participants had lower DSST scores than HAV-seronegative participants (weighted mean, 44.4 vs 53.9, p a multivariable model, the weighted adjusted beta coefficient of DSST score was -2.48 (95% CI -2.49 to -2.46, p < .001) for the HAV-seropositive participants. HAV seropositivity is associated with slower psychomotor speed among the U.S. community-dwelling elders.

  19. Influences on Personal Understanding: Intentions, Approaches to Learning, Perceptions of Assessment, and a "Meeting of Minds"

    Science.gov (United States)

    Karagiannopoulou, Evangelia; Entwistle, Noel

    2013-01-01

    Using a case-study approach, interviews with four final-year psychology students showed different approaches to learning and varying experiences of teaching in courses assessed through open-book exams. Analysis of their experiences, supported by previous research findings, provided insights into the reasons for the contrasting approaches being…

  20. Validity of self-reported lunch recalls in Swedish school children aged 6-8 years.

    Science.gov (United States)

    Hunsberger, Monica; Pena, Pablo; Lissner, Lauren; Grafström, Lisen; Vanaelst, Barbara; Börnhorst, Claudia; Pala, Valeria; Eiben, Gabriele

    2013-09-18

    Previous studies have suggested that young children are inaccurate reporters of dietary intake. The purpose of this study was to validate a single recall of the previous day's school lunch reported by 6-8 year old Swedish children and to assess teacher-recorded intake of the same meal in a standardized food journal. An additional research question was whether parents could report their child's intake of the previous day's lunch. Subjects constituted a convenience sample from the large, multi-country study Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS). Validations of both children's recalls and teachers' records were made by comparing results with the duplicate plate reference method. Twenty-five children (12 boys/13 girls) aged 6-8 years participated in the validation study at one school in western Sweden. Children were accurate self-reporters of their dietary intake at lunch, with no significant difference between reported and weighed intake (Mean difference (SD): 7(50) kcals, p=0.49). Teachers significantly over-reported intake (Mean difference (SD): 65(79) kcals, p=0.01). For both methods, child-reported and teacher-recorded, correlations with weighed intake were strong (Pearson's correlations r=0.92, pteacher-records and weighed intakes. Foods were recalled by children with a food-match rate of 90%. In all cases parents themselves were unable to report on quantities consumed and only four of 25 children had parents with knowledge regarding food items consumed. Children 6-8 years of age accurately recalled their school lunch intake for one occasion while teachers recorded with less accuracy. Our findings suggest that children as young as six years of age may be better able to report on their dietary intake than previously suggested, at least for one main meal at school. Teacher-recorded intake provides a satisfactory estimate but with greater systematic deviation from the weighed intake

  1. Induction of labor in grand multiparous women with previous cesarean delivery: how safe is this?

    Science.gov (United States)

    Chibber, Rachana; Al-Harmi, Jehad; Foda, Mohamed; Mohammed K, Zeinab; Al-Saleh, Eyad; Mohammed, Asiya Tasneem

    2015-02-01

    To compare the outcome of induced and spontaneous labor in grand multiparous women with one previous lower segment cesarean section (CS), so that the safety of labor induction could be assessed. In 102 women (study group), labor was induced and the outcome was compared with 280 women (control group) who went into spontaneous labor. All 382 women were grand multiparous and had one previous CS. There were no significant difference in oxytocin augmentation, CS, scar dehiscence, fetal birth weight or apgar scores between groups. There was one neonatal death, two still births, one early neonatal death and one congenital malformation in the study group and this was not significant. There was no significant difference in vaginal birth in the study (80.9%) and the control group (83.8%). In this moderate-sized study, induction of labor may be a safe option in grand multiparous women, if there is no absolute induction for repeating CS.

  2. Two Thinking Skills Assessment Approaches: "Assessment of Pupils' Thinking Skills" and "Individual Thinking Skills Assessments"

    Science.gov (United States)

    Burke, Lynsey A.; Williams, Joanne M.

    2012-01-01

    This paper is linked to a previous paper outlining an evaluation of a thinking skills intervention (Burke & Williams, 2008). Following extensive requests for the assessment tools used in the intervention, this short paper presents the development and potential uses of two thinking skills assessment tools. The aim of the paper is simply to make…

  3. 75 FR 76056 - FEDERAL REGISTER CITATION OF PREVIOUS ANNOUNCEMENT:

    Science.gov (United States)

    2010-12-07

    ... SECURITIES AND EXCHANGE COMMISSION Sunshine Act Meeting FEDERAL REGISTER CITATION OF PREVIOUS ANNOUNCEMENT: STATUS: Closed meeting. PLACE: 100 F Street, NE., Washington, DC. DATE AND TIME OF PREVIOUSLY ANNOUNCED MEETING: Thursday, December 9, 2010 at 2 p.m. CHANGE IN THE MEETING: Time change. The closed...

  4. Distinctive distribution of lymphocytes in unruptured and previously untreated brain arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Yi Guo

    2014-12-01

    Full Text Available Aim: To test the hypothesis that lymphocyte infiltration in brain arteriovenous malformation (bAVM is not associated with iron deposition (indicator of micro-hemorrhage. Methods: Sections of unruptured, previously untreated bAVM specimens (n = 19 were stained immunohistochemically for T-lymphocytes (CD3 + , B-lymphocytes (CD20 + , plasma cells (CD138 + and macrophages (CD68 + . Iron deposition was assessed by hematoxylin and eosin and Prussian blue stains. Superficial temporal arteries (STA were used as control. Results: Both T-lymphocytes and macrophages were present in unruptured, previously untreated bAVM specimens, whereas few B cells and plasma cells were detected. Iron deposition was detected in 8 specimens (42%; 95% confidence intervals = 20-67%. The samples with iron deposition tended to have more macrophages than those without (666 ± 313 vs. 478 ± 174 cells/mm 2 ; P = 0.11. T-cells were clustered on the luminal side of the endothelial surface, on the vessel-wall, and in the perivascular regions. There was no correlation between T-lymphocyte load and iron deposition (P = 0.88. No macrophages and lymphocytes were detected in STA controls. Conclusion: T-lymphocytes were present in bAVM specimens. Unlike macrophages, the load and location of T-lymphocytes were not associated with iron deposition, suggesting the possibility of an independent cell-mediated immunological mechanism in bAVM pathogenesis.

  5. Implant breast reconstruction after salvage mastectomy in previously irradiated patients.

    Science.gov (United States)

    Persichetti, Paolo; Cagli, Barbara; Simone, Pierfranco; Cogliandro, Annalisa; Fortunato, Lucio; Altomare, Vittorio; Trodella, Lucio

    2009-04-01

    The most common surgical approach in case of local tumor recurrence after quadrantectomy and radiotherapy is salvage mastectomy. Breast reconstruction is the subsequent phase of the treatment and the plastic surgeon has to operate on previously irradiated and manipulated tissues. The medical literature highlights that breast reconstruction with tissue expanders is not a pursuable option, considering previous radiotherapy a contraindication. The purpose of this retrospective study is to evaluate the influence of previous radiotherapy on 2-stage breast reconstruction (tissue expander/implant). Only patients with analogous timing of radiation therapy and the same demolitive and reconstructive procedures were recruited. The results of this study prove that, after salvage mastectomy in previously irradiated patients, implant reconstruction is still possible. Further comparative studies are, of course, advisable to draw any conclusion on the possibility to perform implant reconstruction in previously irradiated patients.

  6. Correlates of previous couples’ HIV counseling and testing uptake among married individuals in three HIV prevalence strata in Rakai, Uganda

    Directory of Open Access Journals (Sweden)

    Joseph K. B. Matovu

    2015-06-01

    Full Text Available Background: Studies show that uptake of couples’ HIV counseling and testing (couples’ HCT can be affected by individual, relationship, and socioeconomic factors. However, while couples’ HCT uptake can also be affected by background HIV prevalence and awareness of the existence of couples’ HCT services, this is yet to be documented. We explored the correlates of previous couples’ HCT uptake among married individuals in a rural Ugandan district with differing HIV prevalence levels. Design: This was a cross-sectional study conducted among 2,135 married individuals resident in the three HIV prevalence strata (low HIV prevalence: 9.7–11.2%; middle HIV prevalence: 11.4–16.4%; and high HIV prevalence: 20.5–43% in Rakai district, southwestern Uganda, between November 2013 and February 2014. Data were collected on sociodemographic and behavioral characteristics, including previous receipt of couples’ HCT. HIV testing data were obtained from the Rakai Community Cohort Study. We conducted multivariable logistic regression analysis to identify correlates that are independently associated with previous receipt of couples’ HCT. Data analysis was conducted using STATA (statistical software, version 11.2. Results: Of the 2,135 married individuals enrolled, the majority (n=1,783, 83.5% had been married for five or more years while (n=1,460, 66% were in the first-order of marriage. Ever receipt of HCT was almost universal (n=2,020, 95%; of those ever tested, (n=846, 41.9% reported that they had ever received couples’ HCT. There was no significant difference in previous receipt of couples’ HCT between low (n=309, 43.9%, middle (n=295, 41.7%, and high (n=242, 39.7% HIV prevalence settings (p=0.61. Marital order was not significantly associated with previous receipt of couples’ HCT. However, marital duration [five or more years vis-à-vis 1–2 years: adjusted odds ratio (aOR: 1.06; 95% confidence interval (95% CI: 1.04–1.08] and

  7. 28 CFR 10.5 - Incorporation of papers previously filed.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Incorporation of papers previously filed... CARRYING ON ACTIVITIES WITHIN THE UNITED STATES Registration Statement § 10.5 Incorporation of papers previously filed. Papers and documents already filed with the Attorney General pursuant to the said act and...

  8. Nutrition Education and Training Needs in Texas. Nutrition Education and Training Needs Assessment for Federal Fiscal Year 1995. Final Annual Report.

    Science.gov (United States)

    Martin, Ruth E.; Ahmad, Mahassen

    A 3-year needs assessment study examined nutrition knowledge, attitudes, and food practices. Subjects were 135 preschool children ages 3-5 years, 610 parents, 118 day care teachers and providers, 35 food service personnel, and 76 administrators throughout Texas. Registered family day care homes, group day care homes, and day care centers from 11…

  9. Academic literacy diagnostic assessment in the first semester of first year at university

    Directory of Open Access Journals (Sweden)

    Lorinda Palmer

    2014-03-01

    Full Text Available One vital aspect of the first semester of the first year at university is how academic literacy expectations are made explicit though teaching and assessment practices at the disciplinary level. This paper describes how an academic literacy diagnostic process, and the MASUS tool, was used to ascertain the academic literacy profile of a cohort of undergraduate nursing students [N=569] at the beginning and end of their first semester. Key findings of this quantitative descriptive case study were that only just over half of commencing students possessed appropriate academic literacy skills in all four aspects of the diagnostic and nearly 20% scored in the lowest band—suggesting difficulty with multiple aspects of academic literacy. By the end of semester, 77% of the students who had scored in the lowest band of the MASUS at the beginning of the semester had improved their scores to the middle or highest band, and 73% of them eventually attained a pass or higher grade for the course. The findings of this study suggest that large-scale academic literacy diagnostic assessment, when embedded and contextualized within a course of study, is an effective means of providing the early feedback and targeted support that many commencing university students need.

  10. Do psychopathic traits assessed in mid-adolescence predict mental health, psychosocial, and antisocial, including criminal outcomes, over the subsequent 5 years?

    Science.gov (United States)

    Hemphälä, Malin; Hodgins, Sheilagh

    2014-01-01

    To determine whether psychopathic traits assessed in mid-adolescence predicted mental health, psychosocial, and antisocial (including criminal) outcomes 5 years later and would thereby provide advantages over diagnosing conduct disorder (CD). Eighty-six women and 61 men were assessed in mid-adolescence when they first contacted a clinic for substance misuse and were reassessed 5 years later. Assessments in adolescence include the Psychopathy Checklist-Youth Version (PCL-YV), and depending on their age, either the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children or the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Assessments in early adulthood included the SCID, self-reports of psychosocial functioning, aggressive behaviour, and criminality and official criminal records. The antisocial facet score positively predicted the number of anxiety symptoms and likelihood of receiving treatment for substance use disorders (SUDs). Lifestyle and antisocial facet scores negatively predicted Global Assessment of Functioning scores. By contrast, the interpersonal score and male sex independently and positively predicted the number of months worked or studied, as did the interaction of Lifestyle × Sex indicating that among men, but not women, an increase in lifestyle facet score was associated with less time worked or studied. Interpersonal and antisocial scores positively predicted school drop-out. Antisocial facet scores predicted the number of symptoms of antisocial personality disorder, alcohol and SUDs, and violent and nonviolent criminality but much more strongly among males than females. Predictions from numbers of CD symptoms were similar. Psychopathic traits among adolescents who misuse substances predict an array of outcomes over the subsequent 5 years. Information on the levels of these traits may be useful for planning treatment.

  11. Field assessment of balance in 10 to 14 year old children, reproducibility and validity of the Nintendo Wii board

    Science.gov (United States)

    2014-01-01

    Background Because body proportions in childhood are different to those in adulthood, children have a relatively higher centre of mass location. This biomechanical difference and the fact that children’s movements have not yet fully matured result in different sway performances in children and adults. When assessing static balance, it is essential to use objective, sensitive tools, and these types of measurement have previously been performed in laboratory settings. However, the emergence of technologies like the Nintendo Wii Board (NWB) might allow balance assessment in field settings. As the NWB has only been validated and tested for reproducibility in adults, the purpose of this study was to examine reproducibility and validity of the NWB in a field setting, in a population of children. Methods Fifty-four 10–14 year-olds from the CHAMPS-Study DK performed four different balance tests: bilateral stance with eyes open (1), unilateral stance on dominant (2) and non-dominant leg (3) with eyes open, and bilateral stance with eyes closed (4). Three rounds of the four tests were completed with the NWB and with a force platform (AMTI). To assess reproducibility, an intra-day test-retest design was applied with a two-hour break between sessions. Results Bland-Altman plots supplemented by Minimum Detectable Change (MDC) and concordance correlation coefficient (CCC) demonstrated satisfactory reproducibility for the NWB and the AMTI (MDC: 26.3-28.2%, CCC: 0.76-0.86) using Centre Of Pressure path Length as measurement parameter. Bland-Altman plots demonstrated satisfactory concurrent validity between the NWB and the AMTI, supplemented by satisfactory CCC in all tests (CCC: 0.74-0.87). The ranges of the limits of agreement in the validity study were comparable to the limits of agreement of the reproducibility study. Conclusion Both NWB and AMTI have satisfactory reproducibility for testing static balance in a population of children. Concurrent validity of NWB compared

  12. Improving the Memory Sections of the Standardized Assessment of Concussion Using Item Analysis

    Science.gov (United States)

    McElhiney, Danielle; Kang, Minsoo; Starkey, Chad; Ragan, Brian

    2014-01-01

    The purpose of the study was to improve the immediate and delayed memory sections of the Standardized Assessment of Concussion (SAC) by identifying a list of more psychometrically sound items (words). A total of 200 participants with no history of concussion in the previous six months (aged 19.60 ± 2.20 years; N?=?93 men, N?=?107 women)…

  13. Blinded assessment of operative performance after fundamentals of laparoscopic surgery in gynecology training.

    Science.gov (United States)

    Antosh, Danielle D; Auguste, Tamika; George, Elizabeth A; Sokol, Andrew I; Gutman, Robert E; Iglesia, Cheryl B; Desale, Sameer Y; Park, Amy J

