Efficacy and toxicity of (chemo)radiotherapy for primary subglottic cancer

Energy Technology Data Exchange (ETDEWEB)

Hata, M.; Koike, I.; Odagiri, K.; Minagawa, Y.; Inoue, T. [Yokohama City Univ. Graduate School of Medicine, Yokohama (Japan). Dept. of Radiology; Taguchi, T.; Nishimura, G.; Takahashi, M.; Komatsu, M.; Sano, D. [Yokohama City Univ. Graduate School of Medicine, Yokohama (Japan). Dept. of Otorhinolaryngology

2013-01-15

Background and purpose: Primary subglottic cancer is a rare malignancy. We investigated the efficacy and toxicity of radiotherapy for subglottic cancer. Patients and methods: Nineteen patients with primary squamous cell carcinoma of the subglottis received radiotherapy, 14 of whom also underwent chemotherapy. Of the 19 patients, 15 received definitive radiotherapy to the gross tumors with total doses of 70-70.2 Gy in 35-39 fractions, and 4 underwent preoperative radiotherapy with total doses of 37.8-55.8 Gy in 21-31 fractions, followed by total laryngectomy. Results: Of the 19 patients, 5 developed local progression and 2 developed distant metastasis at the median follow-up period of 5 years. The 5-year local control and disease-free rates were 74 and 63%, respectively. Three patients died of tumor progression, and the 5-year overall and disease-free survival rates were 80 and 63%, respectively. Regarding acute toxicities, transient mucositis and dermatitis of grade 3 or lower were observed in all patients, but there were no late toxicities of grade 3 or higher. Conclusion: Radiotherapy is a safe and effective treatment for patients with primary squamous cell carcinoma of the subglottis. The use of chemotherapy together with radiotherapy may enhance treatment efficacy and contribute to larynx preservation through good local control. (orig.)

Efficacy of Ginger for Alleviating the Symptoms of Primary Dysmenorrhea: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

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Daily, James W; Zhang, Xin; Kim, Da Sol; Park, Sunmin

2015-12-01

There has been no attempt to date to synthesize the available evidence for the efficacy of ginger for treating primary dysmenorrhea. This systematic review evaluates the current evidence for the effectiveness of ginger for treating primary dysmenorrhea. Literature searches were conducted using 12 electronic databases including PubMed, EMBASE, Cochrane Library, Korean databases, Chinese medical databases, and Indian scientific database. Search terms used were: "ginger" or "Zingiber officinale" and "dysmenorrhea" and "pain." Studies using ginger as a treatment of primary dysmenorrhea were considered for inclusion. The major outcome of primary dysmenorrhea was assessed using a pain visual analogue score (PVAS). Initial searches yielded 29 articles. Of these original results, seven met specific selection criteria. Four of the RCTs compared the therapeutic efficacy of ginger with a placebo during the first 3-4 days of the menstrual cycle and were included in the meta analysis. The meta-analysis of these data showed a significant effect of ginger in reducing PVAS in subjects having primary dysmenorrhea (risk ratio, -1.85; 95% CI of -2.87, -0.84, P = 0.0003). Six RCTs out of 7 exhibited low to moderate of risk of bias. Collectively these RCTs provide suggestive evidence for the effectiveness of 750-2000 mg ginger powder during the first 3-4 days of menstrual cycle for primary dysmenorrhea. Wiley Periodicals, Inc.

Traditional and new composite endpoints in heart failure clinical trials : facilitating comprehensive efficacy assessments and improving trial efficiency

NARCIS (Netherlands)

Anker, Stefan D. t; Schroeder, Stefan; Atar, Dan; Bax, Jeroen J.; Ceconi, Claudio; Cowie, Martin R.; AdamCrisp,; Dominjon, Fabienne; Ford, Ian; Ghofrani, Hossein-Ardeschir; Gropper, Savion; Hindricks, Gerhard; Hlatky, Mark A.; Holcomb, Richard; Honarpour, Narimon; Jukema, J. Wouter; Kim, Albert M.; Kunz, Michael; Lefkowitz, Martin; Le Floch, Chantal; Landmesser, Ulf; McDonagh, Theresa A.; McMurray, John J.; Merkely, Bela; Packer, Milton; Prasad, Krishna; Revkin, James; Rosano, Giuseppe M. C.; Somaratne, Ransi; Stough, Wendy Gattis; Voors, Adriaan A.; Ruschitzka, Frank

Composite endpoints are commonly used as the primary measure of efficacy in heart failure clinical trials to assess the overall treatment effect and to increase the efficiency of trials. Clinical trials still must enrol large numbers of patients to accrue a sufficient number of outcome events and

The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic Review.

Science.gov (United States)

Demarzo, Marcelo M P; Montero-Marin, Jesús; Cuijpers, Pim; Zabaleta-del-Olmo, Edurne; Mahtani, Kamal R; Vellinga, Akke; Vicens, Caterina; López-del-Hoyo, Yolanda; García-Campayo, Javier

2015-11-01

Positive effects have been reported after mindfulness-based interventions (MBIs) in diverse clinical and nonclinical populations. Primary care is a key health care setting for addressing common chronic conditions, and an effective MBI designed for this setting could benefit countless people worldwide. Meta-analyses of MBIs have become popular, but little is known about their efficacy in primary care. Our aim was to investigate the application and efficacy of MBIs that address primary care patients. We performed a meta-analytic review of randomized controlled trials addressing the effect of MBIs in adult patients recruited from primary care settings. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines were followed. Effect sizes were calculated with the Hedges g in random effects models. The meta-analyses were based on 6 trials having a total of 553 patients. The overall effect size of MBI compared with a control condition for improving general health was moderate (g = 0.48; P = .002), with moderate heterogeneity (I(2) = 59; P .05). Although the number of randomized controlled trials applying MBIs in primary care is still limited, our results suggest that these interventions are promising for the mental health and quality of life of primary care patients. We discuss innovative approaches for implementing MBIs, such as complex intervention and stepped care. © 2015 Annals of Family Medicine, Inc.

A cluster randomised controlled trial of the efficacy of a brief walking intervention delivered in primary care: Study protocol

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Szczepura Ala

2011-06-01

Full Text Available Abstract Background The aim of the present research is to conduct a fully powered explanatory trial to evaluate the efficacy of a brief self-regulation intervention to increase walking. The intervention will be delivered in primary care by practice nurses (PNs and Healthcare Assistants (HCAs to patients for whom increasing physical activity is a particular priority. The intervention has previously demonstrated efficacy with a volunteer population, and subsequently went through an iterative process of refinement in primary care, to maximise acceptability to both providers and recipients. Methods/ Design This two arm cluster randomised controlled trial set in UK general practices will compare two strategies for increasing walking, assessed by pedometer, over six months. Patients attending practices randomised to the self-regulation intervention arm will receive an intervention consisting of behaviour change techniques designed to increase walking self-efficacy (confidence in ability to perform the behaviour, and to help people translate their "good" intentions into behaviour change by making plans. Patients attending practices randomised to the information provision arm will receive written materials promoting walking, and a short unstructured discussion about increasing their walking. The trial will recruit 20 PN/HCAs (10 per arm, who will be trained by the research team to deliver the self-regulation intervention or information provision control intervention, to 400 patients registered at their practices (20 patients per PN/HCA. This will provide 85% power to detect a mean difference of five minutes/day walking between the self-regulation intervention group and the information provision control group. Secondary outcomes include health services costs, and intervention effects in sub-groups defined by age, ethnicity, gender, socio-economic status, and clinical condition. A mediation analysis will investigate the extent to which changes in

"I Didn't Always Perceive Myself as a "Science Person"": Examining Efficacy for Primary Science Teaching

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Mansfield, Caroline F.; Woods-McConney, Amanda

2012-01-01

Teacher efficacy has become an important field of research especially in subjects teachers may find challenging, such as science. This study investigates the sources of teachers' efficacy for teaching science in primary schools in the context of authentic teaching situations with a view to better understanding sources of teachers' efficacy…

Efficacy of a cognitive and behavioural psychotherapy applied by primary care psychologists in patients with mixed anxiety-depressive disorder: a research protocol.

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Jauregui, Amale; Ponte, Joaquín; Salgueiro, Monika; Unanue, Saloa; Donaire, Carmen; Gómez, Maria Cruz; Burgos-Alonso, Natalia; Grandes, Gonzalo

2015-03-20

In contrast with the recommendations of clinical practice guidelines, the most common treatment for anxiety and depressive disorders in primary care is pharmacological. The aim of this study is to assess the efficacy of a cognitive-behavioural psychological intervention, delivered by primary care psychologists in patients with mixed anxiety-depressive disorder compared to usual care. This is an open-label, multicentre, randomized, and controlled study with two parallel groups. A random sample of 246 patients will be recruited with mild-to-moderate mixed anxiety-depressive disorder, from the target population on the lists of 41 primary care doctors. Patients will be randomly assigned to the intervention group, who will receive standardised cognitive-behavioural therapy delivered by psychologists together with usual care, or to a control group, who will receive usual care alone. The cognitive-behavioural therapy intervention is composed of eight individual 60-minute face-to face sessions conducted in eight consecutive weeks. A follow-up session will be conducted over the telephone, for reinforcement or referral as appropriate, 6 months after the intervention, as required. The primary outcome variable will be the change in scores on the Short Form-36 General Health Survey. We will also measure the change in the frequency and intensity of anxiety symptoms (State-Trait Anxiety Inventory) and depression (Beck Depression Inventory) at baseline, and 3, 6 and 12 months later. Additionally, we will collect information on the use of drugs and health care services. The aim of this study is to assess the efficacy of a primary care-based cognitive-behavioural psychological intervention in patients with mixed anxiety-depressive disorder. The international scientific evidence has demonstrated the need for psychologists in primary care. However, given the differences between health policies and health services, it is important to test the effect of these psychological interventions

The efficacy of postoperative radiotherapy in localized primary soft tissue sarcoma treated with conservative surgery

International Nuclear Information System (INIS)

Zhao, Ru-Ping; Yu, Xiao-Li; Zhang, Zhen; Jia, Li-Juan; Feng, Yan; Yang, Zhao-Zhi; Chen, Xing-Xing; Wang, Jian; Ma, Sheng-Lin; Guo, Xiao-Mao

2016-01-01

To evaluate the efficacy of postoperative radiotherapy (RT) on local failure-free survival (LFFS), distant metastasis-free survival (DMFS) and overall survival (OS) in patients with localized primary soft tissue sarcoma (STS) and to identify prognostic factors. Between January 2000 and July 2010, 220 consecutive patients with localized primary STS, who received conservative surgery with or without postoperative RT, were enrolled in the study. Survival curves were constructed by the Kaplan-Meier method and log-rank test was used to assess statistical significance. Multivariate analysis was applied to identify the prognostic factors. After a median follow-up of 68 months (range, 5–127 months), the 5-year LFFS, DMFS and OS were 70.0, 78.2 and 71.2 %, respectively. Tumor size, histological subtypes, margin status and postoperative RT were independent predictors for OS. Postoperative RT was associated with a significant reduced local recurrence risk versus surgery alone (hazard ratio [HR] = 0.408, 95 % confidence interval [CI] 0.235–0.707, P = 0.001), with 5-year LFFS of 81.1 and 63.6 %, respectively (log-rank, P = 0.004). The log-rank test showed that postoperative RT had a tendency of improving OS compared with surgery alone, with 5-year OS of 74.8 and 65.0 %, respectively (P = 0.089). Multivariate analysis demonstrated that postoperative RT significantly reduced mortality rate compared with surgery alone (HR = 0.512, 95 % CI 0.296–0.886, p = 0.017), especially in patients with liposarcoma (p = 0.034). Postoperative radiotherapy reduce both local recurrence and STS mortality in patients with localized primary STS. The efficacy of RT on survival warrants further prospective study. The online version of this article (doi:10.1186/s13014-016-0605-y) contains supplementary material, which is available to authorized users

Efficacy of Different Types of Mobilization Techniques in Patients With Primary Adhesive Capsulitis of the Shoulder: A Systematic Review.

Science.gov (United States)

Noten, Suzie; Meeus, Mira; Stassijns, Gaetane; Van Glabbeek, Francis; Verborgt, Olivier; Struyf, Filip

2016-05-01

To systematically review the literature for efficacy of isolated articular mobilization techniques in patients with primary adhesive capsulitis (AC) of the shoulder. PubMed and Web of Science were searched for relevant studies published before November 2014. Additional references were identified by manual screening of the reference lists. All English language randomized controlled trials evaluating the efficacy of mobilization techniques on range of motion (ROM) and pain in adult patients with primary AC of the shoulder were included in this systematic review. Twelve randomized controlled trials involving 810 patients were included. Two reviewers independently screened the articles, scored methodologic quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. All studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence Database Scale for randomized controlled trials. The efficacy of 7 different types of mobilization techniques was evaluated. Angular mobilization (n=2), Cyriax approach (n=1), and Maitland technique (n=6) showed improvement in pain score and ROM. With respect to translational mobilizations (n=1), posterior glides are preferred to restore external rotation. Spine mobilizations combined with glenohumeral stretching and both angular and translational mobilization (n=1) had a superior effect on active ROM compared with sham ultrasound. High-intensity mobilization (n=1) showed less improvement in the Constant Murley Score than a neglect group. Finally, positive long-term effects of the Mulligan technique (n=1) were found on both pain and ROM. Overall, mobilization techniques have beneficial effects in patients with primary AC of the shoulder. Because of preliminary evidence for many mobilization techniques, the Maitland technique and combined mobilizations seem recommended at the moment. Copyright © 2016

Primary headaches interfere with the efficacy of temporomandibular disorders management.

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Porporatti, André Luís; Costa, Yuri Martins; Conti, Paulo César Rodrigues; Bonjardim, Leonardo Rigoldi; Calderon, Patrícia dos Santos

2015-01-01

This cross-sectional study aimed to evaluate the influence of Primary Headache (PH) on efficacy of a Temporomandibular Disorders (TMD) conservative therapy and its association with the presence of self-reported parafunctional habits. Sample was composed of 400 medical records, divided into four groups: I) Muscular TMD (n = 64); II) Muscular TMD+PH (n = 48); III) Muscular TMD+Articular TMD (n = 173); IV) Muscular TMD+Articular TMD+PH (n = 115). All groups had undergone a TMD therapy for three months with a stabilization appliance and counseling for habits and behavioral changes, with no specific headache management. Current pain intensity and existence or not of self-reported bruxism were assessed. Repeated measures ANOVA and Chi-Square test followed by Odds were used for statistical analysis, with a significance level of 5%. results of this study showed that: (1) A conservative therapy with stabilization appliance and counseling for habits and behavioral changes was effective in the TMD pain relief; (2) Groups with an additional diagnosis of PH had worsened the pain improvement significantly; and (3) no association between the presence of self-reported bruxism and PH was found. this study could elucidate the important effect that headache may have on the TMD management.

Primary headaches interfere with the efficacy of temporomandibular disorders management

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André Luís PORPORATTI

2015-04-01

Full Text Available OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache (PH on efficacy of a Temporomandibular Disorders (TMD conservative therapy and its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I Muscular TMD (n=64; II Muscular TMD+PH (n=48; III Muscular TMD+Articular TMD (n=173; IV Muscular TMD+Articular TMD+PH (n=115. All groups had undergone a TMD therapy for three months with a stabilization appliance and counseling for habits and behavioral changes, with no specific headache management. Current pain intensity and existence or not of self-reported bruxism were assessed. Repeated measures ANOVA and Chi-Square test followed by Odds were used for statistical analysis, with a significance level of 5%. RESULTS: results of this study showed that: (1 A conservative therapy with stabilization appliance and counseling for habits and behavioral changes was effective in the TMD pain relief; (2 Groups with an additional diagnosis of PH had worsened the pain improvement significantly; and (3 no association between the presence of self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD management.

Efficacy and tolerability of ramelteon in a double-blind, placebo-controlled, crossover study in Japanese patients with chronic primary insomnia.

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Kohsaka, Masako; Kanemura, Takashi; Taniguchi, Mitsutaka; Kuwahara, Hiroo; Mikami, Akira; Kamikawa, Kunihisa; Uno, Hideki; Ogawa, Atsushi; Murasaki, Mitsukuni; Sugita, Yoshiro

2011-10-01

The aim of this study was to evaluate the efficacy and safety of ramelteon 4, 8, 16 or 32 mg and placebo in Japanese patients with chronic insomnia using a randomized, double-blind, five-period crossover design. A total of 65 Japanese patients with chronic primary insomnia received ramelteon or placebo for two nights each in sleep laboratories. Changes in sleep parameters were assessed objectively by polysomnography and subjectively by postsleep questionnaires. Safety and tolerability was evaluated by assessment of the occurrence of adverse events, next-day residual effects and laboratory and ECG investigations. Ramelteon 8 and 32 mg significantly shortened the mean latency to persistent sleep in comparison with placebo, and there was a statistically significant trend for linear dose-response for this sleep parameter. Overall changes in sleep architecture were modest (Japanese and US patients. Overall, ramelteon 8 mg showed the most favorable balance between sleep-promoting effects and tolerability. The unique efficacy profile of ramelteon, promoting sleep initiation without affecting other sleep parameters, may be due to its circadian shifting effect.

Antimicrobial efficacy of the combinations of Acacia nilotica, Murraya koenigii L. sprengel, Eucalyptus hybrid and Psidium guajava on primary plaque colonizers.

Science.gov (United States)

Chandra Shekar, B R; Nagarajappa, Ramesh; Singh, Rupal; Thaku, Roopesh

2014-09-01

There is an urgent need for innovative strategies to combat the two most common dental diseases of mankind namely dental caries and periodontitis. The aim was to assess the antimicrobial efficacy of the double combinations of Acacia nilotica (AN), Murraya koenigii L. Sprengel (MKL), Eucalyptus hybrid and Psidium guajava on primary plaque colonizers. The plant extracts of AN, MKL. Sprengel, Eucalyptus hybrid and P. guajava were prepared using Soxhlet apparatus. The stock solutions of individual plant extracts (100 mg/ml) were prepared. Equal quantities of stock solutions were mixed to obtain six double combinations of herbal extracts. The antimicrobial efficacy testing was done against three primary plaque colonizers using agar well-diffusion method. 0.2% chlorhexidine and dimethyl sulfoxide were used as positive and as negative controls. The mean inhibition zone between the categories was compared using one-way Analysis of Variance and Tukey's post hoc test. The combination of AN and P. guajava produced the highest mean diameter of inhibition zone (21.08 mm ± 2.11) against Streptococcus mutans. The chlorhexidine produced the least inhibition zone against S. mutans (14.50 ± 2.07). The combination of AN and P. guajava produced the maximum antimicrobial efficacy against Streptococcus sanguis (19.67 ± 1.03) and Streptococcus salivarius (20.33 ± 1.86). All the combinations of plant extracts have the potential to be used as antiplaque and anticaries agents. The combinations of herbal extracts offer enhanced antimicrobial efficacy due to the synergistic effects besides slowing the development of resistance.

Assessing primary care in Austria: room for improvement.

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Stigler, Florian L; Starfield, Barbara; Sprenger, Martin; Salzer, Helmut J F; Campbell, Stephen M

2013-04-01

There is emerging evidence that strong primary care achieves better health at lower costs. Although primary care can be measured, in many countries, including Austria, there is little understanding of primary care development. Assessing the primary care development in Austria. A primary care assessment tool developed by Barbara Starfield in 1998 was implemented in Austria. This tool defines 15 primary care characteristics and distinguishes between system and practice characteristics. Each characteristic was evaluated by six Austrian primary care experts and rated as 2 (high), 1 (intermediate) or 0 (low) points, respectively, to their primary care strength (maximum score: n = 30). Austria received 7 out of 30 points; no characteristic was rated as '2' but 8 were rated as '0'. Compared with the 13 previously assessed countries, Austria ranks 10th of 14 countries and is classified as a 'low primary care' country. This study provides the first evidence concerning primary care in Austria, benchmarking it as weak and in need of development. The practicable application of an existing assessment tool can be encouraging for other countries to generate evidence about their primary care system as well.

Quality Assessment in the Primary care

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Muharrem Ak

2013-04-01

Full Text Available -Quality Assessment in the Primary care Dear Editor; I have read the article titled as “Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh” with great interest. Shrivastava et all concluded that assessment mechanism for the achievement of objectives for the suggested RKS model was not successful (1. Hereby I would like to emphasize the importance of quality assessment (QA especially in the era of newly established primary care implementations in our country. Promotion of quality has been fundamental part of primary care health services. Nevertheless variations in quality of care exist even in the developed countries. Accomplishment of quality in the primary care has some barriers like administration and directorial factors, absence of evidence-based medicine practice lack of continuous medical education. Quality of health care is no doubt multifaceted model that covers all components of health structures and processes of care. Quality in the primary care set up includes patient physician relationship, immunization, maternal, adolescent, adult and geriatric health care, referral, non-communicable disease management and prescribing (2. Most countries are recently beginning the implementation of quality assessments in all walks of healthcare. Organizations like European society for quality and safety in family practice (EQuiP endeavor to accomplish quality by collaboration. There are reported developments and experiments related to the methodology, processes and outcomes of quality assessments of health care. Quality assessments will not only contribute the accomplishment of the program / project but also detect the areas where obstacles also exist. In order to speed up the adoption of QA and to circumvent the occurrence of mistakes, health policy makers and family physicians from different parts of the world should share their experiences. Consensus on quality in preventive medicine implementations can help to yield

The Efficacy of Zinc Administration in the Treatment of Primary Dysmenorrhea

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Batool Teimoori

2016-03-01

Full Text Available Objectives: Dysmenorrhea is a common complaint in women. Primary dysmenorrhea is defined as painful menstruation in the absence of pelvic disease and is caused by uterine contractions caused by prostaglandins released from the endometrium. Conventional treatments include nonsteroidal anti-inflammatory drugs and oral contraceptives. We sought to evaluate the efficacy of zinc supplementation in the treatment of primary dysmenorrhea.  Methods: Two-hundred participants with primary dysmenorrhea were randomized into one of two groups. The intervention group received zinc and mefenamic acid, and the control group received mefenamic acid and a placebo drug. After three months of treatment, changes in the incidence of dysmenorrhea and the degree of pain were measured in both groups.  Results: The mean pain score before administration of zinc and mefenamic acid in the intervention group was 5.3±1.8 and after treatment was 1.2±1.9 (p 0.050. We also found that 64% of case group and 33% of the control group did not experience dysmenorrhea after treatment (p < 0.001.  Conclusions: The use of a zinc supplement in combination with mefenamic acid was superior in reducing primary dysmenorrhea compared to mefenamic acid alone.

Alflutop clinical efficacy assessment in osteoarthritis (two-years study

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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.

Assessment of the safety and efficacy of primary retropupillary fixation of iris-claw intraocular lenses in children with large lens subluxations.

Science.gov (United States)

Rastogi, Anju; Goray, Apurva; Thacker, Prolima; Kamlesh; Babita

2017-08-17

To evaluate whether retropupillary fixation of the iris-claw intraocular lens (IOL) is a safe and effective treatment option in children with large lens subluxations. Fourteen eyes of children between the ages of 8-17 years with lens subluxations more than 7 clock hours underwent pars plana lensectomy-vitrectomy with implantation of the iris-claw IOL in the retropupillary position as a primary procedure. The best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial count (EC) and the lens position using ultrasound biomicroscopy (UBM) were assessed pre- and postoperatively. Postoperatively, all patients had an increase in the BCVA with a mean of 0.351 ± 0.154 log MAR units which was statistically significant as compared to the preoperative value of 0.771 ± 0.132 log MAR units (p = 0.003). The difference between the mean preoperative IOP (13.642 ± 2.437 mmHg) and the mean postoperative intraocular pressure at the end of 6 months (13.5 ± 2.244 mmHg) was not statistically significant (p = 0.671). The mean EC decreased by 0.99% from 2838.42 ± 474.76 cells/mm 2 preoperatively to 2810 ± 461.24 cells/mm 2 at the end of 6 months postoperatively (p = 0.117). The lens position was analyzed using UBM and was found to be parallel to the iris plane in all cases at the end of 6 months. Our study shows that primary retropupillary iris-claw IOL implantation can be a safe and efficacious option for children with large (>7 clock hours) lens subluxations that is at least comparable to scleral-fixated PCIOLs.

Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting.

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Tharek, Zahirah; Ramli, Anis Safura; Whitford, David Leonard; Ismail, Zaliha; Mohd Zulkifli, Maryam; Ahmad Sharoni, Siti Khuzaimah; Shafie, Asrul Akmal; Jayaraman, Thevaraajan

2018-03-09

Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control. This was a cross-sectional study involving patients with type 2 diabetes mellitus from two public primary care clinics in Malaysia. Self-efficacy and self-care behaviour levels were measured using previously translated and validated DMSES and SDSCA questionnaires in Malay versions, respectively. Glycaemic control was measured using HbA 1c. RESULTS: A total of 340 patients with type 2 diabetes mellitus were recruited. The total mean (±SD) of self-efficacy and self-care behaviour scores were 7.33 (±2.25) and 3.76 (±1.87), respectively. A positive relationship was found between self-efficacy and self-care behaviour (r 0.538, P self-efficacy score was shown to be correlated with lower HbA 1c (r - 0.41, P self-efficacy scores (b - 0.398; 95% CI: -0.024, - 0.014; P diabetes (b 0.177; 95% CI: 0.002, 0.007; P self-efficacy was correlated with improved self-care behaviour and better glycaemic control. Findings of this study suggest the importance of including routine use of self-efficacy measures in the management of type 2 diabetes mellitus in primary care.

Efficacy of Mindfulness-Based Cognitive Therapy on Late Post-Treatment Pain in Women Treated for Primary Breast Cancer: A Randomized Controlled Trial

DEFF Research Database (Denmark)

Johannsen, Maja; O Connor, Maja; OToole, Mia Skytte

2016-01-01

PURPOSE: To assess the efficacy of mindfulness-based cognitive therapy (MBCT) for late post-treatment pain in women treated for primary breast cancer. METHODS: A randomized wait list-controlled trial was conducted with 129 women treated for breast cancer reporting post-treatment pain (score ≥ 3...... pain rehabilitation strategy for women treated for breast cancer. In addition, the effect on neuropathic pain, a pain type reported by women treated for breast cancer, further suggests the potential of MBCT but should be considered preliminary....

Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting.

OpenAIRE

Tharek, Zahirah; Ramli, Anis Safura; Whitford, David L; Ismail, Zaliha; Mohd Zulkifli, Maryam; Ahmad Sharoni, Siti Khuzaimah; Shafie, Asrul A; Jayaraman, Thevaraajan

2018-01-01

BACKGROUND: Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self...

Efficacy of psychosocial intervention in patients with mild Alzheimer's disease: the multicentre, rater blinded, randomised Danish Alzheimer Intervention Study (DAISY)

DEFF Research Database (Denmark)

Waldorff, F.B.; Buss, D.V.; Eckermann, A.

2012-01-01

To assess the efficacy at 12 months of an early psychosocial counselling and support programme for outpatients with mild Alzheimer's disease and their primary care givers.......To assess the efficacy at 12 months of an early psychosocial counselling and support programme for outpatients with mild Alzheimer's disease and their primary care givers....

Are Primary Healthcare Organizational Attributes Associated with Patient Self-Efficacy for Managing Chronic Disease?

Science.gov (United States)

Lemieux, Valérie; Lévesque, Jean-Frédéric; Ehrmann-Feldman, Debbie

2011-01-01

Our objective was to explore how individual and primary healthcare (PHC) organizational attributes influence patients' ability in chronic illness self-management. We conducted a cohort study, recruiting 776 adults with chronic disease from 33 PHC settings in the province of Quebec. Organizational data on the PHC clinics were obtained from a prior study. Participants were interviewed at baseline, 6 and 12 months, responding to questionnaires on self-efficacy, health status, socio-demographics, healthcare use and experience of care. Multilevel modelling showed that 52.5% of the variance in self-efficacy occurs at the level of the individual and 4.0% at the organizational level. Controlling for diagnosis, patient factors associated with self-efficacy were self-rated health (B coeff 0.76: CI 0.60; 0.92), concurrent depression (B coeff –1.41: CI 1.96; –0.86) and satisfaction with care (B coeff 0.27: CI 0.15; 0.39). None of the organizational attributes was significantly associated with self-efficacy after adjusting for lower-level variables. Patients generally reported receiving little self-management teaching across organizations. PMID:22548102

Are primary healthcare organizational attributes associated with patient self-efficacy for managing chronic disease?

Science.gov (United States)

Lemieux, Valérie; Lévesque, Jean-Frédéric; Ehrmann-Feldman, Debbie

2011-05-01

Our objective was to explore how individual and primary healthcare (PHC) organizational attributes influence patients' ability in chronic illness self-management. We conducted a cohort study, recruiting 776 adults with chronic disease from 33 PHC settings in the province of Quebec. Organizational data on the PHC clinics were obtained from a prior study. Participants were interviewed at baseline, 6 and 12 months, responding to questionnaires on self-efficacy, health status, socio-demographics, healthcare use and experience of care. Multilevel modelling showed that 52.5% of the variance in self-efficacy occurs at the level of the individual and 4.0% at the organizational level. Controlling for diagnosis, patient factors associated with self-efficacy were self-rated health (B coeff 0.76: CI 0.60; 0.92), concurrent depression (B coeff -1.41: CI 1.96; -0.86) and satisfaction with care (B coeff 0.27: CI 0.15; 0.39). None of the organizational attributes was significantly associated with self-efficacy after adjusting for lower-level variables. Patients generally reported receiving little self-management teaching across organizations.

Assessment of Postoperative Analgesic Drug Efficacy

DEFF Research Database (Denmark)

Andersen, Lars Peter Kloster; Gögenur, Ismail; Torup, Henrik

2017-01-01

BACKGROUND: Pain intensity ratings and opioid consumption (OC) are ubiquitous indicators of pain in postoperative trials of the efficacy of interventional procedures. Unfortunately, consensus on the appropriate statistical handling of these outcomes has not been reached. The aim of this article was......, therefore, to reexamine original data obtained from a postoperative analgesic drug trial, applying a collection of standard statistical methods in analgesic outcome assessments. Furthermore, a modified integrated assessment method of these outcomes was evaluated. METHODS: Data from a randomized, double...... also included an integrated assessment of longitudinally measured pain intensity and opioid consumption (PIOC0-6/0-24 h). Also, estimation of effect size, generalized odds ratio of the individual analgesic outcome variables was performed. RESULTS: Sixty-one patients were included in the final data...

The Effect of Self-Assessment on EFL Learners' Self-Efficacy

Science.gov (United States)

Baleghizadeh, Sasan; Masoun, Atieh

2013-01-01

This study investigated the continuous influence of self-assessment on EFL (English as a foreign language) learners' self-efficacy. The participants, divided into an experimental and a control group, were 57 Iranian EFL learners in an English-language institute. The participants' self-efficacy was measured through a questionnaire that was the same…

A randomized, controlled study to assess the efficacy and safety of lotilaner (Credelio™ in controlling ticks in client-owned dogs in Europe

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Daniela Cavalleri

2017-11-01

Full Text Available Abstract Background Oral administration of lotilaner flavoured chewable tablets (Credelio™, Elanco to dogs has been shown to provide a rapid onset of killing activity of infesting ticks, with sustained efficacy for at least 35 days. A study was undertaken in Europe to confirm lotilaner’s safety and anti-tick efficacy in client-owned dogs. Methods In this assessor-blinded study, dogs were enrolled at 19 clinics in Germany, Hungary and Portugal. Qualifying households with no more than three dogs were randomized in an approximate 2:1 ratio to a lotilaner or fipronil/(S-methoprene (FSM (Frontline® Combo Spot-on, Merial treatment group. One household dog with at least three live attached ticks was the primary dog. Treatments were dispensed Days 0, 28 (± 2 and 56 (± 2 for owner administration to all household dogs. Tick counts were performed on primary dogs Days 7 (± 1, and ±2 days on Days 14, 21, 28, 42, 56, 70 and 84; supplementary dogs were assessed for safety ± 2 days on Days 28, 56 and 84. Efficacy was assessed by comparing mean Day 0 live attached tick counts with subsequent counts. Results The most frequently retrieved ticks were Ixodes ricinus, Dermacentor reticulatus and Rhipicephalus sanguineus (sensu lato, with Ixodes hexagonus also present. In the lotilaner group (n = 127 geometric mean tick count reductions were at least 98% from the first post-treatment visit (Day 7 through Day 56, when efficacy was 100%. For FSM (n = 68, efficacy remained at least 96% through Day 84, but at no point were all dogs free of live attached ticks. Mean counts in lotilaner-treated dogs were significantly lower than FSM-treated dogs on Days 7, 42, 70 and 84 (P  98% effective in eliminating live ticks from the first post-treatment assessment (Day 7 through Day 56 and maintained 100% of dogs tick-free on Days 70 and 84. Lotilaner was safe, providing superior tick control to FSM administered according to the same schedule.

Efficacy of carvedilol versus propranolol versus variceal band ligation for primary prevention of variceal bleeding.

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Abd ElRahim, Ayman Yosry; Fouad, Rabab; Khairy, Marwa; Elsharkawy, Aisha; Fathalah, Waleed; Khatamish, Haytham; Khorshid, Omayma; Moussa, Mona; Seyam, Moataz

2018-01-01

Band ligation and propranolol are the current therapies for primary prevention of variceal bleeding. Carvedilol is a rising nonselective beta-blocker used for reducing portal pressure with favorable outcome. The aim of this study to assess the efficacy of carvedilol, propranolol, and band ligation for primary prevention of variceal bleeding based on the effect of each regimen on progression of Child score and portal hypertensive gastropathy after 1 year. The study included 264 cirrhotic patients with medium/large-sized varices who were candidates for primary prophylaxis of variceal bleeding. Patients were randomly divided into three groups: group I: band ligation; group II: propranolol; group III: carvedilol. Group I showed higher success rate of 75 %, followed by group III with 70.2 % and group II with 65.2 %. Risk of bleeding was comparable between the three groups, with group II carrying the highest rate of complications (34.7 %) followed by group III (14.2 %) and finally group I (5.7 %). After 1 year of follow-up, Child score did not improve in any of the studied groups, while portal hypertensive gastropathy significantly increased in group I but decreased in groups II and III. Band ligation is the best treatment option for primary prevention of variceal bleeding with minimal complications. Carvedilol is a good pharmaceutical alternative medicine to propranolol with lesser side-effects. Progress of liver disease as represented by Child score is not affected by any of the primary variceal prophylactic regimens, although medical treatment reduces portal hypertensive gastropathy. Choice of treatment depends on patient will, compliance with treatment, and endoscopist competence.

Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure

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Acker Michael A

2008-05-01

Full Text Available Abstract Background Although orthotopic heart transplantation has been an effective treatment for end-stage heart failure, the incidence of allograft failure has increased, necessitating treatment options. Cardiac retransplantation remains the only viable long-term solution for end-stage cardiac allograft failure. Given the limited number of available donor hearts, the long term results of this treatment option need to be evaluated. Methods 709 heart transplants were performed over a 20 year period at our institution. Repeat cardiac transplantation was performed in 15 patients (2.1%. A retrospective analysis was performed to determine the efficacy of cardiac retransplantation. Variables investigated included: 1 yr and 5 yr survival, length of hospitalization, post-operative complications, allograft failure, recipient and donor demographics, renal function, allograft ischemic time, UNOS listing status, blood group, allograft rejection, and hemodynamic function. Results Etiology of primary graft failure included transplant arteriopathy (n = 10, acute rejection (n = 3, hyperacute rejection (n = 1, and a post-transplant diagnosis of metastatic melanoma in the donor (n = 1. Mean age at retransplantation was 45.5 ± 9.7 years. 1 and 5 year survival for retransplantation were 86.6% and 71.4% respectively, as compared to 90.9% and 79.1% for primary transplantation. Mean ejection fraction was 67.3 ± 12.2% at a mean follow-up of 32.6 ± 18.5 mos post-retransplant; follow-up biopsy demonstrated either ISHLT grade 1A or 0 rejection (77.5 ± 95.7 mos post-transplant. Conclusion Cardiac retransplantation is an efficacious treatment strategy for cardiac allograft failure.

REAL-TIME ASSESSMENT OF MICROWAVE ABLATION EFFICACY BY NIR SPECTROSCOPIC TECHNIQUE

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JINZHE ZHAO

2014-01-01

Full Text Available Microwave ablation (MWA status monitoring in real time plays a key role in assessment of therapeutic effectiveness. As a novel real-time assessment method, near infrared spectroscopy (NIRs was used to evaluate the ablation efficacy. MWA experiments were carried out on in vitro porcine livers. An optical measurement system for biological tissue is developed by our lab to monitor reduced scattering coefficient $(\\mu_{s}^{'}$ at 690 nm of the coagulation zones. It is noted that $\\mu_{s}^{'}$ of liver tissue, which increases as the liver tissue being ablated, is clearly related with the coagulation status. $\\mu_{s}^{'}$ of normal tissue and coagulated tissue is 3–5 and 17–19 cm-1, respectively. Continuous changes of $\\mu_{s}^{'}$ demonstrate that optical parameter can be used as an efficacy evaluation factor because it essentially indicates the degree of thermal damage. Compared with temperature, optical parameter is more sensitive and accurate, which is promising for real-time therapeutic efficacy assessment in MWA.

Assessment of self-efficacy to employ self-initiated pornography use-reduction strategies.

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Kraus, Shane W; Rosenberg, Harold; Tompsett, Carolyn J

2015-01-01

This study evaluated several psychometric properties of a newly developed questionnaire designed to assess individuals' self-efficacy (from 0% to 100%) to employ self-initiated cognitive-behavioral strategies intended to reduce the frequency and duration of their pornography use. Using a web-based data collection procedure, we recruited 1298 male users of pornography to complete questionnaires assessing hypersexuality, pornography use history, and general self-efficacy. Based on a principal component analysis and examination of inter-item correlations, we deleted 13 items from the initial pool of 21 strategies. The resulting 8-item questionnaire had excellent internal consistency reliability, and a moderate mean inter-item correlation considered indicative of unidimensionality. In support of criterion validity, self-efficacy to employ use-reduction strategies was significantly associated with the frequency with which participants used pornography, with scores on a measure of hypersexuality, and with the number of times one had attempted to cut back using pornography. In support of discriminant validity, we found that pornography use-reduction self-efficacy scores were not strongly correlated with general self-efficacy. Both researchers and clinicians could use this questionnaire to assess pornography users' confidence to employ self-initiated strategies intended to reduce the duration and frequency with which they use pornography. Published by Elsevier Ltd.

Root Canal Cleaning Efficacy of Rotary and Hand Files Instrumentation in Primary Molars

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Nazari Moghaddam, Kiumars; Mehran, Majid; Farajian Zadeh, Hamideh

2009-01-01

INTRODUCTION: Pulpectomy of primary teeth is commonly carried out with hand files and broaches; a tricky and time consuming procedure. The purpose of this in vitro study was to compare the cleaning efficacy and time taken for instrumentation of deciduous molars using hand K-files and Flex Master rotary system. MATERIALS AND METHODS: In this study, 68 canals of 23 extracted primary molars with at least two third intact roots and 7-12 mm length were selected. After preparing an access cavity, K-file size #15 was introduced into the root canal and India ink was injected with an insulin syringe. Sixty samples were randomly divided in to experimental groups in group I (n=30), root canals were prepared with hand K-files; in group II (n=30), rotary Flex Master files were used for instrumentation, and in group III 8 remained samples were considered as negative controls. After clearing and root sectioning, the removal of India ink from cervical, middle, and apical thirds was scored. Data was analyzed using student's T-test and Mann-Whitney U test. RESULTS: There was no significant difference between experimental groups cleaning efficacy at the cervical, middle and apical root canal thirds. Only the coronal third scored higher in the hand instrumented group (PInstrumentation with Flex Master rotary files was significantly less time consuming (Protary technique. PMID:23940486

Assessment of Self-Efficacy and its Relationship with Frailty in the Elderly

Science.gov (United States)

Doba, Nobutaka; Tokuda, Yasuharu; Saiki, Keiichirou; Kushiro, Toshio; Hirano, Masumi; Matsubara, Yoshihiro; Hinohara, Shigeaki

2016-01-01

Objective It has been increasingly recognized in various clinical areas that self-efficacy promotes the level of competence in patients. The validity, applicability and potential usefulness of a new, simple model for assessing self-efficacy in the elderly with special reference to frailty were investigated for improving elderly patients' accomplishments. Methods The subjects of the present study comprised 257 elderly people who were members of the New Elder Citizen Movement in Japan and their mean age was 82.3±3.8 years. Interview materials including self-efficacy questionnaires were sent to all participants in advance and all other physical examinations were performed at the Life Planning Center Clinic. Results The internal consistency and close relation among a set of items used as a measure of self-efficacy were evaluated by Cronbach's alpha index, which was 0.79. Although no age-dependent difference was identified in either sex, gender-related differences in some factors were noted. Regarding several parametric parameters, Beck's inventory alone revealed a significant relationship to self-efficacy in both sexes. Additionally, non-parametric items such as stamina, power and memory were strongly correlated with self-efficacy in both sexes. Frailty showed a significant independent relationship with self-efficacy in a multiple linear regression model analysis and using Beck's inventory, stamina, power and memory were identified to be independent factors for self-efficacy. Conclusion The simple assessment of self-efficacy described in this study may be a useful tool for successful aging of elderly people. PMID:27725537

COMPARATIVE STUDY OF EFFICACY OF INJECTION SCLEROTHERAPY VERSUS SURGERY AS PRIMARY MODALITY THERAPY IN PRIMARY VAGINAL HYDROCOELE : A RANDOMISED CONTROL STUDY

OpenAIRE

Jayakarthik; Patil

2015-01-01

CONTEXT (BACKGROUND): Primary/Idiopathic hydrocele is defined as an abnormal collection of serous fluid in tunica vaginalis whose cause is not known as it is neither associated with the disease of testis or epididymis. Surgery is considered as a definitive treatment, though th e reason of injection treatment falling out of favour is ill understood as studies have shown this technique to be efficacious, safe, cost effective treatment modality in idiopathic hydroceles. This...

Clinical Efficacy and Safety of Benjakul Remedy Extract for Treating Primary Osteoarthritis of Knee Compared with Diclofenac: Double Blind, Randomized Controlled Trial

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Patamaporn Rachawat

2017-01-01

Full Text Available Background. The purpose of this study was to investigate the clinical efficacy and safety of Benjakul (BJK extract for treating primary osteoarthritis (OA of the knee compared with diclofenac. Methods. A phase 2, double blind, randomized, and controlled study was conducted. The BJK group received 300 mg of BJK extract per day, while another group received 75 mg of diclofenac per day. All patients were followed up at 14 and 28 days. The changing of visual analogue scale (VAS for pain, 100-meter walking times, the modified Thai WOMAC index scores, and the global assessment were evaluated for efficacy. For safety issue, clinical signs and symptoms, complete physical examination, and renal and liver function were evaluated. Results. 39 and 38 patients for BJK extract group and diclofenac group were evaluated. For efficacy, all patients from both groups reported a decrease in the VAS pain score and 100-meter walking times but only the diclofenac group showed significant reduction of both measurements when compared with day 0. The modified Thai WOMAC scores of both groups were significantly reduced from baseline. However, all efficacy outcomes were not significantly different for both groups. For safety outcomes, the patients from both groups had no severe adverse events reported and only BJK had no toxicity in renal and liver functions. Conclusions. The BJK remedy extract showed equal clinical efficacy in relieving symptoms of OA knee when compared with diclofenac.

Comparing the Effectiveness of Cognitive Behavioral Therapy and Hypnosis Therapy Pain Self-Efficacy and Pain Severity in Girls with Primary Dysmenorrhea

OpenAIRE

F Farshbaf Manei Sefat; A Abolghasemi; U Barahmand; N Hajloo

2017-01-01

ABSTRACT   Background & aim: Menstruation as an important issue in adolescence and menstrual pain is a common problem in adolescents. Regarding the relationship between pain severity and  pain self-efficacy, this study aimed to investigate and compare the efficacy of cognitive-behavioral therapy and hypnosis therapy on pain and pain self-efficacy in girls with primary dysmenorrhea.   Methods: The method of research is Quasi experimental and research design is pretes...

Assessing primary care data quality.

Science.gov (United States)

Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

Evaluation of the efficacy of rotary vs. hand files in root canal preparation of primary teeth in vitro using CBCT.

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Musale, P K; Mujawar, S A V

2014-04-01

This in vitro study aimed to evaluate the efficacy of rotary ProFile, ProTaper, Hero Shaper and K-files in shaping ability, cleaning efficacy, preparation time and instrument distortion in primary molars. Sixty extracted primary mandibular second molars were divided into four equal groups: Group I K-file, Group II ProFile, Group III ProTaper file and Group IV Hero Shaper file. The shaping ability was determined by comparing pre- and post-instrumentation CBCT scans and data analysed with SPSS program using the Chi-square test. Cleaning efficacy was evaluated by the degree of India ink removal from the canal walls under stereomicroscopy. Instrumentation times were calculated for each tooth and instrument distortion was visually checked and duly noted. The cleaning efficacy and instrumentation time were determined using ANOVA with Tukey's correction. Instrument distortion was analysed using Chi-square test. The canal taper was significantly more conical for rotary files as compared to K-files with Chi-square test (p < 0.05). Cleaning efficacy of rotary files with average scores (Groups II- 0.68, III- 0.48 and IV- 0.58) was significantly better than K-files (Group I- 0.93) (p < 0.05). Mean instrumentation time with K-file (20.7 min) was significantly higher than rotary files (Groups II 8.9, III 5.6, and IV 8.1 min) (p < 0.05). Instrument distortion was observed in Group I (4.3%), while none of the rotary files were distorted. Rotary files prepared more conical canals in primary teeth than manual instruments. Reduced preparation time with rotary files enhances patient cooperation especially in young children.

Assessment and management of suicide risk in primary care.

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Saini, Pooja; While, David; Chantler, Khatidja; Windfuhr, Kirsten; Kapur, Navneet

2014-01-01

Risk assessment and management of suicidal patients is emphasized as a key component of care in specialist mental health services, but these issues are relatively unexplored in primary care services. To examine risk assessment and management in primary and secondary care in a clinical sample of individuals who were in contact with mental health services and died by suicide. Data collection from clinical proformas, case records, and semistructured face-to-face interviews with general practitioners. Primary and secondary care data were available for 198 of the 336 cases (59%). The overall agreement in the rating of risk between services was poor (overall κ = .127, p = .10). Depression, care setting (after discharge), suicidal ideation at last contact, and a history of self-harm were associated with a rating of higher risk. Suicide prevention policies were available in 25% of primary care practices, and 33% of staff received training in suicide risk assessments. Risk is difficult to predict, but the variation in risk assessment between professional groups may reflect poor communication. Further research is required to understand this. There appears to be a relative lack of suicide risk assessment training in primary care.

Using ICR and SCID mice as animal models for smallpox to assess antiviral drug efficacy.

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Titova, Ksenya A; Sergeev, Alexander A; Zamedyanskaya, Alena S; Galahova, Darya O; Kabanov, Alexey S; Morozova, Anastasia A; Bulychev, Leonid E; Sergeev, Artemiy A; Glotova, Tanyana I; Shishkina, Larisa N; Taranov, Oleg S; Omigov, Vladimir V; Zavjalov, Evgenii L; Agafonov, Alexander P; Sergeev, Alexander N

2015-09-01

The possibility of using immunocompetent ICR mice and immunodeficient SCID mice as model animals for smallpox to assess antiviral drug efficacy was investigated. Clinical signs of the disease did not appear following intranasal (i.n.) challenge of mice with strain Ind-3a of variola virus (VARV), even when using the highest possible dose of the virus (5.2 log10 p.f.u.). The 50 % infective doses (ID50) of VARV, estimated by the virus presence or absence in the lungs 3 and 4 days post-infection, were 2.7 ± 0.4 log10 p.f.u. for ICR mice and 3.5 ± 0.7 log10 p.f.u. for SCID mice. After i.n. challenge of ICR and SCID mice with VARV 30 and 50 ID50, respectively, steady reproduction of the virus occurred only in the respiratory tract (lungs and nose). Pathological inflammatory destructive changes were revealed in the respiratory tract and the primary target cells for VARV (macrophages and epithelial cells) in mice, similar to those in humans and cynomolgus macaques. The use of mice to assess antiviral efficacies of NIOCH-14 and ST-246 demonstrated the compliance of results with those described in scientific literature, which opens up the prospect of their use as an animal model for smallpox to develop anti-smallpox drugs intended for humans.

Efficacy of Mindfulness-Based Cognitive Therapy on Late Post-Treatment Pain in Women Treated for Primary Breast Cancer: A Randomized Controlled Trial.

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Johannsen, Maja; O'Connor, Maja; O'Toole, Mia Skytte; Jensen, Anders Bonde; Højris, Inger; Zachariae, Robert

2016-10-01

To assess the efficacy of mindfulness-based cognitive therapy (MBCT) for late post-treatment pain in women treated for primary breast cancer. A randomized wait list-controlled trial was conducted with 129 women treated for breast cancer reporting post-treatment pain (score ≥ 3 on pain intensity or pain burden assessed with 10-point numeric rating scales). Participants were randomly assigned to a manualized 8-week MBCT program or a wait-list control group. Pain was the primary outcome and was assessed with the Short Form McGill Pain Questionnaire 2 (SF-MPQ-2), the Present Pain Intensity subscale (the McGill Pain Questionnaire), and perceived pain intensity and pain burden (numeric rating scales). Secondary outcomes were quality of life (World Health Organization-5 Well-Being Index), psychological distress (the Hospital Depression and Anxiety Scale), and self-reported use of pain medication. All outcome measures were assessed at baseline, postintervention, and 3-month and 6-month follow-up. Treatment effects were evaluated with mixed linear models. Statistically significant time × group interactions were found for pain intensity (d = 0.61; P = .002), the Present Pain Intensity subscale (d = 0.26; P = .026), the SF-MPQ-2 neuropathic pain subscale (d = 0.24; P = .036), and SF-MPQ-2 total scores (d = 0.23; P = .036). Only pain intensity remained statistically significant after correction for multiple comparisons. Statistically significant effects were also observed for quality of life (d = 0.42; P = .028) and nonprescription pain medication use (d = 0.40; P = .038). None of the remaining outcomes reached statistical significance. MBCT showed a statistically significant, robust, and durable effect on pain intensity, indicating that MBCT may be an efficacious pain rehabilitation strategy for women treated for breast cancer. In addition, the effect on neuropathic pain, a pain type reported by women treated for breast cancer, further suggests the potential of MBCT but

Self Efficacy and Some Demographic Variables as Predictors of Occupational Stress among Primary School Teachers in Delta State of Nigeria

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Akpochafo, G. O.

2014-01-01

This study investigated self efficacy and some demographic variables as predictors of occupational stress among primary school teachers in Delta State. Three hypotheses were formulated to guide the study. The study adopted a descriptive survey design that utilized an expost-facto research type. A sample of one hundred and twenty primary school…

The efficacy of IntraFlow intraosseous injection as a primary anesthesia technique.

Science.gov (United States)

Remmers, Todd; Glickman, Gerald; Spears, Robert; He, Jianing

2008-03-01

The purpose of this study was to compare the efficacy of intraosseous injection and inferior alveolar (IA) nerve block in anesthetizing mandibular posterior teeth with irreversible pulpitis. Thirty human subjects were randomly assigned to receive either intraosseous injection using the IntraFlow system (Pro-Dex Inc, Santa Ana, CA) or IA block as the primary anesthesia method. Pulpal anesthesia was evaluated via electric pulp testing at 4-minute intervals for 20 minutes. Two consecutive 80/80 readings were considered successful pulpal anesthesia. Anesthesia success or failure was recorded and groups compared. Intraosseous injection provided successful anesthesia in 13 of 15 subjects (87%). The IA block provided successful anesthesia in 9 of 15 subjects (60%). Although this difference was not statistically significant (p = 0.2148), the results of this preliminary study indicate that the IntraFlow system can be used as the primary anesthesia method in teeth with irreversible pulpitis to achieve predictable pulpal anesthesia.

A randomized controlled trial testing the efficacy of a brief cannabis universal prevention program among adolescents in primary care.

Science.gov (United States)

Walton, Maureen A; Resko, Stella; Barry, Kristen L; Chermack, Stephen T; Zucker, Robert A; Zimmerman, Marc A; Booth, Brenda M; Blow, Frederic C

2014-05-01

To examine the efficacy of a brief intervention delivered by a therapist (TBI) or a computer (CBI) in preventing cannabis use among adolescents in urban primary care clinics. A randomized controlled trial comparing: CBI and TBI versus control. Urban primary care clinics in the United States. Research staff recruited 714 adolescents (aged 12-18 years) who reported no life-time cannabis use on a screening survey for this study, which included a baseline survey, randomization (stratified by gender and grade) to conditions (control; CBI; TBI) and 3-, 6- and 12-month assessments. Using an intent-to-treat approach, primary outcomes were cannabis use (any, frequency); secondary outcomes included frequency of other drug use, severity of alcohol use and frequency of delinquency (among 85% completing follow-ups). Compared with controls, CBI participants had significantly lower rates of any cannabis use over 12 months (24.16%, 16.82%, respectively, P cannabis use at 3 and 6 months (P cannabis use or frequency, but had significantly less other drug use at 3 months (P prevent and reduce cannabis use. Both computer and therapist delivered brief interventions appeared to have small effects in reducing other risk behaviors, but these dissipated over time. © 2013 Society for the Study of Addiction.

The Use of the Puzzle Box as a Means of Assessing the Efficacy of Environmental Enrichment

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O'Connor, Angela M.; Burton, Thomas J.; Leamey, Catherine A.; Sawatari, Atomu

2014-01-01

Environmental enrichment can dramatically influence the development and function of neural circuits. Further, enrichment has been shown to successfully delay the onset of symptoms in models of Huntington’s disease 1-4, suggesting environmental factors can evoke a neuroprotective effect against the progressive, cellular level damage observed in neurodegenerative disorders. The ways in which an animal can be environmentally enriched, however, can vary considerably. Further, there is no straightforward manner in which the effects of environmental enrichment can be assessed: most methods require either fairly complicated behavioral paradigms and/or postmortem anatomical/physiological analyses. This protocol describes the use of a simple and inexpensive behavioral assay, the Puzzle Box 5-7 as a robust means of determining the efficacy of increased social, sensory and motor stimulation on mice compared to cohorts raised in standard laboratory conditions. This simple problem solving task takes advantage of a rodent’s innate desire to avoid open enclosures by seeking shelter. Cognitive ability is assessed by adding increasingly complex impediments to the shelter’s entrance. The time a given subject takes to successfully remove the obstructions and enter the shelter serves as the primary metric for task performance. This method could provide a reliable means of rapidly assessing the efficacy of different enrichment protocols on cognitive function, thus paving the way for systematically determining the role specific environmental factors play in delaying the onset of neurodevelopmental and neurodegenerative disease. PMID:25590345

Medicinal plants for primary dysmenorrhoea: A systematic review.

Science.gov (United States)

Pellow, Janice; Nienhuis, Chantelle

2018-04-01

Primary dysmenorrhoea is a common complaint experienced by many females in their reproductive years. The use of medicinal plants in the treatment of various gynaecological conditions is on the increase, despite the limited evidence available regarding efficacy and safety of their use. The aim of this systematic review was to synthesise the most recent evidence relating to the treatment of primary dysmenorrhoea with medicinal plants. A thorough database search was conducted using defined search terms, and randomised controlled trials (RCTs) published in English between 2008 and 2016, pertaining to the use of medicinal plants (single use) for the treatment of primary dysmenorrhoea, were assessed. Studies evaluating dysmenorrhoeal pain and associated symptoms as a primary or secondary outcome were considered and assessed by two reviewers independently of each other, using the JADAD scale and the Cochrane risk of bias tool,. 22 RCTs were included in the review; 9 were placebo-controlled trials and 13 were comparative studies to pharmacological treatment or nutritional supplements. Most of the evaluated medicinal plants showed evidence of efficacy in relieving menstrual pain in at least one RCT. The low or unclear quality of the majority of these studies however warrants caution in interpreting these results. This review adds to the knowledge-base on the use of these medicinal plants in the treatment of primary dysmenorrhoea. Further research is needed before definitive conclusions can be made regarding the efficacy and safety of the use of these medicinal plants. Copyright © 2018 Elsevier Ltd. All rights reserved.

Captopril 25 mg tablets stability assessment in different primary packing materials

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Flávia Costa Mendes Paiva

2017-11-01

Full Text Available Introduction: Packaging is used to provide protection and information, from the production to the administration of a formulation. It is essential to define the primary packaging, for keeping the therapeutic efficacy of drugs, safety of users and for protecting drugs from instability. Objectives: The main objective of this study was to assess the stability of captopril 25 mg tablets in different primary packaging materials. Method: The characterization (IR, DSC and physical tests of the packaging materials used for captopril was carried out prior to the manufacture of tablets. Tablets were also characterized by physical-chemical analysis, comparative dissolution profile and stability studies. Results: The characterization of packaging materials was crucial for understanding the behavior of captopril when packed in each material. Materials with significant barrier, as blisters PVC/PVdC 90 g.m-² and hard aluminum and PVC/PE/PVdC and hard aluminum showed satisfactory results in a second stage, S2. On the contrary, lower barrier materials as blisters PVC/PVdC 40 g.m-² and hard aluminum did not present dissolution analysis S2. Conclusions: The aluminum strip presented the best results. And the batch in glass bottle, although packaged in excellent material, was disapproved in accelerated stability.

Efficacy and tolerability of fixed-combination bimatoprost/timolol versus fixed-combination dorzolamide/brimonidine/timolol in patients with primary open-angle glaucoma or ocular hypertension: a multicenter, prospective, crossover study.

Science.gov (United States)

García-López, Alfonso; Paczka, José A; Jiménez-Román, Jesús; Hartleben, Curt

2014-12-19

Fixed-combination ocular hypotensives have multiple advantages, but triple-therapy dorzolamide/brimonidine/timolol (dorz/brim/tim) is only available in Latin and South America, and information on its relative efficacy is limited. This study compares the efficacy and tolerability of fixed-combination bimatoprost/timolol (bim/tim) and dorz/brim/tim in Mexican patients with primary open-angle glaucoma or ocular hypertension. In this investigator-masked, crossover study, patients with unmet target intraocular pressure (IOP) on once-daily bim/tim or twice-daily dorz/brim/tim received the opposite medication for 3 months before returning to their pre-baseline medication for 3 months. IOP was evaluated before and after morning instillation at months 2, 3, 5 and 6. Primary endpoints were mean IOP change and Ocular Surface Disease Index© (OSDI) score at each visit. The intent-to-treat population was the a priori analysis population, but due to the number of discontinuations, the per-protocol and intent-to-treat populations were used for the primary efficacy and sensitivity analyses, respectively. Seventy-eight and 56 patients were included in the intent-to-treat and per-protocol populations, respectively. At month 3, statistically significant IOP reductions from baseline were observed in the bim/tim (P < 0.01) and dorz/brim/tim (P < 0.0001) groups, regardless of assessment time. At month 6, patients returned to bim/tim exhibited no significant IOP increase (regardless of assessment time), but patients returned to dorz/brim/tim exhibited a statistically significant IOP increase (P < 0.001) when assessed before instillation of study treatment. Results were similar in both intent-to-treat and per-protocol analysis populations. In the per-protocol analysis, 70% of patients on bim/tim at month 3 had an IOP <14 mm Hg, which declined to 58% (P = 0.0061) at month 6 (ie, after 3 months of dorz/brim/tim treatment). In patients receiving dorz/brim/tim at month 3

Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: a meta-analysis

Directory of Open Access Journals (Sweden)

Oghenowede Eyawo

2009-07-01

Full Text Available Oghenowede Eyawo1, Jean Nachega2,3, Pierre Lefebvre4, David Meyer5, Beth Rachlis6, Chia-Wen Lee7, Steven Kelly7, Edward Mills81Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; 2Division of Clinical Pharmacology and Medicine, University of Cape Town, Cape Town, South Africa; 3Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; 4Department of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; 5Department of Ophthalmology, Stellenbosch University, Cape Town, South Africa; 6Department of Public Health, University of Toronto, Toronto, Canada; 7Outcome Research and Evidence Based Medicine, Pfizer Ltd UK. Tadworth, UK; 8Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, CanadaBackground: First-line therapy for primary open-angle glaucoma and ocular hypertension generally involves prostaglandin analogue therapy. The relative efficacy of differing prostaglandin therapy is disputed.Methods: A meta-analysis was conducted of head-to-head randomized trials of prostaglandin therapies. We included randomized trials assessing head-to-head evaluations of prostaglandin analogues travoprost, latanoprost and bimatoprost in patients with predominantly primary open-angle glaucoma or ocular hypertension. Findings were interpreted in light of equivalence margins.Results: Our search identified 16 eligible trials, of which 15 were included in the meta-analysis. Trials were, in general, poorly reported. We pooled 9 trials assessing IOP-lowering effects of travoprost vs latanoprost (total n = 1098, weighted mean difference [WMD], –0.24 mmHg, 95% CI, –0.87 to 0.38, P = 0.45, I2 = 56%, 95% CI, 0 to 0.77, heterogeneity P = 0.01. Eight trials assessed travoprost vs bimatoprost (total n = 714, WMD, 0.88 mmHg, 95% CI, 0.13 to 1.63, P = 0.02, I2 = 56%, 95% CI, 0% to 78%, heterogeneity P = 0.02. And 8 trials assessed latanoprost vs bimatoprost (total n = 943, WMD, 0.73 mmHg, 95% CI, 0.10 to 1

Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars.

Science.gov (United States)

Elbay, Ülkü Şermet; Elbay, Mesut; Kaya, Emine; Yıldırım, Sinem

The purpose of the study was to compare the efficacy, injection pain, duration of soft tissue anesthesia, and postoperative complications of two different anesthetics (2% lidocaine with 1:80,000 epinephrine and 3% plain mepivacaine) in pediatric patients in inferior alveolar nerve block (IANB) administered by a computer-controlled delivery system (CCDS). The study was conducted as a randomized, controlled-crossover, double-blind clinical trial with 60 children requiring bilateral pulpotomy or extraction of primary mandibular molars. A CCDS was used to deliver 3% mepivacaine to 1 primary tooth and 2% lidocaine to the contralateral tooth with an IANB technique. Severity of pain and efficacy of anesthesia were evaluated using the Face, Legs, Activity, Cry, Consolability Scale, and comfort and side effects were assessed using a questionnaire. Data were analyzed using the Mann-Whitney U, Wilcoxon t, and Fisher exact tests. Patients receiving 2% lidocaine experienced significantly less pain during injection than those receiving 3% mepivacaine, and no significant differences were found in the pain scores during treatments or in postoperative complications between the two anesthetics. The mean durations of anesthesia for 3% mepivacaine and 2% lidocaine were 139.68 minutes and 149.10 minutes, respectively. Plain mepivacaine and 2% lidocaine were similarly effective in pulpotomy and the extraction of primary mandibular molars. Although the use of 3% mepivacaine provided a shorter duration of anesthesia than 2% lidocaine, both solutions showed similar results in terms of postoperative complications.

EFFICACY AND SAFETY OF LIPID-LOWERING DRUGS IN PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES IN THE ELDERLY

Directory of Open Access Journals (Sweden)

E. A. Ushkalova

2016-01-01

Full Text Available Effect of hyperlipidemia on morbidity and mortality in elderly patients is considered. Authors also cover issues of efficacy and safety of lipid-lowering therapy in primary and secondary prevention of cardiovascular diseases in patients ≥80 years of age who are the most quickly growing group of population and have the highest cardiovascular risk. They stress the need to take into account polymorbidity and polypharmacy that increase the risk of adverse reactions due to the use of both statins and their drug-drug interactions, which requires an assessment of risk/benefit ratio. In addition, there is a need for development of reliable prognostic tools to predict relevant outcomes (e.g., stroke, decrease in functionality/independence, quality of life reduction and rationales for lipid-lowering therapy in the elderly and also their adherence to treatment.

Primary data collection in health technology assessment.

Science.gov (United States)

McIsaac, Michelle L; Goeree, Ron; Brophy, James M

2007-01-01

This study discusses the value of primary data collection as part of health technology assessment (HTA). Primary data collection can help reduce uncertainty in HTA and better inform evidence-based decision making. However, methodological issues such as choosing appropriate study design and practical concerns such as the value of collecting additional information need to be addressed. The authors emphasize the conditions required for successful primary data collection in HTA: experienced researchers, sufficient funding, and coordination among stakeholders, government, and researchers. The authors conclude that, under specific conditions, primary data collection is a worthwhile endeavor in the HTA process.

A polysomnographic placebo-controlled evaluation of the efficacy and safety of eszopiclone relative to placebo and zolpidem in the treatment of primary insomnia.

Science.gov (United States)

Erman, Milton K; Zammit, Gary; Rubens, Robert; Schaefer, Kendyl; Wessel, Thomas; Amato, David; Caron, Judy; Walsh, James K

2008-06-15

To evaluate the polysomnographic efficacy and the safety of a range of doses of eszopiclone relative to placebo in patients with primary insomnia. Zolpidem 10 mg was included as an active control. This multicenter, randomized, crossover study enrolled patients aged 21-64 years meeting the DSM-IV criteria for primary insomnia (n = 65). Patients received 2 nights treatment each with placebo, eszopiclone 1 mg, 2 mg, 2.5 mg, or 3 mg, and zolpidem 10 mg after randomization to one of 6 treatment sequences. Visits were separated by a 3-7 day washout. Objective efficacy was assessed by polysomnography (PSG). The primary endpoint was latency to persistent sleep (LPS); key secondary endpoints were sleep efficiency (SE) and wake time after sleep onset (WASO); other endpoints included wake time during sleep (WTDS) and number of awakenings (NAW), as well as patient-reported variables. LPS and SE were significantly different than placebo for all active treatments (p zolpidem 10 mg or the other eszopiclone doses. The incidence of central nervous system adverse events was 23.4% for zolpidem 10 mg, 6.2% to 12.5% for the eszopiclone doses, and 7.9% for placebo. Relative to placebo, all active treatments were effective in reducing LPS and increasing SE. Eszopiclone 3 mg was significantly different from placebo on the 3 PSG measures of sleep maintenance (WASO, WTDS, and NAW). Significant differences between zolpidem 10 mg and eszopiclone (2 mg or 3 mg) were not observed for PSG-measured outcomes, although the study was not powered to detect differences between the active drug conditions.

Efficacy of escitalopram compared to citalopram: a meta-analysis.

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Montgomery, Stuart; Hansen, Thomas; Kasper, Siegfried

2011-03-01

The aim of this review was to assess the clinical relevance of the relative antidepressant efficacy of escitalopram and citalopram by meta-analysis. Studies in major depressive disorder (MDD) with both escitalopram and citalopram treatment arms were identified. Adult patients had to meet DSM-IV criteria for MDD. The primary outcome measure was the treatment difference in Montgomery-Asberg Depression Rating Scale (MADRS) total score at week 8 (or last assessment if escitalopram, n=995; citalopram, n=1014). Escitalopram was significantly more effective than citalopram in overall treatment effect, with an estimated mean treatment difference of 1.7 points at week 8 (or last assessment if escitalopram. In this meta-analysis, the statistically significant superior efficacy of escitalopram compared to citalopram was shown to be clinically relevant.

Anesthetic efficacy of a repeated intraosseous injection following a primary intraosseous injection.

Science.gov (United States)

Jensen, Joanne; Nusstein, John; Drum, Melissa; Reader, Al; Beck, Mike

2008-02-01

The purpose of this prospective, randomized, single-blinded study was to determine the anesthetic efficacy of a repeated intraosseous injection given 30 minutes after a primary intraosseous injection. Using a crossover design, 55 subjects randomly received a primary X-tip intraosseous injection (Dentsply Inc, York, PA) of 1.4 mL of 2% lidocaine with epinephrine (using the Wand; Milestone Scientific, Deerfield, IL) and a repeated intraosseous or mock injection at 30 minutes in two appointments. The first molar and adjacent teeth were pulp tested every 2 minutes for a total of 120 minutes. Success was defined as obtaining two consecutive 80 readings with the electric pulp tester. Success of the initial intraosseous injection was 100% for the first molar. The repeated intraosseous injection mimicked the initial intraosseous injection in terms of pulpal anesthesia and statistically provided another 15 minutes of pulpal anesthesia. In conclusion, using the methodology presented, repeating the intraosseous injection 30 minutes after an initial intraosseous injection will provide an additional 15 minutes of pulpal anesthesia.

CT-Guided, Ethanol Sympatholysis for Primary Axillary–Palmar Hyperhidrosis

Energy Technology Data Exchange (ETDEWEB)

Tsitskari, Maria, E-mail: mariadote@hotmail.com [American Medical Center, Vascular & Interventional Radiology (Cyprus); Friehs, Gerhard, E-mail: gerhardf@amc.com.cy; Zerris, Vassilis, E-mail: vassilisz@amc.com.cy [American Medical Center, Neurosurgery (Cyprus); Georgiades, Christos, E-mail: g-christos@hotmail.com [Johns Hopkins Hospital, Vascular & Interventional Radiology (United States)

2016-12-15

PurposePrimary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis.Materials and MethodsNine consecutive patients with axillary–palmar hyperhidrosis were treated between 2013 and 2015. CT-guided sympathetic block was performed in the outpatients at T-2, T-3, and T-4, bilaterally using alcohol under local anesthesia. Immediate postprocedure CT was obtained to assess the complications as per Common Terminology Criteria for Adverse Events, version 4. Technical success and clinical success were recorded. Primary and secondary efficacy were assessed by phone and clinical visits; mean follow-up was 12 months (6–26 months). Descriptive statistics was used to report the outcomes.ResultsOne procedure was aborted due to eyelid ptosis after lidocaine injection. All other eight patients (5:3, F:M) (median age 32) had immediate cessation of sweating. Two major complications (pneumothorax, one requiring a chest tube) occurred. Two patients recurred with unilateral and one with bilateral symptoms. One of the unilateral recurrence and the bilateral recurrence patients was retreated successfully. Median follow-up was 1 year. No cases of Horner’s or compensatory hyperhidrosis were observed.ConclusionsCT-guided EtOH sympatholysis for axillary/palmar primary hyperhidrosis is feasible. Technical failure rate was 11 %. Primary and secondary efficacy are 75 and 94 %, respectively, to a median follow-up of 1 year. Risk profile appears favorable. Despite a small sample size, results confirm feasibility and encourage a larger study.

Efficacy of interventions to increase the uptake of chlamydia screening in primary care: a systematic review

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Donovan Basil

2011-08-01

Full Text Available Abstract Background As most genital chlamydia infections are asymptomatic, screening is the main way to detect and cases for treatment. We undertook a systematic review of studies assessing the efficacy of interventions for increasing the uptake of chlamydia screening in primary care. Methods We reviewed studies which compared chlamydia screening in the presence and the absence of an intervention. The primary endpoints were screening rate or total tests. Results We identified 16 intervention strategies; 11 were randomised controlled trials and five observational studies, 10 targeted females only, five both males and females, and one males only. Of the 15 interventions among females, six were associated with significant increases in screening rates at the 0.05 level including a multifaceted quality improvement program that involved provision of a urine jar to patients at registration (44% in intervention clinics vs. 16% in the control clinic; linking screening to routine Pap smears (6.9% vs. 4.5%, computer alerts for doctors (12.2% vs. 10.6%; education workshops for clinic staff; internet-based continuing medical education (15.5% vs. 12.4%; and free sexual health consultations (16.8% vs. 13.2%. Of the six interventions targeting males, two found significant increases including the multifaceted quality improvement program in which urine jars were provided to patients at registration (45% vs. 15%; and the offering by doctors of a test to all presenting young male clients, prior to consultation (29 vs. 4%. Conclusions Interventions that promoted the universal offer of a chlamydia test in young people had the greatest impact on increasing screening in primary care.

Promoting Assessment Efficacy through an Integrated System for Online Clinical Assessment of Practical Skills

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Hay, Peter J.; Engstrom, Craig; Green, Anita; Friis, Peter; Dickens, Sue; Macdonald, Doune

2013-01-01

This paper presents evaluation outcomes from an externally funded research project involving the online clinical assessment of practical skills (eCAPS) using web-based video technologies within a university medical programme. eCAPS was implemented to trial this web-based approach for promoting the efficacy of "practical" skills…

Frequency and Efficacy of Talk-Related Tasks in Primary Science

Science.gov (United States)

Braund, Martin; Leigh, Joanne

2013-04-01

Pupil talk and discussion are seen as having important social and cognitive outcomes. In science classes, pupils' collaborative talk supports the construction of meaning and helps examine the status of evidence, theory and knowledge. However, pupil interactive talk in groups is rare in science lessons. The research reported is part of a project to increase the amount of pupil-pupil talk in primary schools through a programme of teaching and professional development. Pupils' self-reports of the frequency and learning efficacies of talk related activities in science lessons were collected before and after a programme of teaching in 24 schools in one of the most socially and educationally deprived areas of England. Findings showed pupils valued talking about their ideas over listening to those of other pupils. Science talk frequency (STF) was closely correlated with science talk efficacy (STE) and both were positively correlated with pupils' attitudes to school science. Analysis of covariance (ANCOVA) of the correlation of STF with STE showed values were independent of gender and ability but that school experience was a significant factor. After the teaching programme and, contrary to expectations, the frequency of talk activities in science lessons appeared to have decreased but varied according to class grades. The degree of correlation between STF and STE was stronger after the teaching in over half of the schools. Schools where STF/STE strengthened most as a result of teaching were those involved in an additional initiative to use modelled talk related to industrial contexts.

Comparison of the efficacy of two anesthetic techniques of mandibular primary first molar: A randomized clinical trial

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Davood Ghasemi Tudeshchoie

2013-01-01

Full Text Available Background: The most common technique to anesthetize mandibular primary teeth is inferior alveolar (I.A nerve block injection which induces a relatively sustained anesthesia and in turn may potentially traumatize soft-tissues. Therefore, the need of having an alternative technique of anesthesia with a shorter term but the same efficacy is reasonable. The aim of this study was a comparison of the efficacy of two anesthetic techniques of mandibular primary first molar. Materials and Methods: In this randomized crossover clinical trial, 40 children with ages ranged from 5 years to 8 years whose mandibular primary first molars were eligible for pulpotomy, were selected and divided randomly into two groups. The right and left mandibular first molars of group A were anesthetized with infiltration and I. A nerve block techniques in the first and second sessions respectively. The left and right mandibular first molars of group B were anesthetized with I.A nerve block and infiltration techniques in the first and second sessions respectively. The severity of pain were measured and recorded according to sound-eye-motor scale by a certain person. Data was analyzed using Wilcoxon Signed Rank and Mann-Whitney U tests (P < 0.05. Results: The severity of pain was lower in infiltration technique versus I.A nerve block. There were no significant differences between the severities of pain on pulpal exposure of two techniques. Conclusion: It seems that infiltration technique is more favorable to anesthetize the mandibular primary first molar compared to I.A nerve block.

Pitavastatin demonstrates long-term efficacy, safety and tolerability in elderly patients with primary hypercholesterolaemia or combined (mixed) dyslipidaemia

DEFF Research Database (Denmark)

Stender, Steen; Budinski, Dragos; Hounslow, Neil

2013-01-01

Aims: To assess the long-term efficacy, safety and tolerability of pitavastatin (2 and 4 mg) in elderly patients (≥65 years of age) with primary hypercholesterolaemia or combined (mixed) dyslipidaemia.Design: Patients (n = 545) who had completed a 12-week double-blind comparative study (core study...... Cholesterol Education Program Adult Treatment Plan III (NCEP ATP III) targets for low-density lipoprotein cholesterol (LDL-C) was determined.Results: Of the patients enrolled, 539 received at least one dose of pitavastatin (safety population: men, 45.5%; Caucasian, 99.1%; mean age, 70.3 years; range, 65......-89 years). Only 17% of patients required up-titration to pitavastatin 4 mg. After 60 weeks, NCEP ATP III and EAS targets were attained by 93.8% and 89.0% of patients, respectively. Plasma LDL-C declined by 43.4% and high-density lipoprotein cholesterol increased by 9.6% versus core-study baseline values...

Development and initial validation of primary care provider mental illness management and team-based care self-efficacy scales.

Science.gov (United States)

Loeb, Danielle F; Crane, Lori A; Leister, Erin; Bayliss, Elizabeth A; Ludman, Evette; Binswanger, Ingrid A; Kline, Danielle M; Smith, Meredith; deGruy, Frank V; Nease, Donald E; Dickinson, L Miriam

Develop and validate self-efficacy scales for primary care provider (PCP) mental illness management and team-based care participation. We developed three self-efficacy scales: team-based care (TBC), mental illness management (MIM), and chronic medical illness (CMI). We developed the scales using Bandura's Social Cognitive Theory as a guide. The survey instrument included items from previously validated scales on team-based care and mental illness management. We administered a mail survey to 900 randomly selected Colorado physicians. We conducted exploratory principal factor analysis with oblique rotation. We constructed self-efficacy scales and calculated standardized Cronbach's alpha coefficients to test internal consistency. We calculated correlation coefficients between the MIM and TBC scales and previously validated measures related to each scale to evaluate convergent validity. We tested correlations between the TBC and the measures expected to correlate with the MIM scale and vice versa to evaluate discriminant validity. PCPs (n=402, response rate=49%) from diverse practice settings completed surveys. Items grouped into factors as expected. Cronbach's alphas were 0.94, 0.88, and 0.83 for TBC, MIM, and CMI scales respectively. In convergent validity testing, the TBC scale was correlated as predicted with scales assessing communications strategies, attitudes toward teams, and other teamwork indicators (r=0.25 to 0.40, all statistically significant). Likewise, the MIM scale was significantly correlated with several items about knowledge and experience managing mental illness (r=0.24 to 41, all statistically significant). As expected in discriminant validity testing, the TBC scale had only very weak correlations with the mental illness knowledge and experience managing mental illness items (r=0.03 to 0.12). Likewise, the MIM scale was only weakly correlated with measures of team-based care (r=0.09 to.17). This validation study of MIM and TBC self-efficacy scales

Formative and summative assessment of science in English primary schools: evidence from the Primary Science Quality Mark

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Earle, Sarah

2014-05-01

Background:Since the discontinuation of Standard Attainment Tests (SATs) in science at age 11 in England, pupil performance data in science reported to the UK government by each primary school has relied largely on teacher assessment undertaken in the classroom. Purpose:The process by which teachers are making these judgements has been unclear, so this study made use of the extensive Primary Science Quality Mark (PSQM) database to obtain a 'snapshot' (as of March 2013) of the approaches taken by 91 English primary schools to the formative and summative assessment of pupils' learning in science. PSQM is an award scheme for UK primary schools. It requires the science subject leader (co-ordinator) in each school to reflect upon and develop practice over the course of one year, then upload a set of reflections and supporting evidence to the database to support their application. One of the criteria requires the subject leader to explain how science is assessed within the school. Sample:The data set consists of the electronic text in the assessment section of all 91 PSQM primary schools which worked towards the Quality Mark in the year April 2012 to March 2013. Design and methods:Content analysis of a pre-existing qualitative data set. Text in the assessment section of each submission was first coded as describing formative or summative processes, then sub-coded into different strategies used. Results:A wide range of formative and summative approaches were reported, which tended to be described separately, with few links between them. Talk-based strategies are widely used for formative assessment, with some evidence of feedback to pupils. Whilst the use of tests or tracking grids for summative assessment is widespread, few schools rely on one system alone. Enquiry skills and conceptual knowledge were often assessed separately. Conclusions:There is little consistency in the approaches being used by teachers to assess science in English primary schools. Nevertheless

Percutaneous Radiofrequency Ablation for the Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy

International Nuclear Information System (INIS)

Kang, Tae Wook; Rhim, Hyun Chul; Kim, Eun Young; Kim, Young Sun; Choi, Dong Il; Lee, Won Jae; Lim, Hyo K.

2009-01-01

To assess the safety and therapeutic efficacy of a percutaneous radiofrequency (RF) ablation for the hepatocellular carcinoma (HCC) abutting the diaphragm. We retrospectively assessed 80 patients who underwent a percutaneous RF ablation for a single nodular (< 4 cm) HCC over the last four years. Each patient underwent an ultrasound-guided RF ablation using internally cooled electrodes for the first-line treatment. We divided patients into two subgroups based on whether the index tumor was abutting (less than 5 mm) the diaphragm or not: group A (abutting; n = 31) versus group B (non-abutting; n = 49). We compared the two subgroups for complications and therapeutic efficacy using image and the review of medical records. The statistical assessment included an independent t-test, Fisher's exact test, and chi-square test. The assessment of the diaphragmatic swelling at CT immediately following the procedure was more severe in group A than group B (mean thickness change:1.44 vs. 0.46 mm, p = 0.00). Further, right shoulder pain was more common in group A than B (p = 0.01). Although minor complications (hemothorax 1 case, pleural effusion 1 case) were noted only in group A, no major thoracic complication occurred in either group. The technical success rate was lower in group A than group B (84% vs. 98%, p = 0.03). As well, the primary and secondary technique effectiveness rates in group A and group B were 90% versus 98% (p = 0.29) and 79% versus 91% (p = 0.25), respectively. The local tumor progression rate was higher in group A than in group B (29% vs. 6%, p = 0.02). We found that the percutaneous RF ablation for the HCC abutting the diaphragm is a safe procedure without major complications. However, it is less effective with regard to technical success and local tumor control

Efficacy and Safety of Endovascular Intervention for the Management of Primary Entire-Inferior Vena Cava Occlusion

International Nuclear Information System (INIS)

Zhang, Qingqiao; Huang, Qianxin; Shen, Bin; Sun, Jingmin; Wang, Xiaolong; Liu, Hongtao

2015-01-01

PurposeThis study was designed to investigate the safety and efficacy of endovascular intervention for the treatment of primary entire-inferior vena cava (IVC) occlusion.MethodsEndovascular interventions were performed in six patients for the treatment of primary entire-IVC occlusion. IVC and hepatic venography were performed via the jugular and femoral veins. Balloon angioplasty was used to revascularize the hepatic vein and IVC and a stent was placed in the IVC to maintain patency. Postoperative color Doppler ultrasonography was performed at 1, 3, 6, and 12 months, and then annually, to monitor the patency of the hepatic vein and IVC.ResultsThe IVC and one or two hepatic veins were successfully revascularized in five patients. Revascularization was successful in the right and left hepatic veins in one patient; however, IVC patency could not be established in this patient. Eleven Z-type, self-expanding stents were placed into the IVCs of five patients (three stents in two patients, two stents in two patients, and one stent in one patient). There were no instances of postoperative bleeding or mortality. Follow-up was conducted for 18–90 months (42.8 ± 26.5 months). None of the five patients suffered restenosis of the IVC or hepatic veins. However, there was one of the six cases of right hepatic vein restenosis at 18 months postprocedure that was revascularized after a second balloon dilatation.ConclusionsEndovascular intervention is safe and efficacious for the treatment of primary entire-IVC occlusion

An assessment of Mathematics self – efficacy of secondary school ...

African Journals Online (AJOL)

The study examined an assessment of mathematics self-efficacy of secondary school students in Osun State. It drawn on 500 students comprising 250 males and 250 females randomly selected from 5 secondary schools in Osogbo. Their ages range between 11-17 years with a mean age of 14 years and a standard ...

An Investigation into the Perceptions of Mathematics and Information Literacy Self-Efficacy Levels of Pre-Service Primary Mathematics Teachers

Science.gov (United States)

Dinçer, Bahar; Yilmaz, Süha

2016-01-01

The purpose of this study is to examine the relationship between perceptions of the self-efficacy levels for both mathematics literacy and information literacy in pre-service primary mathematics teachers and the factors on which the relationship depends (variables include gender, class level, hours spent reading books and computer-access…

The LVIS Jr. microstent to assist coil embolization of wide-neck intracranial aneurysms: clinical study to assess safety and efficacy

International Nuclear Information System (INIS)

Moehlenbruch, M.; Herweh, C.; Behrens, L.; Jestaedt, L.; Bendszus, M.; Pham, M.; Amiri, H.; Ringleb, P.A.