    2013-01-01

    To determine the pass rate for the Fundamentals of Laparoscopic Surgery (FLS) examination among senior gynecology residents and fellows and to find whether there is an association between FLS scores and previous laparoscopic experience as well as laparoscopic intraoperative (OR) skills assessment. Prospective cohort study (Canadian Task Force classification II-2). Three gynecology residency training programs. Third- and fourth-year gynecology residents and urogynecology fellows. All participants participated in the FLS curriculum, written and manual skills examination, and completed a survey reporting baseline characteristics and opinions. Fourth-year residents and fellows underwent unblinded and blinded pre- and post-FLS OR assessments. Objective OR assessments of fourth-year residents after FLS were compared with those of fourth-year resident controls who were not FLS trained. Twenty-nine participants were included. The overall pass rate was 76%. The pass rate for third- and fourth-year residents and fellows were 62%, 85%, and 100%, respectively. A trend toward improvement in OR assessments was observed for fourth-year residents and fellows for pre-FLS curriculum compared with post-FLS testing, and FLS-trained fourth-year residents compared with fourth-year resident controls; however, this did not reach statistical significance. Self-report of laparoscopic case load experience of >20 cases was the only baseline factor significantly associated with passing the FLS examination (p = .03). The FLS pass rate for senior residents and fellows was 76%, with higher pass rates associated with increasing levels of training and laparoscopic case experience. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  14. Prospective evaluation of patient-reported quality-of-life outcomes following SBRT ± cetuximab for locally-recurrent, previously-irradiated head and neck cancer

    International Nuclear Information System (INIS)

    Vargo, John A.; Heron, Dwight E.; Ferris, Robert L.; Rwigema, Jean-Claude M.; Wegner, Rodney E.; Kalash, Ronny; Ohr, James; Kubicek, Greg J.; Burton, Steven

    2012-01-01

    Purpose: Stereotactic body radiotherapy (SBRT) has emerged as a promising salvage strategy for unresectable, previously-irradiated recurrent squamous cell carcinomas of the head and neck (rSCCHN). Here-in, we report the first prospective evaluation of patient-reported quality-of-life (PR-QoL) following re-irradiation with SBRT ± cetuximab for rSCCHN. Materials and methods: From November 2004 to May 2011, 150 patients with unresectable, rSCCHN in a previously-irradiated field receiving >40 Gy were treated with SBRT to 40–50 Gy in 5 fractions ± concurrent cetuximab. PR-QoL was prospectively acquired using University of Washington Quality-of-Life Revised (UW-QoL-R). Results: Overall PR-QoL, health-related PR-QoL, and select domains commonly affected by re-irradiation progressively increase following an initial 1-month decline with statistically significant improvements noted in swallowing (p = 0.025), speech (p = 0.017), saliva (p = 0.041), activity (p = 0.032) and recreation (p = 0.039). Conclusions: Especially for patients surviving >1-year, improved tumor control associated with SBRT re-irradiation may ameliorate decreased PR-QoL resulting from rSCCHN. These improvements in PR-QoL transcend all measured domains in a validated PR-QoL assessment tool independent of age, use of cetuximab, tumor volume, and interval since prior irradiation.

  15. Previous experience of family violence and intimate partner violence in pregnancy.

    Science.gov (United States)

    Ludermir, Ana Bernarda; Araújo, Thália Velho Barreto de; Valongueiro, Sandra Alves; Muniz, Maria Luísa Corrêa; Silva, Elisabete Pereira

    2017-01-01

    To estimate differential associations between the exposure to violence in the family of origin and victimization and perpetration of intimate partner violence in pregnancy. A nested case-control study was carried out within a cohort study with 1,120 pregnant women aged 18-49 years old, who were registered in the Family Health Strategy of the city of Recife, State of Pernambuco, Brazil, between 2005 and 2006. The cases were the 233 women who reported intimate partner violence in pregnancy and the controls were the 499 women who did not report it. Partner violence in pregnancy and previous experiences of violence committed by parents or other family members were assessed with a standardized questionnaire. Multivariate logistic regression analyses were modeled to identify differential associations between the exposure to violence in the family of origin and victimization and perpetration of intimate partner violence in pregnancy. Having seen the mother suffer intimate partner violence was associated with physical violence in childhood (OR = 2.62; 95%CI 1.89-3.63) and in adolescence (OR = 1.47; 95%CI 1.01-2.13), sexual violence in childhood (OR = 3.28; 95%CI 1.68-6.38) and intimate partner violence during pregnancy (OR = 1.47; 95% CI 1.01 - 2.12). The intimate partner violence during pregnancy was frequent in women who reported more episodes of physical violence in childhood (OR = 2.08; 95%CI 1.43-3.02) and adolescence (OR = 1.63; 95%CI 1.07-2.47), who suffered sexual violence in childhood (OR = 3.92; 95%CI 1.86-8.27), and who perpetrated violence against the partner (OR = 8.67; 95%CI 4.57-16.45). Experiences of violence committed by parents or other family members emerge as strong risk factors for intimate partner violence in pregnancy. Identifying and understanding protective and risk factors for the emergence of intimate partner violence in pregnancy and its maintenance may help policymakers and health service managers to develop intervention strategies.

  16. Prevalence of pain in the head, back and feet in refugees previously exposed to torture: a ten-year follow-up study

    DEFF Research Database (Denmark)

    Olsen, Dorthe Reff; Montgomery, Edith; Bøjholm, Søren

    2007-01-01

    exposed to torture in their home country were interviewed at a Danish rehabilitation clinic on average 8 years after their final release from confinement and re-interviewed 10 years later. Interviews focused on history of exposure to physical and mental torture and on pain in the head, back and feet...

  17. No discrimination against previous mates in a sexually cannibalistic spider

    Science.gov (United States)

    Fromhage, Lutz; Schneider, Jutta M.

    2005-09-01

    In several animal species, females discriminate against previous mates in subsequent mating decisions, increasing the potential for multiple paternity. In spiders, female choice may take the form of selective sexual cannibalism, which has been shown to bias paternity in favor of particular males. If cannibalistic attacks function to restrict a male's paternity, females may have little interest to remate with males having survived such an attack. We therefore studied the possibility of female discrimination against previous mates in sexually cannibalistic Argiope bruennichi, where females almost always attack their mate at the onset of copulation. We compared mating latency and copulation duration of males having experienced a previous copulation either with the same or with a different female, but found no evidence for discrimination against previous mates. However, males copulated significantly shorter when inserting into a used, compared to a previously unused, genital pore of the female.

  18. Residents' surgical performance during the laboratory years: an analysis of rule-based errors.

    Science.gov (United States)

    Nathwani, Jay N; Wise, Brett J; Garren, Margaret E; Mohamadipanah, Hossein; Van Beek, Nicole; DiMarco, Shannon M; Pugh, Carla M

    2017-11-01

    Nearly one-third of surgical residents will enter into academic development during their surgical residency by dedicating time to a research fellowship for 1-3 y. Major interest lies in understanding how laboratory residents' surgical skills are affected by minimal clinical exposure during academic development. A widely held concern is that the time away from clinical exposure results in surgical skills decay. This study examines the impact of the academic development years on residents' operative performance. We hypothesize that the use of repeated, annual assessments may result in learning even without individual feedback on participants simulated performance. Surgical performance data were collected from laboratory residents (postgraduate years 2-5) during the summers of 2014, 2015, and 2016. Residents had 15 min to complete a shortened, simulated laparoscopic ventral hernia repair procedure. Final hernia repair skins from all participants were scored using a previously validated checklist. An analysis of variance test compared the mean performance scores of repeat participants to those of first time participants. Twenty-seven (37% female) laboratory residents provided 2-year assessment data over the 3-year span of the study. Second time performance revealed improvement from a mean score of 14 (standard error = 1.0) in the first year to 17.2 (SD = 0.9) in the second year, (F[1, 52] = 5.6, P = 0.022). Detailed analysis demonstrated improvement in performance for 3 grading criteria that were considered to be rule-based errors. There was no improvement in operative strategy errors. Analysis of longitudinal performance of laboratory residents shows higher scores for repeat participants in the category of rule-based errors. These findings suggest that laboratory residents can learn from rule-based mistakes when provided with annual performance-based assessments. This benefit was not seen with operative strategy errors and has important implications for

  19. Effect of Previous Abdominal Surgery on Laparoscopic Liver Resection: Analysis of Feasibility and Risk Factors for Conversion.

    Science.gov (United States)

    Cipriani, Federica; Ratti, Francesca; Fiorentini, Guido; Catena, Marco; Paganelli, Michele; Aldrighetti, Luca

    2018-03-28

    Previous abdominal surgery has traditionally been considered an additional element of difficulty to later laparoscopic procedures. The aim of the study is to analyze the effect of previous surgery on the feasibility and safety of laparoscopic liver resection (LLR), and its role as a risk factor for conversion. After matching, 349 LLR in patients known for previous abdominal surgery (PS group) were compared with 349 LLR on patients with a virgin abdomen (NPS group). Subgroup analysis included 161 patients with previous upper abdominal surgery (UPS subgroup). Feasibility and safety were evaluated in terms of conversion rate, reasons for conversion and outcomes, and risk factors for conversion assessed via uni/multivariable analysis. Conversion rate was 9.4%, and higher for PS patients compared with NPS patients (13.7% versus 5.1%, P = .021). Difficult adhesiolysis resulted the commonest reason for conversion in PS group (5.7%). However, operative time (P = .840), blood loss (P = .270), transfusion (P = .650), morbidity rate (P = .578), hospital stay (P = .780), and R1 rate (P = .130) were comparable between PS and NPS group. Subgroup analysis confirmed higher conversion rates for UPS patients (23%) compared with both NPS (P = .015) and PS patients (P = .041). Previous surgery emerged as independent risk factor for conversion (P = .033), alongside the postero-superior location and major hepatectomy. LLR are feasible in case of previous surgery and proved to be safe and maintain the benefits of LLR carried out in standard settings. However, a history of surgery should be considered a risk factor for conversion.

  20. Formal faculty observation and assessment of bedside skills for 3rd-year neurology clerks.

    Science.gov (United States)

    Thompson Stone, Robert; Mooney, Christopher; Wexler, Erika; Mink, Jonathan; Post, Jennifer; Jozefowicz, Ralph F

    2016-11-22

    To evaluate the feasibility and utility of instituting a formalized bedside skills evaluation (BSE) for 3rd-year medical students on the neurology clerkship. A neurologic BSE was developed for 3rd - year neurology clerks at the University of Rochester for the 2012-2014 academic years. Faculty directly observed 189 students completing a full history and neurologic examination on real inpatients. Mock grades were calculated utilizing the BSE in the final grade, and number of students with a grade difference was determined when compared to true grade. Correlation was explored between the BSE and clinical scores, National Board of Medical Examiners (NBME) scores, case complexity, and true final grades. A survey was administered to students to assess their clinical skills exposure and the usefulness of the BSE. Faculty completed and submitted a BSE form for 88.3% of students. There was a mock final grade change for 13.2% of students. Correlation coefficients between BSE score and clinical score/NBME score were 0.36 and 0.35, respectively. A statistically significant effect of BSE was found on final clerkship grade (F 2,186 = 31.9, p neurology clerkship was feasible. Low correlation between BSE score and other evaluations indicated a unique measurement to contribute to student grade. Using real patients with differing case complexity did not alter the grade. © 2016 American Academy of Neurology.

  1. Sex differences in mathematics and reading achievement are inversely related: within- and across-nation assessment of 10 years of PISA data.

    Science.gov (United States)

    Stoet, Gijsbert; Geary, David C

    2013-01-01

    We analyzed one decade of data collected by the Programme for International Student Assessment (PISA), including the mathematics and reading performance of nearly 1.5 million 15 year olds in 75 countries. Across nations, boys scored higher than girls in mathematics, but lower than girls in reading. The sex difference in reading was three times as large as in mathematics. There was considerable variation in the extent of the sex differences between nations. There are countries without a sex difference in mathematics performance, and in some countries girls scored higher than boys. Boys scored lower in reading in all nations in all four PISA assessments (2000, 2003, 2006, 2009). Contrary to several previous studies, we found no evidence that the sex differences were related to nations' gender equality indicators. Further, paradoxically, sex differences in mathematics were consistently and strongly inversely correlated with sex differences in reading: Countries with a smaller sex difference in mathematics had a larger sex difference in reading and vice versa. We demonstrate that this was not merely a between-nation, but also a within-nation effect. This effect is related to relative changes in these sex differences across the performance continuum: We did not find a sex difference in mathematics among the lowest performing students, but this is where the sex difference in reading was largest. In contrast, the sex difference in mathematics was largest among the higher performing students, and this is where the sex difference in reading was smallest. The implication is that if policy makers decide that changes in these sex differences are desired, different approaches will be needed to achieve this for reading and mathematics. Interventions that focus on high-achieving girls in mathematics and on low achieving boys in reading are likely to yield the strongest educational benefits.

  2. Joining the dots: conditional pass and programmatic assessment enhances recognition of problems with professionalism and factors hampering student progress.

    Science.gov (United States)

    Wilkinson, Tim J; Tweed, Mike J; Egan, Tony G; Ali, Anthony N; McKenzie, Jan M; Moore, MaryLeigh; Rudland, Joy R

    2011-06-07

    Programmatic assessment that looks across a whole year may contribute to better decisions compared with those made from isolated assessments alone. The aim of this study is to describe and evaluate a programmatic system to handle student assessment results that is aligned not only with learning and remediation, but also with defensibility. The key components are standards based assessments, use of "Conditional Pass", and regular progress meetings. The new assessment system is described. The evaluation is based on years 4-6 of a 6-year medical course. The types of concerns staff had about students were clustered into themes alongside any interventions and outcomes for the students concerned. The likelihoods of passing the year according to type of problem were compared before and after phasing in of the new assessment system. The new system was phased in over four years. In the fourth year of implementation 701 students had 3539 assessment results, of which 4.1% were Conditional Pass. More in-depth analysis for 1516 results available from 447 students revealed the odds ratio (95% confidence intervals) for failure was highest for students with problems identified in more than one part of the course (18.8 (7.7-46.2) p year under the new system on the basis of performance during the year (20 or 4.5% compared with four or 1.1% under the previous system (p pass has contributed to a paper trail that should improve defensibility. Most importantly it has helped detect and act on some of the more difficult areas to assess such as professionalism.

  3. [Delivery after a previous cesarean in the Gyneco-Obsteric Hospital Garza Garcia, N.L].

    Science.gov (United States)

    de la Garza Quintanilla, C; Celaya Juárez, J A; Hernández Escobar, C

    1997-04-01

    One hundred and four patients who delivered after a previous cesarean section, at Hospital de Ginecoobstetricia de Garza García, N.L., from February 1, 1994 to January 31, 1995, were reviewed. The objective for this study was to know materno-fetal morbi-mortality at our hospital. Age, parity weeks of gestation, cause for previous section, delivery culmination, weight and Apgar of products, as well as, materno-fetal morbi-mortality, were analyzed. Average age group was 21 to 30 years with 68.5%. As to parity nulliparae predominated with 48.1%. As to weeks of gestation, the most frequent was 37 to 40 weeks, 85.5%. Previous section indication was: 1. Pelvic presentation, 2. Fetal stress, 3. Cefalo-pelvic disproportion, 4. Premature rupture of membranes, 5. Toxemia. As to deliveries outcome, there was dystocia in 86.5%, by profilactic low forceps application in 81.7%; and mid low in 4.8%. Eutocic delivery, 13.5%. Product weight was 3,000 to 3,500 g, with 51%. Apgar in 94 products was 8 and 9 at one minute. Maternal morbidity was 15.3% being most frequent vaginal tears. There was one case of uterine atonia, and one case of dura mater adverted puncture. There were no uterine dehiscence nor rupture. Perinatal morbidity was 5.6%. There was no perinatal death.

  4. Central venous stenosis in haemodialysis patients without a previous history of catheter placement.

    Science.gov (United States)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-08-01

    To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

  5. Fundamental movement skills and physical fitness as predictors of physical activity: A 6-year follow-up study.

    Science.gov (United States)

    Jaakkola, T; Yli-Piipari, S; Huotari, P; Watt, A; Liukkonen, J

    2016-01-01

    The purpose of this study was to examine the extent to which fundamental movement skills and physical fitness scores assessed in early adolescence predict self-reported physical activity assessed 6 years later. The sample comprised 333 (200 girls, 133 boys; M age = 12.41) students. The effects of previous physical activity, sex, and body mass index (BMI) were controlled in the main analyses. Adolescents' fundamental movement skills, physical fitness, self-report physical activity, and BMI were collected at baseline, and their self-report energy expenditure (metabolic equivalents: METs) and intensity of physical activity were collected using the International Physical Activity Questionnaire 6 years later. Results showed that fundamental movement skills predicted METs, light, moderate, and vigorous intensity physical activity levels, whereas fitness predicted METs, moderate, and vigorous physical activity levels. Hierarchical regression analyses also showed that after controlling for previous levels of physical activity, sex, and BMI, the size of the effect of fundamental movement skills and physical fitness on energy expenditure and physical activity intensity was moderate (R(2) change between 0.06 and 0.15), with the effect being stronger for high intensity physical activity. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The effects of anticholinergic drugs on regional cerebral blood flow, and oxygen metabolism in previously untreated patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Obara, Satoko; Takahashi, Satoshi; Yonezawa, Hisashi; Sato, Yoshitomo

    1998-01-01

    Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO 2 ) were measured using the steady-state 15 O technique and positron emission tomography (PET) in six previously untreated patients with Parkinson's disease before and after trihexyphenidyl (THP) treatment. The patients comprised of 4 men and 2 women with Hoehn-Yahr stage II-III. Their ages at the onset of the study ranged from 46 to 57 years (mean±SD, 51.8±3.7) and the duration of the illness ranged from 10 to 48 months (mean±SD, 28.8±15.5). The PET study, assessments of the disability and cognitive function were undergone twice. The first time assessments were done was when the patients were not receiving any drugs, and the second time was one to three months after administration of 6 mg THP. All patients showed clinical improvement after THP treatment. The mean disability score of Unified Parkinson's Disease Rating Scale decreased from 35.1 (SD±11.3) to 25.7 (SD±11.6). The cognitive function assessed by Hasegawa's dementia rating scale-revised, Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale-Revised, were not significantly different before and after the THP treatment. After the THP treatment, rCBF and rCMRO 2 decreased significantly in the striatum (about 15%) and all cerebral cortices (about 10%) on both sides contralateral and ipsilateral to the predominantly symptomatic limbs. We conclude that an anticholinergic THP decreases the rCBF and rCMRO 2 significantly in the cerebral cortices without cognitive impairment in early untreated patients with Parkinson's disease. (author)

  7. Crown condition assessment at the CONECOFOR Permanent Monitoring Plots

    Directory of Open Access Journals (Sweden)

    Renzo NIBBI

    2002-09-01

    Full Text Available A detailed crown condition assessment is currently being carried out at the CONECOFOR (CONtrollo ECOsistemi FORestali, Control of Forest Ecosystems plots. The assessment began in 1996, and during the first two years (1996 and 1997 an assessment form based on previous regional experience was used; in 1998 the new official EU form was adopted. The resulting loss of comparability means that only a few indices can be used in the temporal series 1996-1999. Much effort was devoted to Quality Assurance (QA procedures. The QA program is structured as follows: (i specific field manuals have been adopted and are continuously updated; (ii a national training and intercalibration course (NT&IC is undertaken yearly before beginning the assessment campaign;( iii field checks are carried out yearly on a large number of plots. The results of the QA program have shown that for several indices the quality objectives were not reached, but the quality of the data is improving with time. To express the change in crown conditions in each area, a complex index (CCI = Crown Condition Index was adopted. This index is the result of the sum of the relativized values of all the common indices used during the four years. The following parameters were used: transparency, ramification type, leaf colour alteration extension, leaf damage extension, alteration of leaf distension extension. The range within which the CCI fluctuates was evaluated taking into account all the observations carried out at a given plot throughout the years. The number of cases over a given threshold (outliers was calculated for each year. The threshold for outliers was calculated as the median value plus 2 times the range of the interquartile value. All individual cases exceeding this value are considered outliers. The results are presented for all the areas in which the data set is complete for the four years. The yearly fluctuations are discussed and related to possible causes.

  8. Preschoolers' Performance on the Brazilian Adaptation of the Preschool Language Assessment Instrument - Second Edition.

    Science.gov (United States)

    Lindau, Tâmara Andrade; Rossi, Natalia Freitas; Giacheti, Celia Maria

    2016-01-01

    The objective was to test whether the Brazilian version of the Preschool Language Assessment Instrument - Second Edition (PLAI-2) has the potential to assess and identify differences in typical language development of Portuguese-speaking preschoolers. The study included 354 children of both genders with typical language development who were between the ages of 3 years and 5 years 11 months. The version of the PLAI-2 previously translated into Brazilian Portuguese was used to assess the communication skills of these preschool-age children. Statistically significant differences were found between the age groups, and the raw score tended to increase as a function of age. With nonstandardized assessments, the performances of the younger groups revealed behavioral profiles (e.g., nonresponsive, impulsive behavior) that directly influenced the evaluation. The findings of this study show that the PLAI-2 is effective in identifying differences in language development among Brazilian children of preschool age. Future research should include studies validating and standardizing these findings. © 2016 S. Karger AG, Basel.

  9. Quality of life at 6 years after occupational injury.

    Science.gov (United States)

    Chin, Wei-Shan; Guo, Yue Leon; Liao, Shih-Cheng; Wu, Hsueh-Ching; Kuo, Chun-Ya; Chen, Chih-Chieh; Shiao, Judith Shu-Chu

    2018-03-01

    Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain. Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury. A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary after the injury were significant factors for low scores in all domains of the WHOQOL-BREF. In addition, unmarried participants had low scores in the social relationship domain. Workers with family members requiring care scored low in the physical and environment domains. Workers whose injuries had major effects on their physical appearance had low scores in the physical and psychological domains. Workers with unstable employment had low scores in physical, psychological, and environment domains. At 6 years after occupational injury, workers' HRQOL was poor among those whose salaries decreased after the injury, after adjustment for other factors.

  10. Sun exposure habits and health risk-related behaviours among individuals with previous history of skin cancer.

    Science.gov (United States)

    Falk, Magnus; Faresjö, Ashild; Faresjö, Tomas

    2013-02-01

    The aim of the present study was to investigate possible associations between UV exposure and other health risk behaviours in different social environments and in regard to previous history of skin cancer. In two closely-located, equally-sized cities in Sweden, representing different social environments (blue collar and white collar), patients aged 55-69 years, diagnosed with skin cancer (study group, n=489) or seborrhoeic keratosis (control group, n=664), were identified through a regional Health Care Register, and were given a questionnaire mapping for sun habits, tobacco smoking, alcohol use, and physical activity. A previous history of skin cancer was associated with reduced UV exposure (phistory of skin cancer appears to promote increased UV protection. In contrast to alcohol/smoking habits, no association between social environment and sun habits was found.

  11. High Titers of Chlamydia trachomatis Antibodies in Brazilian Women with Tubal Occlusion or Previous Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    A. C. S. Machado

    2007-01-01

    Full Text Available Objective. To evaluate serum chlamydia antibody titers (CATs in tubal occlusion or previous ectopic pregnancy and the associated risk factors. Methods. The study population consisted of 55 women wih tubal damage and 55 parous women. CAT was measured using the whole-cell inclusion immunofluorescence test and cervical chlamydial DNA detected by PCR. Odds ratios were calculated to assess variables associated with C. trachomatis infection. Results. The prevalence of chlamydial antibodies and antibody titers in women with tubal occlusion or previous ectopic pregnancy was significantly higher (P<.01 than in parous women. Stepwise logistic regression analysis showed that chlamydia IgG antibodies were associated with tubal damage and with a larger number of lifetime sexual partners. Conclusions. Chlamydia antibody titers were associated with tubal occlusion, prior ectopic pregnancy, and with sexual behavior, suggesting that a chlamydia infection was the major contributor to the tubal damage in these women.

  12. Pre-operative assessment of patients undergoing endoscopic, transnasal, transsphenoidal pituitary surgery.

    Science.gov (United States)

    Lubbe, D; Semple, P

    2008-06-01

    To demonstrate the importance of pre-operative ear, nose and throat assessment in patients undergoing endoscopic, transsphenoidal surgery for pituitary tumours. Literature pertaining to the pre-operative otorhinolaryngological assessment and management of patients undergoing endoscopic anterior skull base surgery is sparse. We describe two cases from our series of 59 patients undergoing endoscopic pituitary surgery. The first case involved a young male patient with a large pituitary macroadenoma. His main complaint was visual impairment. He had no previous history of sinonasal pathology and did not complain of any nasal symptoms during the pre-operative neurosurgical assessment. At the time of surgery, a purulent nasal discharge was seen emanating from both middle meati. Surgery was abandoned due to the risk of post-operative meningitis, and postponed until the patient's chronic rhinosinusitis was optimally managed. The second patient was a 47-year-old woman with a large pituitary macroadenoma, who presented to the neurosurgical department with a main complaint of diplopia. She too gave no history of previous nasal problems, and she underwent uneventful surgery using the endoscopic, transnasal approach. Two weeks after surgery, she presented to the emergency unit with severe epistaxis. A previous diagnosis of hereditary haemorrhagic telangiectasia was discovered, and further surgical and medical intervention was required before the epistaxis was finally controlled. Pre-operative otorhinolaryngological assessment is essential prior to endoscopic pituitary or anterior skull base surgery. A thorough otorhinolaryngological history will determine whether any co-morbid diseases exist which could affect the surgical field. Nasal anatomy can be assessed via nasal endoscopy and sinusitis excluded. Computed tomography imaging is a valuable aid to decisions regarding additional procedures needed to optimise access to the pituitary fossa.

  13. Subsequent childbirth after a previous traumatic birth.

    Science.gov (United States)

    Beck, Cheryl Tatano; Watson, Sue

    2010-01-01

    Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.

  14. Brain development during the first year of life. Quantitative assessment with ADC imaging

    International Nuclear Information System (INIS)

    Okuda, Yasuyuki

    1994-01-01

    Brain development during the first year of life was assessed quantitatively using apparent diffusion coefficient (ADC) images constructed from diffusion-weighted MR image data. The imaging plane was coronal at the section of the pons. The cerebral peduncle, internal capsule, corona radiata, superior longitudinal fasciculus and thalamus were selected for evaluation of their ADC values. A diffusion sensitive gradient was added in the anteroposterior direction. Thus the orientation of nerve fibers in the cerebral peduncle, internal capsule and corona radiata was perpendicular to it, and that in the superior longitudinal fasciculus was parallel to it. In neonates, the cerebral peduncle and internal capsule, having been moderately myelinated at birth, showed the slowest diffusion. The corona radiata and superior longitudinal fasciculus, having been unmyelinated at birth, showed the fastest diffusion. The thalamus had intermediate diffusion. These neonatal diffusions tended to be promptly restricted within the first five months, followed by additional slight restriction thereafter. ADC values in the first year were significantly reduced in all regions compared with those in the neonatal period, particularly in the corona radiata and thalamus. This study showed that ADC analysis can estimate normal brain development in detail and might be useful for investigating various neonatal brain diseases. (author)

  15. Nonvitamin-K-antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and previous stroke or transient ischemic attack: An updated systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Ntaios, George; Papavasileiou, Vasileios; Diener, Hans-Chris; Makaritsis, Konstantinos; Michel, Patrik

    2017-08-01

    Background In a previous systematic review and meta-analysis, we assessed the efficacy and safety of nonvitamin-K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and stroke or transient ischemic attack. Since then, new information became available. Aim The aim of the present work was to update the results of the previous systematic review and meta-analysis. Methods We searched PubMed until 24 August 2016 for randomized controlled trials using the following search items: "atrial fibrillation" and "anticoagulation" and "warfarin" and "previous stroke or transient ischemic attack." Eligible studies had to be phase III trials in patients with atrial fibrillation comparing warfarin with nonvitamin-K antagonist oral anticoagulants currently on the market or with the intention to be brought to the market in North America or Europe. The outcomes assessed in the efficacy analysis included stroke or systemic embolism, stroke, ischemic or unknown stroke, disabling or fatal stroke, hemorrhagic stroke, cardiovascular death, death from any cause, and myocardial infarction. The outcomes assessed in the safety analysis included major bleeding, intracranial bleeding, and major gastrointestinal bleeding. We performed fixed effects analyses on intention-to-treat basis. Results Among 183 potentially eligible articles, four were included in the meta-analysis. In 20,500 patients, compared to warfarin, nonvitamin-K antagonist oral anticoagulants were associated with a significant reduction of stroke/systemic embolism (relative risk reduction: 13.7%, absolute risk reduction: 0.78%, number needed to treat to prevent one event: 127), hemorrhagic stroke (relative risk reduction: 50.0%, absolute risk reduction: 0.63%, number needed to treat: 157), any stroke (relative risk reduction: 13.1%, absolute risk reduction: 0.7%, number needed to treat: 142), and intracranial hemorrhage (relative risk reduction: 46.1%, absolute risk reduction: 0.88%, number needed

  16. Development of multi-year land cover data to assess wildfire impacts to coastal watersheds and the nearshore environment

    Science.gov (United States)

    Morrison, Katherine D.

    In the Mediterranean ecosystems of coastal California, wildfire is a common disturbance that can significantly alter vegetation in watersheds that transport sediment and nutrients to the adjacent nearshore oceanic environment. We assess the impact of two wildfires that burned in 2008 on land cover and to the nearshore environment along the Big Sur coast in central California. We created a multi-year land cover dataset to assess changes to coastal watersheds as a result of fire. This land cover dataset was then used to model changes in nonpoint source pollutants transported to the nearshore environment. Results indicate post-fire increases in percent export compared to pre-fire years and also link wildfire severity to the specific land cover changes that subsequently increase exports of pollutants and sediment to the nearshore environment. This approach is a replicable across watersheds and also provides a framework for including the nearshore environment as a value at risk terrestrial land management revolving around wildfire, including suppression, thinning, and other activities that change land cover at a landscape scale.