2014-01-01

This study was aimed to assess clinical safety and efficacy of the LVIS Jr. microstent in stent-assisted coil embolization of wide-neck intracranial aneurysms. IRB approved single-center interventional clinical study in 22 patients (10 females, 12 males, mean age 55, age range 33-74 years) for the endovascular treatment of wide-neck aneurysms. After obtaining informed consent, patients were included according to the following criteria: aneurysm fundus-to-neck ratio 4 mm, and a parent vessel diameter of ≤3.5 mm. Primary end point for clinical safety was absence of death, absence of major or minor stroke, and absence of transient ischemic attack. Primary end point for treatment efficacy was complete angiographic occlusion according to the Raymond-Roy Occlusion Classification (RROC) immediately after the procedure and at follow-up after 3 and 6 months on magnetic resonance imaging (MRI). In 20/22 (91 %) of patients, the primary end point of safety was reached; in the two remaining patients, transient ischemic attack, but no permanent deficit was observed; in 16/22 (73 %), efficient occlusion (RROC1) was reached, and in 6/22 (27 %), a residual neck remained (RROC2). Single [seven with antegrade, two in crossover configuration, and four with ''first-balloon-then-stent'' (FBTS) technique] or double-stent (eight patients with Y configuration and one patient with X configuration) deployment was technically successful in all cases. Deployment of the LVIS Jr. microstent in various single- or double-stent configurations is safe and effective to assist the treatment of intracranial wide-neck aneurysms. (orig.)

Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study

OpenAIRE

Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K.; Mali, Gaurao Vasant

2016-01-01

Background: To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. Materials and Methods: The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical i...

Classroom assessment in Chinese primary school mathematics education

NARCIS (Netherlands)

Zhao, X.

2018-01-01

In mainland China, where there exists a deeply-rooted examination culture, an assessment reform promoting the use of assessment to support teaching and learning has been carried out since 2001. After a decade, however, only a few studies have been done that focus on primary school mathematics

Assessment of primary health care: health professionals’ perspective

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Simone Albino da Silva

2014-08-01

Full Text Available Objective To assess primary health care attributes of access to a first contact, comprehensiveness, coordination, continuity, family guidance and community orientation. Method An evaluative, quantitative and cross-sectional study with 35 professional teams in the Family Health Program of the Alfenas region, Minas Gerais, Brazil. Data collection was done with the Primary Care Assessment Tool - Brazil, professional version. Results Results revealed a low percentage of medical experts among the participants who evaluated the attributes with high scores, with the exception of access to a first contact. Data analysis revealed needs for improvement: hours of service; forms of communication between clients and healthcare services and between clients and professionals; the mechanism of counter-referral. Conclusion It was concluded that there is a mismatch between the provision of services and the needs of the population, which compromises the quality of primary health care.

Lung Parenchymal Assessment in Primary and Secondary Pneumothorax.

Science.gov (United States)

Bintcliffe, Oliver J; Edey, Anthony J; Armstrong, Lynne; Negus, Ian S; Maskell, Nick A

2016-03-01

The definition of primary spontaneous pneumothorax excludes patients with known lung disease; however, the assumption that the underlying lung is normal in these patients is increasingly contentious. The purpose of this study was to assess lung structure and compare the extent of emphysema in patients with primary versus secondary spontaneous pneumothorax and to patients with no pneumothorax in an otherwise comparable control group. We identified patients treated for pneumothorax by screening inpatient and outpatient medical records at one medical center in the United Kingdom. From this group, 20 patients had no clinically apparent underlying lung disease and were classified as having a primary spontaneous pneumothorax, and 20 patients were classified as having a secondary spontaneous pneumothorax. We assembled a control group composed of 40 subjects matched for age and smoking history who had a unilateral pleural effusion or were suspected to have a thoracic malignancy and had a chest computed tomography scan suitable for quantitative analysis. Demographics and smoking histories were collected. Quantitative evaluation of low-attenuation areas of the lung on computed tomography imaging was performed using semiautomated software, and the extent of emphysema-like destruction was assessed visually. The extent of emphysema and percentage of low-attenuation areas was greater for patients with primary spontaneous pneumothorax than for control subjects matched for age and smoking history (median, 0.25 vs. 0.00%; P = 0.019) and was also higher for patients with secondary pneumothorax than those with primary spontaneous pneumothorax (16.15 vs. 0.25%, P pneumothorax who smoked had significantly greater low-attenuation area than patients with primary pneumothorax who were nonsmokers (0.7 vs. 0.1%, P = 0.034). The majority of patients with primary spontaneous pneumothorax had quantifiable evidence of parenchymal destruction and emphysema. The exclusion of patients

Assessment of efficacy and safety of praziquantel in the treatment of ...

African Journals Online (AJOL)

This study assessed the efficacy and safety of PZQ in school-aged children in four ... All pupils were also treated with a single dose of PZQ at 40 mg/kg. ... The presence of S. haematobium was neither age nor sex dependent (p>0.05).

Effects of HGF gene polymorphisms and protein expression on transhepatic arterial chemotherapeutic embolism efficacy and prognosis in patients with primary liver cancer

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Chen HY

2017-02-01

Full Text Available Hai-Yong Chen,1,2 Yao-Min Chen,3 Jian Wu,1,2 Fu-Chun Yang,1,2 Zhen Lv,1,2 Yi-Gang Qian,1,2 Shu-Sen Zheng1,2 1Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, 2Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 3Department of Breast Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China Objective: To investigate the correlations of two hepatocyte growth factor (HGF gene polymorphisms (rs5745652 and rs2074725 and their protein expression levels with the efficacy of transhepatic arterial chemotherapeutic embolism (TACE and prognosis in patients with primary liver cancer (PLC. Methods: From March 2011 to June 2012, 109 PLC patients (the case group who chose TACE as primary treatment and 80 healthy people (the control group who had undergone physical examination in The First Affiliated Hospital, Zhejiang University were selected during the same period. Gene polymorphisms of HGF rs5745652 and HGF rs2074725 were detected. Serum HGF level, treating efficacy, survival quality, and 3-year survival rate for PLC patients who received TACE were observed. Results: There were significant differences in genotype and allele frequencies of HGF rs5745652 and HGF rs2074725, between the case and control groups (all P<0.05. Compared with CT+TT genotype of HGF rs5745652, patients carrying CC genotype had lower serum HGF levels, higher efficacy, better survival quality, and prolonged 3-year survival rate (all P<0.05. In rs2074725, patients carrying CA+AA genotype had lower serum HGF levels, higher efficacy, better survival quality, and prolonged 3-year survival rate compared with patients carrying rs2074725 CC genotype (all P<0.05. Gene polymorphisms of HGF rs5745652 and HGF rs2074725, tumor size, and Barcelona Clinic Liver Cancer stage were independent prognostic factors for PLC (P<0.05. Conclusion: Our

Is it possible to improve radiotherapy team members’ communication skills? A randomized study assessing the efficacy of a 38-h communication skills training program

International Nuclear Information System (INIS)

Gibon, Anne-Sophie; Merckaert, Isabelle; Liénard, Aurore; Libert, Yves; Delvaux, Nicole; Marchal, Serge; Etienne, Anne-Marie; Reynaert, Christine; Slachmuylder, Jean-Louis; Scalliet, Pierre; Van Houtte, Paul; Coucke, Philippe; Salamon, Emile

2013-01-01

Background and purpose: Optimizing communication between radiotherapy team members and patients and between colleagues requires training. This study applies a randomized controlled design to assess the efficacy of a 38-h communication skills training program. Material and methods: Four radiotherapy teams were randomly assigned either to a training program or to a waiting list. Team members’ communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient were the primary endpoints. These encounters were scheduled at the baseline and after training for the training group, and at the baseline and four months later for the waiting list group. Encounters were audiotaped and transcribed. Transcripts were analyzed with content analysis software (LaComm) and by an independent rater. Results: Eighty team members were included in the study. Compared to untrained team members, trained team members used more turns of speech with content oriented toward available resources in the team (relative rate [RR] = 1.38; p = 0.023), more assessment utterances (RR = 1.69; p < 0.001), more empathy (RR = 4.05; p = 0.037), more negotiation (RR = 2.34; p = 0.021) and more emotional words (RR = 1.32; p = 0.030), and their self-efficacy to communicate increased (p = 0.024 and p = 0.008, respectively). Conclusions: The training program was effective in improving team members’ communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient. Future study should assess the effect of this training program on communication with actual patients and their satisfaction. Moreover a cost-benefit analysis is needed, before implementing such an intensive training program on a broader scale

[Prognostic criteria of efficacy of programmed laparoscopic sanitation of the abdominal cavity in peritonitis].

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Salakhov, E K; Vlasov, A P; Bolotskyh, V A

To define prognostic criteria of efficacy of programmed laparoscopic sanitation of the abdominal cavity in peritonitis. There were 32 patients after programmed laparoscopic sanitation of abdominal cavity for peritonitis due to different acute surgical diseases. Subsequently 12 of them required relaparotomy due to poor effectiveness of laparoscopic sanitation. Comprehensive clinical examination and laboratory assessment of some indexes of homeostasis and oxidative status were conducted. Prognostic clinical and laboratory criteria of efficacy of laparoscopic abdominal sanitation were suggested after analysis of intraoperative data during primary surgery and laboratory values in the 1st postoperative day. The offered prognostic criteria allow to define further management of peritonitis patients after primary laparotomy.

Teachers’ work ability: a study of relationships between collective efficacy and self-efficacy beliefs

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Guidetti G

2018-05-01

Full Text Available Gloria Guidetti,1 Sara Viotti,1 Andreina Bruno,2 Daniela Converso1 1Department of Psychology, University of Turin, Turin, Italy; 2Department of Education Science, University of Genoa, Genoa, Italy Introduction: Work ability constitutes one of the most studied well-being indicators related to work. Past research highlighted the relationship with work-related resources and demands, and personal resources. However, no studies highlight the role of collective and self-efficacy beliefs in sustaining work ability. Purpose: The purpose of this study was to examine whether and by which mechanism work ability is linked with individual and collective efficacies in a sample of primary and middle school teachers. Materials and methods: Using a dataset consisting of 415 primary and middle school Italian teachers, the analysis tested for the mediating role of self-efficacy between collective efficacy and work ability. Results: Mediational analysis highlights that teachers’ self-efficacy totally mediates the relationship between collective efficacy and perceived work ability. Conclusion: Results of this study enhance the theoretical knowledge and empirical evidence regarding the link between teachers’ collective efficacy and self-efficacy, giving further emphasis to the concept of collective efficacy in school contexts. Moreover, the results contribute to the study of well-being in the teaching profession, highlighting a process that sustains and promotes levels of work ability through both collective and personal resources. Keywords: collective efficacy, mediation, self-efficacy, teachers, work ability

The contribution of assessment experiences to student teachers’ self-efficacy in competence-based education

NARCIS (Netherlands)

Prof. Dr. Mien Segers; Dr. Mart van Dinther; Prof. Dr. Filip Dochy

2015-01-01

Earlier research argues that educational programmes based on social cognitive theory are successful in improving students’ self-efficacy. Focusing on some formative assessment characteristics, this qualitative research intends to study in-depth how student teachers’ assessment experiences contribute

The breastfeeding self-efficacy scale: psychometric assessment of the short form.

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Dennis, Cindy-Lee

2003-01-01

The purpose of this study was to reduce the number of items on the original Breastfeeding Self-Efficacy Scale (BSES) and psychometrically assess the revised BSES-Short Form (BSES-SF). As part of a longitudinal study, participants completed mailed questionnaires at 1, 4, and 8 weeks postpartum. Health region in British Columbia. A population-based sample of 491 breastfeeding mothers. BSES, Edinburgh Postnatal Depression Scale, Rosenberg Self-Esteem Scale, and Perceived Stress Scale. Internal consistency statistics with the original BSES suggested item redundancy. As such, 18 items were deleted, using explicit reduction criteria. Based on the encouraging reliability analysis of the new 14-item BSES-SF, construct validity was assessed using principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated through significant mean differences between breastfeeding and bottle feeding mothers at 4 (p self-efficacy and considered ready for clinical use to (a) identify breastfeeding mothers at high risk, (b) assess breastfeeding behaviors and cognitions to individualize confidence-building strategies, and (c) evaluate the effectiveness of various interventions and guide program development.

Conditioned pain modulation predicts duloxetine efficacy in painful diabetic neuropathy.

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Yarnitsky, David; Granot, Michal; Nahman-Averbuch, Hadas; Khamaisi, Mogher; Granovsky, Yelena

2012-06-01

This study aims to individualize the selection of drugs for neuropathic pain by examining the potential coupling of a given drug's mechanism of action with the patient's pain modulation pattern. The latter is assessed by the conditioned pain modulation (CPM) and temporal summation (TS) protocols. We hypothesized that patients with a malfunctioning pain modulation pattern, such as less efficient CPM, would benefit more from drugs augmenting descending inhibitory pain control than would patients with a normal modulation pattern of efficient CPM. Thirty patients with painful diabetic neuropathy received 1 week of placebo, 1 week of 30 mg/d duloxetine, and 4 weeks of 60 mg/d duloxetine. Pain modulation was assessed psychophysically, both before and at the end of treatment. Patient assessment of drug efficacy, assessed weekly, was the study's primary outcome. Baseline CPM was found to be correlated with duloxetine efficacy (r=0.628, P<.001, efficient CPM is marked negative), such that less efficient CPM predicted efficacious use of duloxetine. Regression analysis (R(2)=0.673; P=.012) showed that drug efficacy was predicted only by CPM (P=.001) and not by pretreatment pain levels, neuropathy severity, depression level, or patient assessment of improvement by placebo. Furthermore, beyond its predictive value, the treatment-induced improvement in CPM was correlated with drug efficacy (r=-0.411, P=.033). However, this improvement occurred only in patients with less efficient CPM (16.8±16.0 to -1.1±15.5, P<.050). No predictive role was found for TS. In conclusion, the coupling of CPM and duloxetine efficacy highlights the importance of pain pathophysiology in the clinical decision-making process. This evaluative approach promotes personalized pain therapy. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Development and Exemplification of a Model for Teacher Assessment in Primary Science

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Davies, D. J.; Earle, S.; McMahon, K.; Howe, A.; Collier, C.

2017-01-01

The Teacher Assessment in Primary Science project is funded by the Primary Science Teaching Trust and based at Bath Spa University. The study aims to develop a whole-school model of valid, reliable and manageable teacher assessment to inform practice and make a positive impact on primary-aged children's learning in science. The model is based on a…

Analysis System for Self-Efficacy Training (ASSET). Assessing treatment fidelity of self-management interventions.

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Zinken, Katarzyna M; Cradock, Sue; Skinner, T Chas

2008-08-01

The paper presents the development of a coding tool for self-efficacy orientated interventions in diabetes self-management programmes (Analysis System for Self-Efficacy Training, ASSET) and explores its construct validity and clinical utility. Based on four sources of self-efficacy (i.e., mastery experience, role modelling, verbal persuasion and physiological and affective states), published self-efficacy based interventions for diabetes care were analysed in order to identify specific verbal behavioural techniques. Video-recorded facilitating behaviours were evaluated using ASSET. The reliability between four coders was high (K=0.71). ASSET enabled assessment of both self-efficacy based techniques and participants' response to those techniques. Individual patterns of delivery and shifts over time across facilitators were found. In the presented intervention we observed that self-efficacy utterances were followed by longer patient verbal responses than non-self-efficacy utterances. These detailed analyses with ASSET provide rich data and give the researcher an insight into the underlying mechanism of the intervention process. By providing a detailed description of self-efficacy strategies ASSET can be used by health care professionals to guide reflective practice and support training programmes.

Safety and efficacy of everolimus-eluting stents compared with first-generation drug-eluting stents in patients undergoing primary percutaneous coronary intervention

Energy Technology Data Exchange (ETDEWEB)

Escárcega, Ricardo O.; Baker, Nevin C.; Magalhaes, Marco A.; Lipinski, Michael J.; Minha, Sa’ar; Torguson, Rebecca; Satler, Lowell F.; Pichard, Augusto D.; Suddath, William O.; Waksman, Ron, E-mail: ron.waksman@medstar.net

2014-09-15

Objective: To assess the safety and efficacy everolimus-eluting stents (EES) compared with first-generation drug-eluting stents (DES) in patients with acute myocardial infarction (MI) undergoing primary percutaneous coronary intervention (PCI). Background: EES have been associated with improved clinical outcomes compared to paclitaxel-eluting stents (PES) and with similar outcomes compared to sirolimus-eluting stents (SES). Methods: A total of 520 patients who presented with ST-elevation myocardial infarction (STEMI) from 2003 to 2013, who underwent primary PCI with DES, were retrospectively analyzed. Of these, 247 received SES, 136 PES, and 137 EES. Patients were followed up to 2 years for major adverse cardiac events (MACE). Univariate and multivariate models detected correlates to outcome. Results: EES implantation, compared with PES and SES, resulted in comparable rates of MACE (8.8% vs. 16.2%, p = 0.06 and 8.8% vs. 12.6%, respectively, p = 0.26), stent thrombosis, MI, and target lesion revascularization. Patients who received EES had lower rates of all-cause mortality (3.7% vs. 12.6% vs. 9.4%, p = 0.03) at 1-year follow up. However, in the univariate and multivariate analyses, stent type was not independently associated with the primary outcome or with all-cause mortality. Diabetes mellitus and number of stents implanted were independently associated with the primary outcome. Conclusion: While EES seem to be associated with better outcome when compared to PES, the main correlates of STEMI patients are the presence of diabetes and number of stents implanted, and not the type of stent used for intervention.

Efficacy of ibuprofen, naproxen and mefenamic acid for relief of pain from primary dysmenorrheal

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Azita Norouzi

2003-09-01

Full Text Available Cyclic pain associated with menses during ovulatory cycles, but without demonstrable lesions affecting the reproductive cycle, is a common disability, which causes significant absence from school or work. To evaluate the efficacy of naproxen, ibuprofen and mefenamic acid in the treatment of primary dysmenorrheal, 120 girls were randomized to four groups (three as treatment groups and the other as placebo. The pain intensity was recorded using self visual analogue scale in 0, 1, 2, 4 and 6 hours after treatment. There was no significant difference in intensity of pain between groups at zero time, however the pain intensity decreased significantly in all treatment group in comparison to placebo (p<0.05. The mean of pain intensity was lower in ibuprofen in comparison to the other treatment groups, however there was no significant difference in pain intensity between the treatment groups in the sixth hour of treatment. Therefore, ibuprofen is recommended as a treatment choice for pain reduction in primary dysmenorrheal due to its rapid onset of action.

Principal Self-Efficacy and Work Engagement: Assessing a Norwegian Principal Self-Efficacy Scale

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Federici, Roger A.; Skaalvik, Einar M.

2011-01-01

One purpose of the present study was to develop and test the factor structure of a multidimensional and hierarchical Norwegian Principal Self-Efficacy Scale (NPSES). Another purpose of the study was to investigate the relationship between principal self-efficacy and work engagement. Principal self-efficacy was measured by the 22-item NPSES. Work…

Using realist evaluation to assess primary healthcare teams' responses to intimate partner violence in Spain.

Science.gov (United States)

Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel; Marchal, Bruno; Vives-Cases, Carmen

2015-01-01

Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application. We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis. There were several key mechanisms -the teams' self-efficacy, perceived preparation, women-centred care-, and contextual factors -an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care- that should be considered to develop adequate primary health-care responses to violence. The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

The Efficacy of Eradication of Helicobacter pylori Infection in Primary Prevention of NSAID-induced Gastropathy

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S.M. Tkach

2015-09-01

Full Text Available With the aim of clarifying the efficacy of eradication therapy for Helicobacter pylori (Hp infection in primary prevention of NSAID-induced gastropathy, we have examined 39 Hp-positive patients, in whom we planned to administer non-steroidal anti-inflammatory drugs (NSAIDs for various arthritis. In group I, non-steroidal anti-inflammatory drugs were prescribed after anti-helicobacter therapy, in group II eradication was not carried out, and the patients immediately received diclofenac. In both groups the incidence of peptic ulcers has been compared in 1 month after receiving diclofenac. In group I, peptic ulcers occurred in 2 patients (10.5 %, in group II — in 5 patients (26.3 %, ie in the group of eradication therapy they occurred significantly less frequently (χ2 = 0.5221. It is concluded that eradication of Hp-infection can be considered as an effective strategy for primary prevention of NSAID-induced gastropathy.

Assessing the efficacy of the healthy eating and lifestyle programme (HELP compared with enhanced standard care of the obese adolescent in the community: study protocol for a randomized controlled trial

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Christie Deborah

2011-11-01

Full Text Available Abstract Background The childhood obesity epidemic is one of the foremost UK health priorities. Childhood obesity tracks into adult life and places individuals at considerable risk for diabetes, cardiovascular disease, liver disease and other morbidities. There is widespread need for paediatric lifestyle programmes as change may be easier to accomplish in childhood than later in life. Study Design/Method The study will evaluate the management of adolescent obesity by conducting a Medical Research Council complex intervention phase III efficacy randomised clinical trial of the Healthy Eating Lifestyle Programme within primary care. The study tests a community delivered multi-component intervention designed for adolescents developed from best practice as identified by National Institute for Health and Clinical Excellence. The hospital based pilot reduced body mass index and improved health-related quality of life. Subjects will be individually randomised to receiving either the Healthy Eating Lifestyle Programme (12 fortnightly family sessions or enhanced standard care. Baseline and follow up assessments will be undertaken blind to allocation status. A health economic evaluation is also being conducted. 200 obese young people (13-17 years, body mass index > 98th centile for age and sex will be recruited from primary care within the greater London area. The primary hypothesis is that a motivational and solution-focused family-based weight management programme delivered over 6 months is more efficacious in reducing body mass index in obese adolescents identified in the community than enhanced standard care. The primary outcome will be body mass index at the end of the intervention, adjusted for baseline body mass index, age and sex. The secondary hypothesis is that the Healthy Eating Lifestyle Programme is more efficacious in improving quality of life and psychological function and reducing waist circumference and cardiovascular risk factors in

Assessment of treatment efficacy and sebosuppressive effect of fractional radiofrequency microneedle on acne vulgaris.

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Lee, Kyung Real; Lee, Eo Gin; Lee, Hee Jung; Yoon, Moon Soo

2013-12-01

A minimally invasive fractional radiofrequency microneedle (FRM) device has been used in skin rejuvenation and acne scars, and a recent pilot study demonstrated the positive therapeutic effect on acne. We evaluated the efficacy of FRM device for acne vulgaris in Asians and conducted objective measurement to assess its effect on sebum production. Twenty Korean patients with acne vulgaris received a single full-face FRM treatment. Outcome assessments included standardized photography, physician's global assessment, patient's satisfaction scores, acne lesion count, and objective measurements of casual sebum level (CSL) and sebum excretion rate (SER). They were evaluated at baseline and 2, 4, 8 weeks after the treatment. After a single FRM treatment, the CSL and the SER showed 30-60% and 70-80% reduction, respectively, at week 2 (P acne severity and acne lesion count also revealed clinical improvement with maximum efficacy at week 2, but returned to the baseline in most patients by week 8. Patients' satisfaction scores (0-4) were above 2 on average, and adverse effects were minimal. This prospective study demonstrated the sebosuppressive effect from a single FRM treatment, but its therapeutic efficacy in acne requires further evaluation. © 2013 Wiley Periodicals, Inc.

Examining the Impact of Video Modeling Techniques on the Efficacy of Clinical Voice Assessment.

Science.gov (United States)

Werner, Cara; Bowyer, Samantha; Weinrich, Barbara; Gottliebson, Renee; Brehm, Susan Baker

2017-01-01

The purpose of the current study was to determine whether or not presenting patients with a video model improves efficacy of the assessment as defined by efficiency and decreased variability in trials during the acoustic component of voice evaluations. Twenty pediatric participants with a mean age of 7.6 years (SD = 1.50; range = 6-11 years), 32 college-age participants with a mean age of 21.32 years (SD = 1.61; range = 18-30 years), and 17 adult participants with a mean age of 54.29 years (SD = 2.78; range = 50-70 years) were included in the study and divided into experimental and control groups. The experimental group viewed a training video prior to receiving verbal instructions and performing acoustic assessment tasks, whereas the control group received verbal instruction only prior to completing the acoustic assessment. Primary measures included the number of clinician cues required and instructional time. Standard deviations of acoustic measurements (eg, minimum and maximum frequency) were also examined to determine effects on stability. Individuals in the experimental group required significantly less cues, P = 0.012, compared to the control group. Although some trends were observed in instructional time and stability of measurements, no significant differences were observed. The findings of this study may be useful for speech-language pathologists in regard to improving assessment of patients' voice disorders with the use of video modeling. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

An Integrative Review of Self-Efficacy Measurement Instruments in Youth with Type 1 Diabetes (T1DM)

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Rasbach, Lisa; Jenkins, Carolyn; Laffel, Lori

2014-01-01

Purpose The purpose of this study is to assess the extant literature on instruments used to measure self-efficacy in youth with type 1 diabetes (T1DM) and their caregivers and to critically evaluate these measurements. Methods An integrative review (2003–2013) was conducted searching PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and U.S. National Library of Medicine PubMed service (PubMed) databases using key words diabetes, type 1 diabetes, and self-efficacy. The authors reviewed the resulting294 references for inclusion criteria of (a) sample of youth with T1DM or sample of caregivers of youth with T1DM, (b) description of the self-efficacy instrument as primary research, and (c) the instrument measured self-efficacy specifically related to diabetes management. Forty-five articles out of the initial 294 met criteria. Results Of the 45 articles, 10 different self-efficacy instruments were identified. The primary theoretical framework used was Bandura’s social cognitive theory and model of self-efficacy. Most participants were white middle class T1DM youth. Evaluations to assess validity often were not reported; however, a majority of studies reported high internal consistency of the instruments. Conclusions Sample homogeneity could limit the applicability of results to certain patient populations. Further psychometric analysis, including validity assessments, should be conducted in more diverse samples. Development of valid and reliable instruments for measuring self-efficacy that are sensitive to change across a wider caregiver base over time is necessary. While this review examined reliable and valid instruments used in research, future opportunities include evaluation of measuring self-efficacy in T1DM youth exposed to recent advances in diabetes management technologies. PMID:25216655

Student perceptions of assessment and student self-efficacy in competence-based education

NARCIS (Netherlands)

Dinther, van M.; Dochy, F.; Segers, M.; Braeken, J.

2014-01-01

The purpose of this study was to provide insight into the interplay between student perceptions of competence-based assessment and student self-efficacy, and how this influences student learning outcomes. Results reveal that student perceptions of the form authenticity aspect and the quality

Assessment of the Knowledge of Primary Health Care Staff about Primary Health Care

OpenAIRE

Elzubier, Ahmed G.; Bella, Hassan; Sebai, Zohair A.

1995-01-01

The orientation about Primary Health Care among staff working in the PHC centers was assessed. Staff members numbering 909 were studied. The main criteria for judging orientation were a working knowledge of the definition and elements of PHC in addition to knowledge of the meaning of the word Alma Ata. Differences of this knowledge depending on sex, age, spoken language, type of job, postgraduate experience, previous experience in PHC and previous training in PHC were assessed. The main findi...

Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

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Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie

2016-12-01

Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Long-term efficacy and safety of ExPress implantation for treatment of open angle glaucoma

OpenAIRE

Lee, Geun Young; Lee, Chong Eun; Lee, Kyoo Won; Seo, Sam

2017-01-01

AIM: To compare the long-term efficacy and safety of ExPress implantation and standard trabeculectomy in patients with primary open angle glaucoma (POAG). METHODS: In this retrospective study, we compared 17 eyes treated by ExPress implantation with 23 eyes treated by trabeculectomy. Efficacy was assessed according to the relevant intraocular pressure (IOP) values and success rates during the first year of follow-up. Postoperative corneal endothelial cell loss was also compared. RESULTS...

PRIMARY SCHOOL TEACHERS’ PERCEPTION ABOUT CURRICULUM 2013 ASSESSMENT SYSTEM

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Ika Maryani

2017-05-01

Full Text Available The research is intended to find out: 1the level of primary school teacher understanding of Curriculum 2013, 2. The level of teacher understanding on the authentic assessment, 3The difficulties faced by the teacher when doing authentic assessment, and 4The effort of the teacher to solve those difficulties. In collecting the data, the researcher used questionnaires and interviews to the primary school teachers in Yogyakarta, then analyzed the data using statistic descriptive analysis technique. The results of this research showed that: a most of the teachers didn’t understand the Curriculum 2013, yet they were not given any training before; b teachers’ understanding in authentic assessment system were low; c the teacher were lack of the ability to define the  competence, indicators, learning objectives, and also arranging of assessment instrument and final report, d the teacher effort to solve those difficulties were by joining the training peer discussion, and mentoring by Education Department as well as to the higher education institution.

Science Self-Efficacy in the Primary Classroom: Using Mixed Methods to Investigate Sources of Self-Efficacy

Science.gov (United States)

Webb-Williams, Jane

2017-04-01

Self-efficacy has been shown to influence student engagement, effort and performance as well as course selection and future career choice. Extending our knowledge regarding the development of self-efficacy has important implications for educators and for those concerned about the international uptake of science careers. Previous research has identified four sources that may contribute towards self-efficacy: mastery experiences, vicarious experiences, verbal persuasion and physiological/affective states. Very little research has been conducted within the school environment that looks at the formation of these sources and yet early school experiences have been posited to be a key factor in girls' lack of engagement in post compulsory science education. This paper investigates children's self-efficacy beliefs in science and reports on findings from mixed method research conducted with 182 children aged between 10 and 12 years. Classroom data were collected through focus groups, individual interviews and surveys. Findings revealed that although girls and boys held similar levels of academic performance in science, many girls underestimated their capability. The four sources of self-efficacy identified by Bandura (1997) plus self-regulation as an additional source, were evident in the children's descriptions, with boys being more influenced by mastery experience and girls by a combination of vicarious experience and physiological/affective states. Girl's appraisal of information appeared to operate through a heuristic process whereby girls disregarded salient information such as teacher feedback in favour of reliance on social comparison. Contextual factors were identified. Implications for science teachers are discussed.

Taiwan College Students' Self-Efficacy and Motivation of Learning in Online Peer Assessment Environments

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Tseng, Sheng-Chau; Tsai, Chin-Chung

2010-01-01

Online peer assessment is an innovative evaluation method that has caught both educators' and practitioners' attention in recent years. The purpose of this study was to develop relevant questionnaires for teachers to understand student self-efficacy and motivation in online peer assessment learning environments. A total of 205 college students…

Reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting wheelchair skills (SEATS) outcome measure.

Science.gov (United States)

Rushton, Paula W; Smith, Emma M; Miller, William C; Kirby, R Lee; Daoust, Geneviève

2018-01-31

The aim of this study was to evaluate the internal consistency, test-retest reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting manual wheelchair skills (SEATS-M) and Self-Efficacy in Assessing, Training and Spotting power wheelchair skills (SEATS-P). A 2-week test-retest design was used with a convenience sample of occupational and physical therapists who worked at a provincial rehabilitation centre (inpatient and outpatient services). Sixteen participants completed the SEATS-M and 18 participants completed the SEATS-P. For the SEATS-M assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.90 to 0.97, the 2-week intraclass correlation coefficients (ICC 1,1 ) ranged from 0.81 to 0.95, the standard error of measurements (SEM) ranged from 5.06 to 8.70 and the smallest real differences (SRD) ranged from 6.24 to 8.18. For the SEATS-P assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.83 to 0.92, the ICCs ranged from 0.72 to 0.86, the SEMs ranged from 4.54 to 8.91 and the SRDs ranged from 5.90 to 8.27. There is preliminary evidence that both the SEATS-M and the SEATS-P have high internal consistency, good test-retest reliability and support for responsiveness. These tools can be used in evaluating clinician self-efficacy with assessing, training, spotting and documenting wheelchair skills included on the Wheelchair Skills Test. Implications for Rehabilitation There is preliminary evidence that the SEATS-M and SEATS-P are reliable and responsive outcome measures that can be used to evaluate the self-efficacy of clinicians to administer the Wheelchair Skills Program. Measurement of clinicians' self-efficacy in this area of practice may enable an enhanced understanding of the areas in which clinicians lack self-efficacy, thereby informing the development of improved knowledge translation interventions.

Sensitivity Analysis of Per-Protocol Time-to-Event Treatment Efficacy in Randomized Clinical Trials

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Gilbert, Peter B.; Shepherd, Bryan E.; Hudgens, Michael G.

2013-01-01

Summary Assessing per-protocol treatment effcacy on a time-to-event endpoint is a common objective of randomized clinical trials. The typical analysis uses the same method employed for the intention-to-treat analysis (e.g., standard survival analysis) applied to the subgroup meeting protocol adherence criteria. However, due to potential post-randomization selection bias, this analysis may mislead about treatment efficacy. Moreover, while there is extensive literature on methods for assessing causal treatment effects in compliers, these methods do not apply to a common class of trials where a) the primary objective compares survival curves, b) it is inconceivable to assign participants to be adherent and event-free before adherence is measured, and c) the exclusion restriction assumption fails to hold. HIV vaccine efficacy trials including the recent RV144 trial exemplify this class, because many primary endpoints (e.g., HIV infections) occur before adherence is measured, and nonadherent subjects who receive some of the planned immunizations may be partially protected. Therefore, we develop methods for assessing per-protocol treatment efficacy for this problem class, considering three causal estimands of interest. Because these estimands are not identifiable from the observable data, we develop nonparametric bounds and semiparametric sensitivity analysis methods that yield estimated ignorance and uncertainty intervals. The methods are applied to RV144. PMID:24187408

Efficacy of obeticholic acid in patients with primary biliary cirrhosis and inadequate response to ursodeoxycholic acid.

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Hirschfield, Gideon M; Mason, Andrew; Luketic, Velimir; Lindor, Keith; Gordon, Stuart C; Mayo, Marlyn; Kowdley, Kris V; Vincent, Catherine; Bodhenheimer, Henry C; Parés, Albert; Trauner, Michael; Marschall, Hanns-Ulrich; Adorini, Luciano; Sciacca, Cathi; Beecher-Jones, Tessa; Castelloe, Erin; Böhm, Olaf; Shapiro, David

2015-04-01

We evaluated the efficacy and safety of obeticholic acid (OCA, α-ethylchenodeoxycholic acid) in a randomized controlled trial of patients with primary biliary cirrhosis who had an inadequate response to ursodeoxycholic acid therapy. We performed a double-blind study of 165 patients with primary biliary cirrhosis (95% women) and levels of alkaline phosphatase (ALP) 1.5- to 10-fold the upper limit of normal. Patients were randomly assigned to groups given 10 mg, 25 mg, or 50 mg doses of OCA or placebo, once daily for 3 months. Patients maintained their existing dose of ursodeoxycholic acid throughout the study. The primary outcome was change in level of ALP from baseline (day 0) until the end of the study (day 85 or early termination). We also performed an open-label extension of the trial in which 78 patients were enrolled and 61 completed the first year. OCA was superior to placebo in achieving the primary end point. Subjects given OCA had statistically significant relative reductions in mean ALP from baseline to the end of the study (P ursodeoxycholic acid. The incidence and severity of pruritus were lowest among patients who received 10 mg/d OCA. Biochemical responses to OCA were maintained in a 12-month open-label extension trial. ClinicalTrials.gov ID: NCT00550862. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Implementing Self-Assessment in Singapore Primary Schools: Effects on Students' Perceptions of Self-Assessment

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Wong, Hwei Ming

2017-01-01

Student academic self-assessment engages the students in deliberate reflection about what they are learning and how they are learning it. This intervention study investigated the effects of self-assessment training on students' perceptions towards self-assessment in two Singaporean primary schools. The study, which used a pretest-posttest design,…

Development and exemplification of a model for Teacher Assessment in Primary Science

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Davies, D. J.; Earle, S.; McMahon, K.; Howe, A.; Collier, C.

2017-09-01

The Teacher Assessment in Primary Science project is funded by the Primary Science Teaching Trust and based at Bath Spa University. The study aims to develop a whole-school model of valid, reliable and manageable teacher assessment to inform practice and make a positive impact on primary-aged children's learning in science. The model is based on a data-flow 'pyramid' (analogous to the flow of energy through an ecosystem), whereby the rich formative assessment evidence gathered in the classroom is summarised for monitoring, reporting and evaluation purposes [Nuffield Foundation. (2012). Developing policy, principles and practice in primary school science assessment. London: Nuffield Foundation]. Using a design-based research (DBR) methodology, the authors worked in collaboration with teachers from project schools and other expert groups to refine, elaborate, validate and operationalise the data-flow 'pyramid' model, resulting in the development of a whole-school self-evaluation tool. In this paper, we argue that a DBR approach to theory-building and school improvement drawing upon teacher expertise has led to the identification, adaptation and successful scaling up of a promising approach to school self-evaluation in relation to assessment in science.

I Can Assess Myself: Singaporean Primary Students' and Teachers' Perceptions of Students' Self-Assessment Ability

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Wong, Hwei Ming

2016-01-01

Student self-assessment engages the students in purposeful reflection about what they are learning and how they are learning it. This study investigated the perceptions of students and teachers towards the students' self-assessment ability in two Singapore primary schools. A total of 75 students were taught how to use self-assessment. Eighteen…

Assessment of the Safety and Efficacy of a Raft-Forming Alginate Reflux Suppressant (Liquid Gaviscon) for the Treatment of Heartburn during Pregnancy

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Strugala, Vicki; Bassin, Julian; Swales, Valerie S.; Lindow, Stephen W.; Dettmar, Peter W.; Thomas, Edward C. M.

2012-01-01

Gastro-oesophageal reflux (GER) and the symptoms of heartburn and regurgitation are common in pregnancy. These symptoms are transient and mostly resolve postpartum but have a negative impact on quality of life. Here, we present a prospective clinical evaluation of the safety and efficacy of an alginate raft-forming oral suspension that is licensed for use in pregnancy. The study was a multicentre, prospective, open-label, and baseline-controlled study of Liquid Gaviscon (LG) in the treatment of heartburn in pregnant women with current symptoms of heartburn and/or reflux requiring treatment (recruited 144). The efficacy of the study medication was rated by the investigator (primary endpoint) and patient. Treatment was deemed to be a success in 91% of patients as judged by the investigator (95% CI 85.0–95.3) and 90% (95% CI 84.1–94.8) when assessed by the patient themselves. Very few adverse events or serious adverse events were reported that were considered to be related to the study medication, and these were consistent with the normal population incidences. Serum sodium levels remained unchanged. This prospective open-label study in a large number of pregnant women has shown that LG is both safe and highly efficacious in the treatment of heartburn and GER symptoms in pregnancy. PMID:23209926

Efficacy of RADPAD® protection drape in reducing radiation exposure to the primary operator during Transcatheter Aortic Valve Implantation (TAVI).

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Sharma, Divyesh; Ramsewak, Adesh; Manoharan, Ganesh; Spence, Mark S

2016-02-01

The efficacy of RADPAD® (a sterile, lead-free drape) has been demonstrated to reduce the scatter radiation to the primary operator during fluoroscopic procedures. However, the use of the RADPAD® during TAVI procedures has not been studied. Transcatheter aortic valve implantation (TAVI) is now an established treatment for patients with symptomatic severe aortic stenosis who are deemed inoperable or at high risk for conventional surgical aortic valve replacement (AVR). Consequently the radiation exposure to the patient and the interventional team from this procedure has become a matter of interest and importance. Methods to reduce radiation exposure to the interventional team during this procedure should be actively investigated. In this single center prospective study, we determined the radiation dose during this procedure and the efficacy of RADPAD® in reducing the radiation dose to the primary operator. Fifty consecutive patients due to undergo elective TAVI procedures were identified. Patients were randomly assigned to undergo the procedure with or without the use of a RADPAD® drape. There were 25 patients in each group and dosimetry was performed at the left eye level of the primary operator. The dosimeter was commenced at the start of the procedure, and the dose was recorded immediately after the end of the procedure. Fluoroscopy times and DAP were also recorded prospectively. Twenty-five patients underwent transfemoral TAVI using a RADPAD® and 25 with no-RADPAD®. The mean primary operator radiation dose was significantly lower in the RADPAD group at 14.8 mSv vs. 24.3 mSv in the no-RADPAD group (P=0.008). There was no significant difference in fluoroscopy times or dose-area products between the two patient groups. The dose to the primary operator relative to fluoroscopy time (RADPAD: slope=0.325; no RADPAD: slope=1.148; analysis of covariance F=7.47, P=0.009) and dose area product (RADPAD: slope=0.0007; no RADPAD: slope=0.002; analysis of covariance F=7

Implementing Curriculum-Embedded Formative Assessment in Primary School Science Classrooms

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Hondrich, Annika Lena; Hertel, Silke; Adl-Amini, Katja; Klieme, Eckhard

2016-01-01

The implementation of formative assessment strategies is challenging for teachers. We evaluated teachers' implementation fidelity of a curriculum-embedded formative assessment programme for primary school science education, investigating both material-supported, direct application and subsequent transfer. Furthermore, the relationship between…

Efficacy of radiotherapy in esophageal cancer patients with dysphagia

International Nuclear Information System (INIS)

Shimizu, Yuri; Niibe, Yuzuru; Terahara, Atsuro; Shimada, Hideaki; Yajima, Satoshi; Kikuchi, Yoshinori

2016-01-01

To retrospectively assess the efficacy of radiotherapy in esophageal cancer patients with dysphagia due to the primary lesion at our institute, by evaluating change of Mellow-Pinkas-dysphagia score and subjective symptom. We confarmed radiotherapy for esophageal cancer help improve dysphagia. Change of Mel-low-Pinkas-dysphagia score throughout radiotherapy did not match with change of subjective dysphagia, which have relevancy to patients' quality of life. New evaluation criterion is required. (author)

A Climate for Self-Efficacy: The Relationship between School Climate and Teacher Efficacy for Inclusion

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Hosford, Susan; O'Sullivan, Siobhán

2016-01-01

Teacher efficacy represents a key construct in exploring successful implementation of inclusive policy. Teachers' impression of school climate is shown to relate to teacher efficacy; however, few studies pay due deference to its context/specific conceptualisation, with a particular lacuna in research noted in an Irish mainstream primary school…

The efficacy of sleeve technique in primary nasolacrimal duct obstruction with a high lacrimal sac

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Kyoung-Nam Kim

2014-01-01

Full Text Available Purpose: To evaluate the efficacy of a sleeve technique during endoscopic dacryocystorhinostomy (DCR in primary nasolacrimal duct obstruction (NLDO patients with a high lacrimal sac. Materials and Methods: The medical records of 45 patients (49 cases undergoing endoscopic DCR for primary NLDO with a high lacrimal sac were retrospectively reviewed. In 19 patients (21 cases, the thick maxilla covering the common canalicular opening was removed using a drill and a bicanalicular silicone tube was inserted (group 1. In 26 patients (28 cases, instead of removal of the thick maxilla, a sleeve was inserted into the bicanalicular silicone tube (group 2. At 6 months postoperatively, the success rate was evaluated and the size of the intranasal mucosal ostium was measured. Results: The success rates in group 1 and 2 was 90.5% and 96.4%, respectively (P = 0.400. The intranasal mucosal ostium in group 1 and 2 measured 1.7 ± 0.7 mm and 3.1 ± 1.0 mm, respectively, and the difference was significant (P = 0.042. Conclusions: In primary NLDO patients with a high lacrimal sac, DCR inserting a silicone tube and a sleeve together had a satisfactory success rate without using a drill. In comparison with traditional surgical methods, it helped enlarge the size of the intranasal mucosal ostium.