  17. One-Year Longitudinal Study of Fatigue, Cognitive Functions, and Quality of Life After Adjuvant Radiotherapy for Breast Cancer

    International Nuclear Information System (INIS)

    Noal, Sabine; Levy, Christelle; Hardouin, Agnes; Rieux, Chantal; Heutte, Natacha; Segura, Carine; Collet, Fabienne; Allouache, Djelila; Switsers, Odile; Delcambre, Corinne; Delozier, Thierry; Henry-Amar, Michel; Joly, Florence

    2011-01-01

    Purpose: Most patients with localized breast cancer (LBC) who take adjuvant chemotherapy (CT) complain of fatigue and a decrease in quality of life during or after radiotherapy (RT). The aim of this longitudinal study was to compare the impact of RT alone with that occurring after previous CT on quality of life. Methods and Materials: Fatigue (the main endpoint) and cognitive impairment were assessed in 161 CT-RT and 141 RT patients during RT and 1 year later. Fatigue was assessed with Functional Assessment of Cancer Therapy-General questionnaires, including breast and fatigue modules. Results: At baseline, 60% of the CT-RT patients expressed fatigue vs. 33% of the RT patients (p <0.001). Corresponding values at the end of RT were statistically similar (61% and 53%), and fatigue was still reported at 1 year by more than 40% of patients in both groups. Risk factors for long-term fatigue included depression (odds ratio [OR] = 6), which was less frequent in the RT group at baseline (16% vs. 28 %, respectively, p = 0.01) but reached a similar value at the end of RT (25% in both groups). Initial mild cognitive impairments were reported by RT (34 %) patients and CT-RT (24 %) patients and were persistent at 1 year for half of them. No biological disorders were associated with fatigue or cognitive impairment. Conclusions: Fatigue was the main symptom in LBC patients treated with RT, whether they received CT previously or not. The correlation of persistent fatigue with initial depressive status favors administering medical and psychological programs for LBC patients treated with CT and/or RT, to identify and manage this main quality-of-life-related symptom.

  18. Early Years Students' Relationships with Mathematics

    Science.gov (United States)

    Takeuchi, Miwa Aoki; Towers, Jo; Plosz, Jennifer

    2016-01-01

    Early years mathematics experiences have been shown to be a significant predictor for students' school readiness and future mathematics achievement. Previous research also indicates an important connection between emotion and mathematics learning. How do students in early years education in Alberta describe their emotional relationship with…

  19. Relationship between self-assessed masticatory disability and 9-year mortality in a cohort of community-residing elderly people.

    Science.gov (United States)

    Nakanishi, Noriyuki; Fukuda, Hideki; Takatorige, Toshio; Tatara, Kozo

    2005-01-01

    To examine the relationship between self-assessed masticatory disability and mortality. Prospective. Community based. Total of 1,405 randomly selected people aged 65 and older living in Settsu, Osaka Prefecture, in October 1992. Data on health status as indicated by disability scores, history of health management, self-assessed masticatory ability, and psychosocial conditions were collected by means of interviews during home visits at the time of enrollment. Nine-year follow-up was completed for 1,245 (88.6%; 398 deceased and 847 alive). Self-assessed masticatory disability was significantly associated with being 75 and older, having overall disability, not using dental health checks or general health checks, not participating in social activities, not feeling that life is worth living (no ikigai), and finding relationships with people difficult. As for the association between self-assessed masticatory disability and mortality, the estimated survival rate for those with self-assessed masticatory disability was lower than that for those without for each group stratified by sex and age (65-74 and >or=75), and the equality of survival curves according to self-assessed masticatory disability was significant for each group. After controlling for potential predictors of mortality, self-assessed masticatory disability remained as a significant predictor of mortality (adjusted hazard ratio=1.63, 95% confidence interval=1.30-2.03, P<.001). These results indicate that self-assessed masticatory disability may be associated with a greater risk of mortality in community-residing elderly people.

  20. Mining international year book, 1978

    International Nuclear Information System (INIS)

    Skinner, W.

    1978-01-01

    The 1978 issue of the Mining International Year Book marks the 91st year of publication and contains particulars of the principal and other international companies associated with the Mining Industry. The book is recognized as the foremost reference work of its kind with a coverage both wide and detailed. The many companies registered abroad are distinguished by an entry immediately beneath the title giving the date and place of incorporation; where the date of registration alone is mentioned, the company is registered in the United Kingdom. As in previous years each entry has been reviewed and, where necessary, revised in the light of additional information received since the previous volume. The information thus recorded is the latest available at the time of going to press. Special features of value and interest include cross-reference index to all principal, subsidiary and associated companies in this edition, geographical index, suppliers' directory and buyers' guide, world production table, mining areas of Australia, and professional services section

  1. Emphysema and bronchiectasis in COPD patients with previous pulmonary tuberculosis: computed tomography features and clinical implications

    Directory of Open Access Journals (Sweden)

    Jin J

    2018-01-01

    Full Text Available Jianmin Jin,1 Shuling Li,2 Wenling Yu,2 Xiaofang Liu,1 Yongchang Sun1,3 1Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 2Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 3Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China Background: Pulmonary tuberculosis (PTB is a risk factor for COPD, but the clinical characteristics and the chest imaging features (emphysema and bronchiectasis of COPD with previous PTB have not been studied well.Methods: The presence, distribution, and severity of emphysema and bronchiectasis in COPD patients with and without previous PTB were evaluated by high-resolution computed tomography (HRCT and compared. Demographic data, respiratory symptoms, lung function, and sputum culture of Pseudomonas aeruginosa were also compared between patients with and without previous PTB.Results: A total of 231 COPD patients (82.2% ex- or current smokers, 67.5% male were consecutively enrolled. Patients with previous PTB (45.0% had more severe (p=0.045 and longer history (p=0.008 of dyspnea, more exacerbations in the previous year (p=0.011, and more positive culture of P. aeruginosa (p=0.001, compared with those without PTB. Patients with previous PTB showed a higher prevalence of bronchiectasis (p<0.001, which was more significant in lungs with tuberculosis (TB lesions, and a higher percentage of more severe bronchiectasis (Bhalla score ≥2, p=0.031, compared with those without previous PTB. The overall prevalence of emphysema was not different between patients with and without previous PTB, but in those with previous PTB, a higher number of subjects with middle (p=0.001 and lower (p=0.019 lobe emphysema, higher severity score (p=0.028, higher prevalence of panlobular emphysema (p=0.013, and more extensive centrilobular emphysema (p=0.039 were observed. Notably, in patients with

  2. A comparison of two novel antipsychotics in first episode non-affective psychosis: one-year outcome on symptoms, motor side effects and cognition.

    Science.gov (United States)

    Malla, Ashok; Norman, Ross; Scholten, Derek; Townsend, Laurel; Manchanda, Rahul; Takhar, Jatinder; Haricharan, Raj

    2004-12-15

    The main objective of this study was to compare 1-year outcome on symptoms, extrapyramidal side effects (EPS) , positive and negative symptoms, and domains of cognition in first episode psychosis (FEP) patients. Drug-naive FEP patients, who were similar on a number of characteristics likely to affect outcome, were treated with only one antipsychotic (risperidone or olanzapine) for at least 1 year and compared at baseline and after 1 year of treatment. Differences in outcome were assessed using an analysis of co-variance with change scores between initial assessment and after 1 year of treatment on levels of psychotic, disorganization and psychomotor poverty symptoms, EPS (parkinsonism, akathesia and dyskineisa) and domains of cognition as the dependent variable, respective baseline scores as covariates, and drug group as the independent variable. While patients in both groups showed substantial improvement, there were no significant differences in the magnitude of change in reality distortion, disorganization and psychomotor poverty symptoms. Trends in change in EPS favouring olanzapine and on some domains of cognition (processing speed and executive functions) favouring risperidone failed to reach statistical significance. The failure to confirm previous claims of greater improvement on either risperidone or olanzapine in patients with a first episode of psychosis may be the result of methodological bias introduced by unequal dosing between the two drugs or the use of chronically ill and treatment-refractory patients in previous studies.

  3. Dental age estimation: the role of probability estimates at the 10 year threshold.

    Science.gov (United States)

    Lucas, Victoria S; McDonald, Fraser; Neil, Monica; Roberts, Graham

    2014-08-01

    The use of probability at the 18 year threshold has simplified the reporting of dental age estimates for emerging adults. The availability of simple to use widely available software has enabled the development of the probability threshold for individual teeth in growing children. Tooth development stage data from a previous study at the 10 year threshold were reused to estimate the probability of developing teeth being above or below the 10 year thresh-hold using the NORMDIST Function in Microsoft Excel. The probabilities within an individual subject are averaged to give a single probability that a subject is above or below 10 years old. To test the validity of this approach dental panoramic radiographs of 50 female and 50 male children within 2 years of the chronological age were assessed with the chronological age masked. Once the whole validation set of 100 radiographs had been assessed the masking was removed and the chronological age and dental age compared. The dental age was compared with chronological age to determine whether the dental age correctly or incorrectly identified a validation subject as above or below the 10 year threshold. The probability estimates correctly identified children as above or below on 94% of occasions. Only 2% of the validation group with a chronological age of less than 10 years were assigned to the over 10 year group. This study indicates the very high accuracy of assignment at the 10 year threshold. Further work at other legally important age thresholds is needed to explore the value of this approach to the technique of age estimation. Copyright © 2014. Published by Elsevier Ltd.

  4. Assessing the nutritional status of hospitalized elderly

    Directory of Open Access Journals (Sweden)

    Abd Aziz NAS

    2017-10-01

    Full Text Available Nur Adilah Shuhada Abd Aziz, Nur Islami Mohd Fahmi Teng, Mohd Ramadan Abdul Hamid, Nazrul Hadi Ismail Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia Purpose: The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue.Methods: A literature search was performed on six databases using the terms “malnutrition”, “hospitalised elderly”, “nutritional assessment”, “Mini Nutritional Assessment (MNA”, “Geriatric Nutrition Risk Index (GNRI”, and “Subjective Global Assessment (SGA”.Results: According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients.Conclusion: It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future. Keywords: malnutrition in elderly

  5. Grating-acuity in children. Normal values of visual acuity in children up to 13 years as assessed by the acuity card procedure.

    Science.gov (United States)

    Schenk-Rootlieb, A J; van Nieuwenhuizen, O; van Zoggel, J; van der Graaf, Y; Willemse, J

    1992-09-01

    The acuity card procedure proved to be a useful method for assessing visual acuity in children. Normal values of visual acuity measured by this method had already been assessed in children up to four years. To enable application of the test in older children this study obtained values in a group of 396 normal children, aged three months to 13 years. The mean curve as well as the 10th centile was calculated in different age groups. A considerable variation of acuity values causing a 'dip' in the 10th centile was found in the ages 18 to 24 months. A smaller 'dip' was found in the ages 48 to 52 months. This has to be attributed to behavioural properties connected with age. The results obtained in the group of children under four years of age corresponded fairly well with other studies. In schoolchildren a fair agreement could also be found between the data obtained using the acuity card procedure and the data obtained with the Landolt-C rings. Obtaining normal values for the acuity card procedure in children covering a wide age range facilitates recognition of visual handicap in children who are difficult to assess.

  6. Repeated Surgical or Endoscopic Myotomy for Recurrent Dysphagia in Patients After Previous Myotomy for Achalasia.

    Science.gov (United States)

    Fumagalli, Uberto; Rosati, Riccardo; De Pascale, Stefano; Porta, Matteo; Carlani, Elisa; Pestalozza, Alessandra; Repici, Alessandro

    2016-03-01

    Surgical myotomy of the lower esophageal sphincter has a 5-year success rate of approximately 91 %. Peroral endoscopic myotomy can provide similar results for controlling dysphagia. Some patients experience either persistent or recurrent dysphagia after myotomy. We present here a retrospective analysis of our experience with redo myotomy for recurrent dysphagia in patients with achalasia. From March 1996 to February 2015, 234 myotomies for primary or recurrent achalasia were performed in our center. Fifteen patients (6.4 %) had had a previous myotomy and were undergoing surgical redo myotomy (n = 9) or endoscopic redo myotomy (n = 6) for recurrent symptoms. Patients presented at a median of 10.4 months after previous myotomy. Median preoperative Eckardt score was 6. Among the nine patients undergoing surgical myotomy, three esophageal perforations occurred intraoperatively (all repaired immediately). Surgery lasted 111 and 62 min on average (median) in the surgical and peroral endoscopic myotomy (POEM) groups, respectively. No postoperative complications occurred in either group. Median postoperative stay was 3 and 2.5 days in the surgical and POEM groups, respectively. In the surgical group, Eckardt score was dysphagia. Preliminary results using POEM indicate that the technique can be safely used in patients who have undergone previous surgical myotomy.

  7. Influence of cow breed type, age and previous lactation status on cow height, calf growth, and patterns of body weight, condition, and blood metabolites for cows grazing bahiagrass pastures.

    Science.gov (United States)

    Coleman, S W; Chase, C C; Riley, D G; Williams, M J

    2017-01-01

    This study was initiated to evaluate performance and patterns of cow traits and blood metabolites of 3 breeds of cows grazing bahiagrass (Paspalum notatum Flügge) pastures in central Florida. Purebred cows (n = 411) of either Angus (Bos taurus), Brahman (Bos indicus), or Romosinuano (Bos taurus) breeding, rotationally grazed (moved twice weekly) bahiagrass pastures year-round, and received bahiagrass hay supplemented with molasses and soyhulls or legume hay supplemented with unfortified molasses from October to June each production year. At monthly intervals, all cows were weighed, measured at the hip (HH), scored for BCS, and blood samples collected by jugular puncture from 10 cows per cow breed/block group for plasma urea N (PUN), glucose and non-esterified fatty acids (NEFA). Data were analyzed on cows that calved with a statistical model that included fixed effects of year, cowage, cow breed, month, block, supplement group (n = 2, but not presented), and whether the cow weaned a calf the previous year. Cow was a repeated observation over mo. Three-way interactions involving monthly patterns for cowage x year, year x lactation status the previous year, cowage × cow breed, year × cow breed, and cow breed × lactation status the previous year were significant (P cow breed × month was important (P cows compared to 3-yr old cows; 2) greater BW and BCS before calving for cows that did not lactate the previous year; 3) PUN levels were above 11 mg/dl except for February, August and September, and was generally greater in tropically adapted breeds; 4) GLU was greatest in Brahman, lowest in Angus, and intermediate in Romosinuano cows; and 5) plasma levels of NEFA escalated at calving and then declined, but Brahman cows maintained greater (P Cows that lactated the previous year had less NEFA than those that did not lactate. Brahman cows were less fertile than Bos taurus breeds, and weaned heavier calves.

  8. Children and Young People-Mental Health Safety Assessment Tool (CYP-MH SAT) study: Protocol for the development and psychometric evaluation of an assessment tool to identify immediate risk of self-harm and suicide in children and young people (10–19 years) in acute paediatric hospital settings

    Science.gov (United States)

    Walker, Gemma M; Carter, Tim; Aubeeluck, Aimee; Witchell, Miranda; Coad, Jane

    2018-01-01

    Introduction Currently, no standardised, evidence-based assessment tool for assessing immediate self-harm and suicide in acute paediatric inpatient settings exists. Aim The aim of this study is to develop and test the psychometric properties of an assessment tool that identifies immediate risk of self-harm and suicide in children and young people (10–19 years) in acute paediatric hospital settings. Methods and analysis Development phase: This phase involved a scoping review of the literature to identify and extract items from previously published suicide and self-harm risk assessment scales. Using a modified electronic Delphi approach, these items will then be rated according to their relevance for assessment of immediate suicide or self-harm risk by expert professionals. Inclusion of items will be determined by 65%–70% consensus between raters. Subsequently, a panel of expert members will convene to determine the face validity, appropriate phrasing, item order and response format for the finalised items. Psychometric testing phase: The finalised items will be tested for validity and reliability through a multicentre, psychometric evaluation. Psychometric testing will be undertaken to determine the following: internal consistency, inter-rater reliability, convergent, divergent validity and concurrent validity. Ethics and dissemination Ethical approval was provided by the National Health Service East Midlands—Derby Research Ethics Committee (17/EM/0347) and full governance clearance received by the Health Research Authority and local participating sites. Findings from this study will be disseminated to professionals and the public via peer-reviewed journal publications, popular social media and conference presentations. PMID:29654046

  9. Phenylalanine tolerance can already reliably be assessed at the age of 2 years in patients with PKU.

    Science.gov (United States)

    van Spronsen, F J; van Rijn, M; Dorgelo, B; Hoeksma, M; Bosch, A M; Mulder, M F; de Klerk, J B C; de Koning, T; Rubio-Gozalbo, M Estela; de Vries, M; Verkerk, P H

    2009-02-01

    The clinical severity of phenylalanine hydroxylase deficiency is usually defined by either pre-treatment phenylalanine (Phe) concentration or Phe tolerance at 5 years of age. So far, little is known about the course of Phe tolerance or the ability of both pre-treatment Phe and Phe tolerance at early age to predict Phe tolerance at later age. This study was conducted to investigate the course of the individual Phe tolerance and to assess the predictive value of both the pre-treatment Phe concentration and Phe tolerance at 1 and 6 months and 1, 2, 3 and 5 years for Phe tolerance at 10 years of age. Data on blood Phe concentration, prescribed Phe intake and weight of 213 early and continuously treated Dutch PKU patients up to 10 years of age were collected. Data acquired under good metabolic control were used in the study. Tolerance was expressed in mg/day and mg/kg per day. Data at 1 and 6 months and at 1, 2, 3 and 5 years of 61, 58, 59, 57, 56 and 59 patients were included for comparison with the Phe tolerance at 10 years. Phe tolerances (mg/kg per day) at 2, 3 and 5 years showed a clear correlation with the tolerance at 10 years of age (r = 0.608, r = 0.725 and r = 0.661). Results for tolerance expressed as mg/day were comparable. Pre-treatment Phe concentrations did not correlate significantly with the tolerance. Pre-treatment Phe is unreliable but Phe tolerance is a reliable predictor of the tolerance at 10 years of age, starting at 2 years of age.

  10. An assessment of worldwide supercomputer usage

    Energy Technology Data Exchange (ETDEWEB)

    Wasserman, H.J.; Simmons, M.L.; Hayes, A.H.

    1995-01-01

    This report provides a comparative study of advanced supercomputing usage in Japan and the United States as of Spring 1994. It is based on the findings of a group of US scientists whose careers have centered on programming, evaluating, and designing high-performance supercomputers for over ten years. The report is a follow-on to an assessment of supercomputing technology in Europe and Japan that was published in 1993. Whereas the previous study focused on supercomputer manufacturing capabilities, the primary focus of the current work was to compare where and how supercomputers are used. Research for this report was conducted through both literature studies and field research in Japan.

  11. A service development study of the assessment and management of fracture risk in Parkinson's disease.

    Science.gov (United States)

    Shribman, Samuel; Torsney, Kelli M; Noyce, Alastair J; Giovannoni, Gavin; Fearnley, Julian; Dobson, Ruth

    2014-06-01

    Parkinson's disease (PD) is associated with an increased risk of fragility fracture. FRAX and Qfracture are risk calculators that estimate the 10-year risk of hip and major fractures and guide definitive investigation for osteoporosis using dual X-ray absorptiometry (DEXA) imaging. It is unclear which PD patients should be considered for fracture risk assessment and whether FRAX or Qfracture should be used. Seventy-seven patients with PD were recruited in the movement disorders clinic. Data were collected on PD-related characteristics and fracture risk scores were calculated. Patients with previous osteoporotic fractures had a higher incidence of falls (p = 0.0026) and use of bilateral walking aids (p = 0.0187) in addition to longer disease duration (p = 0.0037). Selecting patients with falls in combination with either disease duration >5 years, bilateral walking aids, or previous osteoporotic fracture distinguished patients with and without previous osteoporotic fracture with specificity 67.7 % (95 % CI 55.0-78.8) and sensitivity 100.0 % (95 % CI 73.5-100.0). Qfracture calculated significantly higher fracture risk scores than FRAX for hip (p < 0.0001) and major (p = 0.0008) fracture in PD patients. Receiver operating characteristic curves demonstrated that FRAX outperformed Qfracture with an area under the curve of 0.84 (95 % CI 0.70-0.97, p = 0.0004) for FRAX and 0.68 (95 % CI 52-86, p = 0.0476) for Qfracture major fracture risk calculators. We suggest that falls in combination with either a disease duration longer than 5 years or bilateral walking aids or previous osteoporotic fracture should be used as red flags in PD patients to prompt clinicians to perform a FRAX fracture risk assessment in the neurology clinic.

  12. The BEVPS: A new test battery to assess visual perceptual and spatial processing abilities in 5-14 year-old children.

    Science.gov (United States)

    Schmetz, Emilie; Rousselle, Laurence; Ballaz, Cécile; Detraux, Jean-Jacques; Barisnikov, Koviljka

    2017-06-20

    This study aims to examine the different levels of visual perceptual object recognition (early, intermediate, and late) defined in Humphreys and Riddoch's model as well as basic visual spatial processing in children using a new test battery (BEVPS). It focuses on the age sensitivity, internal coherence, theoretical validity, and convergent validity of this battery. French-speaking, typically developing children (n = 179; 5 to 14 years) were assessed using 15 new computerized subtests. After selecting the most age-sensitive tasks though ceiling effect and correlation analyses, an exploratory factorial analysis was run with the 12 remaining subtests to examine the BEVPS' theoretical validity. Three separate factors were identified for the assessment of the stimuli's basic features (F1, four subtests), view-dependent and -independent object representations (F2, six subtests), and basic visual spatial processing (F3, two subtests). Convergent validity analyses revealed positive correlations between F1 and F2 and the Beery-VMI visual perception subtest, while no such correlations were found for F3. Children's performances progressed until the age of 9-10 years in F1 and in view-independent representations (F2), and until 11-12 years in view-dependent representations (F2). However, no progression with age was observed in F3. Moreover, the selected subtests, present good-to-excellent internal consistency, which indicates that they provide reliable measures for the assessment of visual perceptual processing abilities in children.

  13. Argentine references for the assessment of body proportions from birth to 17 years of age.

    Science.gov (United States)

    Del Pino, Mariana; Orden, Alicia B; Arenas, María A; Fano, Virginia

    2017-06-01

    Abnormal body proportions may indicate skeletal disorders; therefore, their detection has great clinical significance. To estimate centiles for head circumference/height (HC/H) and sitting height/height (SH/H) ratios, and assess their diagnostic usefulness among a group of children with skeletal dysplasia. Centiles 3, 10, 25, 50, 75, 90 and 97 for HC/H and SH/H ratios were estimated with the LMS method using Box-Cox transformation to normalize data distribution for each age. Q-Q plot tests were applied to evaluate normality of residuals and the Q test to calculate goodness-of-fit. The sample included 4818 girls and4803 boys, all healthy, between 0-17 years old. The median of the SH/H ratio for each age decreased from 0.67 at birth to 0.57 at age 4. At 12 years of age, values reached 0.52 and 0.53 for males and females, respectively, remaining unchanged until age 17. The median of the HC/H ratio decreased from 0.45 at 6 years old to 0.34 at 17 years old for both sexes. Z-scores for SH/H among 20 children diagnosed with hypochondroplasia were better at showing abnormal proportions than the SH/H ratio not adjusted by age. Estimated centiles for HC/H and SH/H ratios show that the most dramatic changes in body proportions occur in the prepubertal period. These references allow an earlier detection of abnormal body proportions in children with skeletal dysplasia.

  14. Cognitive performance of detoxified alcoholic Korsakoff syndrome patients remains stable over two years.

    Science.gov (United States)

    Fujiwara, Esther; Brand, Matthias; Borsutzky, Sabine; Steingass, Hans-P; Markowitsch, Hans J

    2008-07-01

    Excessive alcohol consumption is assumed to promote cognitive decline, eventually increasing the risk of dementia. However, little is known about the time course of cognitive functions in patients with chronic alcoholic Korsakoff syndrome (KS). Therefore, we assessed neuropsychological performance in 20 detoxified chronic KS inpatients at time 1 (T1) with a follow-up after two years (T2). The neuropsychological tests assessed verbal and visual short- and long-term memory, working memory, basic executive functions, language, general knowledge, and visual-spatial abilities. Surveys with caregivers and medical records provided information about current and previous disease-related parameters, drinking history, additional pathologies, as well as psychosocial and cognitive therapy within the two-year period. At both sessions, the majority of the KS patients' results were inferior to those of normal subjects. Comparing T1 and T2 revealed no significant decline in any of the investigated functions. Instead, general knowledge, visual long-term memory, and verbal fluency improved slightly after two years, though they still remained within pathological range. Comparing most improved and most deteriorated patients, better outcome occurred more frequently in men than women and was associated with higher premorbid education and fewer detoxifications in the past. In this sample of detoxified KS patients there was no indication of accelerated cognitive decline or onset of dementia-like symptoms over two years.

  15. Previously unknown species of Aspergillus.

    Science.gov (United States)

    Gautier, M; Normand, A-C; Ranque, S

    2016-08-01

    The use of multi-locus DNA sequence analysis has led to the description of previously unknown 'cryptic' Aspergillus species, whereas classical morphology-based identification of Aspergillus remains limited to the section or species-complex level. The current literature highlights two main features concerning these 'cryptic' Aspergillus species. First, the prevalence of such species in clinical samples is relatively high compared with emergent filamentous fungal taxa such as Mucorales, Scedosporium or Fusarium. Second, it is clearly important to identify these species in the clinical laboratory because of the high frequency of antifungal drug-resistant isolates of such Aspergillus species. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been shown to enable the identification of filamentous fungi with an accuracy similar to that of DNA sequence-based methods. As MALDI-TOF MS is well suited to the routine clinical laboratory workflow, it facilitates the identification of these 'cryptic' Aspergillus species at the routine mycology bench. The rapid establishment of enhanced filamentous fungi identification facilities will lead to a better understanding of the epidemiology and clinical importance of these emerging Aspergillus species. Based on routine MALDI-TOF MS-based identification results, we provide original insights into the key interpretation issues of a positive Aspergillus culture from a clinical sample. Which ubiquitous species that are frequently isolated from air samples are rarely involved in human invasive disease? Can both the species and the type of biological sample indicate Aspergillus carriage, colonization or infection in a patient? Highly accurate routine filamentous fungi identification is central to enhance the understanding of these previously unknown Aspergillus species, with a vital impact on further improved patient care. Copyright © 2016 European Society of Clinical Microbiology and

  16. Exploring Expressive Vocabulary Variability in Two-Year-Olds: The Role of Working Memory.

    Science.gov (United States)

    Newbury, Jayne; Klee, Thomas; Stokes, Stephanie F; Moran, Catherine

    2015-12-01

    This study explored whether measures of working memory ability contribute to the wide variation in 2-year-olds' expressive vocabulary skills. Seventy-nine children (aged 24-30 months) were assessed by using standardized tests of vocabulary and visual cognition, a processing speed measure, and behavioral measures of verbal working memory and phonological short-term memory. Strong correlations were observed between phonological short-term memory, verbal working memory, and expressive vocabulary. Speed of spoken word recognition showed a moderate significant correlation with expressive vocabulary. In a multivariate regression model for expressive vocabulary, the most powerful predictor was a measure of phonological short-term memory (accounting for 66% unique variance), followed by verbal working memory (6%), sex (2%), and age (1%). Processing speed did not add significant unique variance. These findings confirm previous research positing a strong role for phonological short-term memory in early expressive vocabulary acquisition. They also extend previous research in two ways. First, a unique association between verbal working memory and expressive vocabulary in 2-year-olds was observed. Second, processing speed was not a unique predictor of variance in expressive vocabulary when included alongside measures of working memory.

  17. In Women with Previous Pregnancy Hypertension, Levels of Cardiovascular Risk Biomarkers May Be Modulated by Haptoglobin Polymorphism

    Directory of Open Access Journals (Sweden)

    Andreia Matos

    2014-01-01

    Full Text Available Preeclampsia (PE may affect the risk for future cardiovascular disease. Haptoglobin (Hp, an acute phase protein with functional genetic polymorphism, synthesized in the hepatocyte and in many peripheral tissues secondary of oxidative stress of PE, may modulate that risk through the antioxidant, angiogenic, and anti-inflammatory differential effects of their genotypes. We performed a prospective study in 352 women aged 35±5.48 years, which 165 had previous PE, 2 to 16 years ago. We studied demographic, anthropometric, and haemodynamic biomarkers such as C-reactive protein (CRP, myeloperoxidase (MPO, and nitric oxide metabolites (total and nitrites, and others associated with liver function (AST and ALT and lipid profile (total LDL and cholesterol HDL, non-HDL, and apolipoproteins A and B. Finally, we study the influence of Hp genetic polymorphism on all these biomarkers and as a predisposing factor for PE and its remote cardiovascular disease prognosis. Previously preeclamptic women either hypertensive or normotensive presented significant differences in those risk biomarkers (MPO, nitrites, and ALT, whose variation may be modulated by Hp 1/2 functional genetic polymorphism. The history of PE may be relevant, in association with these biomarkers to the cardiovascular risk in premenopausal women.

  18. Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors.

    Science.gov (United States)

    Witt, Katrina; Lichtenstein, Paul; Fazel, Seena

    2015-05-01

    Violence risk assessment in schizophrenia relies heavily on criminal history factors. To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia. A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification. Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder. Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance. © The Royal College of Psychiatrists 2015.

  19. A Flexible-Dose Study of Paliperidone ER in Patients With Nonacute Schizophrenia Previously Treated Unsuccessfully With Oral Olanzapine.

    Science.gov (United States)

    Kotler, Moshe; Dilbaz, Nesrin; Rosa, Fernanda; Paterakis, Periklis; Milanova, Vihra; Smulevich, Anatoly B; Lahaye, Marjolein; Schreiner, Andreas

    2016-01-01

    The goal of this study was to explore the tolerability, safety, and treatment response of switching from oral olanzapine to paliperidone extended release (ER). Adult patients with nonacute schizophrenia who had been treated unsuccessfully with oral olanzapine were switched to flexible doses of paliperidone ER (3 to 12 mg/d). The primary efficacy outcome was a ≥ 20% improvement in Positive and Negative Syndrome Scale (PANSS) total scores from baseline to endpoint for patients who switched medications because of lack of efficacy with olanzapine and noninferiority versus previous olanzapine treatment (mean endpoint change in PANSS total scores vs. baseline of ≤ 5 points) for patients who switched for reasons other than lack of efficacy. Safety and tolerability were assessed by monitoring adverse events, extrapyramidal symptoms, and weight change. Of 396 patients, 65.2% were men, mean age was 40.0 ± 12.0 years, and 75.5% had paranoid schizophrenia. Among the patients whose main reason for switching was lack of efficacy, an improvement in the PANSS total score of ≥ 20% occurred in 57.4% of patients. Noninferiority was confirmed for each subgroup of patients whose main reason for switching was something other than lack of efficacy. Paliperidone ER was generally well tolerated. Extrapyramidal symptoms as measured by total Extrapyramidal Symptom Rating Scale scores showed statistically significant and clinically relevant improvements at endpoint, the average weight decreased by 0.8 ± 5.2 kg at endpoint, and a clinically relevant weight gain of ≥ 7% occurred in 8.0% of patients. Paliperidone ER flexibly-dosed over 6 months was well tolerated and associated with a meaningful clinical response in patients with nonacute schizophrenia who had previously been unsuccessfully treated with oral olanzapine.