The Assessment of Self-Efficacy Level According to University StudentsAND#8217; Smoking Situation

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Nur Ozlem Kilinc

2012-06-01

Full Text Available ABSTRACT AIM: This essay is made with the aim of assessing of self-efficacy level according to university students’ smoking situation. METHOD: The study that is descriptive type was made in between September 2009-June 2010 in University of Bingol. Totally 920 students who attend Bingol Universty in 2009-2010 academic year consist of the universe of the study. The choice of sample wasn’t used in the study, the study completed with 765 students who were volunteer to join the study data was collected by using the form including socio-demographic data and self-efficacy scale. Evaluating data was made by descriptive tests in computer environment, t test and analysis of variance. RESULTS: The rate of students’ smoking is 6,9 % among girls, 37,4 % among boys and it is totally 44,3 %. It was determined that place that they live, their fathers’ education of smoking students idea quit smoking effect their self-efficacy level. It was determined that family type, marital status, fathers’ education of non-smoking students effect their self-efficacy level. CONCLUSION: It is found that self-efficacy of non-smoking students is higher than the self-efficacy of smoking students. [TAF Prev Med Bull 2012; 11(3.000: 255-264

An Assessment of Factors Relating to High School Students' Science Self-Efficacy

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Gibson, Jakeisha Jamice

This mixed-methods case study examined two out-of-school (OST) Science, Technology, Engineering and Math (STEM) programs at a science-oriented high school on students' Self-Efficacy. Because STEM is a key for future innovation and economic growth, Americans have been developing a variety of approaches to increase student interest in science within the school curriculum and in OST programs. Nationwide, many OST programs are offered for students but few have engaged in an in-depth assessment. This study included an assessment of two different types of OST programs and direct observations by the researcher. This study involved two advisors (one male, one female), 111 students, and their parents during 2016. Student participants completed two standardized surveys, one to determine their Science Self-Efficacy and another to assess their engagement in science during their OST programs. Parents described their parental involvement and their child's interest in the OST program(s). The OST program advisors participated in lengthy interviews. Additionally, the advisors rated their perceived interest level of the enrolled students and recorded attendance data. Bandura's Social Cognitive Theory (1997a) provided the theoretical framework. This theory describes the multidirectional influence of behavioral factors, personal factors, and environmental factors have on a student's Self-Efficacy. Compiled data from the teachers, students, and parents were used to determine the relationship of selected variables on Science Self-Efficacy of students. A correlational analysis revealed that students who participated in these OST programs possessed a high Mindset for the Enjoyment of science and that teacher ratings were also positively correlated to Mindset and Enjoyment of Science. Descriptive analyses showed that (a) girls who chose to participate in these OST programs possessed higher school grades in their in-school coursework than boys, (b) that parents of girls participated in more

Efficient assessment of efficacy in post-traumatic peripheral neuropathic pain patients: pregabalin in a randomized, placebo-controlled, crossover study

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Jenkins TM

2012-07-01

Full Text Available Tim M Jenkins, Trevor S Smart, Frances Hackman, Carol Cooke, Keith KC TanClinical Research, Pfizer Worldwide Research and Development, Sandwich, Kent, UKBackground: Detecting the efficacy of novel analgesic agents in neuropathic pain is challenging. There is a critical need for study designs with the desirable characteristics of assay sensitivity, low placebo response, reliable pain recordings, low cost, short duration of exposure to test drug and placebo, and relevant and recruitable population.Methods: We designed a proof-of-concept, double-blind, randomized, placebo-controlled, crossover study in patients with post-traumatic peripheral neuropathic pain (PTNP to evaluate whether such a study design had the potential to detect efficacious agents. Pregabalin, known to be efficacious in neuropathic pain, was used as the active analgesic. We also assessed physical activity throughout the study.Results: Twenty-five adults (20–70 years of age with PTNP for ≥3 months entered a screening week and were then randomized to one of the two following treatment sequences: (1 pregabalin followed by placebo or (2 placebo followed by pregabalin. These 2-week treatment periods were separated by a 2-week washout period. Patients on pregabalin treatment received escalating doses to a final dosage of 300 mg/day (days 5–15. In an attempt to minimize placebo response, patients received placebo treatment during the screening week and the 2-week washout period. Average daily pain scores (primary endpoint were significantly reduced for pregabalin versus placebo, with a mean treatment difference of -0.81 (95% confidence interval: -1.45 to -0.17; P = 0.015.Conclusion: The efficacy of pregabalin was similar to that identified in a large, parallel group trial in PTNP. Therefore, this efficient crossover study design has potential utility for future proof-of-concept studies in neuropathic pain.Keywords: pregabalin, post-traumatic peripheral neuropathic pain, randomized

Efficacy of amoxycillin versus amoxycillin/clavulanate in acute exacerbations of chronic pulmonary obstructive disease in primary care

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Carl Llor

2008-10-01

Full Text Available Carl Llor1, Silvia Hernández1, Anna Ribas2, Carmen Álvarez3, Josep Maria Cots4, Carolina Bayona5, Isabel González6, Marc Miravitlles7, BRAMOX Study Group 1Primary Care Centre Jaume I, Tarragona, Spain; 2Primary Care Centre Santa Eugènia de Berga, Spain; 3Primary Care Centre Manlleu, Spain; 4Primary Care Centre La Marina, Barcelona, Spain; 5Primary Care Centre Valls, Spain; 6Primary Care Centre Maragall, Barcelona, Spain; 7Pneumology Department. Institut Clínic del Tòrax (IDIBAPS, Hospital Clínic, Barcelona, CIBER de Enfermedades Respiratorias (CIBERES, SpainBackground: Amoxycillin/clavulanate is considered first-line treatment for ambulatory exacerbations of COPD. However, narrow-spectrum antibiotics may be as useful for mild to moderate patients.Objective: To compare the clinical efficacy of amoxycillin versus amoxicyllin/clavulanate in exacerbations of COPD in primary care.Methods: A randomized, double-blind, noninferiority clinical trial was carried out in eight primary care centers in Catalonia, Spain. Spirometrically-diagnosed patients older than 40 years with COPD, without criteria of hospitalization and Anthonisen’s types I or II exacerbations were included. The main outcome was clinical cure at the end of treatment (EOT visit on day 10.Results: A total of 137 patients were enrolled in the study (68 assigned to amoxycillin and 69 to amoxycillin/clavulanate. The mean forced expiratory flow in one second was 61.6% and the mean age was 71.4 years. At EOT, 92.8% of patients in the amoxycillin/clavulanate and 90.9% in the amoxycillin group were considered clinically cured, a statistically non-significant difference. Adverse effects were observed in 11 subjects, 3 in the amoxycillin group and 8 in the amoxycillin/clavulanate group, 2 of whom required a change in treatment.Conclusions: Amoxycillin was at least as effective clinically and as safe as amoxycilin/clavulanate in the treatment of acute exacerbations of COPD in mild to

Comparison of the anesthetic efficacy of articaine infiltration versus lidocaine inferior alveolar nerve block in pulp therapy of lower primary molars

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Maryam Sharifi

2017-12-01

Full Text Available Introduction: Pain control is essential to the behavioral management of children in pediatric dentistry. Effective anesthesia plays a key role in this regard, especially in pulp therapy. In order to achieve successful anesthesia, the type of analgesics and injection techniques should be considered. The present study aimed to compare the anesthetic efficacy of articaine infiltration and lidocaine inferior alveolar nerve block in the pulp therapy of lower primary molars. Materials and Methods: This randomized, crossover, triple-blind clinical trial was conducted on 64 children aged 4-10 years, who required the bilateral pulp therapy of the lower primary molars. Subjects were randomly divided into two groups. Treatment was performed for two sessions, and one lower primary molar was treated in each session. In the first treatment session, subjects in group A were injected with lidocaine inferior alveolar nerve block, and in the second session, they were injected with articaine infiltration. In group B, all the procedures were similar to group A. In the first treatment session, subjects in group B were injected with articaine infiltration, and in the second session, they were injected with lidocaine inferior alveolar nerve block. Pain intensity was measured upon the initiation of the pulp exposure using the visual analogue scale (VAS. Data analysis was performed by crossover analysis, paired t-test, and independent two-sample t-test. Results: During the study period, mean pain intensity in the children treated by lidocaine inferior alveolar nerve block was significantly lower compared to those treated by articaine infiltration. However, the two techniques had no statistically significant difference in the children aged 4-6 years and the treatment of the first primary molars. Conclusion: According to the results, lidocaine inferior alveolar nerve block has higher anesthetic efficacy in the pulp therapy of the lower primary molars compared to articaine

Assessment of the efficacy and safety of hyaluronic acid gel injection in the restoration of fullness of the upper lips

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Taraneh Yazdanparast

2017-01-01

Full Text Available Background and Aim: Lips have a significant role in face aesthetic perception, and lip augmentation is one of the most commonly requested aesthetic procedures. Non-permanent dermal fillers, such as hyaluronic acid (HA, are used for augmenting the lips. This article presents the results of Phase II, before – after designed study, assessing the safety and efficacy of a soft tissue HA filler, for upper lip augmentation.Materials and Methods: Investigators treated 10 healthy adult women 28–45 years old, using a single injection of Hyamax Kiss soft tissue HA filler (a product from Hyamed Laboratories, Switzerland for upper lip augmentation. The primary efficacy endpoint was an increase in lip fullness at least one grade on Medicis Lip Fullness Scale at 2, 12 and 24 weeks post-treatment. Furthermore, the effectiveness and durability of filler were assessed using a 5-point Investigator's Global Assessment (IGA. Adverse events and volunteers' satisfaction were reported using visual analog scale.Results: Response to treatment (as defined above after 2, 12 and 24 weeks were observed in 80%, 70% and 80% of patients, respectively. No statistical difference was found in response to treatment rate between follow-up visits (P = 0.83. The mean value of IGA score in weeks 2, 12 and 24 were 3.4 ± 0.96, 3.3 ± 0.67 and 3.3 ± 0.67, respectively. The study subjects were almost all satisfied with their lip improvement. Reported adverse effects were temporary and mostly mild in severity.Conclusion: Soft tissue HA filler tested in this study was well tolerated, efficient and durable when used for upper lip augmentation.

Efficacy of 18F-FDG PET/CT in investigation of elevated CEA without known primary malignancy

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Simon Sin-man Wong

2016-01-01

Full Text Available Aim: To evaluate the efficacy of 18flurodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT in investigating patients with elevated carcinoembryonic antigen (CEA and without known primary malignancy, and the impact of PET/CT findings on patient management. Setting and Design: PET/CT scans done in a tertiary hospital between December 2007 and February 2012 for elevated CEA in patients without known primary malignancy were retrospectively reviewed. Materials and Methods: The PET/CT findings, patients' clinical information, level of CEA, histological diagnosis, and subsequent management were retrieved by the electronic patient record for analysis. Statistical Analysis: Data were analyzed using SPSS version 19. Results: One hundred and one PET/CT scans were performed for patients with elevated CEA. Fifty-eight of these were performed for patients with known primary malignancy and were excluded; 43 PET/CT scans were performed for patients without known primary malignancy and were included. Thirty-three (77% had a positive PET/CT. Among the 32 patients with malignancy, 15 (47% suffered from lung cancer and 8 (25% suffered from colorectal cancer. The sensitivity (97%, specificity (82%, positive predictive value (94%, negative predictive value (90%, and accuracy (93% were calculated. Thirty (91% patients had resultant change in management. The mean CEA level for patients with malignancy (46.1 ng/ml was significantly higher than those without malignancy (3.82 ng/ml (P < 0.05. In predicting the presence of malignancy, a CEA cutoff at 7.55 ng/ml will achieve a sensitivity of 91% and a specificity of 73%. Conclusion: PET/CT, in our study population, appears to be sensitive, specific, and accurate in investigating patients with elevated CEA and without known primary malignancy. In addition to diagnosis of underlying primary malignancy, PET/CT also reveals occult metastases which would affect patient treatment options.Its role in

Validation of the Spanish Version of the CAPES: A Brief Instrument for Assessing Child Psychological Difficulties and Parental Self-Efficacy

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Mejia, Anilena; Filus, Ania; Calam, Rachel; Morawska, Alina; Sanders, Matthew R.

2016-01-01

In the present study, we explored the factor structure as well as validity and reliability of the Spanish version of the Child Adjustment and Parent Efficacy Scale (CAPES) suitable for assessing child behavioural and emotional difficulties (Intensity Scale) and parental self-efficacy (Self-Efficacy Scale) among Spanish-speaking parents from the…

Understanding and treatment of chronic abdominal pain in pediatric primary care.

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Schurman, Jennifer Verrill; Kessler, Emily D; Friesen, Craig A

2014-10-01

This study examined the practices used by primary care pediatricians to assess and treat chronic abdominal pain (CAP), as an initial step in guiding clinical practice guideline (CPG) development. A survey was mailed to a random sample of office-based pediatrician members (primary care pediatricians [PCPs]) of the American Medical Association. PCPs (n = 470) provided information about the typical presentation of CAP, assessment/treatment approaches used in their own practice, their definition of a functional gastrointestinal disorder (FGID), and their familiarity with the Rome Criteria for diagnosing FGIDs. Substantial variability among PCPs was noted across all these areas. Results suggest that perceptions and practices of pediatric CAP vary widely among PCPs; no single standard of care emerged to guide development of a CPG for this population. Future research should evaluate the efficacy of specific strategies currently in use to identify potential opportunities for improving assessment and treatment of CAP in pediatric primary care. © The Author(s) 2014.

In vitro investigation of the cleaning efficacy, shaping ability, preparation time and file deformation of continuous rotary, reciprocating rotary and manual instrumentations in primary molars

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Nahid Ramazani

2016-03-01

Full Text Available Background. Efficient canal preparation is the key to successful root canal treatment. This study aimed to assess the cleaning and shaping ability, preparation time and file deformation of rotary, reciprocating and manual instrumentation in canal preparation of primary molars. Methods. The mesiobuccal canals of 64 extracted primary mandibular second molars were injected with India ink. The samples were randomly divided into one control and three experimental groups. Experimental groups were instrumented with K-file, Mtwo in continuous rotation and Reciproc in reciprocating motion, respectively. The control group received no treatment. The files were discarded after four applications. Shaping ability was evaluated using CBCT. After clearing, ink removal was scored. Preparation time and file fracture or deformation was also recorded. Data were analyzed with SPSS 19 using chi-squared, Fisher’s exact test, Kruskal-Wallis and post hoc tests at a significance level of 0.05. Results. Considering cleanliness, at coronal third Reciproc was better than K-file (P < 0.001, but not more effective than Mtwo (P = 0.080. Furthermore, Mtwo leaved the canal cleaner than K-file (P = 0.001. In the middle third, only Reciproc exhibited better cleaning efficacy than K-file (P = 0.005. In the apical third, no difference was detected between the groups (P = 0.794. Regarding shaping ability, no differences were found between Reciproc and Mtwo (P = 1.00. Meanwhile, both displayed better shaping efficacy than K-file (P < 0.05. Between each two groups, there were differences in preparation time (P < 0.05, with Reciproc being the fastest. No file failure occurred. Conclusion. Fast and sufficient cleaning and shaping could be achieved with Mtwo and especially with Reciproc.

In vitro investigation of the cleaning efficacy, shaping ability, preparation time and file deformation of continuous rotary, reciprocating rotary and manual instrumentations in primary molars.

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Ramazani, Nahid; Mohammadi, Abbas; Amirabadi, Foroogh; Ramazani, Mohsen; Ehsani, Farzane

2016-01-01

Background. Efficient canal preparation is the key to successful root canal treatment. This study aimed to assess the cleaning and shaping ability, preparation time and file deformation of rotary, reciprocating and manual instrumentation in canal preparation of primary molars. Methods. The mesiobuccal canals of 64 extracted primary mandibular second molars were injected with India ink. The samples were randomly divided into one control and three experimental groups. Experimental groups were instrumented with K-file, Mtwo in continuous rotation and Reciproc in reciprocating motion, respectively. The control group received no treatment. The files were discarded after four applications. Shaping ability was evaluated using CBCT. After clearing, ink removal was scored. Preparation time and file fracture or deformation was also recorded. Data were analyzed with SPSS 19 using chi-squared, Fisher's exact test, Kruskal-Wallis and post hoc tests at a significance level of 0.05. Results. Considering cleanliness, at coronal third Reciproc was better than K-file (P < 0.001), but not more effective than Mtwo (P = 0.080). Furthermore, Mtwo leaved the canal cleaner than K-file (P = 0.001). In the middle third, only Reciproc exhibited better cleaning efficacy than K-file (P = 0.005). In the apical third, no difference was detected between the groups (P = 0.794). Regarding shaping ability, no differences were found between Reciproc and Mtwo (P = 1.00). Meanwhile, both displayed better shaping efficacy than K-file (P < 0.05). Between each two groups, there were differences in preparation time (P < 0.05), with Reciproc being the fastest. No file failure occurred. Conclusion. Fast and sufficient cleaning and shaping could be achieved with Mtwo and especially with Reciproc.

Assessing the Efficacy of a School Health Education Advocacy Lesson with College Students

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Wallen, Michele; Chaney, Beth H.; Birch, David A.

2012-01-01

Purpose: The researchers evaluated the efficacy of an advocacy lesson to assess change in intentions to advocate for school health education. This study also measured changes in participants' understanding the importance of school health education and perceived effectiveness in applying advocacy skills. Methods: A convenience sample of college…

The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial.

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Albaladejo, Celia; Kovacs, Francisco M; Royuela, Ana; del Pino, Rafael; Zamora, Javier

2010-03-01

Cluster randomized clinical trial. To assess the efficacy of a short education program and short physiotherapy program for treating low back pain (LBP) in primary care. There is sparse evidence on the effectiveness of education and physiotherapy programs that are short enough to be feasible in primary care. Sixty-nine primary care physicians were randomly assigned to 3 groups and recruited 348 patients consulting for LBP; 265 (79.8%) were chronic. All patients received usual care, were given a booklet and received a consistent 15 minutes group talk on health education, which focused on healthy nutrition habits in the control group, and on active management for LBP in the "education" and "education + physiotherapy" groups. Additionally, in the "education + physiotherapy" group, patients were given a second booklet and a 15-minute group talk on postural hygiene, and 4 one-hour physiotherapy sessions of exercise and stretching which they were encouraged to keep practicing at home. The main outcome measure was improvement of LBP-related disability at 6 months. Patients' assessment and data analyses were blinded. During the 6-month follow-up period, improvement in the "control" group was negligible. Additional improvement in the "education" and "education + physiotherapy" groups was found for disability (2.0 and 2.2 Roland Morris Questionnaire points, respectively), LBP (1.8 and 2.10 Visual Analogue Scale points), referred pain (1.3 and 1.6 Visual Analogue Scale points), catastrophizing (1.6 and 1.8 Coping Strategies Questionnaire points), physical quality of life (2.9 and 2.9 SF-12 points), and mental quality of life (3.7 and 5.1 SF-12 points). The addition of a short education program on active management to usual care in primary care leads to small but consistent improvements in disability, pain, and quality of life. The addition of a short physiotherapy program composed of education on postural hygiene and exercise intended to be continued at home, increases those

Assessment of HIV/AIDS and Life Skills Delivery in Primary Schools in Tanzania

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Rushahu, Bernadetha Gabriel

2015-01-01

This study was conducted to assess the effectiveness of HIV/AIDS and the Life Skills Education delivery in primary schools in Tanzania. Specifically the study investigated pupils' views about the effect of HIV/AIDS and Life Skills teaching in primary schools in Tanzania; assessed pupils' knowledge related to HIV/AIDS and Life Skills education, and…

Risk-adjusted payment and performance assessment for primary care.

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Ash, Arlene S; Ellis, Randall P

2012-08-01

Many wish to change incentives for primary care practices through bundled population-based payments and substantial performance feedback and bonus payments. Recognizing patient differences in costs and outcomes is crucial, but customized risk adjustment for such purposes is underdeveloped. Using MarketScan's claims-based data on 17.4 million commercially insured lives, we modeled bundled payment to support expected primary care activity levels (PCAL) and 9 patient outcomes for performance assessment. We evaluated models using 457,000 people assigned to 436 primary care physician panels, and among 13,000 people in a distinct multipayer medical home implementation with commercially insured, Medicare, and Medicaid patients. Each outcome is separately predicted from age, sex, and diagnoses. We define the PCAL outcome as a subset of all costs that proxies the bundled payment needed for comprehensive primary care. Other expected outcomes are used to establish targets against which actual performance can be fairly judged. We evaluate model performance using R(2)'s at patient and practice levels, and within policy-relevant subgroups. The PCAL model explains 67% of variation in its outcome, performing well across diverse patient ages, payers, plan types, and provider specialties; it explains 72% of practice-level variation. In 9 performance measures, the outcome-specific models explain 17%-86% of variation at the practice level, often substantially outperforming a generic score like the one used for full capitation payments in Medicare: for example, with grouped R(2)'s of 47% versus 5% for predicting "prescriptions for antibiotics of concern." Existing data can support the risk-adjusted bundled payment calculations and performance assessments needed to encourage desired transformations in primary care.

Self-Efficacy as a Longitudinal Predictor of Perceived Cognitive Impairment in Individuals with Multiple Sclerosis

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Hughes, Abbey J.; Beier, Meghan; Hartoonian, Narineh; Turner, Aaron P.; Amtmann, Dagmar; Ehde, Dawn M.

2015-01-01

Objective Self-efficacy plays an important role in symptom management and may be predictive of perceived cognitive impairment (PCI) for individuals with multiple sclerosis (MS). The primary aim of this study was to determine if self-efficacy longitudinally predicts two types of PCI in MS: general cognitive functioning and executive functioning. The secondary aim was to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI. Design Longitudinal analysis of self-report survey data collected over three years. Hierarchical regression analyses examined the relationship between self-efficacy and PCI, adjusting for depression and fatigue. Additional analyses tested self-efficacy as a mediator between depression, fatigue, and PCI. Setting Community-dwelling individuals with MS. Participants 233 individuals (age range 22-83 years) were recruited from a larger longitudinal survey study of 562 individuals with MS. Interventions Not applicable. Main Outcome Measures Primary outcome measures were the Applied Cognition General Concerns (ACGC) and Executive Function (ACEF) domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures. Results Self-efficacy was significantly correlated with PCI at baseline (r = .40 to .53) and three years later (r = .36 to .44). In multivariate regression analyses, self-efficacy was a significant longitudinal predictor of PCI, both for general cognitive functioning (β = .20, p Self-efficacy partially mediated the relationships between depression, fatigue, and PCI. Conclusions Self-efficacy may influence how individuals with MS will perceive their cognitive functioning over time. Interventions that target self-efficacy, particularly early in the disease course, may lead to improvements in PCI, as well as improvements in fatigue and depression. PMID:25597915

Assessment of Efficacy and Quality of Two Albendazole Brands Commonly Used against Soil-Transmitted Helminth Infections in School Children in Jimma Town, Ethiopia.

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Sileshi Belew

2015-09-01

Full Text Available There is a worldwide upscale in mass drug administration (MDA programs to control the morbidity caused by soil-transmitted helminths (STHs: Ascaris lumbricoides, Trichuris trichiura and hookworm. Although anthelminthic drugs which are used for MDA are supplied by two pharmaceutical companies through donation, there is a wide range of brands available on local markets for which the efficacy against STHs and quality remain poorly explored. In the present study, we evaluated the drug efficacy and quality of two albendazole brands (Bendex and Ovis available on the local market in Ethiopia.A randomized clinical trial was conducted according to the World Health Organization (WHO guidelines to assess drug efficacy, by means of egg reduction rate (ERR, of Bendex and Ovis against STH infections in school children in Jimma, Ethiopia. In addition, the chemical and physicochemical quality of the drugs was assessed according to the United States and European Pharmacopoeia, encompassing mass uniformity of the tablets, amount of active compound and dissolution profile. Both drugs were highly efficacious against A. lumbricoides (>97%, but showed poor efficacy against T. trichiura (~20%. For hookworms, Ovis was significantly (p < 0.05 more efficacious compared to Bendex (98.1% vs. 88.7%. Assessment of the physicochemical quality of the drugs revealed a significant difference in dissolution profile, with Bendex having a slower dissolution than Ovis.The study revealed that differences in efficacy between the two brands of albendazole (ABZ tablets against hookworm are linked to the differences in the in-vitro drug release profile. Differences in uptake and metabolism of this benzimidazole drug among different helminth species may explain that this efficacy difference was only observed in hookworms and not in the two other species. The results of the present study underscore the importance of assessing the chemical and physicochemical quality of drugs before

Variables that predict academic procrastination behavior in prospective primary school teachers

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Asuman Seda SARACALOĞLU

2016-04-01

Full Text Available This study aimed to examine the variables predicting academic procrastination behavior of prospective primary school teachers and is conducted using the correlational survey model. The study group is composed of 294 undergraduate students studying primary school teaching programs in faculties of education at Adnan Menderes, Pamukkale, and Muğla Sıtkı Koçman Universities in Turkey. The data collection instruments used were the Procrastination Assessment Scale Students (PASS, Academic Self-Efficacy Scale (ASES, and Academic Motivation Scale (AMS. While analyzing the gathered data, descriptive analysis techniques were utilized. Moreover, while analyzing the data, power of variables namely reasons of academic procrastination, academic motivation, and academic efficacy to predict prospective primary school teachers’ academic procrastination tendencies were tested. For that purpose, stepwise regression analysis was employed. It was found that nearly half of the prospective primary school teachers displayed no academic procrastination behavior. Participants’ reasons for procrastination were fear of failure, laziness, taking risks, and rebellion against control. An average level significant correlation was found between participants’ academic procrastination and other variables. As a result, it was identified that prospective primary school teachers had less academic procrastination than reported in literature and laziness, fear of failure, academic motivation predicted academic procrastination.

Efficacy and safety of a new microneedle patch for skin brightening: A Randomized, split-face, single-blind study.

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Park, Kui Young; Kwon, Hyun Jung; Lee, Changjin; Kim, Daegun; Yoon, Jun Jin; Kim, Myeong Nam; Kim, Beom Joon

2017-09-01

Although microneedles are one of the best transdermal drug delivery systems for active compounds, few clinical trials have examined the safety and efficacy of brightening microneedle patches. To determine the efficacy and safety of a newly developed whitening microneedle patch. A split-face study was designed for efficacy assessment with 34 Korean women applying the tested product (a whitening microneedle patch) on one cheek and a control whitening essence on the other. We objectively measured changes in melanin index values and skin brightness by mexameter and chromameter. Each participant also used global assessment to determine skin whitening. In addition, 55 participants were selected for primary skin irritation tests and repeated insult patch tests for safety assessments. Mean skin brightness and melanin indexes improved (Pmicroneedle patch was effective and safe for skin brightening and would be a promising functional cosmetic product. © 2017 Wiley Periodicals, Inc.

Comparision of the Efficacy of Vit B1 (Thiamine and Ibuprofen in Treatment of Primary Dysmenorrhea in Young Girls, Yazd, 2003

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L Sakhavat

2005-04-01

Full Text Available Introduction: This study was performed in order to compare the efficacy of vitamin B1and Iboprofen in the treatment of primary dysmenorrhea. Methods: 180 women aged between 11-17 years with primary dysmenorrhea were divided to 2 groups: Group A: (n: 60 received 100mg vit B1 daily in leuteal phase for 3 months . Grope B :( n: 60 Received 400mg Ibuprofen 3 times/day for 5days (3 days before and 2 days after start of menses for 3 months. Results: 80% of group A and 88.4% of group B were treated as compared to control (P=0001 , but in group B, side effects were more and the regimen was less tolerated as compared to group A. Conclusion: Vit B (Thiamine is well tolerated and effective drug without side effects in primary dysmenorrhea.

Fatigue in patients with Juvenile Idiopathic Arthritis: relationship to perceived health, physical health, self-efficacy, and participation.

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Armbrust, Wineke; Lelieveld, Otto H T M; Tuinstra, Jolanda; Wulffraat, Nico M; Bos, G J F Joyce; Cappon, Jeannette; van Rossum, Marion A J; Sauer, Pieter J J; Hagedoorn, Mariët

2016-12-06

Fatigue is common in patients with JIA and affects daily life negatively. We assessed the presence and severity of fatigue in patients with JIA, including factors presumed associated with fatigue (e.g., disease activity, disability, pain, physical activity, exercise capacity, and self-efficacy), and whether fatigue is related to participation in physical education classes, school attendance, and sports frequency. The current study used baseline data of 80 patients with JIA (age 8-13) who participated in an intervention aimed at promoting physical activity. Primary outcome measurements were fatigue, assessed using the Pediatric-Quality-of-Life-Inventory (PedsQl)-Fatigue-scale and energy level assessed using a VAS scale. Other outcome measurements were disease activity (VAS Physician Global Assessment Scale), disability (Childhood Health Assessment Questionnaire), physical activity (accelerometer), exercise capacity (Bruce treadmill test), self-efficacy (Childhood Arthritis Self-Efficacy Scale), and participation (self-report). Sixty percent of patients with JIA suffered from daily low-energy levels; 27% suffered from very low-energy levels more than half the week. Low energy levels were best predicted by disability and low physical activity. Fatigue measured with the PEDsQL was higher compared to the control-population. Disability and low self-efficacy were main predictors of fatigue. Self-efficacy was a predictor of fatigue but did not act as moderator. Fatigue was a predictor for sports frequency but not for school attendance. Fatigue is a significant problem for JIA patients. Interventions aimed at reducing perceived disability, stimulating physical activity, and enhancing self-efficacy might reduce fatigue and thereby enhance participation. Trial number ISRCTN92733069.

Breastfeeding Self-efficacy: A Critical Review of Available Instruments

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Tuthill, Emily L.; McGrath, Jacqueline M.; Graber, Melanie; Cusson, Regina M.; Young, Sera L.

2016-01-01

Increasing breastfeeding rates in the United States is a national priority. Yet, initiation and duration of breastfeeding remains below national targets. Breastfeeding self-efficacy has been shown to be a strong predictor of both breastfeeding initiation and duration and is therefore an important characteristic to be able to measure. However, there is currently a myriad of instruments for measuring breastfeeding self-efficacy, which makes selection of an appropriate instrument difficult. Thus, our aim was to identify, compare, and critically review available breastfeeding self-efficacy instruments. In a systematic review, 6 breastfeeding self-efficacy instruments were identified. The instruments’ purposes, theoretical framework, final scale development, and application in 5 most recent settings were analyzed. The 6 breastfeeding self-efficacy instruments apply a number of theoretical and conceptual frameworks in their development, with Bandura’s social cognitive theory being most common. Content, construct, and predictive validity were strong for most scales. Some, but not all, have been successfully adapted to novel settings. In sum, there are several measurements of breastfeeding self-efficacy that can and should be employed to better understand reasons for suboptimal breastfeeding rates and the effects of interventions on breastfeeding self-efficacy. Instrument selection should be based on domains of primary interest, time available, peripartum timing, and assessment of previous adaptations. Failure to apply appropriate measures in research may garner results that are inconclusive, inaccurate, or nonrepresentative of true study effects. PMID:26319113

Developing classroom formative assessment in dutch primary mathematics education

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van den Berg, M.; Harskamp, E.G.; Suhre, C.J.M.

2016-01-01

In the last two decades Dutch primary school students scored below expectation in international mathematics tests. An explanation for this may be that teachers fail to adequately assess their students’ understanding of learning goals and provide timely feedback. To improve the teachers’ formative

Assessment of fall-related self-efficacy and activity avoidance in people with Parkinson's disease

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Drake Anna-Maria

2010-10-01

Full Text Available Abstract Background Fear of falling (FOF is common in Parkinson's disease (PD, and it is considered a vital aspect of comprehensive balance assessment in PD. FOF can be conceptualized differently. The Falls-Efficacy Scale (FES assesses fall-related self-efficacy, whereas the Survey of Activities and Fear of Falling in the Elderly (SAFFE assesses activity avoidance due to the risk of falling. This study aimed at investigating the validity and reliability of FES and SAFFE in people with PD. Methods Seventy-nine people with PD (mean age; 64 years, SD 7.2 completed the Swedish version of FES(S, SAFFE and the physical functioning (PF scale of the 36-Item Short-Form Health Survey (SF-36. FES(S and SAFFE were administered twice, with an 8.8 (SD 2.3 days interval. Assumptions for summing item scores into total scores were examined and score reliability (Cronbach's alpha and test-retest reliability were calculated. Construct validity was assessed by examining the pattern of Spearman correlations (rs between the FES(S/SAFFE and other variables, and by examining differences in FES(S/SAFFE scores between fallers and non-fallers, genders, and between those reporting FOF and unsteadiness while turning. Results For both scales, item mean scores (and standard deviations were roughly similar and corrected item-total correlations exceeded 0.4. Reliabilities were ≥0.87. FES(S-scores correlated strongest (rs, -0.74, p s, -0.76, p s ≤ 0.08. Experiencing falls, unsteadiness while turning, and FOF was associated with lower fall-related self-efficacy and higher activity avoidance. Conclusions This study provides initial support for the score reliability and validity of the FES(S and SAFFE in people with PD.

Evaluating the Efficacy of Primary Treatment for Graves’ Disease Complicated by Thyrotoxic Periodic Paralysis

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Rita Yuk-Kwan Chang

2014-01-01

Full Text Available Objective. Thyrotoxic periodic paralysis (TPP is a potentially life-threatening complication of Graves’ disease (GD. The present study compared the long-term efficacy of antithyroid drugs (ATD, radioactive iodine (RAI, and surgery in GD/TPP. Methods. Sixteen patients with GD/TPP were followed over a 14-year period. ATD was generally prescribed upfront for 12–18 months before RAI or surgery was considered. Outcomes such as thyrotoxic or TPP relapses were compared between the three modalities. Results. Eight (50.0% patients had ATD alone, 4 (25.0% had RAI, and 4 (25.0% had surgery as primary treatment. Despite being able to withdraw ATD in all 8 patients for 37.5 (22–247 months, all subsequently developed thyrotoxic relapses and 4 (50.0% had ≥1 TPP relapses. Of the four patients who had RAI, two (50% developed thyrotoxic relapse after 12 and 29 months, respectively, and two (50.0% became hypothyroid. The median required RAI dose to render hypothyroidism was 550 (350–700 MBq. Of the 4 patients who underwent surgery, none developed relapses but all became hypothyroid. Conclusion. To minimize future relapses, more definitive primary treatment such as RAI or surgery is preferred over ATD alone. If RAI is chosen over surgery, a higher dose (>550 MBq is recommended.

Safety and Efficacy in Early Insulin Initiation as Comprehensive Therapy for Patients with Type 2 Diabetes in Primary Health Care Centers

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Agung Pranoto

2015-04-01

Full Text Available Aim: to analyze the safety and efficacy of early insulin initiation therapy for patients with type 2 diabetes mellitus (T2DM in primary health care provided by general practitioners (GPs in Surabaya, East Java, Indonesia. Methods: pre-post study of ninety nine diabetic patients without previous insulin treatment with HbA1c levels >8% were involved in this study. The study was conducted in 10 primary health care centers in Surabaya between October 2011 to June 2012. Each patient received insulin therapy for 12 weeks. Laboratory examination was performed for each patient including fasting plasma glucose (FPG, 2 hours post-prandial plasma glucose (2hPPG and HbA1c examination before and after the study. Self monitoring blood glucose (SMBG examination was conducted in order to adjust the insulin dose and prevent the incidence of hypoglycemia. Data was statistically analyzed using paired-T test. Results: FPG level was decreased from baseline data (209 mg/dL to 152.07 mg/dL at the end of the study (Δ56.93 mg/dl; p=0.0001. The average of 2hPPG level was also decreased from 313.00 mg/dl to 220.72 mg/dL (Δ 92.28 mg/dL; p=0.0001. HbA1c was reduced from 11.60% at baseline to 8.95% at the end of study (Δ 2.65%; p=0.0001. Hypoglycemia was found in 6 patients (6.06% in this study, but all events were mild and did not need to be admitted to hospital. Conclusion: the safety of insulin therapy iniatiation might be provided by GPs at primary health centers with significant efficacy and minimal side effects. Key words: insulin, general practioner, primary health center.

Randomized placebo controlled blinded study to assess valsartan efficacy in preventing left ventricle remodeling in patients with dual chamber pacemaker--Rationale and design of the trial.

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Tomasik, Andrzej; Jacheć, Wojciech; Wojciechowska, Celina; Kawecki, Damian; Białkowska, Beata; Romuk, Ewa; Gabrysiak, Artur; Birkner, Ewa; Kalarus, Zbigniew; Nowalany-Kozielska, Ewa

2015-05-01

Dual chamber pacing is known to have detrimental effect on cardiac performance and heart failure occurring eventually is associated with increased mortality. Experimental studies of pacing in dogs have shown contractile dyssynchrony leading to diffuse alterations in extracellular matrix. In parallel, studies on experimental ischemia/reperfusion injury have shown efficacy of valsartan to inhibit activity of matrix metalloproteinase-9, to increase the activity of tissue inhibitor of matrix metalloproteinase-3 and preserve global contractility and left ventricle ejection fraction. To present rationale and design of randomized blinded trial aimed to assess whether 12 month long administration of valsartan will prevent left ventricle remodeling in patients with preserved left ventricle ejection fraction (LVEF ≥ 40%) and first implantation of dual chamber pacemaker. A total of 100 eligible patients will be randomized into three parallel arms: placebo, valsartan 80 mg/daily and valsartan 160 mg/daily added to previously used drugs. The primary endpoint will be assessment of valsartan efficacy to prevent left ventricle remodeling during 12 month follow-up. We assess patients' functional capacity, blood plasma activity of matrix metalloproteinases and their tissue inhibitors, NT-proBNP, tumor necrosis factor alpha, and Troponin T. Left ventricle function and remodeling is assessed echocardiographically: M-mode, B-mode, tissue Doppler imaging. If valsartan proves effective, it will be an attractive measure to improve long term prognosis in aging population and increasing number of pacemaker recipients. ClinicalTrials.org (NCT01805804). Copyright © 2015 Elsevier Inc. All rights reserved.

Linking employee perceptions of collective efficacy in self-managing service teams with customer-perceived service quality : a psychometric assessment

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Jong, de A.; Wetzels, M.G.M.; Ruyter, de J.C.

2008-01-01

Purpose – The purpose of this paper is to investigate the linkage between self-managing team (SMT) member perceptions of collective efficacy and customer-perceived service quality, and the most cost-efficient way to reliably assess collective efficacy and customer-perceived service quality, using

Assessment of Efficacy and Quality of Two Albendazole Brands Commonly Used against Soil-Transmitted Helminth Infections in School Children in Jimma Town, Ethiopia.

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Belew, Sileshi; Getachew, Mestawet; Suleman, Sultan; Mohammed, Tesfaye; Deti, Habetewold; D'Hondt, Matthias; Wynendaele, Evelien; Mekonnen, Zeleke; Vercruysse, Jozef; Duchateau, Luc; De Spiegeleer, Bart; Levecke, Bruno

2015-09-01

There is a worldwide upscale in mass drug administration (MDA) programs to control the morbidity caused by soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura and hookworm. Although anthelminthic drugs which are used for MDA are supplied by two pharmaceutical companies through donation, there is a wide range of brands available on local markets for which the efficacy against STHs and quality remain poorly explored. In the present study, we evaluated the drug efficacy and quality of two albendazole brands (Bendex and Ovis) available on the local market in Ethiopia. A randomized clinical trial was conducted according to the World Health Organization (WHO) guidelines to assess drug efficacy, by means of egg reduction rate (ERR), of Bendex and Ovis against STH infections in school children in Jimma, Ethiopia. In addition, the chemical and physicochemical quality of the drugs was assessed according to the United States and European Pharmacopoeia, encompassing mass uniformity of the tablets, amount of active compound and dissolution profile. Both drugs were highly efficacious against A. lumbricoides (>97%), but showed poor efficacy against T. trichiura (~20%). For hookworms, Ovis was significantly (p Ovis. The study revealed that differences in efficacy between the two brands of albendazole (ABZ) tablets against hookworm are linked to the differences in the in-vitro drug release profile. Differences in uptake and metabolism of this benzimidazole drug among different helminth species may explain that this efficacy difference was only observed in hookworms and not in the two other species. The results of the present study underscore the importance of assessing the chemical and physicochemical quality of drugs before conducting efficacy assessment in any clinical trials to ensure appropriate therapeutic efficacy and to exclude poor drug quality as a factor of reduced drug efficacy other than anthelminthic resistance. Overall, this paper demonstrates

The impact of temperament and character on the efficacy of nonpharmacologic treatment of primary insomnia.