  20. Life-threatening MRSA sepsis with bilateral pneumonia, osteomyelitis, and septic arthritis of the knee in a previously healthy 13-year-old boy

    DEFF Research Database (Denmark)

    Hardgrib, Nina; Wang, Michala; Jurik, Anne Grethe

    2016-01-01

    The incidence and severity of methicillin resistant Staphylococcus aureus (MRSA) infections are increasing and cause high mortality and morbidity. We describe the first pediatric case in Scandinavia with Panton-Valentine leucocidin (PVL) positive MRSA septicemia who developed bilateral pneumonia...... and antimicrobial combination therapy. The outcome was a healthy patient without sequelae, a favorable course unlike those previously described in the literature. This case underlines the necessity of a close interdisciplinary cooperation in children with severe MRSA infection encompassing pneumonia, septic...

  1. Wind Resource Assessment of Gujarat (India)

    Energy Technology Data Exchange (ETDEWEB)

    Draxl, C.; Purkayastha, A.; Parker, Z.

    2014-07-01

    India is one of the largest wind energy markets in the world. In 1986 Gujarat was the first Indian state to install a wind power project. In February 2013, the installed wind capacity in Gujarat was 3,093 MW. Due to the uncertainty around existing wind energy assessments in India, this analysis uses the Weather Research and Forecasting (WRF) model to simulate the wind at current hub heights for one year to provide more precise estimates of wind resources in Gujarat. The WRF model allows for accurate simulations of winds near the surface and at heights important for wind energy purposes. While previous resource assessments published wind power density, we focus on average wind speeds, which can be converted to wind power densities by the user with methods of their choice. The wind resource estimates in this study show regions with average annual wind speeds of more than 8 m/s.

  2. 22 CFR 40.93 - Aliens unlawfully present after previous immigration violation.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Aliens unlawfully present after previous... TO BOTH NONIMMIGRANTS AND IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.93 Aliens unlawfully present after previous immigration violation. An alien described...

  3. Lost life years attributable to stroke among patients with nonvalvular atrial fibrillation: a nationwide population-based follow-up study

    DEFF Research Database (Denmark)

    Frost, Lars; Andersen, Ljubica; Johnsen, Søren Paaske

    2007-01-01

    Registry of Patients from calendar year 1980 to 2002, and no previous or concomitant diagnosis of stroke or heart valve disease. All patients were followed in the Danish National Registry of Patients for occurrence of an incident diagnosis of stroke of any type (ischemic and/or hemorrhagic......AIM: We assessed the number of lost life years attributable to stroke among patients with a hospital diagnosis of nonvalvular atrial fibrillation. METHODS: We identified all patients, aged 40-89 years, with an incident hospital diagnosis of atrial fibrillation or flutter in the Danish National...... lost life years by sex, age, and time to incident stroke after diagnosis of atrial fibrillation, adjusted for conditions of comorbidity and calendar year of diagnosis of atrial fibrillation. RESULTS: The mean loss of life years attributable to incident stroke within 20 years after a first diagnosis...

  4. External cephalic version among women with a previous cesarean delivery: report on 36 cases and review of the literature.

    Science.gov (United States)

    Abenhaim, Haim A; Varin, Jocelyne; Boucher, Marc

    2009-01-01

    Whether or not women with a previous cesarean section should be considered for an external cephalic version remains unclear. In our study, we sought to examine the relationship between a history of previous cesarean section and outcomes of external cephalic version for pregnancies at 36 completed weeks of gestation or more. Data on obstetrical history and on external cephalic version outcomes was obtained from the C.H.U. Sainte-Justine External Cephalic Version Database. Baseline clinical characteristics were compared among women with and without a history of previous cesarean section. We used logistic regression analysis to evaluate the effect of previous cesarean section on success of external cephalic version while adjusting for parity, maternal body mass index, gestational age, estimated fetal weight, and amniotic fluid index. Over a 15-year period, 1425 external cephalic versions were attempted of which 36 (2.5%) were performed on women with a previous cesarean section. Although women with a history of previous cesarean section were more likely to be older and para >2 (38.93% vs. 15.0%), there were no difference in gestational age, estimated fetal weight, and amniotic fluid index. Women with a prior cesarean section had a success rate similar to women without [50.0% vs. 51.6%, adjusted OR: 1.31 (0.48-3.59)]. Women with a previous cesarean section who undergo an external cephalic version have similar success rates than do women without. Concern about procedural success in women with a previous cesarean section is unwarranted and should not deter attempting an external cephalic version.

  5. Central venous stenosis in haemodialysis patients without a previous history of catheter placement

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-01-01

    Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term

  6. Timing of elective repeated cesarean delivery in patients with previous two or more cesarean section.

    Science.gov (United States)

    Mohammed, Abdel-Baset F; Bayo, Arabo I; Abu-Jubara, Mahmoud F

    2013-01-01

    To assess the maternal and neonatal consequences of scheduling elective repeated cesarean section (ERCS) at 39 weeks rather than 38 weeks and to assess the impacts of delivering by emergency cesarean section (CS) before the planned date. Retrospective Cohort study. Patients with previous two or more CS planned for ERCS at term during the period from January to June 2011. Medical records were reviewed for demographic and clinical data, planned timing of CS, emergency cesarean and any adverse maternal or neonatal outcome. Adverse maternal or neonatal outcome. Four hundred and twenty women were included, 71.4% of cases were posted <39 weeks and 28.6% were posted at ≥39 weeks. Patients posted ≥ 39 weeks were more prone to deliver by emergency CS (16.6 vs. 10.6%) and the neonates were less prone to RDS and NICU admission (p < 0.05). Our data support the justification to book patients for ERCS at ≥39 weeks.

  7. [Validity of an instrument for assessing food consumption, food habits and cooking skills in 8-11 years old students].

    Science.gov (United States)

    Lera, Lydia; Fretes, Gabriela; González, Carmen Gloria; Salinas, Judith; Vio del Rio, Fernando

    2015-05-01

    An instrument to measure food knowledge, food consumption, cooking skills, food habits and food expenses at school is necessary to assess changes in food practices. To validate an instrument to measure changes in food knowledge, food consumption, cooking skills, food habits and food expenses in Chilean school children 8 - 11 years from third to fifth grade. A validation of a questionnaire with 42 questions was conducted in two stages: the first to assess temporal stability, concordance and internal consistency in 45 children. The second one to apply the survey, modified with the results of the first stage, in 90 children assessing internal consistency. The first survey with 42 questions showed a reasonable temporal stability, concordance and internal consistency for cooking skills, habits and food expenditure at school. Internal consistency was good for food consumption, but not so good for food knowledge. In the final validation with 90 children, there was good consistency for food consumption but bad for food knowledge. Besides, children with cooking skills ate more healthy food and those who expended more money at school, consumed less healthy food. Food knowledge questions were eliminated from the instrument, which was elaborated with 28 questions about food consumption, cooking skills, food habits and food expenses at school. This instrument is useful to assess changes in food and nutrition education interventions in 8 -11 years children, in particular to measure cooking skills and food expenses at school. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  8. The COMFORT-behavior scale is useful to assess pain and distress in 0- to 3-year-old children with Down syndrome.

    Science.gov (United States)

    Valkenburg, Abraham J; Boerlage, Anneke A; Ista, Erwin; Duivenvoorden, Hugo J; Tibboel, Dick; van Dijk, Monique

    2011-09-01

    Many pediatric intensive care units use the COMFORT-Behavior scale (COMFORT-B) to assess pain in 0- to 3-year-old children. The objective of this study was to determine whether this scale is also valid for the assessment of pain in 0- to 3-year-old children with Down syndrome. These children often undergo cardiac or intestinal surgery early in life and therefore admission to a pediatric intensive care unit. Seventy-six patients with Down syndrome were included and 466 without Down syndrome. Pain was regularly assessed with the COMFORT-B scale and the pain Numeric Rating Scale (NRS). For either group, confirmatory factor analyses revealed a 1-factor model. Internal consistency between COMFORT-B items was good (Cronbach's α=0.84-0.87). Cutoff values for the COMFORT-B set at 17 or higher discriminated between pain (NRS pain of 4 or higher) and no pain (NRS pain below 4) in both groups. We concluded that the COMFORT-B scale is also valid for 0- to 3-year-old children with Down syndrome. This makes it even more useful in the pediatric intensive care unit setting, doing away with the need to apply another instrument for those children younger than 3. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  9. Evolution of US DOE Performance Assessments Over 20 Years - 13597

    Energy Technology Data Exchange (ETDEWEB)

    Suttora, Linda C. [U.S. Department of Energy, Office of Site Restoration, 19901 Germantown Rd, Germantown, MD 20874-1290 (United States); Seitz, Roger R. [Savannah River National Laboratory, Savannah River Site, Bldg 773-43A, Aiken, SC 29808 (United States)

    2013-07-01

    Performance assessments (PAs) have been used for many years for the analysis of post-closure hazards associated with a radioactive waste disposal facility and to provide a reasonable expectation of the ability of the site and facility design to meet objectives for the protection of members of the public and the environment. The use of PA to support decision-making for LLW disposal facilities has been mandated in United States Department of Energy (US DOE) directives governing radioactive waste management since 1988 (currently DOE Order 435.1, Radioactive Waste Management). Prior to that time, PAs were also used in a less formal role. Over the past 20+ years, the US DOE approach to conduct, review and apply PAs has evolved into an efficient, rigorous and mature process that includes specific requirements for continuous improvement and independent reviews. The PA process has evolved through refinement of a graded and iterative approach designed to help focus efforts on those aspects of the problem expected to have the greatest influence on the decision being made. Many of the evolutionary changes to the PA process are linked to the refinement of the PA maintenance concept that has proven to be an important element of US DOE PA requirements in the context of supporting decision-making for safe disposal of LLW. The PA maintenance concept is central to the evolution of the graded and iterative philosophy and has helped to drive the evolution of PAs from a deterministic compliance calculation into a systematic approach that helps to focus on critical aspects of the disposal system in a manner designed to provide a more informed basis for decision-making throughout the life of a disposal facility (e.g., monitoring, research and testing, waste acceptance criteria, design improvements, data collection, model refinements). A significant evolution in PA modeling has been associated with improved use of uncertainty and sensitivity analysis techniques to support efficient

  10. Evolution of US DOE Performance Assessments Over 20 Years - 13597

    International Nuclear Information System (INIS)

    Suttora, Linda C.; Seitz, Roger R.

    2013-01-01

    Performance assessments (PAs) have been used for many years for the analysis of post-closure hazards associated with a radioactive waste disposal facility and to provide a reasonable expectation of the ability of the site and facility design to meet objectives for the protection of members of the public and the environment. The use of PA to support decision-making for LLW disposal facilities has been mandated in United States Department of Energy (US DOE) directives governing radioactive waste management since 1988 (currently DOE Order 435.1, Radioactive Waste Management). Prior to that time, PAs were also used in a less formal role. Over the past 20+ years, the US DOE approach to conduct, review and apply PAs has evolved into an efficient, rigorous and mature process that includes specific requirements for continuous improvement and independent reviews. The PA process has evolved through refinement of a graded and iterative approach designed to help focus efforts on those aspects of the problem expected to have the greatest influence on the decision being made. Many of the evolutionary changes to the PA process are linked to the refinement of the PA maintenance concept that has proven to be an important element of US DOE PA requirements in the context of supporting decision-making for safe disposal of LLW. The PA maintenance concept is central to the evolution of the graded and iterative philosophy and has helped to drive the evolution of PAs from a deterministic compliance calculation into a systematic approach that helps to focus on critical aspects of the disposal system in a manner designed to provide a more informed basis for decision-making throughout the life of a disposal facility (e.g., monitoring, research and testing, waste acceptance criteria, design improvements, data collection, model refinements). A significant evolution in PA modeling has been associated with improved use of uncertainty and sensitivity analysis techniques to support efficient

  11. A previously unreported association between Nance-Horan syndrome and spontaneous dental abscesses.

    Science.gov (United States)

    Hibbert, Sally

    2005-02-01

    Atypical dentofacial structures may be the first indicator of other anomalies linked to a syndrome. This case describes the management of a 9-year-old girl referred for the routine management of supernumerary teeth. The anomalous form of her teeth, together with multiple supernumerary units and a history of congenital cataracts, were suggestive of a diagnosis of Nance-Horan syndrome. This is an X-linked disorder, in which females usually demonstrate mild expression; this case was unusual in respect to the marked phenotype expressed. Unusually, the girl developed 2 spontaneous abscesses of her noncarious upper incisor teeth; a feature never previously described in this syndrome. This report details the patient's dental management and discusses the possible pathogenesis of the dental abscesses, together with the genetic implications of this syndrome.

  12. Psychological Assessment Training in Clinical Psychology Doctoral Programs.

    Science.gov (United States)

    Mihura, Joni L; Roy, Manali; Graceffo, Robert A

    2017-01-01

    We surveyed American Psychological Association-accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment-specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method-self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.

  13. Evaluation of clinical skills for first-year surgical residents using orientation programme and objective structured clinical evaluation as a tool of assessment

    Directory of Open Access Journals (Sweden)

    Pandya J

    2010-01-01

    Full Text Available Background: Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE. Aim: To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Settings and Design: Observational study. Materials and Methods: Twenty new first-year surgical residents (10 each in 2008 and 2009 participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc. were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test". The questions were validated by senior department staff. A post-programme OSCE (the "post-test" helped to evaluate the change in clinical skill level brought about by the orientation programme. Statistical Analysis: Wilcoxson matched-pairs signed-ranks test. Results: Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively. Overall reliability of the OSCE was found to be 0.7026 (Cronbach′s coefficient alpha. Conclusions: This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

  14. 18 CFR 154.302 - Previously submitted material.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Previously submitted material. 154.302 Section 154.302 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... concurrently with the rate change filing. There must be furnished to the Director, Office of Energy Market...

  15. Subsequent pregnancy outcome after previous foetal death

    NARCIS (Netherlands)

    Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.

    Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to

  16. Towards e-Government project assessment: European approach

    Directory of Open Access Journals (Sweden)

    Pavel Mates

    2013-06-01

    Full Text Available The objective of the paper is to analyse current approaches to the assessment of e-Government projects as the specifi c public projects and to suggest how to improve these approaches in order to eliminate their shortcomings. The nonnormative theoretical methods are used to analyse empirical results of previous researches; particularly the deduction method is used to prove that current approaches to the evaluation of e-Government projects have some inequalities, the analogy and comparison methods are used to create general typology of e-Government projects and the induction method is used to seek examples of the indicators and metrics. The results are based on analysis of extensive amount of e-Government projects, which have been realized in different European countries in the past twenty years. The basic result of the research is creation of the ten most common types of e-Government projects typology. The fundamental conclusion obtained from the results of this research is that this typology can be used as the core of new E-Government General Assessment Framework, which eliminates problems of previous approaches, allows adjusting metrics and indicators to each type of projects, keeps comparability of results and thus making possible the use of benchmarking methods.

  17. The first three years of the Journal of Global Health: Assessing the impact

    Directory of Open Access Journals (Sweden)

    Igor Rudan

    2014-06-01

    Full Text Available The Journal of Global Health (JoGH is three years old. To assess its impact, we analysed online access to JoGH’s articles using PubMed Central and Google Analytics tools. Moreover, we tracked citations that JoGH received in 2013 using ISI Web of KnowledgeSM and Google Scholar® tools. The 66 items (articles, viewpoints and editorials published between June 2011 and December 2013 were accessed more than 50 000 times during 2013, from more than 160 countries of the world. Seven among the 13 most accessed papers were focused on global, regional and national epidemiological estimates of important infectious diseases. JoGH articles published in 2011 and 2012 received 77 citations in Journal Citation Reports® (JCR–indexed journals in 2013 to 24 original research articles, setting our first, unofficial impact factor at 3.208. In addition, JoGH received 11 citations during 2013 to its 12 original research papers published during 2013, resulting in an immediacy index of 0.917. The number of external, non–commissioned submissions that we consider to be of high quality is continuously increasing, leading to current JoGH’s rejection rate of about 80%. The current citation analysis raises favourable expectations for the JoGH’s overall impact on the global health community in future years.

  18. The effects of anticholinergic drugs on regional cerebral blood flow, and oxygen metabolism in previously untreated patients with Parkinson`s disease

    Energy Technology Data Exchange (ETDEWEB)

    Obara, Satoko; Takahashi, Satoshi; Yonezawa, Hisashi; Sato, Yoshitomo [Iwate Medical Univ., Morioka (Japan). School of Medicine

    1998-12-01

    Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO{sub 2}) were measured using the steady-state {sup 15}O technique and positron emission tomography (PET) in six previously untreated patients with Parkinson`s disease before and after trihexyphenidyl (THP) treatment. The patients comprised of 4 men and 2 women with Hoehn-Yahr stage II-III. Their ages at the onset of the study ranged from 46 to 57 years (mean{+-}SD, 51.8{+-}3.7) and the duration of the illness ranged from 10 to 48 months (mean{+-}SD, 28.8{+-}15.5). The PET study, assessments of the disability and cognitive function were undergone twice. The first time assessments were done was when the patients were not receiving any drugs, and the second time was one to three months after administration of 6 mg THP. All patients showed clinical improvement after THP treatment. The mean disability score of Unified Parkinson`s Disease Rating Scale decreased from 35.1 (SD{+-}11.3) to 25.7 (SD{+-}11.6). The cognitive function assessed by Hasegawa`s dementia rating scale-revised, Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale-Revised, were not significantly different before and after the THP treatment. After the THP treatment, rCBF and rCMRO{sub 2} decreased significantly in the striatum (about 15%) and all cerebral cortices (about 10%) on both sides contralateral and ipsilateral to the predominantly symptomatic limbs. We conclude that an anticholinergic THP decreases the rCBF and rCMRO{sub 2} significantly in the cerebral cortices without cognitive impairment in early untreated patients with Parkinson`s disease. (author)

  19. Cognitive deficits at age 22 years associated with prenatal exposure to methylmercury

    DEFF Research Database (Denmark)

    Debes, Frodi; Weihe, Pál; Grandjean, Philippe

    2016-01-01

    methylmercury exposure was assessed in terms of the mercury concentration in cord blood and maternal hair. Clinical examinations of 847 cohort members at age 22 years were carried out in 2008-2009 using a panel of neuropsychological tests that reflected major functional domains. Subjects with neurological...... and psychiatric diagnoses were excluded from the data analysis, thus leaving 814 subjects. Multiple regression analysis included covariates previously identified for adjustment. Deficits in Boston Naming Test (BNT) and other tests of verbal performance were significantly associated with the cord-blood mercury...... to about 2.2 IQ points at a 10-fold increased prenatal methylmercury exposure. Thus, although the cognitive deficits observed were smaller than at examinations at younger ages, maternal diets with contaminated seafood were associated with adverse effects in this birth cohort at age 22 years. The deficits...

  20. Treatment response with mepolizumab in severe eosinophilic asthma patients with previous omalizumab treatment.

    Science.gov (United States)

    Magnan, A; Bourdin, A; Prazma, C M; Albers, F C; Price, R G; Yancey, S W; Ortega, H

    2016-09-01

    We performed post hoc analyses to evaluate the effect of humanized monoclonal antibody mepolizumab in patients with severe eosinophilic asthma previously treated with omalizumab. Data were collected from two randomized double-blind, placebo-controlled studies: MENSA (NCT01691521: 32-week treatment phase) and SIRIUS (NCT01691508: 24-week treatment phase). Active treatment was 75 mg intravenous mepolizumab (MENSA) or 100 mg subcutaneous mepolizumab (MENSA, SIRIUS). Patients had evidence of eosinophilic inflammation ≥150 cells/μl (at screening) or ≥300 cells/μl (during the previous year). Primary outcomes were the rate of exacerbations (MENSA) and the percentage reduction in oral corticosteroid (OCS) dose (SIRIUS). Other outcomes included lung function (forced expiratory volume in 1 s and morning peak expiratory flow), Asthma Control Questionnaire (ACQ-5), St George's Respiratory Questionnaire (SGRQ) scores, and safety. Overall, 576 patients were included from MENSA and 135 from SIRIUS, with 13% and 33% previously receiving omalizumab, respectively. In MENSA, mepolizumab reduced the rate of exacerbations by 57% (prior omalizumab) and 47% (no prior omalizumab) vs placebo. In SIRIUS, reductions in OCS use were comparable regardless of prior omalizumab use. Despite reducing chronic OCS use, mepolizumab also resulted in similar reductions in exacerbation rate relative to placebo in both subgroups. Asthma control and quality of life improved with mepolizumab vs placebo in both studies independent of prior omalizumab use, as shown by ACQ-5 and SGRQ scores. Adverse events were also comparable irrespective of prior omalizumab use. These post hoc analyses indicate that patients with severe eosinophilic asthma respond positively to mepolizumab regardless of prior use of omalizumab. © 2016 The Authors. Allergy Published by John Wiley & Sons Ltd.

  1. Ten-year cardiovascular risk assessment in university students.

    Science.gov (United States)

    Uvacsek, Martina; Kneffel, Zs; Tóth, M; Johnson, A W; Vehrs, P; Myrer, J W; Hager, R

    2014-09-01

    Cardiovascular disease (CVD) is responsible for more than half of all deaths in the European region. The aim of the study was to compare body composition, blood pressure, total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C), family history, activity behaviors, and the 10-year risk of having a heart attack between 166 university students (21.62 ± 2.59 yrs) from Utah (USA) and 198 students (22.11 ± 2.51 yrs) from Hungary. Ninety-two percent of the Hungarian students and 100% of the Utah students had an estimated 10-year Framingham risk score of 1% or less. The high prevalence of low risk was primarily due to the young age of study participants, healthy body composition and non-smoking behavior. Hungarians who had higher 10-year risk of heart attack had significantly higher waist hip ratio (WHR), TC, diastolic blood pressure (DBP) and were smokers compared to those Hungarians with lower risk. The self-reported physical activity levels between the two groups of students were not different. In conclusion the young men and women who participated in this study were, for the most part healthy; however the smoking habits and the lower physical activity of the Hungarian students likely elevated their risk of CVD.

  2. Personality traits measured at baseline can predict academic performance in upper secondary school three years late.

    Science.gov (United States)

    Rosander, Pia; Bäckström, Martin

    2014-12-01

    The aim of the present study was to explore the ability of personality to predict academic performance in a longitudinal study of a Swedish upper secondary school sample. Academic performance was assessed throughout a three-year period via final grades from the compulsory school and upper secondary school. The Big Five personality factors (Costa & McCrae, ) - particularly Conscientiousness and Neuroticism - were found to predict overall academic performance, after controlling for general intelligence. Results suggest that Conscientiousness, as measured at the age of 16, can explain change in academic performance at the age of 19. The effect of Neuroticism on Conscientiousness indicates that, as regarding getting good grades, it is better to be a bit neurotic than to be stable. The study extends previous work by assessing the relationship between the Big Five and academic performance over a three-year period. The results offer educators avenues for improving educational achievement. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  3. Influence of previous breast surgery in sentinel lymph node biopsy in patients with breast cancer.

    Science.gov (United States)

    López-Prior, V; Díaz-Expósito, R; Casáns Tormo, I

    The aim of this study was to review the feasibility of selective sentinel lymph node biopsy in patients with previous surgery for breast cancer, as well as to examine the factors that may interfere with sentinel node detection. A retrospective review was performed on 91 patients with breast cancer and previous breast surgery, and who underwent sentinel lymph node biopsy. Patients were divided into two groups according to their previous treatment: aesthetic breast surgery in 30 patients (group I) and breast-conserving surgery in 61 (group II). Lymphoscintigraphy was performed after an intra-tumour injection in 21 cases and a peri-areolar injection in 70 cases. An analysis was made of lymphatic drainage patterns and overall sentinel node detection according to clinical, pathological and surgical variables. The overall detection of the sentinel lymph node in the lymphoscintigraphy was 92.3%, with 7.7% of extra-axillary drainages. The identification rate was similar after aesthetic breast surgery (93.3%) and breast-conserving surgery (91.8%). Sentinel lymph nodes were found in the contralateral axilla in two patients (2.2%), and they were included in the histopathology study. The non-identification rate in the lymphoscintigraphy was 7.7%. There was a significantly higher non-detection rate in the highest histological grade tumours (28.6% grade III, 4.5% grade I and 3.6% grade II). Sentinel lymph node biopsy in patients with previous breast surgery is feasible and deserves further studies to assess the influence of different aspects in sentinel node detection in this clinical scenario. A high histological grade was significantly associated with a lower detection. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  4. Left ventricular asynergy score as an indicator of previous myocardial infarction

    International Nuclear Information System (INIS)

    Backman, C.; Jacobsson, K.A.; Linderholm, H.; Osterman, G.

    1986-01-01

    Sixty-eight patients with coronary heart disease (CHD) i.e. a hisotry of angina of effort and/or previous 'possible infarction' were examined inter alia with ECG and cinecardioangiography. A system of scoring was designed which allowed a semiquantitative estimate of the left ventricular asynergy from cinecardioangiography - the left ventricular motion score (LVMS). The LVMS was associated with the presence of a previous myocardial infarction (MI), as indicated by the history and ECG findings. The ECG changes specific for a previous MI were associated with high LVMS values and unspecific or absent ECG changes with low LVMS values. Decision thresholds for ECG changes and asynergy in diagnosing a previous MI were evaluated by means of a ROC analysis. The accuracy of ECG in detecting a previous MI was slightly higher when asynergy indicated a 'true MI' than when autopsy result did so in a comparable group. Therefore the accuracy of asynergy (LVMS ≥ 1) in detecting a previous MI or myocardial fibrosis in patients with CHD should be at least comparable with that of autopsy (scar > 1 cm). (orig.)

  5. Space use by Black-tailed Godwits Limosa limosa limosa during settlement at a previous or a new nest location

    NARCIS (Netherlands)

    Van Den Brink, Valentijn; Schroeder, Julia; Both, Christiaan; Lourenco, Pedro M.; Piersma, Theunis; Hooijmeijer, Jos C.E.W.

    Capsule Black-tailed Godwits first return to the nest location of the previous year, even when moving to a different nest location later that season. Aims To examine the use of space by Black-tailed Godwits during the two months before egg-laying to two weeks afterwards. Methods We compare the

  6. Satellite telemetry reveals higher fishing mortality rates than previously estimated, suggesting overfishing of an apex marine predator.

    Science.gov (United States)

    Byrne, Michael E; Cortés, Enric; Vaudo, Jeremy J; Harvey, Guy C McN; Sampson, Mark; Wetherbee, Bradley M; Shivji, Mahmood

    2017-08-16

    Overfishing is a primary cause of population declines for many shark species of conservation concern. However, means of obtaining information on fishery interactions and mortality, necessary for the development of successful conservation strategies, are often fisheries-dependent and of questionable quality for many species of commercially exploited pelagic sharks. We used satellite telemetry as a fisheries-independent tool to document fisheries interactions, and quantify fishing mortality of the highly migratory shortfin mako shark ( Isurus oxyrinchus ) in the western North Atlantic Ocean. Forty satellite-tagged shortfin mako sharks tracked over 3 years entered the Exclusive Economic Zones of 19 countries and were harvested in fisheries of five countries, with 30% of tagged sharks harvested. Our tagging-derived estimates of instantaneous fishing mortality rates ( F = 0.19-0.56) were 10-fold higher than previous estimates from fisheries-dependent data (approx. 0.015-0.024), suggesting data used in stock assessments may considerably underestimate fishing mortality. Additionally, our estimates of F were greater than those associated with maximum sustainable yield, suggesting a state of overfishing. This information has direct application to evaluations of stock status and for effective management of populations, and thus satellite tagging studies have potential to provide more accurate estimates of fishing mortality and survival than traditional fisheries-dependent methodology. © 2017 The Author(s).

  7. EXPERIMENTAL CHALLENGE STUDY OF FV3-LIKE RANAVIRUS INFECTION IN PREVIOUSLY FV3-LIKE RANAVIRUS INFECTED EASTERN BOX TURTLES (TERRAPENE CAROLINA CAROLINA) TO ASSESS INFECTION AND SURVIVAL.

    Science.gov (United States)

    Hausmann, Jennifer C; Wack, Allison N; Allender, Matthew C; Cranfield, Mike R; Murphy, Kevin J; Barrett, Kevin; Romero, Jennell L; Wellehan, James F X; Blum, Stella A; Zink, M Christine; Bronson, Ellen

    2015-12-01

    The Maryland Zoo in Baltimore experienced an outbreak of Frog virus-3 (FV3)-like ranavirus during the summer of 2011, during which 14 of 27 (52%) of its captive eastern box turtles (Terrapene carolina carolina) survived. To assess survival, immunity, and viral shedding, an experimental challenge study was performed in which the surviving, previously infected turtles were reinfected with the outbreak strain of FV3-like ranavirus. Seven turtles were inoculated with virus intramuscularly and four control turtles received saline intramuscularly. The turtles were monitored for 8 wk with blood and oral swabs collected for quantitative polymerase chain reaction (qPCR). During that time, one of seven (14%) inoculated turtles and none of the controls (0%) died; there was no significant difference in survival. Clinical signs of the inoculated turtles, except for the turtle that died, were mild compared to the original outbreak. Quantitative PCR for FV3-like ranavirus on blood and oral swabs was positive for all inoculated turtles and negative for all controls. The turtle that died had intracytoplasmic inclusion bodies in multiple organs. Three inoculated and two control turtles were euthanized at the end of the study. No inclusion bodies were present in any of the organs. Quantitative PCR detected FV3-like ranavirus in the spleen of a control turtle, which suggested persistence of the virus. The surviving five turtles were qPCR-negative for FV3-like ranavirus from blood and oral swabs after brumation. Quantitative PCR for Terrapene herpesvirus 1 found no association between ranavirus infection and herpesvirus loads. In conclusion, previously infected eastern box turtles can be reinfected with the same strain of FV3-like ranavirus and show mild to no clinical signs but can shed the virus from the oral cavity.