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An, Hoyoung; Park, Jangho; Jang, Eun-Sook; Chung, Seockhoon

2012-02-01

Nonpharmacologic treatment, also known as cognitive behavioral treatment, is a first-line treatment of primary insomnia. We aimed to assess factors, including temperament and character, that were associated with responses to nonpharmacologic treatments of primary insomnia, that may assist physicians to recommend appropriate treatment. Outpatients diagnosed with psychophysiological insomnia (n = 99) were recruited between May 2009 and January 2010. Among 69 patients who consented to participate, 44 completed treatment and all assessment measures. In addition, 37 normal control subjects were also recruited. Baseline characteristics were assessed using the Temperament and Character Inventory, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Dysfunctional Beliefs and Attitudes about Sleep scale, and the Hospital Anxiety and Depression Scale. After treatment, all assessment scales excluding the Temperament and Character Inventory were repeated. All patients received nonpharmacologic treatments, including sleep restriction, cognitive therapy, and sleep hygiene education. Novelty seeking, harm avoidance, reward dependence, cooperativeness, and self-transcendence scores were significantly different between normal controls and study subjects. Participants were divided into treatment responders (n = 23) and nonresponders (n = 21). Responders were significantly younger (50.3 ± 12.8 vs 58.7 ± 9.6 years, P = .02) and had significantly higher reward dependence scores (51.7 ± 5.9 vs 42.9 ± 6.9, P < .01) compared with nonresponders. The difference in reward dependence scores remained significant after controlling for other factors (odds ratio, 1.23; 95% confidence interval, 1.08-1.40; P = .01). Among personality dimensions, reward dependence was significantly associated with response to nonpharmacologic treatment in patients with primary insomnia. Copyright © 2012 Elsevier Inc. All rights reserved.

Health literacy, self-efficacy, and patients' assessment of medical disclosure and consent documentation.

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Donovan-Kicken, Erin; Mackert, Michael; Guinn, Trey D; Tollison, Andrew C; Breckinridge, Barbara; Pont, Stephen J

2012-01-01

Informed consent documents are designed to convey the risks of medical procedures to patients, yet they are often difficult to understand; this is especially true for individuals with limited health literacy. An important opportunity for advancing knowledge about health literacy and informed consent involves examining the theoretical pathways that help to explain how health literacy relates to information processing when patients read consent forms. In this study, we proposed and tested a model that positioned self-efficacy as a mediator of the association between health literacy and patients' comprehension and assessment of informed consent documentation. Findings from structured interviews with patients (n = 254) indicated that lower health literacy predicted lower self-efficacy, which predicted feeling less well informed and less prepared, being more confused about the procedure and its hazards, and wanting more information about risks. Incorporating awareness of self-efficacy into disclosure documents and consent conversations may be a useful means of prompting patients to ask questions that can help them make informed decisions about care.

At-Risk Boys' Social Self-Efficacy and Physical Activity Self-Efficacy in a Summer Sports Camp

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Su, Xiaoxia; Xiang, Ping; McBride, Ron E.; Liu, Jiling; Thornton, Michael A.

2016-01-01

This study examined at-risk boys' social self-efficacy and physical activity self-efficacy within Bandura's self-efficacy framework. A total of 97 boys, aged between 10 and 13 years, attending a summer sports camp completed questionnaires assessing their social self-efficacy, physical activity self- efficacy, prosocial behaviors, and effort.…

Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

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Slone, Michelle; Shoshani, Anat

2010-01-01

The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

Evaluating undergraduate nursing students' self-efficacy and competence in writing: Effects of a writing intensive intervention.

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Miller, Louise C; Russell, Cynthia L; Cheng, An-Lin; Skarbek, Anita J

2015-05-01

While professional nurses are expected to communicate clearly, these skills are often not explicitly taught in undergraduate nursing education. In this research study, writing self-efficacy and writing competency were evaluated in 52 nontraditional undergraduate baccalaureate completion students in two distance-mediated 16-week capstone courses. The intervention group (n = 44) experienced various genres and modalities of written assignments set in the context of evidence-based nursing practice; the comparison group (n = 8) received usual writing undergraduate curriculum instruction. Self-efficacy, measured by the Post Secondary Writerly Self-Efficacy Scale, indicated significant improvements for all self-efficacy items (all p's = 0.00). Writing competency, assessed in the intervention group using a primary trait scoring rubric (6 + 1 Trait Writing Model(®) of Instruction and Assessment), found significant differences in competency improvement on five of seven items. This pilot study demonstrated writing skills can improve in nontraditional undergraduate students with guided instruction. Further investigation with larger, culturally diverse samples is indicated to validate these results. Copyright © 2014 Elsevier Ltd. All rights reserved.

Efficacy of musculoskeletal injections by primary care providers in the office: a retrospective cohort study

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Bhagra A

2013-04-01

Full Text Available Anjali Bhagra,1 Husnain Syed,1 Darcy A Reed,1 Thomas H Poterucha,1 Stephen S Cha,2 Tammy J Baumgartner,1 Paul Y Takahashi1 1Department of Internal Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA Background: Musculoskeletal joint pain of varied etiology can be diagnosed and treated with joint and soft-tissue corticosteroid injections. Purpose: The purpose of our study was to compare patients’ bodily pain and quality of life (QOL, in addition to the procedural benefit and patient satisfaction, before and after musculoskeletal injections in the office setting. Patients and methods: Patients were eligible for recruitment if they were over age 18 and had an injection for musculoskeletal pain from a primary care provider in an office procedural practice. Included in our analysis were knee joint/bursa, trochanteric bursa, and shoulder joint/bursa injection sites. The variables measured were pain, benefit from the injection, QOL physical and mental components, and patient satisfaction. This was a retrospective cohort study approved by the institutional review board. Results: Patients’ pain was assessed by the patients using a six-point Likert scale (none, very mild, mild, moderate, severe, and very severe. We noted that self-perception of pain decreased from 3.10 (± standard deviation at baseline 0.96 before to 2.36 (± standard deviation after the infection 1.21 (P = 0.0001 after the injection. In terms of the impact on QOL, our patients had a pre-injection physical score of 37.25 ± 8.39 and a mental score at 52.81 ± 8.98. After the injections, the physical score improved to 42.35 ± 9.07 (P = 0.0001 and the mental to 53.54 ± 8.20 (P = 0.0001 for the overall group. Ninety-six percent of the patients reported they were satisfied or extremely satisfied in the procedure clinic. Conclusion: In this study, we found significant pain relief and improved physical QOL in patients undergoing an injection in the knee

The contribution of formative assessment and self-efficacy to inquiry learning

DEFF Research Database (Denmark)

Dolin, Jens; Evans, Robert Harry

2013-01-01

This chapter suggests the use of formative assessment in inquiry lessons as a helpful source of positive personal capacity beliefs for both teachers and students. The challenge most commonly experienced when first using inquiry learning methods is that pupils and even teachers become uncertain...... of their abilities to use inquiry and ‘give-up’ on it. With the use of formative assessment combined with conscious efforts to increase self-efficacy among students, teachers can help provide students with the confidence and motivation to engage in inquiry methods. Such student engagement can in-turn affirm teachers......’ inquiry teaching efforts and raise the likelihood that they will continue to improve them. We see inquiry methods as the motor for changing teacher practice and formative assessment methods combined with capacity beliefs as the fuel that keeps the motor running. The central position of the chapter is how...

Passive versus active follow-up to investigate the efficacy of primary prevention programs

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Högel, Josef

2005-04-01

Full Text Available Before general application of a primary prevention program its efficacy has to be demonstrated. For this purpose a randomized controlled trial with active or passive follow-up may be conducted. In the last 5 years, the ratio of controlled trials with passive versus those with active follow-up was 1:13. However, under certain circumstances a passive follow-up may be more appropriate and useful to overcome the drawbacks of an active follow-up, as e.g. high costs and many drop-outs. In a randomized controlled trial, a passive follow-up is based on the reporting of cases by physicians or hospitals instead of actively following up all study participants individually. The statistical evaluation can be carried out using a one-sample chi2-test. Advantages and limitations are discussed. A passive follow-up may be advantageous in situations with low incidence, large number of participants, complete ascertainment of conditions with obligatory notification or effective disease registries and should be preferred in such a context.

Assessing the Efficacy of an App-Based Method of Family Planning: The Dot Study Protocol.

Science.gov (United States)

Simmons, Rebecca G; Shattuck, Dominick C; Jennings, Victoria H

2017-01-18

assess pregnancy status over time. This paper outlines the protocol for this efficacy trial, following the Standard Protocol Items: Recommendations for Intervention Trials checklist, to provide an overview of the rationale, methodology, and analysis plan. Participants will be asked to provide daily sexual history data and periodically answer surveys administered through a call center or directly on their phone. Funding for the study was provided in 2013 under the United States Agency for International Development Fertility Awareness for Community Transformation project. Recruitment for the study will begin in January of 2017. The study is expected to last approximately 18 months, depending on recruitment. Findings on the study's primary outcomes are expected to be finalized by September 2018. Reproducibility and transparency, important aspects of all research, are particularly critical in developing new approaches to research design. This protocol outlines the first study to prospectively test both the efficacy (correct use) and effectiveness (actual use) of a pregnancy prevention app. This protocol and the processes it describes reflect the dynamic integration of mobile technologies, a call center, and Health Insurance Portability and Accountability Act-compliant study procedures. Future fertility app studies can build on our approaches to develop methodologies that can contribute to the evidence base around app-based methods of contraception. ClinicalTrials.gov NCT02833922; https://clinicaltrials.gov/ct2/show/NCT02833922 (Archived be WebCite at http://www.webcitation.org/6nDkr0e76). ©Rebecca G Simmons, Dominick C Shattuck, Victoria H Jennings. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.01.2017.

Using protection motivation theory to predict condom usage and assess HIV health communication efficacy in Singapore.

Science.gov (United States)

Lwin, May O; Stanaland, Andrea J S; Chan, Desmond

2010-01-01

The number of individuals infected with HIV/AIDS continues to rise in Asia. Condom use is considered to be the first line of defense against AIDS (UNAIDS, 2006). Using protection motivation theory (Rogers, 1983), this research aims to first understand the factors affecting condom usage intention among homosexual and heterosexual men in Singapore, and then to utilize those findings to assess the efficacy of HIV-directed health communications. We collected survey data from 484 men and analyzed the data using hierarchical regression and structural equation modeling. We found self-efficacy to be a significant predictor for both groups of men, together with perceived severity for homosexuals and response efficacy for heterosexuals. Next, we analyzed HIV-directed condom usage communication materials and found that the use of threat appeal themes is more common than themes promoting self-efficacy. Implications for health communications and policy are discussed.

Employment status, employment functioning, and barriers to employment among VA primary care patients.

Science.gov (United States)

Zivin, Kara; Yosef, Matheos; Levine, Debra S; Abraham, Kristen M; Miller, Erin M; Henry, Jennifer; Nelson, C Beau; Pfeiffer, Paul N; Sripada, Rebecca K; Harrod, Molly; Valenstein, Marcia

2016-03-15

Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed. Single VA primary care clinic; cross-sectional study. Employment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes. Published by Elsevier B.V.

Randomised Study to Compare the Efficacy and Tolerability of Duloxetine and Escitalopram in subjects with Major Depressive Disorder

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Kiran Haridas

2015-02-01

Full Text Available Management of depression presents a significant medical challenge. Drugs with improved efficacy and better tolerability are valuable additions to the present therapy of this disorder. Evidence suggests that therapy with a combined serotonin and noradrenaline reuptake inhibitor may be a more effective therapy of major depressive disorder (MDD than a single neurotransmitter inhibitor. The present study assessed the efficacy and tolerability between duloxetine (dual neurotransmitter reuptake inhibitor 40-60 mg/day and escitalopram (single neurotransmitter reuptake inhibitor 10-20mg/day in 24 patients as an open labeled randomized study over a duration of 12 weeks. The primary efficacy measure was the mean total change in 17 items Hamilton rating scale for depression (HAMD17 from baseline to end point using the last observation carrying forward. Tolerability was evaluated by assessing discontinuation rates, adverse event rates, vital signs, and laboratory tests. In the present study, the primary analysis detected a statistically significant difference at p=.025 using Fischer’s test between duloxetine and escitalopram in both response and remission rates. There was no significant difference detected in efficacy of onset between the two study groups. Response rate, remission rate and efficacy of onset were highly significant at p<0.05 using Wilcoxon signed rank test within each group. There were a few adverse effects that were mild and self limiting with both molecules. Duloxetine is superior to escitalopram in response and remission of treatment of MDD in similar clinical setting. Both duloxetine and escitalopram are well tolerated molecules at comparable doses.

Comparison of Cleaning Efficacy and Instrumentation Time in Primary Molars: Mtwo Rotary Instruments vs. Hand K-Files.

Science.gov (United States)

Ramezanali, Fatemeh; Afkhami, Farzaneh; Soleimani, Ali; Kharrazifard, Mohammad Javad; Rafiee, Farshid

2015-01-01

Pulpectomy is the preferred treatment for restorable primary teeth with symptomatic irreversible pulpitis or periradicular lesion. Considering the rather new application of rotary files for pulpectomy of primary teeth, the aim of this study was to compare the cleaning efficacy and instrumentation time of hand K-files and Mtwo rotary system for preparation of human primary molars. This experimental study was conducted on 100 extracted primary maxillary and mandibular intact molars with no resorption. Access cavities were prepared and India ink was injected into the root canal on a vibrator using an insulin syringe. Canals were then divided into 5 groups (n=20): in group I, canals were instrumented using K-files up to #25 for mesial and buccal canals and #30 for palatal and distal canals. In group II, canals were prepared using Mtwo rotary files (15/0.05, 20/0.06 and 25/0.06 for mesial and buccal canals and 15/0.05, 20/0.06, 25/0.06 and finally 30/0.05 for distal and palatal canals). In group III, root canals were only irrigated with saline. Groups IV and V were the positive and negative control groups, respectively. The time required for cleaning and preparation of the canals for each of the specimens in groups I, II and III was recorded. The mean score of cleanliness of Mtwo was not significantly different from K-file group (P>0.05). However the mean instrumentation time in Mtwo group was significantly shorter (Protary files were far more time efficient.

Psychiatry in primary care using the three-stage assessment

African Journals Online (AJOL)

terms of the patient's readiness to change his/her behaviour and then use an agenda-setting technique to decide which risk factor to .... and occasionally uses cannabis. She is not using any family planning (besides ... require a long-term relationship with their primary care physician,. Table 1. The three-stage assessment.

Efficacy of Artemisinin-Naphtoquine and Dihydroartemisinin-Piperaquine for uncomplicated malaria patient at primary health care

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Hadjar Siswantoro

2015-01-01

could be widely used in Primary Health Care (PHCs in Indonesia.Methods: For this study, we modified the 2009 WHO guidelines for clinical trials. This quasi-experimental study compared two parallel groups, subjects given ANT at 5 PHCs with inpatient facilities, and subjects given the control drug dihydroartemisinin-piperaquine (DHP administered to subjects at 5 PHCs without inpatient facilities. Results: Of a total 182 recruited subjects, 168 malaria cases could be analyzed. There were 71 cases in the ANT group and 97 cases in the DHP group. The characteristics of subjects receiving ANT and DHP at baseline were similar except the proportion of axillary temperature ≥37.50C, and proportion of anaemic subjects (Hb <11 g/dl in the ANT group were higher than DHP group (61.8% vs 23.8%, and 83.1% vs 48.5%. Subjects in ANT group also had a lower proportion of asexual parasitemia on day-3 than DHP group (1.4% vs 10.3%. The therapeutic efficacy of ANT and DHP, were 95.1% [95% confidence interval (CI = 88.8-99.1] and 91.9%  (95% CI = 84.3-96.0 by day 42. Both drugs had mild adverse events. Conclusion: The use of ANT is safe and has similar efficacy to DHP for treatment of adults and children patient with uncomplicated malaria at Primary Health Care. (Health Science Indones 2014;2:100-5.Key words: malaria, artemisinin-naphthoquine, dihydroartemisinin-piperaquine, primary health care.

Primary care direct access MRI for the investigation of chronic headache

International Nuclear Information System (INIS)

Taylor, T.R.; Evangelou, N.; Porter, H.; Lenthall, R.

2012-01-01

Aim: To assess the efficacy of a primary-care imaging pathway for neurology outpatients, from inception to deployment, compared with traditional outpatient referral. Materials and methods: After local agreement, guidelines were generated providing pathways for diagnosis and treatment of common causes of headache, highlighting “red-flag” features requiring urgent neurology referral, and selecting patients for direct magnetic resonance imaging (MRI) referral. In addition, reports were clarified and standardized. To evaluate the efficacy of the access pathway, a retrospective sequential review of 100 MRI investigations was performed comparing general practitioner (GP) referral, with traditional neurology referral plus imaging, acquired before the pathway started. Results: No statistically significant difference in rates of major abnormalities, incidental findings or ischaemic lesions were identified between the two cohorts. Reported patient satisfaction was high, with a cost reduction for groups using the pathway. Conclusion: The findings of the present study suggest that a defined access pathway for imaging to investigate chronic headache can be deployed appropriately in a primary-care setting.

Primary care direct access MRI for the investigation of chronic headache

Energy Technology Data Exchange (ETDEWEB)

Taylor, T.R., E-mail: timt@nhs.net [Queens Medical Centre, Nottingham (United Kingdom); Evangelou, N. [Queens Medical Centre, Nottingham (United Kingdom); Porter, H. [Nottingham Cripps Health Centre, Nottingham (United Kingdom); Lenthall, R. [Queens Medical Centre, Nottingham (United Kingdom)

2012-01-15

Aim: To assess the efficacy of a primary-care imaging pathway for neurology outpatients, from inception to deployment, compared with traditional outpatient referral. Materials and methods: After local agreement, guidelines were generated providing pathways for diagnosis and treatment of common causes of headache, highlighting 'red-flag' features requiring urgent neurology referral, and selecting patients for direct magnetic resonance imaging (MRI) referral. In addition, reports were clarified and standardized. To evaluate the efficacy of the access pathway, a retrospective sequential review of 100 MRI investigations was performed comparing general practitioner (GP) referral, with traditional neurology referral plus imaging, acquired before the pathway started. Results: No statistically significant difference in rates of major abnormalities, incidental findings or ischaemic lesions were identified between the two cohorts. Reported patient satisfaction was high, with a cost reduction for groups using the pathway. Conclusion: The findings of the present study suggest that a defined access pathway for imaging to investigate chronic headache can be deployed appropriately in a primary-care setting.

Assessing the Efficacy of Adjustable Moving Averages Using ASEAN-5 Currencies.

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Jacinta Chan Phooi M'ng

Full Text Available The objective of this research is to examine the trends in the exchange rate markets of the ASEAN-5 countries (Indonesia (IDR, Malaysia (MYR, the Philippines (PHP, Singapore (SGD, and Thailand (THB through the application of dynamic moving average trading systems. This research offers evidence of the usefulness of the time-varying volatility technical analysis indicator, Adjustable Moving Average (AMA' in deciphering trends in these ASEAN-5 exchange rate markets. This time-varying volatility factor, referred to as the Efficacy Ratio in this paper, is embedded in AMA'. The Efficacy Ratio adjusts the AMA' to the prevailing market conditions by avoiding whipsaws (losses due, in part, to acting on wrong trading signals, which generally occur when there is no general direction in the market in range trading and by entering early into new trends in trend trading. The efficacy of AMA' is assessed against other popular moving-average rules. Based on the January 2005 to December 2014 dataset, our findings show that the moving averages and AMA' are superior to the passive buy-and-hold strategy. Specifically, AMA' outperforms the other models for the United States Dollar against PHP (USD/PHP and USD/THB currency pairs. The results show that different length moving averages perform better in different periods for the five currencies. This is consistent with our hypothesis that a dynamic adjustable technical indicator is needed to cater for different periods in different markets.

Assessing the Efficacy of Adjustable Moving Averages Using ASEAN-5 Currencies.

Science.gov (United States)

Chan Phooi M'ng, Jacinta; Zainudin, Rozaimah

2016-01-01

The objective of this research is to examine the trends in the exchange rate markets of the ASEAN-5 countries (Indonesia (IDR), Malaysia (MYR), the Philippines (PHP), Singapore (SGD), and Thailand (THB)) through the application of dynamic moving average trading systems. This research offers evidence of the usefulness of the time-varying volatility technical analysis indicator, Adjustable Moving Average (AMA') in deciphering trends in these ASEAN-5 exchange rate markets. This time-varying volatility factor, referred to as the Efficacy Ratio in this paper, is embedded in AMA'. The Efficacy Ratio adjusts the AMA' to the prevailing market conditions by avoiding whipsaws (losses due, in part, to acting on wrong trading signals, which generally occur when there is no general direction in the market) in range trading and by entering early into new trends in trend trading. The efficacy of AMA' is assessed against other popular moving-average rules. Based on the January 2005 to December 2014 dataset, our findings show that the moving averages and AMA' are superior to the passive buy-and-hold strategy. Specifically, AMA' outperforms the other models for the United States Dollar against PHP (USD/PHP) and USD/THB currency pairs. The results show that different length moving averages perform better in different periods for the five currencies. This is consistent with our hypothesis that a dynamic adjustable technical indicator is needed to cater for different periods in different markets.

Do Published Data in Trials Assessing Cancer Drugs Reflect the Real Picture of Efficacy and Safety?

Science.gov (United States)

Lv, Jia-Wei; Chen, Yu-Pei; Zhou, Guan-Qun; Liu, Xu; Guo, Ying; Mao, Yan-Ping; Ma, Jun; Sun, Ying

2017-11-01

Background: The reporting quality of publications is of vital importance to ensure accurate evidence dissemination. This study aimed to compare the consistency of results reporting between the ClinicalTrials.gov results database and the respective matching publications. Methods: We identified 323 phase III/IV cancer drug trials with a randomized controlled design and searched PubMed for publications in a 50% random sample (n=160). Data were extracted independently from ClinicalTrials.gov and publications. A scoring system was applied to determine characteristics associated with reporting quality. Results: Of 117 reviewed trials with publications, result reporting was significantly more complete in ClinicalTrials.gov for efficacy measurement (92.3% vs 90.6%), serious adverse events (SAEs; 100% vs 43.6%), and other adverse events (OAEs; 100% vs 62.4%). For trials with both posted and published results for design information (n=117), efficacy measurements (n=98), SAEs (n=51), and OAEs (n=73), discrepancies were found in 16 (13.7%), 38 (38.8%), 26 (51.0%), and 54 (74.0%) trials, respectively. Overreporting of treatment effects (7 trials) and alteration of primary end points favoring statistically significant outcomes (11 trials) were the major discrepancies in efficacy reporting; incomplete (66 trials) and underreporting (20 trials) of SAEs were the predominant issues in benefit/risk reporting. Median quality score was 21 (range, 14-28). Trials that had parallel assignment, were phase IV, had primary funding by industry, were completed after 2009, and had earlier results posted possessed better reporting quality. Conclusions: Although most trials showed reasonable completeness and consistency, some discrepancies are prevalent and persistent, jeopardizing evidence-based decision-making. Our findings highlight the need to consult results systematically from both ClinicalTrials.gov and publications. Copyright © 2017 by the National Comprehensive Cancer Network.

Preclinical safety and efficacy of a new recombinant FIX drug product for treatment of hemophilia B.

Science.gov (United States)

Dietrich, Barbara; Schiviz, Alexandra; Hoellriegl, Werner; Horling, Frank; Benamara, Karima; Rottensteiner, Hanspeter; Turecek, Peter L; Schwarz, Hans Peter; Scheiflinger, Friedrich; Muchitsch, Eva-Maria

2013-11-01

Baxter has developed a new recombinant factor IX (rFIX) drug product (BAX326) for treating patients with hemophilia B, or congenital FIX deficiency. An extensive preclinical program evaluated the pharmacokinetics, efficacy, and safety of BAX326 in different species. The efficacy of BAX326 was tested in three mouse models of primary pharmacodynamics: tail-tip bleeding, carotid occlusion, and thrombelastography. The pharmacokinetics was evaluated after a single intravenous bolus injection in mice, rats, and macaques. Toxicity was assessed in rats and macaques, safety pharmacology in rabbits and macaques, and immunogenicity in mice. BAX326 was shown to be efficacious in all three primary pharmacodynamic studies (P ≤ 0.0076). Hemostatic efficacy was dose related and similar for the three lots tested. Pharmacokinetic results showed that rFIX activity and rFIX antigen concentrations declined in a bi-phasic manner, similar to a previously licensed rFIX product. BAX326 was well tolerated in rabbits and macaques at all dose levels; no thrombogenic events and no adverse clinical, respiratory, or cardiovascular effects occurred. BAX326 was also shown to have a similar immunogenicity profile to the comparator rFIX product in mice. These results demonstrate that BAX326 has a favorable preclinical safety and efficacy profile, predictive of a comparable effect to that of the previously licensed rFIX in humans.

A comparative In vivo efficacy of three spiral techniques versus incremental technique in obturating primary teeth

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Shalini Chandrasekhar

2018-01-01

Full Text Available Background: The aim of this study was to evaluate the efficiency of four different obturating techniques in filling the radicular space in primary teeth. Materials and Methods: This clinical trial was carried out on 34 healthy, cooperative children (5–9 years who had 63 carious primary teeth indicated for pulpectomy. They were divided into four groups, such that in each group, a total of 40 canals were allotted for obturation with respective technique. The root canals of selected primary teeth were filled with Endoflas obturating material using either bi-directional spiral (Group 1; incremental technique (Group 2, past inject (Group 3 or lentulo spiral (Group 4 according to the groups assigned. The effectiveness of the obturation techniques was assessed using postoperative radiographs. The assessment was made for a depth of fill in the canal, the presence of any voids using Modified Coll and Sadrian criteria. The obtained data were analyzed by using ANOVA test and unpaired t-test. Results: Bi-directional spiral and lentulo spiral were superior to other techniques in providing optimally filled canals (P< 0.05. The bi-directional spiral was superior to lentulo spiral in preventing overfill (P< 0.05. Conclusion: Based on the present study results, bi-directional spiral can be recommended as an alternate obturating technique in primary teeth.

Safety, Efficacy and Recurrence rate following tenosynovectomy and ...

African Journals Online (AJOL)

Objective: This study was conducted to compare the safety, efficacy and recurrence rate of primary tenosynovectomy versus intralesional steroid injection in the treatment of sclerosing tenosynovitis of deQuervain. Method: A prospective, comparative study of the safety, efficacy and recurrence rate following intralesional ...

Communication skills training for physicians performing work disability assessments increases knowledge and self-efficacy: results of a randomised controlled trial.

Science.gov (United States)

van Rijssen, Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2015-07-21

It was assessed whether a post-graduate communication skills training course would increase physicians' competence and knowledge with regard to communication during work disability assessment interviews, and would change the determinants of their communication behaviour. A randomised controlled trial was performed. At baseline and at follow-up, 42 physicians completed questionnaires. The primary outcome measures were competence and knowledge about communication. The secondary outcome measures were 21 self-reported determinants of communication behaviour. One-way analyses of variance and covariance were performed. There was no significant difference between the intervention and control groups in overall competence, but there was for the introduction phase (intervention: mean = 7.0, SD 2.7; control: mean = 4.8, SD 2.7; p = 0.014). Knowledge about communication was significantly higher (p = 0.001) in the intervention group (mean = 79.6, SD 9.2) than in the control group (mean = 70.9, SD 6.7), especially concerning the information-gathering phase of the interview (intervention: mean = 80.0, SD 10.2; control: mean = 69.4, SD 8.9; p = 0.001). The intervention group scored significantly better on 7 of the 21 self-reported determinants (secondary outcomes), including self-efficacy, intentions, skills and knowledge. The communication skills training course may improve some aspects of physician communication, but not all. Because physicians were unanimously positive about the course, further development is warranted. Implications for Rehabilitation Even though optimal communication is essential in face-to-face assessment interviews for determining entitlement to work disability benefits, and there is a lot at stake for the claimants, this issue has scarcely been addressed in scientific research. A tailor-made two-day communication skills training course, based on scientific research, increases physicians' knowledge about communication

Clinical undergraduate training and assessment in primary health care: Experiences gained from Crete, Greece

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Fioretos Michael

2005-05-01

Full Text Available Abstract Background Primary Health Care (PHC is increasingly being introduced into undergraduate medical education. In Greece, the Faculty of Medicine of the University of Crete was the first to introduce a 4-week long training in primary health care. This paper presents the experiences gained from the initial implementation of the teaching of practice-based primary care in rural Crete and reports on the assessment scale that was developed. Methods 284 students' case write-ups from the 6 primary care units (PCUs where they were allocated for the period 1990 to 1994 were analysed. The demographic data of the students and patients and the number of home visits were studied. Content analysis of the students' write-ups was carried out, using an assessment scale consisting of 10 dichotomous variables, in order to quantify eight (8 primary qualitative criteria. Results Internal reliability was estimated by the index KR20 = 0.67. Face and content validity was found to conform to the standards set for the course, while logistic linear regression analysis showed that the quality criteria could be used as an assessment scale. The number of home visits carried out varied between the various different PCUs (p Conclusion The primary health care course achieved the objectives of introducing students to comprehensive, community oriented care, although there was variation between the PCUs. The assessment scale that was developed to analyse the case-write ups of the students provided data that can be used to evaluate the course.

A primary care-based health needs assessment in inner city Dublin.

LENUS (Irish Health Repository)

O'Kelly, C M

2012-02-01

BACKGROUND: In 2001, a primary care-based health needs assessment (HNA) in South Inner City of Dublin identified high levels of morbidity and widespread and frequent use of primary care and specialist hospital services as particular concerns. AIMS: This study aims to determine the primary care health needs of a local community, from the perspective of service users and service providers. METHODS: A similar methodology to our 2001 HNA was adopted, involving semi-structured interviews with a convenience sample of patients attending two general practices and key informants regarding local health issues and health service utilisation. RESULTS: High levels of morbidity and chronic illness were found. A correlation between the local environment and ill-health was identified, as well as high utilisation of primary care services in the area. CONCLUSION: The establishment of a Primary Care Team would begin to address the health needs of the community.

Self-esteem, Self-efficacy, and Appearance Assessment of Young Female Patients Undergoing Facial Cosmetic Surgery: A Comparative Study of the Chinese Population.

Science.gov (United States)

Yin, Zhuming; Wang, Dafang; Ma, Yan; Hao, Shuwei; Ren, Huiwen; Zhang, Tingting; Chen, Wenlin; Fan, Jincai

2016-01-01

The psychological traits of cosmetic surgery patients (CSP) are important for selecting patients and postoperative patient satisfaction. A patient's self-esteem, self-efficacy, and self-assessment affect his or her motivation for cosmetic surgery, but the association among these traits remains unclear, especially in the Asian population. To clarify the association of a patient's psychological traits, decision to undergo cosmetic surgery, and the effectiveness of facial cosmetic surgery on the psychological conditions of young, female Chinese patients. Three different groups of young women (aged 18-30 years) from the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and 7 universities were enrolled from January 1, 2012, through December 31, 2014: CSPs (n = 161), general population controls (GPCs) (n = 355), and facial appearance raters (FARs) (n = 268). The last date of follow-up was January 20, 2015. Patient data from questionnaires were obtained preoperatively and 6 months postoperatively, and the data from the control groups were obtained immediately after enrollment. Front-view facial images of the study participants were taken and then shown to independent raters to assess the participants' facial appearances on a rating scale. Evaluation of self-esteem and self-efficacy, subjective and objective assessment of facial appearance, and structural equation models. A total of 163 CSPs and 387 GPCs were recruited for the study, and complete and valid data were obtained from 161 CSPs and 355 GPCs. All responses from the 268 FARs met the criteria for subsequent analysis. Of the questionnaires issued to the CSPs 6 months postoperatively, 126 valid responses were returned (response rate, 78.3%). Self-esteem and self-efficacy decreased significantly in preoperative patients compared with controls (P self-esteem and 21.50 [2.40] for CSPs and 28.59 [4.23] for GPCs for self-efficacy) and were found to be at nearly normal levels 6 months postoperatively (mean [SD

Efficacy of Carbopol 974P (Siccafluid in the treatment of severe to moderate keratoconjunctivitis sicca (KCS in patients with primary Sjögren’s syndrome (SS not responding to standard treatment with artificial tears

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A. Furlan

2011-09-01

Full Text Available Objective. To determine efficacy and safety of Carbopol 974P in the treatment of severe to moderate keratoconjunctivitis sicca (KCS in patients with primary Sjögren’s syndrome (SS not responding to standard treatment with artificial tears. Methods. 60 patients (57 F, 3 M, mean age 52.5±12.0, mean disease duration 12.2±7.1 yrs affected with primary SS diagnosed according to the European Community Study Group criteria were studied. Foregoing medications for SS and artificial tears for KCS have not been changed within 3 and 2 months respectively prior to the study onset. In all cases Carbopol 974P was added because symptoms of KCS were not adequately controlled with traditional lubricants. Schirmer I test, B.U.T. (break up time, rose Bengal-stain, clinical ophthalmological examination (i.e. fluorescein staining, keratis, corneal infiltrates and ulcers and a questionnaire for dry eye symptoms (range 0-30 were performed at entry (T0 and after 2 (T1 and 12 (T2 weeks. Assessment of global efficacy was obtained by VAS 0-100 at T2 either by patients and by the ophthalmologist. Results. Lachrymal tests significantly improved after 2 and, even more, after 12 weeks. Clinical ophthalmologic picture also ameliorated: a remarkable reduction of fluorescein positive lesions was demonstrated from 71.6% of the cases at T0 to 38.3% at T2. Total score of symptoms (T0: 16.1±7.3 dropped to 11.9±6.6 (T1 (p=0.000 and then to 6.7±5.3 (T2 (p=0.000. Global efficacy expressed by patients and physician was 74.8±15.9 and 76.6±13.0, respectively. No adverse events (blurred vision, allergy were reported throughout the study. Conclusions. Our study seems to demonstrate that addition of Carbopol 974P to the traditional therapeutic armamentarium for moderate to severe KCS is useful and well accepted in patients with primary SS in which management of ocular symptoms is unsatisfactory.

Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool.

Science.gov (United States)

Renfro, Mindy Oxman; Fehrer, Steven

2011-01-01

Unintentional falls is an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. This article describes the content selection and development of a simple-to-administer, multifactorial, Fall Risk Assessment & Screening Tool (FRAST), designed specifically for use in primary care settings to identify those older adults with high fall risk. Fall Risk Assessment & Screening Tool incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. Fall Risk Assessment & Screening Tool has been developed to assess fall risk in the target population of older adults (older than 65 years) living and ambulating independently in the community. Many fall risk factors have been considered and 15 items selected for inclusion. Fall Risk Assessment & Screening Tool includes 4 previously validated measures to assess balance, depression, falls efficacy, and home safety. Reliability and validity studies of FRAST are under way. Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing primary care practitioners (PCPs) with a very simple screening tool is imperative. Fall Risk Assessment & Screening Tool was created to allow for safe, quick, and low-cost administration by minimally trained office staff with interpretation and

Assessment of the anterior chamber parameters after laser iridotomy in primary angle close suspect using Pentacam and gonioscopy.

Science.gov (United States)

Esmaeili, Alireza; Barazandeh, Behzad; Ahmadi, Sina; Haghi, Alireza; Ahmadi Hosseini, Seyed Mahdi; Abolbashari, Fereshteh

2013-01-01

To evaluate the changes in the anterior segment parameters of the subjects with primary angle closure suspect (PACS) before and after laser iridotomy (LI) using the Pentacam and gonioscopy. Forty-eight eyes of 48 PACS were included. Anterior chamber angle (ACA), central anterior chamber depth (ACD), anterior chamber volume (ACV) and central corneal thickness (CCT) were recorded from the Pentacam before and one month after LI. ACA was graded according to Shaffer classification using the Goldmann gonioscopy. ACA increased significantly from 25.59±4.41 to 26.46±4.33 degrees (P=0.009) and ACV changed from 85.97±16.07mm(3) to 99.25±15.83mm(3) (P=0.000). The changes in ACD, CCT and intraocular pressure were non-significant (P>0.05). Gonioscopy showed significant widening of the Shaffer angle in 4 quadrants (P<0.001). Pentacam can serve as the objective instrument in assessing the efficacy of LI.

Assessment of the efficacy of second life, a virtual learning environment, in dental education.

Science.gov (United States)

El Tantawi, Maha M A; El Kashlan, Mona K; Saeed, Yasmin M

2013-12-01

This study assessed the efficacy of Second Life (SL) in delivering lectures and demonstrating clinical procedures. Sixteen students in a dental school in Alexandria, Egypt, volunteered to participate in SL to learn about topical fluoride through lectures and YouTube videos demonstrating the application of fluoride gel. This was followed by face to face (F2F) sessions about pits and fissures sealant including lectures and F2F demonstration. Knowledge improvement was assessed by pre- and posttests; practical skills were assessed by a checklist; and percent scores were calculated. The relation between these scores and some background variables was assessed. Students' satisfaction with and perceptions of SL were also assessed. Knowledge improved significantly after both SL and F2F experiences (peducation institutions with problems of increasing numbers of students and limited space.

Gamification of cognitive assessment and cognitive training: A systematic review of applications, approaches and efficacy

Directory of Open Access Journals (Sweden)

Jim Lumsden

2015-11-01

5.\tHow successful has gamification been in cognitive testing and training thus far? Method: Using several online databases, we searched the titles, abstracts and keywords of database entries using the search strategy (gamif* OR game OR games AND (cognit* OR engag* OR behavi* OR health* OR attention OR motiv*. Searches included articles published in English between January 2007 and October 2015. Non-peer reviewed studies such as abstracts or conference posters were excluded. Furthermore, due to the specific focus on cognitive assessment and training we excluded several other common uses of gamification including: gamification for education purposes, advertising purposes, disease management, health promotion, physical activity promotion, exposure therapy or rehabilitation. We also excluded studies that were merely used virtual reality or a 3D environment without involving any game mechanics: engagement had to be the primary reason for using a game-like design. Results: Our review identified 33 relevant studies, covering 31 gamified cognitive tasks used across a wide range of disorders and cognitive domains. Gamified cognitive training to relieve attention deficit hyperactivity disorder symptoms was particularly prominent. We describe the game mechanics used in gamified cognitive tasks, their effectiveness and frequency of use by designers. We also found that the majority of gamified cognitive tasks were rated as enjoyable or engaging by the study participants. Gamified assessments were typically validated successfully; however the efficacy of game-like cognitive training is more difficult to interpret due to several poor quality studies. High heterogeneity of study designs and small sample sizes highlight the need for further research in both training and testing. Conclusions: The evidence suggests that gamified cognitive training is motivating for users, though not necessarily an effective intervention. Nevertheless, gamification can provide a way to develop

Impact of Pretreatment Change on Mechanism of Behavior Change Research: An Applied Example Using Alcohol Abstinence Self-Efficacy.

Science.gov (United States)

Noyes, Emily T; Levine, Jacob A; Schlauch, Robert C; Crane, Cory A; Connors, Gerard J; Maisto, Stephen A; Dearing, Ronda L

2018-03-01

With the growing recognition that, for some, significant changes in drinking occur before the first treatment session (i.e., pretreatment change), researchers have called for the careful assessment of when change occurs and its potential impact on mechanism of behavior change (MOBC) research. Using a commonly hypothesized MOBC variable, alcohol abstinence self-efficacy, the primary aim of this study was to examine the effect of pretreatment change on the study of MOBCs. Sixty-three individuals diagnosed with alcohol dependence were recruited to participate in a 12-week cognitive-behavioral treatment. Participants completed weekly assessments of self-efficacy and drinking behaviors. Multilevel time-lagged regression models indicated that pretreatment change significantly moderated the effect of self-efficacy on the number of drinking days, such that among those higher on pretreatment change, higher self-efficacy ratings predicted lower rates of drinking days in the week until the next treatment session. In contrast, pretreatment change did not moderate the effect of self-efficacy on the rate of heavy drinking days. Results from the current study add to a small but growing body of research highlighting the importance of pretreatment change when studying MOBCs. Further, these results provide important insights into the conditions in which self-efficacy may play an important role in treatment outcomes.

Vietnam as a Case Example of School-Based Mental Health Services in Low and Middle Income Countries: Efficacy and Effects of Risk Status

Science.gov (United States)

Dang, Hoang-Minh; Weiss, Bahr; Nguyen, Cao Minh; Tran, Nam; Pollack, Amie

2017-01-01

The purposes of this study were to (a) assess the efficacy of a universal classroom-based mental health and social skills program for primary school students in Vietnam, and (b) given the universal nature of the intervention, assess outcomes as a function of risk status (high versus low). RECAP-VN is a semi-structured program that provides…

Diagnostic Efficacy of a Single Progesterone Determination to Assess Full-Term Pregnancy in the Bitch.

Science.gov (United States)

Rota, A; Charles, C; Starvaggi Cucuzza, A; Pregel, P

2015-12-01

In clinical settings, when the reproductive history of a near-term bitch is limited to mating dates, the possibility to accurately assess whether pregnancy is at term could be very useful in order to be able to plan a correct management of parturition or to safely perform an elective Caesarean section. The aim of this study was to assess the diagnostic efficacy of a single progesterone determination, measured by chemiluminescent immunoassay (CLIA), in predicting the occurrence of parturition on the following day. At least one blood sample was collected from 51 pre-partum bitches during the 3 days before parturition and on day of parturition. The efficacy of progesterone as a marker of the end of pregnancy was tested using a receiver operating characteristic (ROC) analysis. Youden's index was calculated to select the optimal cut-off value (with 95% confidence interval), aiming at maximizing the correct identification of negative events, so not to risk to diagnose as full term a bitch which is not. Progesterone concentration lower than 3.4 ng/ml correctly identified the bitches whelping the following day; however, because of the obliged prudential approach, sensitivity was low (46.88%), and 17 of 32 full-term bitches were missed. Due to a very large individual variation, a single progesterone determination has low diagnostic efficacy, although it can represent a useful first screening. © 2015 Blackwell Verlag GmbH.

Safety and efficacy of erenumab for preventive treatment of chronic migraine

DEFF Research Database (Denmark)

Tepper, Stewart; Ashina, Messoud; Reuter, Uwe

2017-01-01

BACKGROUND: The calcitonin gene-related peptide (CGRP) pathway is important in migraine pathophysiology. We assessed the efficacy and safety of erenumab, a fully human monoclonal antibody against the CGRP receptor, in patients with chronic migraine. METHODS: This was a phase 2, randomised, double...... assignment. The primary endpoint was the change in monthly migraine days from baseline to the last 4 weeks of double-blind treatment (weeks 9-12). Safety endpoints were adverse events, clinical laboratory values, vital signs, and anti-erenumab antibodies. The efficacy analysis set included patients who...... received at least one dose of investigational product and completed at least one post-baseline monthly measurement. The safety analysis set included patients who received at least one dose of investigational product. The study is registered with ClinicalTrials.gov, number NCT02066415. FINDINGS: From April...