  8. Assessing the Previous Economic Knowledge of Beginning Students in Germany: Implications for Teaching Economics in Basic Courses

    Science.gov (United States)

    Happ, Roland; Förster, Manuel; Zlatkin-Troitschanskaia, Olga; Carstensen, Vivian

    2016-01-01

    Study-related prior knowledge plays a decisive role in business and economics degree courses. Prior knowledge has a significant influence on knowledge acquisition in higher education, and teachers need information on it to plan their introductory courses accordingly. Very few studies have been conducted of first-year students' prior economic…

  9. Reasoning with Previous Decisions: Beyond the Doctrine of Precedent

    DEFF Research Database (Denmark)

    Komárek, Jan

    2013-01-01

    in different jurisdictions use previous judicial decisions in their argument, we need to move beyond the concept of precedent to a wider notion, which would embrace practices and theories in legal systems outside the Common law tradition. This article presents the concept of ‘reasoning with previous decisions...... law method’, but they are no less rational and intellectually sophisticated. The reason for the rather conceited attitude of some comparatists is in the dominance of the common law paradigm of precedent and the accompanying ‘case law method’. If we want to understand how courts and lawyers......’ as such an alternative and develops its basic models. The article first points out several shortcomings inherent in limiting the inquiry into reasoning with previous decisions by the common law paradigm (1). On the basis of numerous examples provided in section (1), I will present two basic models of reasoning...

  10. On the Tengiz petroleum deposit previous study

    International Nuclear Information System (INIS)

    Nysangaliev, A.N.; Kuspangaliev, T.K.

    1997-01-01

    Tengiz petroleum deposit previous study is described. Some consideration about structure of productive formation, specific characteristic properties of petroleum-bearing collectors are presented. Recommendation on their detail study and using of experience on exploration and development of petroleum deposit which have analogy on most important geological and industrial parameters are given. (author)

  11. Cognitive functioning over 2 years after intracerebral hemorrhage in school-aged children.

    Science.gov (United States)

    Murphy, Lexa K; Compas, Bruce E; Gindville, Melissa C; Reeslund, Kristen L; Jordan, Lori C

    2017-11-01

    Previous research investigating outcomes after pediatric intracerebral hemorrhage (ICH) has generally been limited to global and sensorimotor outcomes. This study examined cognitive outcomes after spontaneous ICH in school-aged children with serial assessments over 2 years after stroke. Seven children (age range 6-16y, median 13; six males, one female; 57% white, 43% black) presenting with spontaneous ICH (six arteriovenous malformations) were assessed at 3 months, 12 months, and 24 months after stroke. The Pediatric Stroke Outcome Measure (PSOM) quantified neurological outcome and Wechsler Intelligence Scales measured cognitive outcomes: verbal comprehension, perceptual reasoning, working memory, and processing speed. PSOM scales showed improved neurological function over the first 12 months, with mild to no sensorimotor deficits and moderate overall deficits at 1- and 2-year follow-ups (median 2-year sensorimotor PSOM=0.5, total PSOM=1.5). Changes in cognitive function indicated a different trajectory; verbal comprehension and perceptual reasoning improved over 24 months; low performance was sustained in processing speed and working memory. Age-normed centile scores decreased between 1- and 2-year follow-ups for working memory, suggesting emerging deficits compared with peers. Early and serial cognitive testing in children with ICH is needed to assess cognitive functioning and support children in school as they age and cognitive deficits become more apparent and important for function. In children with intracerebral hemorrhage (ICH), motor function improved between 3 months and 24 months. Improvements in cognitive function were variable between 3 months and 24 months. Working memory centiles declined, suggesting emerging deficits compared with peers. Processing speed improved but remained significantly below the 50th centile. Cognitive impact of ICH may increase with age in children. © 2017 Mac Keith Press.

  12. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    Science.gov (United States)

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    Purpose The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Patients and methods Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Results Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80) mm, corneal diameter was 14.71±1.07 (13.0–16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0), and IOP was 39.5±5.7 (30–55) mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (Pglaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications. PMID:26082610

  13. Adolescents' physical activity is associated with previous and current physical activity practice by their parents.

    Science.gov (United States)

    Christofaro, Diego Giulliano Destro; Andersen, Lars Bo; Andrade, Selma Maffei de; Barros, Mauro Virgílio Gomes de; Saraiva, Bruna Thamyres Ciccotti; Fernandes, Rômulo Araújo; Ritti-Dias, Raphael Mendes

    The purpose of this study was to determine whether parents' current and previous physical activity practice is associated with adolescents' physical activity. The sample was composed of 1231 adolescents (14-17 years), and 1202 mothers and 871 fathers were interviewed. Weight and height of the adolescents were measured. Self-reported parents' weight and height were obtained. The current and previous physical activity levels (Baecke's questionnaire) of parents (during childhood and adolescence) and adolescents' physical activity levels were obtained using a questionnaire. The magnitude of the associations between parent and adolescent physical activity levels was determined by binary logistic regression (adjusted by sex, age, and socioeconomic level of adolescents and education level of parents). The current physical activity practice by parents was associated with adolescents' physical activity (p<0.001). The physical activities reported by parents in their childhood and adolescence were also associated with higher physical activity levels among adolescents. Adolescents whose parents were both physically active in the past and present were six times (OR=6.67 [CI=1.94-22.79]) more likely to be physically active compared to adolescents with no parents who were physically active in the past. The current and previous physical activities of parents were associated with higher levels of physical activity in adolescents, even after controlling for confounding factors. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  14. Adolescents' physical activity is associated with previous and current physical activity practice by their parents

    Directory of Open Access Journals (Sweden)

    Diego Giulliano Destro Christofaro

    Full Text Available Abstract Objective: The purpose of this study was to determine whether parents' current and previous physical activity practice is associated with adolescents' physical activity. Methods: The sample was composed of 1231 adolescents (14-17 years, and 1202 mothers and 871 fathers were interviewed. Weight and height of the adolescents were measured. Self-reported parents' weight and height were obtained. The current and previous physical activity levels (Baecke's questionnaire of parents (during childhood and adolescence and adolescents' physical activity levels were obtained using a questionnaire. The magnitude of the associations between parent and adolescent physical activity levels was determined by binary logistic regression (adjusted by sex, age, and socioeconomic level of adolescents and education level of parents. Results: The current physical activity practice by parents was associated with adolescents' physical activity (p < 0.001. The physical activities reported by parents in their childhood and adolescence were also associated with higher physical activity levels among adolescents. Adolescents whose parents were both physically active in the past and present were six times (OR = 6.67 [CI = 1.94-22.79] more likely to be physically active compared to adolescents with no parents who were physically active in the past. Conclusions: The current and previous physical activities of parents were associated with higher levels of physical activity in adolescents, even after controlling for confounding factors.

  15. Assessment of China's energy-saving and emission-reduction accomplishments and opportunities during the 11th Five Year Plan

    International Nuclear Information System (INIS)

    Price, Lynn; Levine, Mark D.; Zhou Nan; Fridley, David; Aden, Nathaniel; Lu Hongyou; McNeil, Michael; Zheng, Nina; Qin Yining; Yowargana, Ping

    2011-01-01

    From 1980 to 2002, China experienced a 5% average annual reduction in energy consumption per unit of gross domestic product (GDP). With a dramatic reversal of this historic relationship, energy intensity increased 5% per year during 2002-2005. China's 11th Five Year Plan (FYP) set a target of reducing energy intensity by 20% by 2010. This paper assesses selected policies and programs that China has instituted to fulfill the national goal, finding that China made substantial progress and many of the energy-efficiency programs appear to be on track to meet - or in some cases exceed - their energy-saving targets. Most of the Ten Key Projects, the Top-1000 Program, and the Small Plant Closure Program will meet or surpass the 11th FYP savings goals. China's appliance standards and labeling program has become very robust. China has greatly enhanced its enforcement of new building energy standards but energy-efficiency programs for buildings retrofits, as well as the goal of adjusting China's economic structure, are failing. It is important to maintain and strengthen the existing energy-saving policies and programs that are successful while revising programs or adding new policy mechanisms to improve the programs that are not on track to achieve the stated goals. - Research highlights: → This paper assesses selected national energy efficiency policies and programs China. → The policies were established to fulfill the 11th Five Year Plan energy efficiency improvement goal. → Many of the programs appear to be on track to meet or exceed their energy-saving targets. → For the 12th Five Year Plan, it is important to maintain and strengthen energy-saving policies. → Recommendations are made for revising or adding programs based on international experience.

  16. Workplace immersion in the final year of an undergraduate medicine course: the views of final year students and recent graduates.

    Science.gov (United States)

    Sen Gupta, Tarun; Hays, Richard; Woolley, Torres; Kelly, Gill; Jacobs, Harry

    2014-06-01

    Most medical schools require formal competence assessment of students immediately prior to graduation, but variation exists in the approach to endpoint assessments. This article reports perceptions of senior students and graduates from a school with a six-year program which has introduced final year workplace immersion placements following a barrier examination at the end of the penultimate Year 5. Final year students (22) and recent graduates (4) attended focus groups and in-depth interviews exploring their perceptions of the value of the curriculum experience during the final two years, the structure and timing of assessment, and their preparation for internship. Participants felt that the penultimate year was more pressured, and focused on passing "artificial" examinations. In contrast, the final year was more relaxed, building skills for postgraduate work and later career development. As a result, students felt well prepared for internship with some indication that the self-directed nature of the final year promoted a lifelong learning approach. The final year workplace immersion model was regarded positively by senior students of this medical school. This model may be a better way of preparing students to be junior doctors than a traditional final year heavy on theoretical learning and assessment.

  17. Assessment of the vegetation cover in a burned area 22-years ago using remote sensing techniques and GIS analysis (Sierra de las Nieves, South of Spain).

    Science.gov (United States)

    Martínez-Murillo, Juan F.; Remond, Ricardo; Ruiz-Sinoga, José D.

    2015-04-01

    The study aim was to characterize the vegetation cover in a burned area 22-years ago considering the previous situation to wildfire in 1991 and the current one in 2013. The objectives were to: (i) compare the current and previous vegetation cover to widlfire; (ii) evaluate whether the current vegetation has recovered the previous cover to wildfire; and (iii) determine the spatial variability of vegetation recovery after 22-years since the wildfire. The study area is located in Sierra de las Nieves, South of Spain. It corresponds to an area affected by a wildfire in August 8th, 1991. The burned area was equal to 8156 ha. The burn severity was spatially very high. The main geographic features of the burned area are: mountainous topography (altitudes ranging from 250 m to 1500 m; slope gradient >25%; exposure mainly southfacing); igneous (peridotites), metamorphic (gneiss) and calcareous rocks (limestones); and predominant forest land use (Pinus pinaster sp. woodlands, 10%; pinus opened forest + shrubland, 40%; shrubland, 35%; and bare soil + grassland, 15%). Remote sensing techniques and GIS analysis has been applied to achieve the objectives. Landsat 5 and Landsat 8 images were used: July 13th, 1991 and July 1st, 2013, for the previous wildfire situation and 22-years after, respectively. The 1990 CORINE land cover was also considered to map 1991 land uses prior the wildfire. Likewise, the Andalucía Regional Government wildfire historic records were used to select the burned area and its geographical limit. 1991 and 2013 land cover map were obtained by means of object-oriented classifications. Also, NDVI and PVI1 vegetation indexes were calculated and mapped for both years. Finally, some images transformations and kernel density images were applied to determine the most recovered areas and to map the spatial concentration of bare soil and pine cover areas in 1991 and 2013, respectively. According to the results, the combination of remote sensing and GIS analysis let

  18. The experience of 3 years of external quality assessment of preimplantation genetic diagnosis for cystic fibrosis

    Science.gov (United States)

    Deans, Zandra; Fiorentino, Francesco; Biricik, Anil; Traeger-Synodinos, Joanne; Moutou, Céline; De Rycke, Martine; Renwick, Pamela; SenGupta, Sioban; Goossens, Veerle; Harton, Gary

    2013-01-01

    Preimplantation genetic diagnosis (PGD) was first performed over 20 years ago and has become an accepted part of genetic testing and assisted reproduction worldwide. The techniques and protocols necessary to carry out genetic testing at the single-cell level can be difficult to master and have been developed independently by the laboratories worldwide offering preimplantation testing. These factors indicated the need for an external quality assessment (EQA) scheme for monogenic disease PGD. Toward this end, the European Society for Human Reproduction and Embryology came together with United Kingdom National External Quality Assessment Services for Molecular Genetics, to create a pilot EQA scheme followed by practical EQA schemes for all interested parties. Here, we detail the development of the pilot scheme as well as development and findings from the practical (clinical) schemes that have followed. Results were generally acceptable and there was marked improvement in results and laboratory scores for those labs that participated in multiple schemes. Data from the first three schemes indicate that the EQA scheme is working as planned and has helped laboratories improve their techniques and result reporting. The EQA scheme for monogenic PGD will continue to be developed to offer assessment for other monogenic disorders. PMID:23150080

  19. Comparing caries risk profiles between 5- and 10- year-old children with cleft lip and/or palate and non-cleft controls

    DEFF Research Database (Denmark)

    Sundell, Anna Lena; Ullbro, Christer; Marcusson, Agneta

    2015-01-01

    of cleft lip and/or palate (CL(P)) children with non-cleft controls in the same age using a computerized caries risk assessment model. METHODS: The study group consisted of 133 children with CL(P) (77 subjects aged 5 years and 56 aged 10 years) and 297 non-cleft controls (133 aged 5 years and 164 aged 10......BACKGROUND: Previous studies have suggested that children with oral clefts may have higher caries prevalence in comparison with non-cleft controls but the relative importance of the potential risk factors is not clear. The aim of this study was to compare the caries risk profiles in a group...

  20. Previously unclassified bacteria dominate during thermophilic and mesophilic anaerobic pre-treatment of primary sludge.

    Science.gov (United States)

    Pervin, Hasina M; Batstone, Damien J; Bond, Philip L

    2013-06-01

    Thermophilic biological pre-treatment enables enhanced anaerobic digestion for treatment of wastewater sludges but, at present, there is limited understanding of the hydrolytic-acidogenic microbial composition and its contribution to this process. In this study, the process was assessed by comparing the microbiology of thermophilic (50-65 °C) and mesophilic (35 °C) pre-treatment reactors treating primary sludge. A full-cycle approach for the 16S rRNA genes was applied in order to monitor the diversity of bacteria and their abundance in a thermophilic pre-treatment reactor treating primary sludge. For the thermophilic pre-treatment (TP), over 90% of the sequences were previously undetected and these had less than 97% sequence similarity to cultured organisms. During the first 83 days, members of the Betaproteobacteria dominated the community sequences and a newly designed probe was used to monitor a previously unknown bacterium affiliated with the genus Brachymonas. Between days 85 and 183, three phylotypes that affiliated with the genera Comamonas, Clostridium and Lysobacter were persistently dominant in the TP community, as revealed by terminal-restriction fragment length polymorphism (T-RFLP). Hydrolytic and fermentative functions have been speculated for these bacteria. Mesophilic pre-treatment (MP) and TP communities were different but they were both relatively dynamic. Statistical correlation analysis and the function of closely allied reference organisms indicated that previously unclassified bacteria dominated the TP community and may have been functionally involved in the enhanced hydrolytic performance of thermophilic anaerobic pre-treatment. This study is the first to reveal the diversity and dynamics of bacteria during anaerobic digestion of primary sludge. Copyright © 2013 Elsevier GmbH. All rights reserved.