Integrated impact assessment in the UK--use, efficacy and future development

International Nuclear Information System (INIS)

Milner, Susan J.; Bailey, Cathy; Deans, Julia; Pettigrew, Dulcie

2005-01-01

This paper reports on the findings of an English Department of Health funded study that mapped out examples of integrated impact assessment (IIA) activity, mainly in the UK. Approximately 350 regional and local organisations that have policy and policy implementation roles were contacted via e-mail and from these, 77 telephone interviews were carried out. The interviews revealed 21 examples of IIA being used or developed within the UK. The 77 interviews also generated a rich discussion about the use, efficacy and future development of IIA. Although the findings indicate little IIA activity in the UK, discussions with interviewees suggest that there is growing receptiveness to integrating different forms of assessment into a single assessment process. In part this appears to be driven by sustainable development objectives, both at a strategic and at a local level. In part receptivity to IIA may also be driven by a growing interest in health impact assessment (HIA). There are advocates of the need to integrate health criteria more fully into other forms of impact assessment. The study also highlights the challenges involved in trying to develop IIA methods that are adaptable, flexible and tailored to the different needs of policy-makers and planners

Assessment of Physical Activity, Exercise Self-Efficacy, and Stages of Change in College Students Using a Street-Based Survey Method.

Science.gov (United States)

Leenders, Nicole Y. J. M.; Silver, Lorraine Wallace; White, Susan L.; Buckworth, Janet; Sherman, W. Michael

2002-01-01

Used a street-based survey to assess college students' physical activity level, exercise self-efficacy, and stages of change for exercise behavior. A large proportion of respondents were not regularly active. Exercise self-efficacy was an important variable in exercise behavior. The low cost, ease of data collection, and short turnaround for…

Ophthalmic Skills Assessment of Primary Health Care Workers at ...

African Journals Online (AJOL)

Proficiency in the basic ophthalmic skills is a cri cal factor in the effec ve delivery of eye care services at the primary level of care. The aim of the study was to assess the ability of ... out visual acuity test and correctly iden fy cataract and conjunc vi s using pictures of eye condi ons and ..... Medical Laboratory Technician.

Self-efficacy for exercise, more than disease-related factors, is associated with objectively assessed exercise time and sedentary behaviour in rheumatoid arthritis.

Science.gov (United States)

Huffman, K M; Pieper, C F; Hall, K S; St Clair, E W; Kraus, W E

2015-01-01

Until recently, reports of physical activity in rheumatoid arthritis (RA) were limited to self-report methods and/or leisure-time physical activity. Our objectives were to assess, determine correlates of, and compare to well-matched controls both exercise and sedentary time in a typical clinical cohort of RA. Persons with established RA (seropositive or radiographic erosions; n = 41) without diabetes or cardiovascular disease underwent assessments of traditional and disease-specific correlates of physical activity and 7 days of triaxial accelerometry. Twenty-seven age, gender, and body mass index (BMI)-matched controls were assessed. For persons with RA, objectively measured median (25th-75th percentile) exercise time was 3 (1-11) min/day; only 10% (n = 4) of participants exercised for ≥ 30 min/day. Time spent in sedentary activities was 92% (89-95%). Exercise time was not related to pain but was inversely related to disease activity (r = -0.3, p self-efficacy for endurance activity (r = 0.4, p self-efficacy for endurance activity (r = -0.4, p self-efficacy for physical activity but similar amounts of exercise and sedentary time. For persons with RA and without diabetes or cardiovascular disease, time spent in exercise was well below established guidelines and activity patterns were predominantly sedentary. For optimal care in RA, in addition to promoting exercise, clinicians should consider assessing sedentary behaviour and self-efficacy for exercise. Future interventions might determine whether increased self-efficacy can increase physical activity in RA.

Assessment of Primary Representational Systems with Neurolinguistic Programming: Examination of Preliminary Literature.

Science.gov (United States)

Dorn, Fred J.; And Others

1983-01-01

Reviews the inconsistent findings of studies on neurolinguistic programing and recommends some areas that should be examined to verify various claims. Discusses methods of assessing client's primary representational systems, including predicate usage and eye movements, and suggests that more reliable methods of assessing PRS must be found. (JAC)

The headache under-response to treatment (HURT) questionnaire, an outcome measure to guide follow-up in primary care: development, psychometric evaluation and assessment of utility.

Science.gov (United States)

Steiner, T J; Buse, D C; Al Jumah, M; Westergaard, M L; Jensen, R H; Reed, M L; Prilipko, L; Mennini, F S; Láinez, M J A; Ravishankar, K; Sakai, F; Yu, S-Y; Fontebasso, M; Al Khathami, A; MacGregor, E A; Antonaci, F; Tassorelli, C; Lipton, R B

2018-02-14

Headache disorders are both common and burdensome but, given the many people affected, provision of health care to all is challenging. Structured headache services based in primary care are the most efficient, equitable and cost-effective solution but place responsibility for managing most patients on health-care providers with limited training in headache care. The development of practical management aids for primary care is therefore a purpose of the Global Campaign against Headache. This manuscript presents an outcome measure, the Headache Under-Response to Treatment (HURT) questionnaire, describing its purpose, development, psychometric evaluation and assessment for clinical utility. The objective was a simple-to-use instrument that would both assess outcome and provide guidance to improving outcome, having utility across the range of headache disorders, across clinical settings and across countries and cultures. After literature review, an expert consensus group drawn from all six world regions formulated HURT through item development and item reduction using item-response theory. Using the American Migraine Prevalence and Prevention Study's general-population respondent panel, two mailed surveys assessed the psychometric properties of HURT, comparing it with other instruments as external validators. Reliability was assessed in patients in two culturally-contrasting clinical settings: headache specialist centres in Europe (n = 159) and primary-care centres in Saudi Arabia (n = 40). Clinical utility was assessed in similar settings (Europe n = 201; Saudi Arabia n = 342). The final instrument, an 8-item self-administered questionnaire, addressed headache frequency, disability, medication use and effect, patients' perceptions of headache "control" and their understanding of their diagnoses. Psychometric evaluation revealed a two-factor model (headache frequency, disability and medication use; and medication efficacy and headache control), with

An assessment of primary care attributes from the perspective of female healthcare users1

OpenAIRE

Lima, Eliane de F?tima Almeida; Sousa, Ana In?s; Primo, C?ndida Cani?ali; Leite, Francielie Marabotti Costa; Lima, Rita de Cassia Duarte; Maciel, Ethel Leonor N?ia

2015-01-01

OBJECTIVE: this study sought to assess the quality of the Family Health Strategy (FHS) and investigated the association between primary care attributes (PCAs) and the sociodemographic characteristics of users. METHOD: a total of 215 female FHS users were interviewed for this descriptive and cross-sectional study. The Primary Care Assessment Tool (PCATool), Adult Edition was used, and the results were analyzed using Fisher's exact tests, Pearson's chi-square tests and logistic regressions. RES...

assessment of the english literacy level of patients in primary health ...

African Journals Online (AJOL)

2010-09-07

Sep 7, 2010 ... The English literacy level of primary health care patients in Tshwane .... It is therefore important to use appropriate literacy assessment tools to .... Participants were given the following instruction: ..... One of the disadvantages.

Efficacy of applying self-assessment of larviciding operation, Chabahar, Iran

Science.gov (United States)

2012-01-01

Background Appropriate supervision, along with availability of an effective system for monitoring and evaluation, is a crucial requirement to guarantee sufficient coverage and quality of malaria vector control procedures. This study evaluated the efficacy of self-assessment practice as a possible innovative method towards achieving high coverage and excellent quality of larviciding operation in Iran. Methods The research was conducted on the randomly selected rural health centre of Kanmbel Soliman with 10 staff and 30 villages, in three main steps: (i) assessment of effectiveness of larviciding operations in the study areas before intervention through external assessment by a research team; (ii) self-assessment of larviciding operations (intervention) by staff every quarter for three rounds; and, (iii) determining the effectiveness of applying self-assessment of larviciding operations in the study areas. Two toolkits were used for self-assessment and external evaluation. The impact of self-assessment of larviciding operations was measured by two indicators: percentage of missed breeding habitats and cleaned breeding habitats among randomly selected breeding sites. Moreover, the correlation coefficients were measured between self-assessment measures and scores from external evaluation. The correlation coefficient and Mann Whitney test were used to analyse data. Results Following the utilization of self-assessment, the percentage of missed breeding habitats decreased significantly from 14.23% to 1.91% (P self-assessment in performance of vector control; the maximum effect of intervention were seen in an action plan for monitoring and evaluation of larviciding operations at field level, geographical reconnaissance for the registration of breeding habitats and worker skills related to larviciding. Before intervention, the results of self-assessment practice were compatible with external evaluation in 76.3% of 139 reviewed reports of self-assessment. After intervention

Efficacy and safety of latanoprost versus timolol for primary open angle glaucoma and ocular hypertension: a Meta-analysis

Directory of Open Access Journals (Sweden)

Yang-Yang Wu

2014-03-01

Full Text Available AIM: To evaluate the efficacy and safety of latanoprost versus timolol for primary open angle glaucoma(POAGand ocular hypertension(OHT.METHODS: This was an evidence-based medicine science study. Pertinent studies of randomized controlled trial(RCTwere identified through searches of PubMed, Medline, CNKI and China Biology Medicine disc. The intensive searching by hand and internet was also designed. According to inclusion and exclusion criteria, the study object was limited. Quality of literatures were evaluated by experienced researchers according to the Jadad Score. RevMan 5.0 offered by Cochrane was used for Meta-analysis aimed at the ratio of low intraocular tension and adverse drug reaction.RESULTS: A total of 9 RCT sadded up to 555 patients were involved. The results of meta-analysis showed that, athe difference at 2, 6, 12wk both had statistical significance, latanoprost showed greater intraocular pressure(IOPlowering efficacy compared with timolol. The weighted mean difference(WMDat 2, 6, 12wk was respectively \\〖-0.76, 95% CI(-1.32 to -0.20\\〗, \\〖-1.15, 95% CI(-1.68 to 0.63\\〗 and \\〖-1.01, 95% CI(-1.42 to -0.61\\〗. bThe difference in conjunctival congestion(OR=2.25, 95% CI 0.99 to 5.08and foreign body sensation(OR=2.48, 95% CI 1.02 to 6.03 between latanoprost and timolol group was not statistically significant. CONCLUSION: Latanoprost showed greater IOP lowering efficacy at 12wk compared with timolol for OAG and OH patients. The conjunctival hyperemia, foreign body sensation, iris pigmentation deepened, vision damage of latanoprost group at 12wk compared with timolol, the difference was not significant. This conclusion is not powerful enough in proof due to the medium methodology quality of the included studies, so a large number of high-quality RCTs with large sample are needed for objectively, precisely and entirely evaluating the efficacy.

Teacher self-efficacy in instruction and in parent involvement

OpenAIRE

Peter Gavora; Jana Majerčíková

2012-01-01

The study investigated self-efficacy of a sample of Slovak primary schoolteachers in two areas: area of instruction and area of parent involvement. Twoinstruments were used: the 16-item Slovak version of Teacher Efficacy Scale ofGibson and Dembo, and ZdUR, a 24-item scale to measure self-efficacy of teacherin parents’ involvement, developed by authors of the present study. The correlation between scores of personal teaching efficacy dimension of TES and ZdUR was 0.58 and between general teach...

Pre-Service Teacher Self-Efficacy in Digital Technology

Science.gov (United States)

Lemon, Narelle; Garvis, Susanne

2016-01-01

Self-efficacy is an important motivational construct for primary school teachers (teachers of children aged 5-12 years) within Australia. Teacher self-efficacy beliefs will determine the level of teacher confidence and competence to engage with a task. In this study, we explore engagement with digital technology and the associated learning and…

Efficacy and Tolerability of Indiplon in Transient Insomnia

Science.gov (United States)

Rosenberg, Russell; Roth, Thomas; Scharf, Martin B.; Lankford, D. Alan; Farber, Robert

2007-01-01

Objectives: The efficacy of indiplon was evaluated by polysomnography (PSG) in an experimental model of transient insomnia consisting of the first night effect combined with a 2-hour phase advance. Methods: Healthy volunteers age 21–64 years (N=593; 62% female; mean (± SEM) years, 32±0.39) were randomized to double-blind treatment with a single nighttime dose of indiplon (10 mg or 20 mg) or placebo. PSG assessments included latency to persistent sleep (LPS, primary endpoint) and total sleep time (TST); self-report assessments included sleep quality (SQ); next day residual effects were evaluated by the Digit Symbol Substitution Test (DSST), Symbol Copying Test (SCT), and a Visual Analog Scale of sleepiness (VAS). Results: LPS mean (± SEM) values were significantly reduced on indiplon 10 mg (21.2±1.5 minutes) and indiplon 20 mg (16.8±1.1 minutes) compared to placebo (33.1±2.5minutes; p inducing sleep, increasing sleep duration, and improving overall sleep quality without next day residual effects in healthy volunteers in a model of transient insomnia. Citation: Rosenberg R; Roth T; Scharf MB et al. Efficacy and tolerability of indiplon in transient insomnia. J Clin Sleep Med 2007;3(4):374-379. PMID:17694726

The Measurement Properties of the Assessing Math Concepts' Assessments of Primary Students' Number Sense Skills.

Science.gov (United States)

Martin, Christie; Lambert, Richard; Polly, Drew; Wang, Chuang; Pugalee, David

The purpose of this study was to examine the measurement properties of the Assessing Math Concepts AMC Anywhere Hiding and Ten Frame Assessments, formative assessments of primary students' number sense skills. Each assessment has two parts, where Part 1 is intended to be foundational skills for part two. Part 1 includes manipulatives whereas Part 2 does not. Student data from 228 kindergarten through second grade teachers with a total of 3,666 students was analyzed using Rasch scaling. Data analyses indicated that when the two assessments were examined separately the intended order of item difficulty was clear. When the parts of both assessments were analyzed together, the items in Part 2 were not consistently more difficult that the items in Part 1. This suggests an alternative sequence of tasks in that students may progress from working with a specific number with manipulatives then without manipulatives rather than working with a variety of numbers with manipulatives before moving onto assessments without manipulatives.

Adipocytes Impair Efficacy of Antiretroviral Therapy

Science.gov (United States)

Couturier, Jacob; Winchester, Lee C.; Suliburk, James W.; Wilkerson, Gregory K.; Podany, Anthony T.; Agarwal, Neeti; Chua, Corrine Ying Xuan; Nehete, Pramod N.; Nehete, Bharti P.; Grattoni, Alessandro; Sastry, K. Jagannadha; Fletcher, Courtney V.; Lake, Jordan E.; Balasubramanyan, Ashok; Lewis, Dorothy E.

2018-01-01

Adequate distribution of antiretroviral drugs to infected cells in HIV patients is critical for viral suppression. In humans and primates, HIV- and SIV-infected CD4 T cells in adipose tissues have recently been identified as reservoirs for infectious virus. To better characterize adipose tissue as a pharmacological sanctuary for HIV-infected cells, in vitro experiments were conducted to assess antiretroviral drug efficacy in the presence of adipocytes, and drug penetration in adipose tissue cells (stromal-vascular-fraction cells and mature adipocytes) was examined in treated humans and monkeys. Co-culture experiments between HIV-1-infected CD4 T cells and primary human adipocytes showed that adipocytes consistently reduced the antiviral efficacy of the nucleotide reverse transcriptase inhibitor tenofovir and its prodrug forms tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF). In HIV-infected persons, LC-MS/MS analysis of intracellular lysates derived from adipose tissue stromal-vascular-fraction cells or mature adipocytes suggested that integrase inhibitors penetrate adipose tissue, whereas penetration of nucleoside/nucleotide reverse transcriptase inhibitors such as TDF, emtricitabine, abacavir, and lamivudine is restricted. The limited distribution and functions of key antiretroviral drugs within fat depots may contribute to viral persistence in adipose tissue. PMID:29630975

Efficacy of the Aussie Optimism Program: Promoting Pro-social Behavior and Preventing Suicidality in Primary School Students. A Randomised-Controlled Trial

Directory of Open Access Journals (Sweden)

Clare M. Roberts

2018-02-01

Full Text Available The efficacy of an enhanced version of the Aussie Optimism Program (AOP was investigated in a cluster randomized controlled trial. Grade 6 students aged 10–11 years of age (N = 2288 from 63 government primary schools in Perth, Western Australia, participated in the pre, post, and follow-up study. Schools were randomly assigned to one of three conditions: Aussie Optimism with teacher training, Aussie Optimism with teacher training plus coaching, or a usual care condition that received the regular Western Australian Health Education Curriculum. Students in the Aussie Optimism conditions received 20, 1-h lessons relating to social and interpersonal skills and optimistic thinking skills over the last 2 years of primary school. Parents in the active conditions received a parent information booklet each year, plus a self-directed program in Grade 7. Students and parents completed the Extended Strengths and Difficulties Questionnaire. Students who scored in the clinical range on the Emotional Symptoms Scale were given The Diagnostic Interview for Children and Adolescents IV, to assess suicidal ideation and behavior, and depressive and anxiety disorders. Results indicated that Aussie Optimism with teacher training plus coaching was associated with the best outcomes: a significant increase in student-reported pro-social behavior from pre-test to post-test 1 (maintained at post-test 2 and significantly lower incidence rates from suicidal ideation at post-test 2 and follow-up. No significant intervention effects on anxiety and depressive disorders, and total difficulties were reported. These findings suggest that the AOP with teacher training along with coaching may have the potential to positively impact on suicidality and pro-social behavior in the pre-adolescent years.

Algorithms for the assessment and management of insomnia in primary care

Directory of Open Access Journals (Sweden)

Donald Hilty

2009-04-01

Full Text Available Donald Hilty1, Julie S Young1, James A Bourgeois1, Sally Klein2, Kimberly A Hardin31Department of Psychiatry and Behavioral Sciences; 2UC Davis Medical Center; 3Sleep Medicine Fellowship Training Program, University of California Davis, Sacramento, CA, USAAbstract: Insomnia is a leading cause of sleep disturbance in primary care practice affecting >30% of people in the United States and can result in psychological and physiological consequences. We aim for a focused discussion of some of the underpinnings of insomnia and practical tips for management (eg, algorithms. A PubMed search was conducted using English language papers between 1997–2007, with the terms “sleep,” “insomnia”; “primary care” and “clinics”; “comorbid conditions”; “treatment” and “management.” Sleep, psychiatric and medical disorders significantly affect sleep, causing patient suffering, potentially worsening of other disorders and increasing the use of primary care services. We provide an outline for practical assessment and treatment of insomnia in primary care, including the strengths and weaknesses of medications.Keywords: insomnia, primary care, depression, anxiety, sleep, disorder

Adenoviral Gene Delivery to Primary Human Cutaneous Cells and Burn Wounds

OpenAIRE

Hirsch, Tobias; von Peter, Sebastian; Dubin, Grzegorz; Mittler, Dominik; Jacobsen, Frank; Lehnhardt, Markus; Eriksson, Elof; Steinau, Hans-Ulrich; Steinstraesser, Lars

2006-01-01

The adenoviral transfer of therapeutic genes into epidermal and dermal cells is an interesting approach to treat skin diseases and to promote wound healing. The aim of this study was to assess the in vitro and in vivo transfection efficacy in skin and burn wounds after adenoviral gene delivery. Primary keratinocytes (HKC), fibroblasts (HFB), and HaCaT cells were transfected using different concentrations of an adenoviral construct (eGFP). Transfection efficiency and cytotoxicity was determine...

Quality assessment of diagnosis and antibiotic treatment of infectious diseases in primary care

DEFF Research Database (Denmark)

Saust, Laura Trolle; Monrad, Rikke Nygaard; Hansen, Malene Plejdrup

2016-01-01

QIs, especially disease-specific QIs concerning the diagnostic process, is needed. KEY POINTS In order to improve the use of antibiotics in primary care, measurable instruments, such as quality indicators, are needed to assess the quality of care being provided. A total of 11 studies were found......OBJECTIVE: To identify existing quality indicators (QIs) for diagnosis and antibiotic treatment of patients with infectious diseases in primary care. DESIGN: A systematic literature search was performed in PubMed and EMBASE. We included studies with a description of the development of QIs...... for diagnosis and antibiotic use in patients with infectious diseases in primary care. We extracted information about (1) type of infection; (2) target for quality assessment; (3) methodology used for developing the QIs; and (4) whether the QIs were developed for a national or international application. The QIs...

Reliability of diagnosis and clinical efficacy of visceral osteopathy: a systematic review.

Science.gov (United States)

Guillaud, Albin; Darbois, Nelly; Monvoisin, Richard; Pinsault, Nicolas

2018-02-17

In 2010, the World Health Organization published benchmarks for training in osteopathy in which osteopathic visceral techniques are included. The purpose of this study was to identify and critically appraise the scientific literature concerning the reliability of diagnosis and the clinical efficacy of techniques used in visceral osteopathy. Databases MEDLINE, OSTMED.DR, the Cochrane Library, Osteopathic Research Web, Google Scholar, Journal of American Osteopathic Association (JAOA) website, International Journal of Osteopathic Medicine (IJOM) website, and the catalog of Académie d'ostéopathie de France website were searched through December 2017. Only inter-rater reliability studies including at least two raters or the intra-rater reliability studies including at least two assessments by the same rater were included. For efficacy studies, only randomized-controlled-trials (RCT) or crossover studies on unhealthy subjects (any condition, duration and outcome) were included. Risk of bias was determined using a modified version of the quality appraisal tool for studies of diagnostic reliability (QAREL) in reliability studies. For the efficacy studies, the Cochrane risk of bias tool was used to assess their methodological design. Two authors performed data extraction and analysis. Eight reliability studies and six efficacy studies were included. The analysis of reliability studies shows that the diagnostic techniques used in visceral osteopathy are unreliable. Regarding efficacy studies, the least biased study shows no significant difference for the main outcome. The main risks of bias found in the included studies were due to the absence of blinding of the examiners, an unsuitable statistical method or an absence of primary study outcome. The results of the systematic review lead us to conclude that well-conducted and sound evidence on the reliability and the efficacy of techniques in visceral osteopathy is absent. The review is registered PROSPERO 12th of December

The development of a new breast feeding assessment tool and the relationship with breast feeding self-efficacy.

Science.gov (United States)

Ingram, Jenny; Johnson, Debbie; Copeland, Marion; Churchill, Cathy; Taylor, Hazel

2015-01-01

to develop a breast feeding assessment tool to facilitate improved targeting of optimum positioning and attachment advice and to describe the changes seen following the release of a tongue-tie. development and validation of the Bristol Breastfeeding Assessment Tool (BBAT) and correlation with breast feeding self-efficacy. maternity hospital in South West England. 218 breast feeds (160 mother-infant dyads); seven midwife assessors. the tool has more explanation than other tools to remind those supporting breast-feeding women about the components of an efficient breast feed. There was good internal reliability for the final 4-item BBAT (Cronbach's alpha=0.668) and the midwives who used it showed a high correlation in the consistency of its use (ICC=0.782). Midwives were able to score a breast feed consistently using the BBAT and felt that it helped them with advice to mothers about improving positioning and attachment to make breast feeding less painful, particularly with a tongue-tied infant. The tool showed strong correlation with breast feeding self-efficacy, indicating that more efficient breast feeding technique is associated with increased confidence in breast feeding an infant. the BBAT is a concise breast feeding assessment tool facilitating accurate, rapid breast feeding appraisal, and targeting breast feeding advice to mothers acquiring early breast feeding skills or for those experiencing problems with an older infant. Accurate assessment is essential to ensure enhanced breast feeding efficiency and increased maternal self-confidence. the BBAT could be used both clinically and in research to target advice to improve breast feeding efficacy. Further research is needed to establish its wider usefulness. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Assessment of Scientific Communication Self-Efficacy, Interest, and Outcome Expectations for Career Development in Academic Medicine

Science.gov (United States)

Anderson, Cheryl B.; Lee, Hwa Young; Byars-Winston, Angela; Baldwin, Constance D.; Cameron, Carrie; Chang, Shine

2015-01-01

Competency in forms of scientific communication, both written and spoken, is essential for success in academic science. This study examined the psychometric properties of three new measures, based on social cognitive career theory, that are relevant to assessment of skill and perseverance in scientific communication. Pre- and postdoctoral trainees in biomedical science (N = 411) completed online questionnaires assessing self-efficacy in scientific communication, career outcome expectations, and interest in performing tasks in scientific writing, oral presentation, and impromptu scientific discourse. Structural equation modeling was used to evaluate factor structures and model relations. Confirmatory factor analysis supported a 22-item, 3-factor measure of self-efficacy, an 11-item, 2-factor measure of outcome expectations, and a 12-item, 3-factor measure of interest in scientific communication activities. Construct validity was further demonstrated by theory-consistent inter-factor relations and relations with typical communications performance behaviors (e.g., writing manuscripts, abstracts, presenting at national meetings). PMID:26924920

In vitro comparative evaluation of cleaning efficacy and volumetric filling in primary molars: Cone beam computed tomography evaluation

Directory of Open Access Journals (Sweden)

Anshula Neeraj Deshpande

2017-01-01

Full Text Available Introduction: Pulpectomy of primary teeth is mostly carried out with hand files and broaches which is tricky and time consuming procedure. The development of new design features like varying tapers, non-cutting safety tips and varying length of cutting blades have resulted in new generation of rotary instruments. Aim: To compare and evaluate cleaning efficacy, canal preparation and volumetric filling using conventional files and rotary V Taper files through cone beam computed tomography. Materials and Method: Thirty extracted primary molars were selected. The teeth were randomly divided into three groups each containing 10 teeth i.e. 30 canals in each group. Group A was instrumented with K files; Group B rotary V Taper files and Group C was Hybrid group. Sodium hypochlorite (1% was used for irrigation. Root canal filling was done with Zinc Oxide Eugenol cement in all groups. The volumetric analysis i.e. Percentage of Volume (POV of the root canal filling in primary molars was done through CBCT Software. Result: In present study, p- value was found to be significant (<0.05. Almost 100% of canals of hybrid group were fully filled and 63.3% of canals of hand filing group were partially filled. The filling was found to be dense and no. of voids was least in hybrid group. Conclusion: Clinical time required in primary molar endodontics, especially with unpredictability and difficulty of canal morphology, is inevitable. The study confirms superior ability of rotary-file systems to shape severely curved canals with less time and significant decrease in procedural errors like partial filling, voids and inappropriate canal preparation.

Assessing the Relationship between Community Education, Political Efficacy and Electoral Participation: A Case Study of the Asylum Seeking Community in Cork

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Harris, Clodagh; Murphy, Philip

2012-01-01

This paper assesses the relationship between community education and internal political efficacy. In particular it examines the association between voter/civic programmes run in advance of the 2009 local elections in Ireland and internal political efficacy amongst the asylum seeking community in Cork. A survey is used to test this relationship.…

Developing and Validating the Scale of Economic Self-Efficacy.

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Hoge, Gretchen L; Stylianou, Amanda M; Hetling, Andrea; Postmus, Judy L

2017-05-01

Experiencing intimate partner violence (IPV) and financial hardship are often intertwined. The dynamics of an abusive relationship may include economic abuse tactics that compromise a survivor's ability to work, pursue education, have access to financial resources, and establish financial skills, knowledge, and security. An increasingly common goal among programs serving IPV survivors is increasing financial empowerment through financial literacy. However, providing financial education alone may not be enough to improve financial behaviors. Psychological factors also play a role when individuals make financial choices. Economic self-efficacy focuses on the individual's perceived ability to perform economic or financial tasks, and may be considered a primary influence on one's ability to improve financial decisions and behaviors. The current study tests the reliability and validity of a Scale of Economic Self-Efficacy with a sample of female survivors of IPV. This study uses a calibration and validation analysis model including full and split-sample exploratory and confirmatory factor analyses, assesses for internal consistency, and examines correlation coefficients between economic self-efficacy, economic self-sufficiency, financial strain, and difficulty living with income. Findings indicate that the 10-item, unidimensional Scale of Economic Self-Efficacy demonstrates strong reliability and validity among this sample of IPV survivors. An ability to understand economic self-efficacy could facilitate individualized service approaches and allow practitioners to better support IPV survivors on their journey toward financial empowerment. Given the increase in programs focused on assets, financial empowerment, and economic well-being, the Scale of Economic Self-Efficacy has potential as a very timely and relevant tool in the design, implementation, and evaluation of such programs, and specifically for programs created for IPV survivors.

Teachers' use of classroom assessment in primary school mathematics education in the Netherlands

NARCIS (Netherlands)

Veldhuis, M.; van den Heuvel-Panhuizen, M.; Vermeulen, Jorine; Eggen, Theodorus Johannes Hendrikus Maria

2013-01-01

This paper reports on a survey of the classroom assessment practices of Dutch primary school teachers in mathematics education. We investigated, using an online questionnaire, how teachers collect information on their studentś progress and how teacherś assessment methods, purposes, and beliefs about

Assessing the impact of vicarious experiences on preservice elementary science teacher efficacy and preservice elementary teacher efficacy

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Wagler, Ronald Robert

Scope and method of study. The purpose of this study was to investigate the impact of vicarious experiences (preservice teacher field experiences) on perceived preservice science teacher efficacy and perceived preservice teacher efficacy. The participants for the study were 46 preservice elementary education students who were enrolled in CIED 3430 (Early Lab and Clinical Experience in Elementary Education II) at a large Midwestern state university and 20 classroom inservice teachers. A pretest was administered early in the spring 2007 semester, before the preservice teachers did their field experience and consisted of demographic questions and the STEBI-B. A posttest was administered at the end of the spring 2007 semester, after the preservice teachers had completed their field experiences, and consisted of demographic questions, a rating of the teachers they observed during their educational field experience, the STEBI-B and the TES. The field experience classroom inservice teachers provided personal, professional, and classroom data in the middle of the spring 2007 semester. All data were analyzed using analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Findings and conclusions. Factors of gender, ethnicity, socioeconomic status and preservice teacher program placement were found to be significant predictors of preservice teachers' efficacy scores. Even though, in some cases, these factors negatively impacted preservice teacher efficacy, preservice teachers should be placed in these environments when support is most available. The Teacher Efficacy Scale (Gibson & Dembo, 1984) is invalid. Even the construct of a general teacher efficacy is questionable.

Genetic Counseling Supervisors' Self-Efficacy for Select Clinical Supervision Competencies.

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Finley, Sabra Ledare; Veach, Pat McCarthy; MacFarlane, Ian M; LeRoy, Bonnie S; Callanan, Nancy

2016-04-01

Supervision is a primary instructional vehicle for genetic counseling student clinical training. Approximately two-thirds of genetic counselors report teaching and education roles, which include supervisory roles. Recently, Eubanks Higgins and colleagues published the first comprehensive list of empirically-derived genetic counseling supervisor competencies. Studies have yet to evaluate whether supervisors possess these competencies and whether their competencies differ as a function of experience. This study investigated three research questions: (1) What are genetic counselor supervisors' perceptions of their capabilities (self-efficacy) for a select group of supervisor competencies?, (2) Are there differences in self-efficacy as a function of their supervision experience or their genetic counseling experience, and 3) What training methods do they use and prefer to develop supervision skills? One-hundred thirty-one genetic counselor supervisors completed an anonymous online survey assessing demographics, self-efficacy (self-perceived capability) for 12 goal setting and 16 feedback competencies (Scale: 0-100), competencies that are personally challenging, and supervision training experiences and preferences (open-ended). A MANOVA revealed significant positive effects of supervision experience but not genetic counseling experience on participants' self-efficacy. Although mean self-efficacy ratings were high (>83.7), participant comments revealed several challenging competencies (e.g., incorporating student's report of feedback from previous supervisors into goal setting, and providing feedback about student behavior rather than personal traits). Commonly preferred supervision training methods included consultation with colleagues, peer discussion, and workshops/seminars.

Osteomalacia and osteoporosis associated with primary intestinal lymphangiectasis.

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Li, Xin-Ping; Shen, Wen-Bin; Long, Ming-Qing; Meng, Xun-Wu; Lian, Xiao-Lan; Yu, Miao

2012-05-01

Primary Intestinal lymphangiectasia (PIL) is a common cause of protein losing enteropathy (PLE). It will affect enter-hepatic circulation of lipid-soluble vitamin, and absorption of electrolytes, cause malnutrition related osteomalacia or osteoporosis. While seldom health care workers noted to assess and treat osteomalacia or osteoporosis in PIL. Here we report a related case. We found increased parathyroid hormone, decreased 25(OH)D3, low bone mineral density, which indicated that the PIL patient had osteomalacia and/or osteoporosis. Adequate calcium and vitamin D supply can relieve the condition efficaciously. We should pay attention to osteomalacia and osteoporosis in PIL patients.

[New questionnaire to assess self-efficacy toward physical activity in children].

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Aedo, Angeles; Avila, Héctor

2009-10-01

To design a questionnaire for assessment of self-efficacy toward physical activity in school children, as well as to measure its construct validity, test-retest reliability, and internal consistency. A four-stage multimethod approach was used: (1) bibliographic research followed by exploratory study and the formulation of questions and responses based on a dichotomous scale of 14 items; (2) validation of the content by a panel of experts; (3) application of the preliminary version of the questionnaire to a sample of 900 school-aged children in Mexico City; and (4) determination of the construct validity, test-retest reliability, and internal consistency (Cronbach's alpha). Three factors were identified that explain 64.15% of the variance: the search for positive alternatives to physical activity, ability to deal with possible barriers to exercising, and expectations of skill or competence. The model was validated using the goodness of fit, and the result of 65% less than 0.05 indicated that the estimated factor model fit the data. Cronbach's consistency alpha was 0.733; test-retest reliability was 0.867. The scale designed has adequate reliability and validity. These results are a good indicator of self-efficacy toward physical activity in school children, which is important when developing programs intended to promote such behavior in this age group.

Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

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Ellsworth, Rachel E; Toro, Allyson L; Blackburn, Heather L; Decewicz, Alisha; Deyarmin, Brenda; Mamula, Kimberly A; Costantino, Nicholas S; Hooke, Jeffrey A; Shriver, Craig D; Ellsworth, Darrell L

2015-01-01

Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN) metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome (P = 0.009). In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance. PMID:26279627

Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

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Rachel E. Ellsworth

2015-01-01

Full Text Available Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome ( P = 0.009. In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance.

The Self-Efficacy Scale: A Construct Validity Study.

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Sherer, Mark; Adams, Carol

Self-efficacy is defined as the belief that one can successfully perform a behavior. Self-efficacy theory asserts that self-efficacy expectancies exert powerful influence on behavior and behavior change. The Self-efficacy Scale, which was developed to assess generalized self-efficacy expectations, consists of two subscales: general self-efficacy…

Teacher Variables As Predictors of Academic Achievement of Primary School Pupils Mathematics

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Adedeji TELLA

2008-10-01

Full Text Available This study examined the relationship between Teacher self- efficacy, interest, attitude, qualification, experience and pupils’ academic achievement in primary school mathematics. The participants of the study comprises of 254 primary school teachers and 120 primary school pupils. Data collected on the study were analysed using a stepwise multiple regression analysis. The results reveals that teacher self – efficacy and interest had significant correlation with pupils achievement scores. Teacher’s self-efficacy being the best predictor of pupils’ academic achievement in mathematics was followed by teacher’s interest. Attitude, qualification and experience were not significant correlation with pupil’s achievement in mathematics. The study recommended that it is high time for primary school mathematics teachers to have a change of attitude towards the teaching of the subject so that the achievement of universal basic education will not be hindered. Furthermore, primary school educational authorities were called upon to ensure that only teachers who are qualified to teach the subject are employed. Not these alone, their attention was also drawn to the fact that they should design educational programmes that will enhance the teacher self- efficacy for a better prediction of pupils’ achievement in mathematics.

Modeling Online Health Information-Seeking Behavior in China: The Roles of Source Characteristics, Reward Assessment, and Internet Self-Efficacy.

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Cao, Weidan; Zhang, Xinyao; Xu, Kaibin; Wang, Yuanxin

2016-09-01

The outbreak of severe acute respiratory syndrome (SARS) in 2003 marked the explosion of health information seeking online in China and the increasing emergence of Chinese health websites. There are both benefits and potential hazards of people's online health information seeking. This article intended to test part of Wilson's second model of information behavior, including source characteristics and activating mechanisms, and to identify the relationships among perceived access, perceived expertise credibility, reward assessment, Internet self-efficacy, and online health information-seeking behavior. Data were drawn from face-to-face surveys and an online survey of health information seekers (N = 393) in China. The results showed that source characteristics predicted activating mechanisms, which in turn predicted online health information-seeking behavior. Activating mechanisms, that is, reward assessment and Internet self-efficacy, mediated the relationship between source characteristics (i.e., access and credibility) and online health information-seeking behavior. Strategies for improving information access, expertise credibility, and Internet self-efficacy are discussed in order to maximize the benefits of online health information seeking and to minimize the potential harm.

Rubrics and Self-Assessment Scripts Effects on Self-Regulation, Learning and Self-Efficacy in Secondary Education

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Panadero, Ernesto; Tapia, Jesus Alonso; Huertas, Juan Antonio

2012-01-01

This study compares the effects of two different self-assessment tools--rubrics and scripts--on self-regulation, learning and self-efficacy in interaction with two other independent variables (type of instructions and feedback). A total of 120 secondary school students analyzed landscapes--a usual task when studying Geography--in one of twelve…

Safety and efficacy of tinea pedis and onychomycosis treatment in people with diabetes: a systematic review

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Matricciani Lisa

2011-12-01

Full Text Available Abstract Background Effective treatment of tinea pedis and onychomycosis is crucial for patients with diabetes as these infections may lead to foot ulcers and secondary bacterial infections resulting in eventual lower limb amputation. Although numerous studies have assessed the effectiveness of antifungal drug and treatment regimens, most exclude patients with diabetes and examine otherwise healthy individuals. While these studies are useful, results cannot necessarily be extrapolated to patients with diabetes. The purpose of this study was to therefore identify the best evidence-based treatment interventions for tinea pedis or onychomycosis in people with diabetes. Methods The question for this systemic review was: 'what evidence is there for the safety and/or efficacy of all treatment interventions for adults with tinea pedis and/or onychomycosis in people with diabetes'? A systematic literature search of four electronic databases (Scopus, EbscoHost, Ovid, Web of Science was undertaken (6/1/11. The primary outcome measure for safety was self-reported adverse events likely to be drug-related, while the primary outcome measures assessed for 'efficacy' were mycological, clinical and complete cure. Results The systematic review identified six studies that examined the safety and/or efficacy of treatment interventions for onychomycosis in people with diabetes. No studies were identified that examined treatment for tinea pedis. Of the studies identified, two were randomised controlled trials (RCTs and four were case series. Based on the best available evidence identified, it can be suggested that oral terbinafine is as safe and effective as oral itraconazole therapy for the treatment of onychomycosis in people with diabetes. However, efficacy results were found to be poor. Conclusions This review indicates that there is good evidence (Level II to suggest oral terbinafine is as safe and effective as itraconazole therapy for the treatment of

Do medical students and young physicians assess reliably their self-efficacy regarding communication skills? A prospective study from end of medical school until end of internship.

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Gude, Tore; Finset, Arnstein; Anvik, Tor; Bærheim, Anders; Fasmer, Ole Bernt; Grimstad, Hilde; Vaglum, Per

2017-06-30

This prospective study from end of medical school through internship investigates the course and possible change of self- reported self-efficacy in communication skills compared with observers' ratings of such skills in consultations with simulated patients. Sixty-two medical students (43 females) from four Norwegian universities performed a videotaped consultation with a simulated patient immediately before medical school graduation (T1) and after internship (internal medicine, surgery and family medicine, half a year each - T2). Before each consultation, the participants assessed their general self-efficacy in communication skills. Trained observers scored the videos and applied a well-validated instrument to rate the communication behaviour. Results from the two assessment methods were correlated at both time points and possible differences from T1 to T2 were explored. A close to zero correlation between self-efficacy and observed communication skills were found at T1. At T2, participants' self-efficacy scores were inversely correlated with levels of observed skills, demonstrating a lack of concordance between young physicians' own assessment of self-efficacy and observers' assessment. When dividing the sample in three groups based on the observers' scores (low 2/3), the group of male physicians showed higher levels of self-efficacy than females in all the three performance groups at T1. At T2, those having a high performance score yielded a low self-efficacy, regardless of gender. The lack of positive correlations between self-efficacy assessment and expert ratings points to limitations in the applicability of self-assessment measures of communication skills. Due to gender differences, groups of female and male physicians should be investigated separately. Those obtaining high-performance ratings from observers, through the period of internship, may become more conscious of how demanding clinical communication with patients may be. This insight may represent a

The Seamless Transfer-of-Care Protocol: a randomized controlled trial assessing the efficacy of an electronic transfer-of-care communication tool

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Okoniewska Barbara M

2012-11-01

Full Text Available Abstract Background The transition between acute care and community care represents a vulnerable period in health care delivery. The vulnerability of this period has been attributed to changes to patients’ medication regimens during hospitalization, failure to reconcile discrepancies between admission and discharge and the burdening of patients/families to take over care responsibilities at discharge and to relay important information to the primary care physician. Electronic communication platforms can provide an immediate link between acute care and community care physicians (and other community providers, designed to ensure consistent information transfer. This study examines whether a transfer-of-care (TOC communication tool is efficacious and cost-effective for reducing hospital readmission, adverse events and adverse drug events as well as reducing death. Methods A randomized controlled trial conducted on the Medical Teaching Unit of a Canadian tertiary care centre will evaluate the efficacy and cost-effectiveness of a TOC communication tool. Medical in-patients admitted to the unit will be considered for this study. Data will be collected upon admission, and a total of 1400 patients will be randomized. The control group’s acute care stay will be summarized using a traditional dictated summary, while the intervention group will have a summary generated using the TOC communication tool. The primary outcome will be a composite, at 3 months, of death or readmission to any Alberta acute-care hospital. Secondary outcomes will be the occurrence of post-discharge adverse events and adverse drug events at 1 month post discharge. Patients with adverse outcomes will have their cases reviewed by two Royal College certified internists or College-certified family physicians, blinded to patients’ group assignments, to determine the type, severity, preventability and ameliorability of all detected adverse outcomes. An accompanying economic

The Seamless Transfer-of-Care Protocol: a randomized controlled trial assessing the efficacy of an electronic transfer-of-care communication tool.

Science.gov (United States)

Okoniewska, Barbara M; Santana, Maria J; Holroyd-Leduc, Jayna; Flemons, Ward; O'Beirne, Maeve; White, Deborah; Clement, Fiona; Forster, Alan; Ghali, William A

2012-11-21

The transition between acute care and community care represents a vulnerable period in health care delivery. The vulnerability of this period has been attributed to changes to patients' medication regimens during hospitalization, failure to reconcile discrepancies between admission and discharge and the burdening of patients/families to take over care responsibilities at discharge and to relay important information to the primary care physician. Electronic communication platforms can provide an immediate link between acute care and community care physicians (and other community providers), designed to ensure consistent information transfer. This study examines whether a transfer-of-care (TOC) communication tool is efficacious and cost-effective for reducing hospital readmission, adverse events and adverse drug events as well as reducing death. A randomized controlled trial conducted on the Medical Teaching Unit of a Canadian tertiary care centre will evaluate the efficacy and cost-effectiveness of a TOC communication tool. Medical in-patients admitted to the unit will be considered for this study. Data will be collected upon admission, and a total of 1400 patients will be randomized. The control group's acute care stay will be summarized using a traditional dictated summary, while the intervention group will have a summary generated using the TOC communication tool. The primary outcome will be a composite, at 3 months, of death or readmission to any Alberta acute-care hospital. Secondary outcomes will be the occurrence of post-discharge adverse events and adverse drug events at 1 month post discharge. Patients with adverse outcomes will have their cases reviewed by two Royal College certified internists or College-certified family physicians, blinded to patients' group assignments, to determine the type, severity, preventability and ameliorability of all detected adverse outcomes. An accompanying economic evaluation will assess the cost per life saved, cost per

Values of functional indexes in assessment of efficacy of osteoarthritis treatment with Chondrolon and Zel T in polyclinic

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O Y Maiko

2009-01-01

Full Text Available Objective. To study change of knee joints functional disability in pts with predominantly I-II stage of knee osteoarthritis (OA with clinical tests and WOMAC index for assessment of efficacy of treatment with Chondrolon and Zel T in polyclinic. Material and methods. 70 pts with I and II stage of OA according to Kellgren-Lawrence aged from 40 to 67 years were included. They were divided in 2 groups (30 pts in group I and40 pts in group II. Group I pts were treated with Chondrolon and group II pts – with Zel T. Treatment efficacy was assessed with WOMAC index, functional Lequesne index, pain on VAS at rest and at movement, knee mobility, time of walking for 30 m and walking stairs. Results. Positive changes of all parameters were revealed in both groups: significant improvement of pain on VAS, functional tests, Lequesne index, WOMAC scales was achieved. During treatment with Zel T improvement of the efficacy measures increased slower, mainly after 12 weeks of treatment (during treatment with Chondrolon – after8 weeks. Both drugs provided functional improvement assessed by WOMAC index butChondrolon was more effective. Conclusion. Chondrolon and Zel T can be used for treatment of OA at I or II stage with moderate knee joints functional disability. Course of treatment with Zel T should be continued not less than 3 months and with Chondrolon – 2 months.

Performance indicators used to assess the quality of primary dental care

NARCIS (Netherlands)

González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana M.

2006-01-01

An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. OBJECTIVES: To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a

The Practice of Continuous Assessment in Primary Schools: The Case of Chagni, Ethiopia

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Abejehu, Sintayehu Belay

2016-01-01

Continuous assessment is part and parcel of instructional process that has to be taken as a key tool in educational quality assurance endeavor. Thus, this article examined the actual practice of continuous assessment in primary schools of Chagni City Administration, Ethiopia. To address this purpose the study employed descriptive survey design.…

Relationship between critical thinking disposition and teaching efficacy among special education integration program teachers in Malaysia

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Sulaiman, Tajularipin; a/l Kuppusamy, Suresh Kumar; Ayub, Ahmad Fauzi Mohd; Rahim, Suzieleez Syrene Abdul

2017-01-01

This study aims to assess the level of critical thinking disposition and teaching efficacy among the Special Education Integration Programme (SEIP) teachers in Negeri Sembilan, Malaysia. The level of critical thinking dispositions and teaching efficacy in the SEIP were compared based on teaching experience and gender. The study also examined the relationship between critical thinking disposition and teaching efficacy at SEIP. The research adopted a quantitative survey approach. A total of 190 primary school teachers from the SEIP in Negeri Sembilan were selected using proportional sampling method. The instrument used in this study comprised of three sections; demography, critical thinking disposition and teaching efficacy. Descriptive and inferential statistics were used in the analysis. Analysis shows that the respondents have a moderate level of critical thinking disposition (M = 2.99, S.D = 0.160) and teaching efficacy (M = 3.01 S.D. = 0.128) was at a high level. For teaching experience, the analysis showed that thinking disposition of novice teachers (mean = 2.52, SD = .503) are significantly higher than experienced teachers (mean = 2.35, SD = .481, t = 2.244, p critical thinking disposition and teaching efficacy. Findings also indicated that there is a significant positive moderate relationship (r = .477) between critical thinking disposition and teaching efficacy among SEIP teachers. This study suggests that critical thinking disposition and teaching efficacy play an important role to enhance the performance of SEIP teachers.

Self-care self-efficacy, religious participation and depression as predictors of poststroke self-care among underserved ethnic minorities

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Suzanne M. Robertson

2013-04-01

Full Text Available Underserved ethnic minorities have multiple chronic disease risk factors, including tobacco, alcohol and substance use, which contribute to increased incidence of stroke. Self-efficacy (self-care self-efficacy, religious participation and depression may directly and indirectly influence engagement in post stroke self-care behaviors. The primary aim of the present study was to investigate the effects of self-care self-efficacy, religious participation and depression, on tobacco, alcohol and substance use in a sample of largely ethnic minority, underserved stroke survivors (n=52. Participants previously recruited for a culturally tailored secondary stroke prevention self-care intervention were included. The treatment group received three stroke self-care sessions. The usual care group completed assessments only. Both groups were included in these analyses. Main outcome measures included tobacco, alcohol and substance use. Self-care self-efficacy, religious participation and depression were also assessed. Logistic regression analyses, using self-efficacy, religious practice and depression as the referents, were used to predict binary outcomes of tobacco, alcohol and substance use at 4-weeks post-stroke. Higher depression and self-care self-efficacy were associated with reduced odds of smoking and substance use. Greater participation in religious activities was associated with lower odds of alcohol use. We can conclude that incorporating depression treatment and techniques to increase self-care self-efficacy, and encouraging religious participation may help to improve stroke self-care behaviors for underserved and low socioeconomic status individuals. Results are discussed in the context of stroke self-management.

Comparative efficacy and safety of mavacoxib and carprofen in the treatment of canine osteoarthritis.

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Payne-Johnson, M; Becskei, C; Chaudhry, Y; Stegemann, M R

2015-03-14

A multi-site, masked, randomised parallel group study employing a double dummy treatment design was performed in canine veterinary patients to determine the comparative efficacy and safety of mavacoxib and carprofen in the treatment of pain and inflammation associated with osteoarthritis for a period of 134 days. Treatments were administered according to their respective summaries of product characteristics. Of 139 dogs screened, 124 were suitable for study participation: 62 of which were dosed with mavacoxib and 62 with carprofen. Both treatments resulted in a very similar pattern of considerable improvement as indicated in all parameters assessed by both owner and veterinarian. The primary efficacy endpoint 'overall improvement' was a composite score of owner assessments after approximately six weeks of treatment. Both drugs were remarkably effective, with 57/61 (93.4 per cent) of mavacoxib-treated dogs and 49/55 (89.1 per cent) of carprofen-treated dogs demonstrating overall improvement and with mavacoxib's efficacy being non-inferior to carprofen. The treatments had a similar safety profile as evidenced by documented adverse events and summaries of clinical pathology parameters. The positive clinical response to treatment along with the safety and dosing regimen of mavacoxib makes it an attractive therapy for canine osteoarthritis. British Veterinary Association.

The contribution of self-efficacy and outcome expectations in the ...

African Journals Online (AJOL)

This study examined the effectiveness of Bandura's self-efficacy theory to predict exercise adherence. A sample of new members at a gymnasium was assessed on a Physical Self-Efficacy Scale, an Adherence Efficacy Scale and an Outcome Expectancy Scale. The dependent variable, exercise adherence, was assessed by ...

Efficacy and safety of comfrey root extract ointment in the treatment of acute upper or lower back pain: results of a double-blind, randomised, placebo controlled, multicentre trial.

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Giannetti, B M; Staiger, C; Bulitta, M; Predel, H-G

2010-07-01

The objective was to show the superiority of comfrey root extract ointment to placebo ointment in patients with acute upper or lower back pain. The study was conducted as a double-blind, multicentre, randomised clinical trial with parallel group design over a period of 5 days (SD 1). The patients (n = 120, mean age 36.9 years) were treated with verum or placebo ointment three times a day, 4 g ointment per application. The trial included four visits. The primary efficacy variable was the area under the curve (AUC) of the visual analogue scale (VAS) on active standardised movement values at visits 1 to 4. The secondary efficacy variables were back pain at rest using assessment by the patient on VAS, pressure algometry (pain-time curve; AUC over 5 days), global assessment of efficacy by the patient and the investigator, consumption of analgesic medication and functional impairment measured using the Oswestry disability index. There was a significant treatment difference between comfrey extract and placebo regarding the primary variable. In the course of the trial the pain intensity on active standardised movement decreased on average (median) approximately 95.2% in the verum group and 37.8% in the placebo group. The results of this clinical trial were clear-cut and consistent across all primary and secondary efficacy variables. Comfrey root extract showed a remarkably potent and clinically relevant effect in reducing acute back pain. For the first time a fast-acting effect of the ointment (1 h) was also witnessed.

Comparative efficacy assessment of Tramadol versus Morphine for post operative pain relief following abdominal surgery, Shariati Hospital (1999

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Soroosh AR

2002-11-01

Full Text Available Introduction: The objective of the present study is to compare the respiratory function and pain relief of two parenteral analgesics tramadol and morphine under clinical conditions. Materials and Methods: The trial was conducted as an open label-randomized, single center study. The study was performed during 3 months in 1999. In total, 64 patients were enrolled in Shariatie University Hospital, while the other 32 patients were treated with morphine. Results: There were 12 male and 20 female in either groups. The mean age was 48±15 in tramadol versus 43±16 morphine group. Concerning the amount of the medication given to the patients. It would be observed that tramadol patients received 194±72 mg and morphine patients 17±7 mg out of drugs. At study admission vital signs were recorded. The pulse rate, blood pressure and respiratory rate are presented revealing no obvious differences between the treatment groups. There was a broad range regarding the underlying type of operation, however, a laparatomy or a cholecystectomy was performed in 24 (75.0% Vs. 26 (81.3% patients, respectively. All 64 patients were receiving anaesthetics as stipulated in the protocol. Of them being diazepam, sufentanil, succinylcholine chloride and thiopental as the most frequent reported, 4 Vs. 3 patient were given additional fentanylin a mean dosage of 220 mg Vs. 83 mcg. The oxygen saturation was the main safety parameter of the present study. No obvious differences between the two treatment groups can be detected (P<0.472. Primary efficacy end point was the pain assessment. The pain intensity at each scheduled time point was recorded. At study inclusion no differences between the treatment groups uncured, but during the 24 hour observation period the tramadol patients were in advantage (P<0.001. Conclusion: This study shows that long-term efficacy of tramadol is better than morphine.

Perceived self-efficacy, personality and bioethics before a heart rehabilitation programme in primary health care.

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Madueño Caro, Antonio J; Mellado Fernández, Manuel Luis; Delgado Pacheco, Juana; Muñoz Ayllon, Marta; Pardos Lafarga, Manuel; Saez García, Laura

There is a clear evidence of the benefit of cardiac rehabilitation after a cardiovascular event on patients' mood and perceived self-efficacy in terms of their own health care. Our aim is to define the correlation between mood-related variables, biotype and self-efficacy in this population. Descriptive study. The entire population of patients discharged from thecardiac rehabilitation unit over 12 months. Universal anthropometric and psychometric (general self-efficacy scale, Salamanca personality traits questionnaire, Hamilton anxiety scale and Beck depression inventory) variables are determined. Descriptive statistics and association between variables (correlation) is determined. This study involved 88 patients, response rate 92%. The average age was 53 years old, 80.23% were males. Descriptive statistics and Pearson correlations for the main dependent variable and associated variables is performed. Significant evidence is shown, self-efficacy is negatively correlated with anxiety (r=-0.4009) and depression (r=-0.4152), as well as dependent(r=-03 175) and impulsive (r=-0.4243) personality traits. Higher levels of anxiety positively correlate with endomorph biotype (r=0.3304), and depression-associated symptoms (r=0.2563). Age and gender do not correlate with self-perceived efficacy. Self-efficacy in the study population is correlated with personality traits, mood and body biotype. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Activation and Self-Efficacy in a Randomized Trial of a Depression Self-Care Intervention.

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McCusker, Jane; Lambert, Sylvie D; Cole, Martin G; Ciampi, Antonio; Strumpf, Erin; Freeman, Ellen E; Belzile, Eric

2016-12-01

In a sample of primary care participants with chronic physical conditions and comorbid depressive symptoms: to describe the cross-sectional and longitudinal associations of activation and self-efficacy with demographic, physical and mental health status, health behaviors, depression self-care, health care utilization, and use of self-care tools; and to examine the effects of a depression self-care coaching intervention on these two outcomes. Design/Study Setting. A secondary analysis of activation and self-efficacy data collected as part of a randomized trial to compare the effects of a telephone-based coached depression self-care intervention with a noncoached intervention. Activation (Patient Activation Measure) was measured at baseline and 6 months. Depression self-care self-efficacy was assessed at baseline, at 3 months, and at 6 months. In multivariable cross-sectional analyses (n = 215), activation and/or self-efficacy were associated with language, birthplace, better physical and mental health, individual exercise, specialist visits, and antidepressant nonuse. In longitudinal analyses (n = 158), an increase in activation was associated with increased medication adherence; an increase in self-efficacy was associated with use of cognitive self-care strategies and increases in social and solitary activities. There were significant improvements from baseline to 6 months in activation and self-efficacy scores both among coached and noncoached groups. The self-care coaching intervention did not affect 6-month activation or self-efficacy but was associated with quicker improvement in self-efficacy. Overall, the results for activation and self-efficacy were similar, although self-efficacy correlated more consistently than activation with depression-specific behaviors and was responsive to a depression self-care coaching intervention. © 2016 Society for Public Health Education.

Mood disorders in adolescents: diagnosis, treatment, and suicide assessment in the primary care setting.

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Neves, Marilia G; Leanza, Francesco

2014-09-01

The primary care setting is considered the entry point of adolescents with mental illness in the health care system. This article informs primary care providers about the diagnostic features and differential of mood disorders in adolescents, screening and assessment, as well as evidence-based psychosocial and psychopharmacologic therapies. The article also provides a framework for decision making regarding initiating treatment in the primary care setting and referral to mental health services. Furthermore, the article highlights the importance of the collaboration between primary care and mental health providers to facilitate engagement of adolescents with mood disorders and adherence to treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Impact of biofeedback on self-efficacy and stress reduction in obesity: a randomized controlled pilot study.

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Teufel, Martin; Stephan, Kerstin; Kowalski, Axel; Käsberger, Saskia; Enck, Paul; Zipfel, Stephan; Giel, Katrin E

2013-09-01

Biofeedback application is an evidence-based technique to induce relaxation. A primary mechanism of action is the improvement of self-efficacy, which is needed to facilitate the translation of health behavioral intentions into action. Obesity is often associated with low self-efficacy and dysfunctional eating patterns, including comfort eating as an inexpedient relaxation technique. This is the first study investigating the effects of biofeedback on self-efficacy and relaxation in obesity. In the present experiment, 31 women, mean body mass index 35.5 kg/m², were randomized to a food-specific biofeedback paradigm, a non-specific relaxation biofeedback paradigm, or a waiting list control. Eight sessions of biofeedback of the electrodermal activity were performed while presenting either a challenging food stimulus or a non-specific landscape stimulus. Self-efficacy, stress, ability to relax, eating behavior, and electrodermal activity were assessed before, directly after, and 3 months after the intervention. The food-specific biofeedback predominantly showed effects on food-related self-efficacy and perceived stress. The non-specific relaxation biofeedback showed effects on the ability to relax. Self-reported improvements were confirmed by corresponding decrease in the electrodermal reaction to food stimuli. Biofeedback treatment is effective in improving self-efficacy in individuals with obesity and might therefore be a valuable additional intervention in obesity treatment.

Self-Efficacy in Social Work: Development and Initial Validation of the Self-Efficacy Scale for Social Workers

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Monica Pedrazza

2013-09-01

Full Text Available Self-efficacy beliefs do not reflect a generic sense of competence, but are instead context-specific. Therefore, self-efficacy should be assessed by using an ad hoc scale measuring individual behaviors that allows social workers to exercise influence over events that affect their work life. The present study describes the development and initial validation of the self-efficacy scale for social workers (SESSW. Items were generated through the Critical Incident Technique. Sixteen social workers with at least 10 years of service participated in two focus groups; they were asked to recall critical incidents in their work and to indicate the most effective behaviors to manage the incidents. Content analysis of the focus group transcripts provided 13 key self-efficacy beliefs. The 13-item scale was validated with a sample of 805 social workers. Data were analyzed using a split-sample technique. Exploratory factor analysis on the first split sample (n = 402 revealed three dimensions of self-efficacy, corresponding to emotion regulation, support request, and procedural self-efficacy. The three-factor structure of the scale was further confirmed with confirmatory factor analysis on the second split sample (n = 403. Our results show that SESSW is an adequate instrument for assessment of self-efficacy beliefs in social work.

Development and efficacy assessments of tea seed oil makeup remover.

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Parnsamut, N; Kanlayavattanakul, M; Lourith, N

2017-05-01

The efficacy of tea seed oil to clean foundation and eyeliner was evaluated. The safe and efficient tea seed oil makeup remover was developed. In vitro cleansing efficacy of makeup remover was UV-spectrophotometric validated. The stability evaluation by means of accelerated stability test was conducted. In vitro and in vivo cleansing efficacy of the removers was conducted in a comparison with benchmark majorly containing olive oil. Tea seed oil cleaned 90.64±4.56% of foundation and 87.62±8.35% of eyeliner. The stable with most appropriate textures base was incorporated with tea seed oil. Three tea seed oil removers (50, 55 and 60%) were stabled. The 60% tea seed oil remover significantly removed foundation better than others (94.48±3.37%; Pmakeup removers had been developed. The consumers' choices towards the makeup remover containing the bio-oils are widen. In vitro cleansing efficacy during the course of makeup remover development using UV-spectrophotometric method feasible for pharmaceutic industries is encouraged. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Study protocol for a pragmatic randomised controlled trial evaluating efficacy of a smoking cessation e-‘Tabac Info Service’: ee-TIS trial

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Cambon, L; Bergman, P; Le Faou, Al; Vincent, I; Le Maitre, B; Pasquereau, A; Arwidson, P; Thomas, D; Alla, F

2017-01-01

Introduction A French national smoking cessation service, Tabac Info Service, has been developed to provide an adapted quitline and a web and mobile application involving personalised contacts (eg, questionnaires, advice, activities, messages) to support smoking cessation. This paper presents the study protocol of the evaluation of the application (e-intervention Tabac Info Service (e-TIS)). The primary objective is to assess the efficacy of e-TIS. The secondary objectives are to (1) describe efficacy variations with regard to users' characteristics, (2) analyse mechanisms and contextual conditions of e-TIS efficacy. Methods and analyses The study design is a two-arm pragmatic randomised controlled trial including a process evaluation with at least 3000 participants randomised to the intervention or to the control arm (current practices). Inclusion criteria are: aged 18 years or over, current smoker, having completed the online consent forms, possessing a mobile phone with android or apple systems and using mobile applications, wanting to stop smoking sooner or later. The primary outcome is the point prevalence abstinence of 7 days at 6 months later. Data will be analysed in intention to treat (primary) and per protocol analyses. A logistic regression will be carried out to estimate an OR (95% CI) for efficacy. A multivariate multilevel analysis will explore the influence on results of patients' characteristics (sex, age, education and socioprofessional levels, dependency, motivation, quit experiences) and contextual factors, conditions of use, behaviour change techniques. Ethics and dissemination The study protocol was reviewed by the ethical and deontological institutional review board of the French Institute for Public Health Surveillance on 18 April 2016. The findings of this study will allow us to characterise the efficacy of e-TIS and conditions of its efficacy. These findings will be disseminated through peer-reviewed articles. Trial registration

Pairing motivational interviewing with a nutrition and physical activity assessment and counseling tool in pediatric clinical practice: a pilot study.

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Christison, Amy L; Daley, Brendan M; Asche, Carl V; Ren, Jinma; Aldag, Jean C; Ariza, Adolfo J; Lowry, Kelly W

2014-10-01

Recommendations to screen and counsel for lifestyle behaviors can be challenging to implement during well-child visits in the primary care setting. A practice intervention was piloted using the Family Nutrition and Physical Activity (FNPA) Screening Tool paired with a motivational interviewing (MI)-based counseling tool during well-child visits. Acceptability and feasibility of this intervention were assessed. Its impact on parent-reported obesigenic behavior change and provider efficacy in lifestyle counseling were also examined. This was an observational study in a pediatric primary care office. During well-child visits of 100 patients (ages 4-16 years), the FNPA tool was implemented and providers counseled patients in an MI-consistent manner based on its results. Duration of implementation, patient satisfaction of the intervention, and success of stated lifestyle goals were measured. Provider self-efficacy and acceptability were also surveyed. The FNPA assessment was efficient to administer, requiring minutes to complete and score. Patient acceptability was high, ranging from 4.0 to 4.8 on a 5-point scale. Provider acceptability was good, with the exception of duration of counseling; self-efficacy in assessing patient "readiness for change" was improved. Parent-reported success of primary lifestyle goal was 68% at 1 month and 46% at 6 months. The FNPA assessment with an MI-based counseling tool shows promise as an approach to identify and address obesigenic behaviors during pediatric well-child visits. It has the potential to improve provider efficacy in obesity prevention and also influence patient health behaviors, which can possibly impact childhood excessive weight gain. After refinement, this practice intervention will be used in a larger trial.

Evaluation of the Effectiveness of Nurse-Led Continence Care Treatments for Chinese Primary Care Patients with Lower Urinary Tract Symptoms.

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Edmond P H Choi

Full Text Available The aim of this study was to evaluate whether community-based nurse-led continence care interventions are effective in improving outcomes for adult Chinese primary care patients with lower urinary tract symptoms (LUTS.A case-controlled intervention study was conducted. An intervention group of 360 primary care patients enrolled into a nurse-led continence care programme were recruited by consecutive sampling. A control group of 360 primary care patients with LUTS identified by screening were recruited from the waiting rooms of primary care clinics by consecutive sampling. Both groups were monitored at baseline and at 12 months.Outcome measures included symptom severity, health-related quality of life (HRQOL, self-efficacy, global health and self-reported health service utilization at 12-months. The effect of the continence care programme on symptom severity and HRQOL was assessed by the difference-in-difference estimation, using independent t-test and multiple liner regression. Chi-square test was used to compare the self-efficacy, global health and self-reported health service utilization between the two groups at 12-months.After adjusting for baseline severity and socio-demographics, the intervention group had significant improvements in LUTS severity (P<0.05 and HRQOL (P<0.05. Improvements in the amount of urine leakage were not significantly different between the two groups. A higher proportion of subjects in the intervention group reported increased self-efficacy (43.48% vs. 66.83%, improved global health condition (17.74% vs. 41.5%, having doctor consultation (18.5% vs. 8.06, having medication due to LUTS (26.50% vs.11.29% and having non-drug therapy due to LUTS (59.5% vs.9.68%.Community-based nurse-led continence care can effectively alleviate symptoms, improve health-related quality of life, and enhance self-efficacy and the global health condition of Chinese male and female primary care patients with LUTS.

Primary (Month-6) Outcomes of the STOP-Uveitis Study: Evaluating the Safety, Tolerability, and Efficacy of Tocilizumab in Patients With Noninfectious Uveitis.

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Sepah, Yasir Jamal; Sadiq, Mohammad Ali; Chu, David S; Dacey, Mark; Gallemore, Ron; Dayani, Pouya; Hanout, Mostafa; Hassan, Muhammad; Afridi, Rubbia; Agarwal, Aniruddha; Halim, Muhammad Sohail; Do, Diana V; Nguyen, Quan Dong

2017-11-01

To report the primary endpoint analyses of the safety and efficacy of 2 different doses of intravenous (IV) infusions of tocilizumab (TCZ), an IL-6 inhibitor, in eyes with noninfectious intermediate uveitis, posterior uveitis, or panuveitis. Randomized, controlled, multicenter clinical trial. STOP-Uveitis is a randomized, open-label safety, efficacy, and bioactivity clinical trial conducted at 5 clinical centers across the United States. The study evaluated the role of TCZ in patients with noninfectious uveitis (NIU). Thirty-seven patients with NIU were randomized into one of 2 treatment groups in a ratio of 1:1. Group 1 received IV infusions of 4 mg/kg TCZ and group 2 received IV infusions of 8 mg/kg TCZ. Infusions were given every 4 weeks in both groups until month 6 (primary endpoint). Primary outcome measure was incidence and severity of systemic and ocular adverse events through month 6. Secondary outcome measures included mean change in visual acuity (VA), vitreous haze (VH), and central macular thickness (CMT) at month 6. A total of 37 patients were randomized in the study. At month 6, 43.5% of patients who had the potential for a 2-step decrease in VH demonstrated a 2-step decrease (40% in Group 1 and 46.1% in Group 2). Mean change in CMT was -83.88 ± 136.1 μm at month 6 (-131.5 ± 41.56 μm in Group 1 and -38.92 ± 13.7 μm in Group 2). Mean change in VA was +8.22 ± 11.83 ETDRS letters at month 6 (10.9 ± 14.6 in Group 1 and 5.5 ± 7.8 in Group 2). Repeated infusions of TCZ were well tolerated. Repeated IV administrations of TCZ are well tolerated. TCZ (both 4 and 8 mg/kg) is effective in improving VA and reducing VH and CMT in eyes with noninfectious intermediate uveitis, posterior uveitis, and panuveitis. Copyright © 2017 Elsevier Inc. All rights reserved.

The Brief Early Childhood Screening Assessment: Preliminary Validity in Pediatric Primary Care.

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Fallucco, Elise M; Wysocki, Tim; James, Lauren; Kozikowski, Chelsea; Williams, Andre; Gleason, Mary M

Brief, well-validated instruments are needed to facilitate screening for early childhood behavioral and emotional problems (BEPs). The objectives of this study were to empirically reduce the length of the Early Childhood Screening Assessment (ECSA) and to assess the validity and reliability of this shorter tool. Using caregiver ECSA responses for 2467 children aged 36 to 60 months seen in primary care, individual ECSA items were ranked on a scale ranging from "absolutely retain" to "absolutely delete." Items were deleted sequentially beginning with "absolutely delete" and going up the item prioritization list, resulting in 35 shorter versions of the ECSA. A separate primary care sample (n = 69) of mothers of children aged 18 to 60 months was used to determine the sensitivity and specificity of each shorter ECSA version using psychiatric diagnosis on the Diagnostic Infant and Preschool Assessment as the gold standard. The version with the optimal balance of sensitivity, specificity, and length was selected as the Brief ECSA. Associations between Brief ECSA scores and other pertinent measures were evaluated to estimate reliability and validity. A 22-item measure reflected the best combination of brevity, sensitivity and specificity. A cutoff score of 9 or higher on the 22-item Brief ECSA demonstrated acceptable sensitivity (89%) and specificity (85%) for predicting a psychiatric diagnosis. Brief ECSA scores correlated significantly and in expected directions with scores on pertinent measures and with demographic variables. The results indicate that the Brief ECSA has sound psychometric properties for identifying young children with BEPs in primary care.

Humility and Forgiveness as Predictors of Teacher Self-Efficacy

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Sezgin, Ferudun; Erdogan, Onur

2018-01-01

This study explores the predictive influence of teachers' humility and forgiveness on their self-efficacy perceptions. The population of this research consists of teachers who work at public primary and secondary schools located in the central districts of Ankara, Turkey. The sample of the study is composed of 303 primary and secondary school…

Teacher self-efficacy in instruction and in parent involvement

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Peter Gavora

2012-06-01

Full Text Available The study investigated self-efficacy of a sample of Slovak primary schoolteachers in two areas: area of instruction and area of parent involvement. Twoinstruments were used: the 16-item Slovak version of Teacher Efficacy Scale ofGibson and Dembo, and ZdUR, a 24-item scale to measure self-efficacy of teacherin parents’ involvement, developed by authors of the present study. The correlation between scores of personal teaching efficacy dimension of TES and ZdUR was 0.58 and between general teaching efficacy of TES and ZdUR was only 0.01. Teachers inthis sample had better scores in all dimensions of ZdUR than those of TES, with theexception of engaging parents in school activities. Scores of four teachers in TES andZdUR were analysed to document the possibility of making the individual profiles ofteacher self-efficacy.

Personality modulates the efficacy of treatment in patients with major depressive disorder.

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Wardenaar, Klaas J; Conradi, Henk Jan; Bos, Elisabeth H; de Jonge, Peter

2014-09-01

Effects of depression treatment are obscured by heterogeneity among patients. Personality types could be one source of heterogeneity that explains variability in treatment response. Clinically meaningful variations in personality patterns could be captured with data-driven subgroups. The aim of this study was to identify such personality types and to explore their predictive value for treatment efficacy. Participants (N = 146) in the current exploratory study came from a randomized controlled trial in primary care depressed patients, conducted between January 1998 and June 2003, comparing different treatments. All participants were diagnosed with a major depressive disorder (MDD) according to the DSM-IV. Primary (care as usual [CAU] or CAU plus a psychoeducational prevention program [PEP]) and specialized (CAU + PEP + psychiatric consultation or cognitive-behavioral therapy) treatment were compared. Personality was assessed with the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI). Personality classes were identified with latent profile analysis (LPA). During 1 year, weekly depression ratings were obtained by trimonthly assessment with the Composite International Diagnostic Interview. Mixed models were used to analyze the effects of personality on treatment efficacy. A 2-class LPA solution fit best to the NEO-FFI data: Class 1 (vulnerable, n = 94) was characterized by high neuroticism, low extraversion, and low conscientiousness, and Class 2 (resilient, n = 52) by medium neuroticism and extraversion and higher agreeableness and conscientiousness. Recovery was quicker in the resilient class (class × time: P Personality profile may predict whether specialized clinical efforts have added value, showing potential implications for planning of treatments. © Copyright 2014 Physicians Postgraduate Press, Inc.

Efficacy of Pelvisoft® Biomesh for cystocele repair: assessment of long-term results

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Erwann Le Long

2014-12-01

Full Text Available Introduction and Hypothesis To our knowledge a study regarding the efficacy of Pelvisoft® Biomesh for cystocele repair has not previously been reported in the literature. The aim of our study was to assess the long-term efficacy, subjective outcomes and complications in the use of a non-synthetic porcine skin mesh graft (Pelvisoft® Biomesh associated with transvaginal anterior colporrhaphy in the treatment of cystocele prolapse. Materials and Methods A retrospective study was performed at a single centre. Thirty-three women aged 35-77 years underwent cystocele repair using Pelvisoft® graft between December 2005 and June 2009. Twenty-nine women who underwent transvaginal cystocele repair with Pelvisoft® Biomesh for over a 2 years period were assessed. Four patients were lost to follow-up. Cystocele repair was performed via the vaginal route using Pelvisoft®Biomesh implant by inserting it in the anterior vaginal wall. The median follow-up time was 54.0 months. The rate of recurrence was 17.3%. A total of 6.9% of patients presented early mesh exposure treated by conservative treatment. The mean PFDI-20 score was 72.2. Among sexually active women, the mean PISQ 12 was 33.9 but 56.2% had dyspareunia. After surgery, 6 patients had de novo intercourse. Our results show that the use of Pelvisoft® biomaterial associated with anterior colporrhaphy for cystocele repair appears to be safe with acceptable failure and complication rates at long term. Nevertheless, an adverse impact on sexual function was reported by the majority of patients.

Potential of acoustic monitoring for safety assessment of primary system

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Olma, B.J.

1997-01-01

Safety assessment of the primary system and its components with respect to their mechanical integrity is increasingly supported by acoustic signature analysis during power operation of the plants. Acoustic signals of Loose Parts Monitoring System sensors are continuously monitored by dedicated digital systems for signal bursts associated with metallic impacts. Several years of ISTec/GRS experience and the practical use of its digital systems MEDEA and RAMSES have shown that acoustic monitoring is very successful for detecting component failures at an early stage. Advanced powerful tools for classification and acoustic evaluation of burst signals have recently been realized. The paper presents diagnosis experiences of BWR's and PWR's safety assessment. (author). 7 refs, 8 figs

Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study.

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Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K; Mali, Gaurao Vasant

2016-09-01

To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus , Staphylococcus epidermidis , Pseudomonas aeruginosa , Escherichia coli , and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical isolates of the aforementioned test organisms. The well variant of agar disk diffusion test using Mueller-Hinton agar was used for evaluating the antimicrobial efficacy of hand sanitizers. McFarland 0.5 turbidity standard was taken as reference to adjust the turbidity of bacterial suspensions. Fifty microliters of the hand sanitizer was introduced into each of the 4 wells while the 5 th well incorporated with sterile water served as a control. This was done for all the test organisms and plates were incubated in an incubator for 24 h at 37΀C. After incubation, antimicrobial effectiveness was determined using digital caliper (mm) by measuring the zone of inhibition. The mean diameters of zones of inhibition (in mm) observed in Group A (Sterillium), Group B (PureHands), Group C (Lifebuoy), and Group D (Dettol) were 22 ± 6, 7.5 ± 0.5, 9.5 ± 1.5, and 8 ± 1, respectively. Maximum inhibition was found with Group A against all the tested organisms. Data were statistically analyzed using analysis of variance, followed by post hoc test for group-wise comparisons. The difference in the values of different sanitizers was statistically significant at P hand sanitizer to maintain the hand hygiene.

Efficacy and safety of pimecrolimus cream 1% in mild-to-moderate chronic hand dermatitis: a randomized, double-blind trial.

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Hordinsky, Maria; Fleischer, Alan; Rivers, Jason K; Poulin, Yves; Belsito, Donald; Hultsch, Thomas

2010-08-01

Chronic hand dermatitis is common and difficult to treat. Our aim was to assess the efficacy of pimecrolimus cream 1% in mild-to-moderate chronic hand dermatitis. Adult patients (n = 652) were randomized to pimecrolimus 1% or vehicle cream twice daily with overnight occlusion for 6 weeks, followed by a 6-week open-label pimecrolimus treatment. Primary efficacy was 5-point Investigators' Global Assessment of prospectively selected 'target hand' as treatment success (Investigators' Global Assessment 0 or 1) and treatment failure. Pruritus relief was also assessed. Following double-blind phase treatment, target hand treatment success was achieved in 29.8 and 23.2% of the patients in the pimecrolimus and vehicle groups, respectively (p = 0.057). The proportion of patients experiencing pruritus relief was significantly higher in the pimecrolimus group compared to the vehicle group at all time points throughout the double-blind phase. The groups were comparable with respect to treating disease signs. Pruritus relief, however, was significantly greater in the pimecrolimus group. Copyright 2010 S. Karger AG, Basel.

How to assess the efficacy of phosphate binders

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Francisco Caravaca

2017-05-01

Conclusions: The proposed parameter Pu/PCR may reflect the rate of intestinal phosphate absorption, and therefore, its variations after PB prescription may be a useful tool for estimating the pharmacological efficacy of these drugs.

Assessment tools for the measurement of the self-efficacy of drug users: protocol for a systematic review.

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Vasconcelos, Selene Cordeiro; Frazão, Iracema da Silva; Sougey, Everton Botelho; Souza, Sandra Lopes de; Silva, Tatiana de Paula Santana da; Lima, Murilo Duarte da Costa

2018-03-14

The abuse of alcohol and other drugs is a worldwide problem, the treatment of which poses a challenge to healthcare workers. This study presents a proposal for a systematic review to analyse the psychometric properties of assessment tools developed to measure the self-efficacy of drug users with regard to resisting the urge to take drugs in high-risk situations. The guiding question was based on PICOS (Population Intervention Comparator Outcome Setting), and the report of the methods of review protocol was written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Searches will be performed in the PsycINFO, Cochrane, Pubmed, Web of Science, SCOPUS and CINAHL databases, followed by the use of the 'snowball' strategy. The inclusion criteria for the articles will be (1) assessment tool validation studies; (2) assessment tools developed to measure self-efficacy; (3) quantitative measures; (4) measures designed for use on adults; (5) data from self-reports of the participants; (6) studies involving a description of psychometric properties of the measures; and (7) studies that explain how the level of self-efficacy is scored. The search, selection and analysis will be performed by two independent reviewers. In cases of a divergence of opinion, a third reviewer will be consulted. The COSMIN checklist will be used for the appraisal of the methodological quality of the assessment tools and the certainty of the evidence in the articles (risk of bias) will be analysed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. This protocol does not require ethical approval. However, this protocol is part of the thesis entitled Drug-Taking Confidence Questionnaire for use in Brazil, presented for obtaining a doctorate in neuropsychiatry and behavioural sciences from the Federal University of Pernambuco, and has received approval from the human research ethics committee of the Federal

Efficacy and safety assessment of a water-soluble formulation of fluralaner for treatment of natural Ornithonyssus sylviarum infestations in laying hens

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Nancy C. Hinkle

2018-02-01

Full Text Available Abstract Background Northern fowl mite, Ornithonyssus sylviarum (Canestrini & Fanzago, 1877, infestations can stress birds, impairing welfare and causing substantial economic losses. A study was undertaken to determine the efficacy of an ectoparasiticide solution (fluralaner for oral administration in the treatment of mite-infested hens. Methods Clinically healthy, naturally mite-infested laying hens (n = 132, approximately 32 weeks of age, were ranked by Day -9 mite vent counts and randomized among 12 study pens, each to hold one of four treatment groups. Three groups received fluralaner-medicated water by oral gavage at dose rates of 0.25, 0.5 or 1.0 mg/kg on Days 0 and 7; one group was an untreated control (three pens for each group. Five naturally infested untreated birds were included in each pen to act as mite-infested source birds. Thus each pen, treated and control, had six non-source birds for assessment of efficacy, plus five source birds to provide ongoing challenge. Primary efficacy assessments were based on mean O. sylviarum vent counts from non-source birds in the control and treated group pens on Days 1, 2, 6, 8, 12, 15, 19, 22 and 26. Results Source-birds maintained infestations throughout the study, validating the challenge to study birds. On Days 1 through 22, mean control group mite counts were significantly greater than those of the treated groups (P ≤ 0.013. Relative to the control group, mean O. sylviarum counts were reduced by at least 90% from Day 6 through Days 19, 22 and 22 in the fluralaner 0.25, 0.5 and 1.0 mg/kg groups, respectively. On Day 19, mean mite counts were lower in the 0.5 and 1.0 mg/kg groups compared with the 0.25 mg/kg group (P ≤ 0.018, and in the 1.0 mg/kg compared with the 0.5 mg/kg group (P = 0.014. There were no adverse events in treated birds. Conclusions A fluralaner solution administered twice by gavage to laying hens with a one-week between-treatment interval was safe

relationship between self-efficacy and academic achievement

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Many studies have been conducted on self-efficacy and academic achievement but ... efficacy beliefs affect how people approach new challenges and will contribute to ..... In addition, three psychology instructors critically assessed and ...

Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach.

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Seematter-Bagnoud, Laurence; Büla, Christophe

2018-01-01

This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status. It proposes using brief screening tests in primary care practice to identify patients who may need further comprehensive geriatric assessment or specific interventions.

Assessment Orientations of State Primary EFL Teachers in Two Mediterranean Countries

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Dina Tsagari

2016-01-01

Full Text Available Many researchers have highlighted the central role that assessment plays in second language (L2 classrooms and have expressed the need for research into classroom-based language assessment (CBLA, an area that is gradually coming into its own in the field of language testing and assessment (e.g., Hasselgreen, 2008; Leung, 2014; Hill & McNamara, 2012; Turner, 2012. Motivated by the prominence of CBLA in recent discussions, the present study set out to investigate the CBLA practices, knowledge and skills of Greek and Cypriot primary school EFL teachers. The data was collected through teacher interviews and classroom-based tests. The results showed that teachers employ a summative orientation towards evaluating their students’ performance and seem to have unclear ideas about the purposes and implementation of formative assessment, mainly due to lack of professional training in language assessment. The paper concludes with suggestions as to how EFL teachers’ CBLA literacy can be enhanced.

Comparison of 3 in vivo methods for assessment of alcohol-based hand rubs.

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Edmonds-Wilson, Sarah; Campbell, Esther; Fox, Kyle; Macinga, David

2015-05-01

Alcohol-based hand rubs (ABHRs) are the primary method of hand hygiene in health-care settings. ICPs increasingly are assessing ABHR product efficacy data as improved products and test methods are developed. As a result, ICPs need better tools and recommendations for how to assess and compare ABHRs. Two ABHRs (70% ethanol) were tested according to 3 in vivo methods approved by ASTM International: E1174, E2755, and E2784. Log10 reductions were measured after a single test product use and after 10 consecutive uses at an application volume of 2 mL. The test method used had a significant influence on ABHR efficacy; however, in this study the test product (gel or foam) did not significantly influence efficacy. In addition, for all test methods, log10 reductions obtained after a single application were not predictive of results after 10 applications. Choice of test method can significantly influence efficacy results. Therefore, when assessing antimicrobial efficacy data of hand hygiene products, ICPs should pay close attention to the test method used, and ensure that product comparisons are made head to head in the same study using the same test methodology. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Primary and revision efficacy of cross-wired metallic stents for endoscopic bilateral stent-in-stent placement in malignant hilar biliary strictures.

Science.gov (United States)

Lee, T H; Moon, J H; Kim, J H; Park, D H; Lee, S S; Choi, H J; Cho, Y D; Park, S H; Kim, S J

2013-01-01

Endoscopic bilateral drainage for inoperable malignant hilar biliary strictures (HBS) using metal stents is considered to be technically difficult. Furthermore, endoscopic revision of bilateral stenting after occlusion can be challenging. This study was performed to evaluate the long-term efficacy of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents in high-grade malignant HBS and planned endoscopic bilateral revision. A total of 84 patients with inoperable high-grade malignant HBS were enrolled from three academic tertiary referral centers. Two cross-wired metal stents were inserted using a bilateral stent-in-stent placement method. Bilateral endoscopic revision was also performed during follow-up using either identical metal stents or plastic stents. The main outcome measurements were technical and functional success, complications, stent patency, and endoscopic revision efficacy. The technical and clinical success rates of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents were 95.2% (80/84) and 92.9% (78/84), respectively. Median patency (range) and survival were 238 days (10-429) and 256 days (10-1130), respectively. Obstruction of primary bilateral stents occurred in 30.8% (24/78) of patients with functionally successful stent placement. The technical and clinical success rates of planned bilateral endoscopic revision for occluded stents were 83.3% (20/24) and 79.2% (19/24), respectively. For revision, bilateral metallic stents were placed in 11 patients (55.0%); the remaining patients received plastic stents. Palliative endoscopic bilateral stent-in-stent placement of cross-wired metallic stents was effective in patients with inoperable HBS. Revision endoscopic bilateral stenting may be feasible and successful in cases where the primary deployed metal stents are occluded. © Georg Thieme Verlag KG Stuttgart · New York.

Randomized double-blind placebo-controlled multicenter evaluation of efficacy and dose finding of midodrine hydrochloride in women with mild to moderate stress urinary incontinence: a phase II study.

Science.gov (United States)

Weil, E H; Eerdmans, P H; Dijkman, G A; Tamussino, K; Feyereisl, J; Vierhout, M E; Schmidbauer, C; Egarter, C; Kölle, D; Plasman, J E; Heidler, H; Abbühl, B E; Wein, W

1998-01-01

Midodrine is a potent and selective alpha1-receptor agonist and its potential to increase urethral closure pressure could be useful in the treatment of female stress incontinence. The aim of this randomized double-blind placebo-controlled multicenter study was to evaluate the efficacy and safety of midodrine for the treatment of stress urinary incontinence. The primary criterion of efficacy was the maximum urethral closure pressure at rest. Voiding diaries, symptom and incontinence questionnaires and patient/investigator global assessment were also used to evaluate its efficacy. After 4 weeks of treatment no significant changes in MUCP were found. The global assessment by the patient and investigator did indicate that patients on active treatment had a more positive assessment than the placebo group. In conclusion, midodrine did not cause significant improvements in urodynamic parameters, but there were subjective improvements in some of the patients in the treated groups. Furthermore midodrine was well tolerated.

Living Outside Their Heads: Assessing the Efficacy of a Multicultural Course on the Attitudes of Graduate Students in Teacher Education.

Science.gov (United States)

Martin, Renee J; Dagostino-Kalniz, Victoria

2015-01-01

Given the importance of multicultural education, its impact on students and the ensuing impact on society, it would appear that studies assessing the efficacy of how social justice issues are taught appear to be essential. However, most studies assessing the efficacy of multicultural teacher education coursework appears to be inconclusive. This paper poses the following questions: to what extent is it possible for students who are teachers and administrators in American schools to engage in a multicultural graduate course taught using a social reconstructionist approach to see outside the boundaries of their own perspectives; and to what extent might a multicultural education course have a lasting impact on their personal and professional lives. Additionally, the study asks whether the effects of a multicultural course may be long lasting and significant.

Resection of the primary tumour versus no resection prior to systemic therapy in patients with colon cancer and synchronous unresectable metastases (UICC stage IV): SYNCHRONOUS - a randomised controlled multicentre trial (ISRCTN30964555)

International Nuclear Information System (INIS)

Rahbari, Nuh N; Koch, Moritz; Büchler, Markus W; Kieser, Meinhard; Weitz, Jürgen; Lordick, Florian; Fink, Christine; Bork, Ulrich; Stange, Annika; Jäger, Dirk; Luntz, Steffen P; Englert, Stefan; Rossion, Inga

2012-01-01

Currently, it remains unclear, if patients with colon cancer and synchronous unresectable metastases who present without severe symptoms should undergo resection of the primary tumour prior to systemic chemotherapy. Resection of the primary tumour may be associated with significant morbidity and delays the beginning of chemotherapy. However, it may prevent local symptoms and may, moreover, prolong survival as has been demonstrated in patients with metastatic renal cell carcinoma. It is the aim of the present randomised controlled trial to evaluate the efficacy of primary tumour resection prior to systemic chemotherapy to prolong survival in patients with newly diagnosed colon cancer who are not amenable to curative therapy. The SYNCHRONOUS trial is a multicentre, randomised, controlled, superiority trial with a two-group parallel design. Colon cancer patients with synchronous unresectable metastases are eligible for inclusion. Exclusion criteria are primary tumour-related symptoms, inability to tolerate surgery and/or systemic chemotherapy and history of another primary cancer. Resection of the primary tumour as well as systemic chemotherapy is provided according to the standards of the participating institution. The primary endpoint is overall survival that is assessed with a minimum follow-up of 36 months. Furthermore, it is the objective of the trial to assess the safety of both treatment strategies as well as quality of life. The SYNCHRONOUS trial is a multicentre, randomised, controlled trial to assess the efficacy and safety of primary tumour resection before beginning of systemic chemotherapy in patients with metastatic colon cancer not amenable to curative therapy. http://www.controlled-trials.com/ISRCTN30964555

A Study on the Relationship between Teacher Self Efficacy and Burnout

Science.gov (United States)

Savas, Ahmet Cezmi; Bozgeyik, Yunus; Eser, Ismail

2014-01-01

The major purpose of the study was to examine the relationship between teacher self efficacy and burnout. In order to collect the related data, "Maslach Burnout Inventory" and "Teacher Sense of Efficacy Scale" were used. The sample of the study consisted of 163 randomly chosen teachers who worked in various primary and…

Neoadjuvant radiotherapy for primary advanced or locally recurrent breast cancer

Energy Technology Data Exchange (ETDEWEB)

Watanabe, Hiroaki; Nio, Yoshinori; Inoue, Yasushi; Teramoto, Mutsumi; Nagami, Haruhiko; Yano, Seiji; Sumi, Shoichiro; Tamura, Katsuhiro; Kushima, Takeyuki [Shimane Medical Univ., Izumo (Japan)

1998-03-01

Neoadjuvant radiotherapy for breast cancer has rarely been reported. In the present study, we investigated the objective response and histopathological effects of neoadjuvant radiotherapy in patients with primary advanced or locally recurrent breast cancer. Between 1992 and 1997, a total of 11 patients with primary or recurrent breast cancer (5 primary advanced and 6 locally recurrent breast cancers) were treated with neoadjuvant radiotherapy before surgery. Six patients received radiotherapy alone and 5 received radiotherapy in combination with chemotherapy, and the objective response was assessed according to the criteria of the Japanese Society of Cancer Therapy. After neoadjuvant radiotherapy or radiochemotherapy, all patients underwent surgery or biopsy, and histopathological effects were assessed according to the criteria of the Japanese Research Society for Gastric Cancer Study. The overall objective response was 27% (3PR/11; 2PR in 5 primary cancers and 1PR in 6 recurrent cancers), and histopathological effects included 5 grade-3 or -2 responses (45%; 2 grade-3 and 1 grade-2 in primary cancers and 2 grade-2 in recurrent cancers). There were no correlations between total radiation dose and objective response or histopathological effects. The objective response rates were 40% (2/5) in the radiochemotherapy group and 17% (1/6) in the radiotherapy alone group, histopathological effects higher than grade-2 were seen in 60% (3/5) in the radiochemotherapy group and 33% (2/6) in the radiotherapy alone group, and a grade-3 response was seen only in the radiochemotherapy group. Neoadjuvant radiotherapy for breast cancer resulted in a high response rate and was more effective against primary cancer than recurrent cancer. Furthermore, chemotherapy may be beneficial in improving the efficacy of radiotherapy. (author)

Neoadjuvant radiotherapy for primary advanced or locally recurrent breast cancer

International Nuclear Information System (INIS)

Watanabe, Hiroaki; Nio, Yoshinori; Inoue, Yasushi; Teramoto, Mutsumi; Nagami, Haruhiko; Yano, Seiji; Sumi, Shoichiro; Tamura, Katsuhiro; Kushima, Takeyuki

1998-01-01

Neoadjuvant radiotherapy for breast cancer has rarely been reported. In the present study, we investigated the objective response and histopathological effects of neoadjuvant radiotherapy in patients with primary advanced or locally recurrent breast cancer. Between 1992 and 1997, a total of 11 patients with primary or recurrent breast cancer (5 primary advanced and 6 locally recurrent breast cancers) were treated with neoadjuvant radiotherapy before surgery. Six patients received radiotherapy alone and 5 received radiotherapy in combination with chemotherapy, and the objective response was assessed according to the criteria of the Japanese Society of Cancer Therapy. After neoadjuvant radiotherapy or radiochemotherapy, all patients underwent surgery or biopsy, and histopathological effects were assessed according to the criteria of the Japanese Research Society for Gastric Cancer Study. The overall objective response was 27% (3PR/11; 2PR in 5 primary cancers and 1PR in 6 recurrent cancers), and histopathological effects included 5 grade-3 or -2 responses (45%; 2 grade-3 and 1 grade-2 in primary cancers and 2 grade-2 in recurrent cancers). There were no correlations between total radiation dose and objective response or histopathological effects. The objective response rates were 40% (2/5) in the radiochemotherapy group and 17% (1/6) in the radiotherapy alone group, histopathological effects higher than grade-2 were seen in 60% (3/5) in the radiochemotherapy group and 33% (2/6) in the radiotherapy alone group, and a grade-3 response was seen only in the radiochemotherapy group. Neoadjuvant radiotherapy for breast cancer resulted in a high response rate and was more effective against primary cancer than recurrent cancer. Furthermore, chemotherapy may be beneficial in improving the efficacy of radiotherapy. (author)

A Preliminary Efficacy and Feasibility of an Obstructive Sleep Apnea Educational Intervention in Oman

Science.gov (United States)

Al Mezeini, Khamis Abdallah

Background: Obstructive sleep apnea (OSA) is chronic disorder that contributes to multiple physiological and psychological conditions. Obstructive sleep apnea contributes to high rates of morbidity and mortality and has substantial impacts on both health care costs and the quality of life for affected individuals and their families. Healthcare providers - particularly primary health care nurses - are ideally situated to interrupt the cascading consequences of OSA if they are equipped with evidence-based knowledge about the disease process and appropriate methods for screening, education, and preventive interventions. Purpose: The purpose of the study was to test the preliminary efficacy and feasibility of an online health educational intervention on the knowledge and attitudes of OSA among primary health care nurses in Oman. Methods: This study was designed to assess the preliminary efficacy and feasibility of an online educational program on OSA by randomly assigning subjects to either a treatment (OSA content) or attention control (diabetes content) group. At baseline, the OSA knowledge and attitudes of both groups were assessed by the Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA) questionnaire; both groups also completed the Diabetes Basic Knowledge Test (DBKT) to use for control comparisons. Following randomization, the intervention group viewed a 15-minute narrated video on "Brief Introduction to OSA for Omani Nurses" and the control group viewed a similarly formatted 15-minute narrated video on diabetes. The intent was for the subjects in both groups to complete a posttest that included both the OSAKA and DBKT instruments; however, due to a programming error, the software did not present the DBKT to the intervention subjects and did not present the OSAKA instrument to the control subjects as intended. Therefore, the results describe the findings from a one-group, pretest-posttest intervention study to assess the preliminary efficacy and feasibility

The efficacy of intravenous aminocaproic acid in primary total hip and knee arthroplasty: a meta-analysis.

Science.gov (United States)

Li, Yong-Jiang; Xu, Bi-Sheng; Bai, Sun-Peng; Guo, Xiao-Jun; Yan, Xiang-Yuan

2018-04-17

We conducted a meta-analysis from randomized controlled trials (RCTs) and non-RCTs to assess the efficacy of aminocaproic acid in cases of primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). Potentially relevant academic articles were identified from the Cochrane Library, MEDLINE (1966-2017 October 31), PubMed (1966-2017 October 31), EMBASE (1980-2017 October 31), and ScienceDirect (1985-2017 October 31). Secondary sources were identified from the references of the included literature. The pooled data were analyzed using RevMan 5.1. Three RCTs and four non-RCTs met the inclusion criteria. There were significant differences in total blood loss (mean difference (MD) = - 495.80, 95% CI - 837.29 to - 154.32, P = 0.004), drainage volume (MD = - 249.43, 95% CI - 286.78 to - 212.08, P < 0.00001), postoperative hemoglobin level (MD = 0.90, 95% CI 0.78 to 1.02, P < 0.00001), hemoglobin reduction (MD = - 0.75, 95% CI - 0.93 to - 0.57, P < 0.00001), transfusion rates (risk difference (RD) = - 0.17, 95% CI - 0.25 to - 0.09, P < 0.0001), average transfusion units (MD = - 0.28, 95% CI - 0.48 to - 0.09, P = 0.004), and length of hospital stay (MD = - 0.33, 95% CI - 0.43 to - 0.24, P < 0.00001) between the two groups. No significant differences were found regarding deep vein thrombosis (DVT) (RD = - 0.00, 95% CI - 0.01 to 0.00, P = 0.36) between the two groups. The present meta-analysis indicated that the application of aminocaproic acid in THA or TKA decreases the total blood loss, drainage volume, transfusion rate, transfusion units per patient, and length of hospital stay and does not increase the risk of DVT.

Vismodegib in patients with advanced basal cell carcinoma: Primary analysis of STEVIE, an international, open-label trial.

Science.gov (United States)

Basset-Séguin, N; Hauschild, A; Kunstfeld, R; Grob, J; Dréno, B; Mortier, L; Ascierto, P A; Licitra, L; Dutriaux, C; Thomas, L; Meyer, N; Guillot, B; Dummer, R; Arenberger, P; Fife, K; Raimundo, A; Dika, E; Dimier, N; Fittipaldo, A; Xynos, I; Hansson, J

2017-11-01

The SafeTy Events in VIsmodEgib study (STEVIE, ClinicalTrials.gov, NCT01367665), assessed safety and efficacy of vismodegib-a first-in-class Hedgehog pathway inhibitor demonstrating clinical benefit in advanced basal cell carcinoma (BCC)-in a patient population representative of clinical practice. Primary analysis data are presented. Patients with locally advanced or metastatic BCC received oral vismodegib 150 mg/d until progressive disease, unacceptable toxicity, or withdrawal. Primary objective was safety. Efficacy variables were assessed as secondary end-points. Evaluable adult patients (N = 1215, 1119 locally advanced; 96 metastatic BCC) from 36 countries were treated; 147 patients (12%) remained on study at time of reporting. Median (range) treatment duration was 8.6 (0-44) months. Most patients (98%) had ≥1 treatment-emergent adverse event (TEAE). The incidence of the most common TEAEs was consistent with reports in previous analyses. No association between creatine phosphokinase (CPK) abnormalities and muscle spasm was observed. Serious TEAEs occurred in 289 patients (23.8%). Exposure ≥12 months did not lead to increased incidence or severity of new TEAEs. The majority of the most common TEAEs ongoing at time of treatment discontinuation resolved by 12 months afterwards, regardless of Gorlin syndrome status. Response rates (investigator-assessed) in patients with histologically confirmed measurable baseline disease were 68.5% (95% confidence interval (CI) 65.7-71.3) in patients with locally advanced BCC and 36.9% (95% CI 26.6-48.1) in patients with metastatic BCC. The primary analysis of STEVIE demonstrates that vismodegib is tolerable in typical patients in clinical practice; safety profile is consistent with that in previous reports. Long-term exposure was not associated with worsening severity/frequency of TEAEs. Investigator-assessed response rates showed high rate of tumour control. CLINICALTRIALS.GOV: NCT01367665. Copyright © 2017 The Authors

Self-vs.-Teammate Assessment of Leadership Competence: The Effects of Gender, Leadership Self-Efficacy, and Motivation to Lead

Science.gov (United States)

Rosch, David M.; Collier, Daniel A.; Zehr, Sarah M.

2014-01-01

A sample (N = 81) of undergraduates participating in a semester-long team-project engineering course completed assessments of their leadership competence, motivation to lead, and leadership self-efficacy, as well as the leadership competence of their peers who served within their durable teams. Results indicated that peers scored students lower…

Assessment of safety and efficacy of an indigenous self-expandable fully covered esophageal metal stent for palliation of esophageal cancer.

Science.gov (United States)

Padhan, R K; Nongthombam, S K; Venuthurimilli, A; Dhingra, R; Sahni, P; Garg, P K

2016-01-01

Patients with unresectable esophageal cancer require palliation for dysphagia. Placement of a self-expandable metal stent (SEMS) is the procedure of choice for palliation of dysphagia. To evaluate the safety and efficacy of an indigenous fully-covered SEMS in patients with esophageal cancer. Eligible patients with unresectable esophageal cancer requiring palliation for dysphagia were included in the study. An indigenous fully covered SEMS of appropriate length was placed under endoscopic and fluoroscopic guidance. Outcome measures assessed were adverse events and improvement in dysphagia. Twenty one patients (mean age 57.71±13.14 years; 17 males) were included. After stenting, dysphagia score decreased from 3.2+0.4 to 0.35+0.74 at 4 weeks. Adverse events included retrosternal pain, respiratory distress and aspiration pneumonia in 12, 2 and 1 patients respectively. Five patients required repeat stenting due to stent migration in 4 (following radiotherapy in 3) and tumour ingrowth in 1. There was primary stent malfunction in one patient. The median survival of patients was 140 (76-199) days, which was higher in those who received radiotherapy. The stent was reasonably safe and effective to relieve dysphagia due to unresectable esophageal cancer.

Primary and persistent negative symptoms: Concepts, assessments and neurobiological bases.

Science.gov (United States)

Mucci, Armida; Merlotti, Eleonora; Üçok, Alp; Aleman, André; Galderisi, Silvana

2017-08-01

Primary and persistent negative symptoms (PPNS) represent an unmet need in the care of people with schizophrenia. They have an unfavourable impact on real-life functioning and do not respond to available treatments. Underlying etiopathogenetic mechanisms of PPNS are still unknown. The presence of primary and enduring negative symptoms characterizes deficit schizophrenia (DS), proposed as a separate disease entity with respect to non-deficit schizophrenia (NDS). More recently, to reduce the heterogeneity of negative symptoms by using criteria easily applicable in the context of clinical trials, the concept of persistent negative symptoms (PNS) was developed. Both PNS and DS constructs include enduring negative symptoms (at least 6months for PNS and 12months for DS) that do not respond to available treatments. PNS exclude secondary negative symptoms based on a cross-sectional evaluation of severity thresholds on commonly used rating scales for positive symptoms, depression and extrapyramidal side effects; the DS diagnosis, instead, excludes all potential sources of secondary negative symptoms based on a clinical longitudinal assessment. In this paper we review the evolution of concepts and assessment modalities relevant to PPNS, data on prevalence of DS and PNS, as well as studies on clinical, neuropsychological, brain imaging electrophysiological and psychosocial functioning aspects of DS and PNS. Copyright © 2016 Elsevier B.V. All rights reserved.

DIADEME: A computer code to assess in operation defective fuel characteristics and primary circuit contamination

Energy Technology Data Exchange (ETDEWEB)

Genin, J.B. [DEN/DEC/S3C, CEA Cadarache, 13 - Saint-Paul-lez-Durance (France); Harrer, A. [EdF/SEPTEN, 69 - Villeurbanne (France); Musante, Y. [FRAMATOME-ANP, 69 - Lyon (France)

2002-07-01

DIADEME is a computer code developed within the framework of R and D cooperation between the French Atomic Energy Commission (CEA), Electricite de France (EdF) and FRAMATOME-ANP. Its aim is to assess in operation defective fuel characteristics and primary circuit contamination for actinides and long half-life fission products involved in health physics problems as well as in waste and decommissioning studies. DIADEME has been developed and qualified for the EDF nuclear power plants. For many years, both theoretical and experimental studies have been carried out at the CEA on the release of fission products and actinides out of defective fuel rods in operation, their migration and deposition in PWR primary circuits. These studies have allowed defect characteristic diagnosis methods to be developed, based on radiochemical measurements of the primary coolant. These methods are generally used along with gamma spectrometry measurements on primary water sampling. In order to be completely efficient, these methods can also be used in connection with an on-line primary water gamma spectrometry device. This permits to obtain the most comprehensive data on fission product activity evolutions at steady state and during operation transients, and allows the on-line characterization of the defective fuel assemblies. For long half-life fission products and for actinides, DIADEME is also able to assess the activities of soluble and insoluble forms in the primary water and in the chemical and voluminal control system (CVCS) filters and resins, as well as those activities deposited on primary circuit surfaces. (author)

DIADEME: A computer code to assess in operation defective fuel characteristics and primary circuit contamination

International Nuclear Information System (INIS)

Genin, J.B.; Harrer, A.; Musante, Y.

2002-01-01

DIADEME is a computer code developed within the framework of R and D cooperation between the French Atomic Energy Commission (CEA), Electricite de France (EdF) and FRAMATOME-ANP. Its aim is to assess in operation defective fuel characteristics and primary circuit contamination for actinides and long half-life fission products involved in health physics problems as well as in waste and decommissioning studies. DIADEME has been developed and qualified for the EDF nuclear power plants. For many years, both theoretical and experimental studies have been carried out at the CEA on the release of fission products and actinides out of defective fuel rods in operation, their migration and deposition in PWR primary circuits. These studies have allowed defect characteristic diagnosis methods to be developed, based on radiochemical measurements of the primary coolant. These methods are generally used along with gamma spectrometry measurements on primary water sampling. In order to be completely efficient, these methods can also be used in connection with an on-line primary water gamma spectrometry device. This permits to obtain the most comprehensive data on fission product activity evolutions at steady state and during operation transients, and allows the on-line characterization of the defective fuel assemblies. For long half-life fission products and for actinides, DIADEME is also able to assess the activities of soluble and insoluble forms in the primary water and in the chemical and voluminal control system (CVCS) filters and resins, as well as those activities deposited on primary circuit surfaces. (author)

Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review.

Science.gov (United States)

Cheraghi-Sohi, Sudeh; Bower, Peter

2008-08-21

Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii) Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase) and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form. Nine studies were included (two patient based feedback studies and seven brief training studies). Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect. There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback and brief training interventions is required before these

Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review

Directory of Open Access Journals (Sweden)

Bower Peter

2008-08-01

Full Text Available Abstract Background Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i feedback of real patient assessments of interpersonal care skills, (ii brief training focused on the improvement of interpersonal care (iii interventions combining both (i and (ii Methods Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form. Results Nine studies were included (two patient based feedback studies and seven brief training studies. Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect. Conclusion There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback

A randomised, double-blind, placebo-controlled, crossover study to assess the efficacy and safety of three dosing schedules of agalsidase alfa enzyme replacement therapy for Fabry disease.

Science.gov (United States)

Hughes, D A; Deegan, P B; Milligan, A; Wright, N; Butler, L H; Jacobs, A; Mehta, A B

2013-07-01

Anecdotal reports suggest that the currently approved dosing interval of agalsidase alfa (0.2 mg/kg/2 weeks) for Fabry disease treatment is too long. This randomised, double-blind, placebo-controlled, crossover study investigated three altered dosing intervals. 18 Fabry patients received three agalsidase alfa dosing schedules, each for four weeks (A: 0.2 mg/kg∗2 weeks, B: 0.1 mg/kg/week, C: 0.2 mg/kg/week). Health state, pain levels, sweat volume and latency and plasma and urinary globotriaosylceramide levels were recorded throughout the study. No significant differences were found among the schedules for the primary efficacy outcome of self-assessed health state, or for pain scores. A trend toward increased sweat volume on QSART testing, and reduced urine globotriaosylceramide concentration were seen with treatment schedule C. Agalsidase alfa was safe and well tolerated with all schedules. In conclusion, the primary analyses did not find weekly infusions of agalsidase alfa to be statistically better than the approved dosing schedule however the data indicates that further studies with more patients over a longer period are required to more accurately determine the optimum dose and schedule. Copyright © 2013 Elsevier Inc. All rights reserved.

Towards the effective introduction of physical activity interventions in primary health care

NARCIS (Netherlands)

Huijg, Johanna Maria

2014-01-01

Despite the promising findings related to the efficacy of primary health care-based physical activity interventions and recommendations for primary health care professionals to promote physical activity, the introduction of physical activity interventions in routine daily primary health care

Safety assessment of smoke flavouring primary products by the European Food Safety Authority

NARCIS (Netherlands)

Theobald, A.; Arcella, D.; Carere, A.; Croera, C.; Engel, K.H.; Gott, D.; Gurtler, R.; Meier, D.; Pratt, I.; Rietjens, I.M.C.M.; Simon, R.; Walker, R.

2012-01-01

This paper summarises the safety assessments of eleven smoke flavouring primary products evaluated by the European Food Safety Authority (EFSA). Data on chemical composition, content of polyaromatic hydrocarbons and results of genotoxicity tests and subchronic toxicity studies are presented and

The Influence of an Internet-Based Formative Assessment Tool on Primary Grades Students' Number Sense Achievement

Science.gov (United States)

Polly, Drew; Wang, Chuang; Martin, Christie; Lambert, Richard G.; Pugalee, David K.; Middleton, Catharina Win

2017-01-01

This study examined primary grades students' achievement on number sense tasks administered through an Internet-based formative assessment tool, Assessing Math Concepts Anywhere. Data were analyzed from 2,357 students in teachers' classrooms who had participated in a year-long professional development program on mathematics formative assessment,…

Assessing self-efficacy and college readiness level among new undergraduate students in computer science using metacognitive awareness inventory (MAI)

Science.gov (United States)

Othman, Wan Nor Afiqah Wan; Abdullah, Aziman

2018-04-01

This preliminary study was conducted to address the issue of academic planning skills among new university student. Due to lack of proper measurement mechanism for awareness and readiness among students, this study proposes Metacognitive Awareness Inventory (MAI) to assess the connection between student self-efficacy and college readiness. Qualitative and quantitative approach were used by provide an online self-assessment for new student of Faculty of Computer Systems & Software Engineering (FSKKP) and analyse the data respectively. The possible relationships between MAI and College Readiness Item (CRI) in self-assessment has been evaluated. The sample size of 368 respondents from UMP are responding to the online self-assessment. The initial finding shows most student (71%) of the respondent lack of skills in planning. We manage to use Pearson Product-moment correlation coefficient to find the significant relationship between MAI and CRI. Thus, we found that College Readiness provide sufficient evidence that there is a significant correlation with most of MAI items. The findings also indicated not much difference was found between gender in terms of self-efficacy level. This paper suggests the MAI and CRI is a reliable and valid scale to respond the planning skills issues among new university students.

RUSVISK: DOMESTICALLY DEVELOPED PRODUCT OF HYALURONIC ACID: ASSESSMENT OF EFFICACY AND SAFETY IN EARLY STAGES OF THE KNEE OSTEOARTHRITIS

Directory of Open Access Journals (Sweden)

N. V. Vas'kova

2014-01-01

Full Text Available Objective: to compare the efficacy and safety of intra-articular therapy with Rusvisk (hyaluronic acid product and Ostenil in early stages of knee osteoarthritis.Subjects and methods. 50 patients with II–III stage of the knee osteoarthritis were included in the randomized double blinded controlled study. They had pain at movement of more than 40 mm by visual analogue scale (VAS and Lequesne index of 4–12. All patients received a course of three intra-articular injections with products of hyaluronic acid at the interval of 7 days. Rusvisk (molecular weight 3500 kDa was administered to 25 patients, whereas other 25 received Ostenil (molecular weight 1200–1400 kDa. In 1, 2, 3 weeks after the first injection following criteria were registered: changes of WOMAC index, pain at movement and at rest by VAS, general assessment of therapy efficacy by doctor and patient, assessment of efficacy according to OMERACTOARSI.Results. In three weeks after the first injection a significant decrease of pain at movement (by 69% in Rusvisk group and by 55% in Ostenil group and of WOMAC index (by 63% in Rusvsik group and by 60% in Ostenil group was achieved in both groups without any differences between them. Significant decrease of pain at rest was observed at all visits only in Rusvisk group. When assessing the general efficacy, patients found more advantagesin the  domestic product, whereas the therapist did not see the differences between groups. Response to the therapy by OMERACT-OARSI criteria was observed in 88% of patients in Rusvisk group and in 64% in Ostenil group. Short-term pain in the site of injection was mentioned by 64% of patients from Rusvisk group and by 72% from Ostenil group.Conclusion. Intra-articular therapy with the products of hyaluronic acid «Rusvisk», «Ostenil» provides comparable decrease of pain and improvement of functional parameters in patients with knee osteoarthritis.

Assessment of efficacy and tolerability of once-daily extended release metformin in patients with type 2 diabetes mellitus

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S Yu Vorotnikova

2012-09-01

Full Text Available Реферат по статье: Assessment of efficacy and tolerability of once-daily extended release metformin in patients with type 2 diabetes mellitus Juliana Levy, Roberta A Cobas, Marilia B Gomes. Diabetol Metab Syndr. 2010 Mar 18; 2:16.

Wenjing decoction (herbal medicine) for the treatment of primary dysmenorrhea: a systematic review and meta-analysis.

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Gao, Li; Jia, Chunhua; Zhang, Heng; Ma, Cuilan

2017-10-01

Wenjing decoction is a well-accepted traditional Chinese medicine for the treatment of primary dysmenorrhea in East Asia, but its clinical effectiveness and risk have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea. Eight databases were used in our research: the Cochrane Library, the Web of Science, PubMed, EMBASE, the Chinese Biomedical Literature Database (CBM), the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database, and the Wan-fang Database. The following search terms were used: (Wenjing decoction OR Wenjing formula OR Wenjing tang) AND (primary dysmenorrhea OR dysmenorrhea OR painful menstruation) AND (randomized controlled trial). No language limitation was used. A total of 18 studies, including 1736 patients, were included in the meta-analysis. Wenjing decoction was shown to be significantly better than nonsteroidal anti-inflammatory drugs for the improvement of primary dysmenorrhea according to the clinical effective rate (RR 1.41, 95% CI 1.24-1.61), the visual analogue scale (MD -1.77, 95% CI -2.69 to -0.84), and the pain scale for dysmenorrhea (MD -1.81, 95% CI -2.41 to -1.22). The results supported the clinical use of Wenjing decoction for the treatment of primary dysmenorrhea. However, the quality of the evidence for this finding was low due to a high risk of bias in the included studies. Therefore, well-designed randomized controlled trials are still needed to further evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea.

Assessment of the efficacies, potencies and bacteriological qualities ...

African Journals Online (AJOL)

The efficacies, potencies and qualities of these antibiotics were tested against some clinical isolates which include Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus pyogenes in vitro. The overall mean zones of inhibition for the test organisms ranged from 33.0 ...

Study protocol for a pragmatic randomised controlled trial evaluating efficacy of a smoking cessation e-'Tabac Info Service': ee-TIS trial.

Science.gov (United States)

Cambon, L; Bergman, P; Le Faou, Al; Vincent, I; Le Maitre, B; Pasquereau, A; Arwidson, P; Thomas, D; Alla, F

2017-02-24

A French national smoking cessation service, Tabac Info Service, has been developed to provide an adapted quitline and a web and mobile application involving personalised contacts (eg, questionnaires, advice, activities, messages) to support smoking cessation. This paper presents the study protocol of the evaluation of the application (e-intervention Tabac Info Service (e-TIS)). The primary objective is to assess the efficacy of e-TIS. The secondary objectives are to (1) describe efficacy variations with regard to users' characteristics, (2) analyse mechanisms and contextual conditions of e-TIS efficacy. The study design is a two-arm pragmatic randomised controlled trial including a process evaluation with at least 3000 participants randomised to the intervention or to the control arm (current practices). Inclusion criteria are: aged 18 years or over, current smoker, having completed the online consent forms, possessing a mobile phone with android or apple systems and using mobile applications, wanting to stop smoking sooner or later. The primary outcome is the point prevalence abstinence of 7 days at 6 months later. Data will be analysed in intention to treat (primary) and per protocol analyses. A logistic regression will be carried out to estimate an OR (95% CI) for efficacy. A multivariate multilevel analysis will explore the influence on results of patients' characteristics (sex, age, education and socioprofessional levels, dependency, motivation, quit experiences) and contextual factors, conditions of use, behaviour change techniques. The study protocol was reviewed by the ethical and deontological institutional review board of the French Institute for Public Health Surveillance on 18 April 2016. The findings of this study will allow us to characterise the efficacy of e-TIS and conditions of its efficacy. These findings will be disseminated through peer-reviewed articles. NCT02841683; Pre-results. Published by the BMJ Publishing Group Limited. For

Efficacy of Sublingual Misoprostol versus Intramuscular Methylergometrine in Prevention of Primary Postpartum Hemorrhage

International Nuclear Information System (INIS)

Anwar, R.; Ambreen, A.; Khuram, A.; Mushtaq, M.

2013-01-01

Post partum hemorrhage still remains a major cause of maternal morbidity and mortality in developing countries. Most of oxytocics like methylergometrine require parenteral administration, which requires special storage. Misoprostol is thermo stable, has a long shelf life and is widely recommended for prevention of postpartum hemorrhage. This can be a choice of oxytocic in developing countries like ours, where storage facilities and resources are limited. Objectives: To compare efficacy of sublingual Misoprostol versus intramuscular Methylergometrine in prevention of primary postpartum hemorrhage after delivery. Study Design: Quasi experimental study Place and Duration of Study: Department of Gynae/Obs, Military Hospital and Combined Military Hospital Rawalpindi cantt. December 2007 to July 2008. Material and Methods: One hundred and thirty six pregnant ladies were selected. On arrival each patient was examined thoroughly along with baseline investigations. Therapeutic option was allocated to the patients simply by using a table of random numbers and dividing them in two equal groups. Informed written consent was taken. Each patient was observed for blood loss estimation and hematocrit drop. All the data was analyzed using SPSS version 10.0. Mean +- SD for age, pre-delivery and post-delivery hematocrit, percentage of drop in hematocrit and blood loss during labour was calculated. Results: Mean drop of hematocrit and blood loss were compared among two groups. At the end, it was revealed that there was no significant difference among two groups in blood loss (p=0.49) and hematocrit drop (p=0.14). Conclusion: There is no significant better effect in preventing post partum hemorrhage among the two drugs. (author)

Measuring School Psychology Trainee Self-Efficacy

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Lockwood, Adam B.; Mcclure, John; Sealander, Karen; Baker, Courtney N.

2017-01-01

There is an ever-increasing need for school psychology training programs to demonstrate their ability to produce competent practitioners. One method of addressing this need is through the assessment of self-efficacy. However, little research on self-efficacy in school psychology exists likely due to the lack of a psychometrically sound measure of…

Laboratory Assessment of Bio-efficacies of Phytochemical Extracts ...

African Journals Online (AJOL)

They were ground into powder and stored in air-tight glass bottles. The volatile phytochemical oil ... degrees of mosquitocidal activity. These observed variations in the bio-efficacies of the different extracts could be attributed to the corresponding variations in their qualitative and quantitative bioactive compound contents.

Reporting, Visualization, and Modeling of Immunogenicity Data to Assess Its Impact on Pharmacokinetics, Efficacy, and Safety of Monoclonal Antibodies.

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Passey, Chaitali; Suryawanshi, Satyendra; Sanghavi, Kinjal; Gupta, Manish

2018-02-26

The rapidly increasing number of therapeutic biologics in development has led to a growing recognition of the need for improvements in immunogenicity assessment. Published data are often inadequate to assess the impact of an antidrug antibody (ADA) on pharmacokinetics, safety, and efficacy, and enable a fully informed decision about patient management in the event of ADA development. The recent introduction of detailed regulatory guidance for industry should help address many past inadequacies in immunogenicity assessment. Nonetheless, careful analysis of gathered data and clear reporting of results are critical to a full understanding of the clinical relevance of ADAs, but have not been widely considered in published literature to date. Here, we review visualization and modeling of immunogenicity data. We present several relatively simple visualization techniques that can provide preliminary information about the kinetics and magnitude of ADA responses, and their impact on pharmacokinetics and clinical endpoints for a given therapeutic protein. We focus on individual sample- and patient-level data, which can be used to build a picture of any trends, thereby guiding analysis of the overall study population. We also discuss methods for modeling ADA data to investigate the impact of immunogenicity on pharmacokinetics, efficacy, and safety.

Psychological impact of family history risk assessment in primary care: a mixed methods study.

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Birt, Linda; Emery, Jon D; Prevost, A Toby; Sutton, Stephen; Walter, Fiona M

2014-08-01

Routine family history risk assessment for chronic diseases could enable primary care practitioners to efficiently identify at-risk patients and promote preventive management strategies. To investigate patients' understanding and responses to family history risk assessment in primary care. A mixed methods study set in 10 Eastern England general practices. Participants in a family history questionnaire validation study were triaged into population or increased risk for four chronic diseases (type 2 diabetes, cardiovascular disease, breast cancer, colorectal cancer). Questionnaires completed immediately prior to the family history consultation (baseline) and 4 weeks later (follow-up) assessed the psychological impact, including State-Trait Anxiety Inventory scores. Semi-structured interviews explored the meaning participants gave to their personal familial disease risk. Four hundred and fifty-three participants completed both baseline and follow-up questionnaires and 30 were interviewed. At follow-up, there was no increase in anxiety among either group, or differences between the groups [difference in mean change 0.02, 95% confidence interval -2.04, 2.08, P = 0.98]. There were no significant changes over time in self-rated health in either group. At follow-up, participants at increased risk (n = 153) were more likely to have recent changes to behaviour and they had stronger intentions to make changes to diet (P = 0.001), physical activity (P = 0.006) and to seek further information in the future than those at population risk (n = 300; P assessment for familial risk of chronic diseases may be undertaken in primary care without causing anxiety or reducing self-rated health. Patient responses to family history risk assessment may inform promotion of preventive management strategies. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Safety, efficacy, and immunogenicity of an inactivated influenza vaccine in healthy adults: a randomized, placebo-controlled trial over two influenza seasons

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Bouveret Nancy

2010-03-01

Full Text Available Abstract Background Seasonal influenza imposes a substantial personal morbidity and societal cost burden. Vaccination is the major strategy for influenza prevention; however, because antigenically drifted influenza A and B viruses circulate annually, influenza vaccines must be updated to provide protection against the predicted prevalent strains for the next influenza season. The aim of this study was to assess the efficacy, safety, reactogenicity, and immunogenicity of a trivalent inactivated split virion influenza vaccine (TIV in healthy adults over two influenza seasons in the US. Methods The primary endpoint of this double-blind, randomized study was the average efficacy of TIV versus placebo for the prevention of vaccine-matched, culture-confirmed influenza (VMCCI across the 2005-2006 and 2006-2007 influenza seasons. Secondary endpoints included the prevention of laboratory-confirmed (defined by culture and/or serology influenza, as well as safety, reactogenicity, immunogenicity, and consistency between three consecutive vaccine lots. Participants were assessed actively during both influenza seasons, and nasopharyngeal swabs were collected for viral culture from individuals with influenza-like illness. Blood specimens were obtained for serology one month after vaccination and at the end of each influenza season's surveillance period. Results Although the point estimate for efficacy in the prevention of all laboratory-confirmed influenza was 63.2% (97.5% confidence interval [CI] lower bound of 48.2%, the point estimate for the primary endpoint, efficacy of TIV against VMCCI across both influenza seasons, was 46.3% with a 97.5% CI lower bound of 9.8%. This did not satisfy the pre-specified success criterion of a one-sided 97.5% CI lower bound of >35% for vaccine efficacy. The VMCCI attack rates were very low overall at 0.6% and 1.2% in the TIV and placebo groups, respectively. Apart from a mismatch for influenza B virus lineage in 2005

Neurostimulation therapies for primary headache disorders

DEFF Research Database (Denmark)

Magis, Delphine; Jensen, Rigmor; Schoenen, Jean

2012-01-01

Most pharmacological treatments of primary headache disorders are partially effective and have cumbersome side effects. Therapies with better efficacy and tolerance are needed. Neurostimulation techniques may have this potential. This is an attempt to summarize the latest clinical trial results...

Revolution, Evolution or a Trojan Horse? Piloting Assessment for Learning in Some Scottish Primary Schools

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Kirton, Alison; Hallam, Susan; Peffers, Jack; Robertson, Pamela; Stobart, Gordon

2007-01-01

This article analyses some of the findings of an evaluation of Project One of the "Assessment is for Learning" Development Programme in 16 Scottish primary schools and two junior high schools in which teachers developed formative assessment strategies aimed at improving teaching and learning. Drawing on data from pupils, teachers and…

Measures of Model Uncertainty in the Assessment of Primary Stresses in Ship Structures

DEFF Research Database (Denmark)

Östergaard, Carsten; Dogliani, Mario; Guedes Soares, Carlos

1996-01-01

The paper considers various models and methods commonly used for linear elastic stress analysis and assesses the uncertainty involved in their application to the analysis of the distribution of primary stresses in the hull of a containership example, through statistical evaluations of the results...

Model of affective assessment of primary school students

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Amir Syamsudin

2016-06-01

Full Text Available This study aims to develop an instrument of affective assessment to measure the social competence of elementary school students in the learning process in schools. This study used the development model of Borg & Gall’s approach which was modified into five phases, including the need analyses, developing draft of the product conducted by experts, developing an affective assessment instrument, trying out the affective assessment instrument conducted by teachers of primary education in Yogyakarta, and the dissemination and implementation of the developed affective assessment instrument. The subjects were elementary school students whose school implemented Curriculum 2013 in the academic year of 2013/2014. The validity and reliability of each construct of the affective instrument were established using the PLS SEM Wrap PLS 3.0 analysis program. The study finds the following results. First, the construct of Honesty, Discipline, Responsibility, Decency, Care, and Self-Confidence in the limited, main, and extended testing has been supported by empirical data. Second, the validity of Honesty, Discipline, Responsibility, Decency, Care, and Self-Confidence in the limited, main, and extended testing meets the criteria above 0.70 for each indicator of the loading factor and the criteria below 0.50 for each indicator score of the cross-loading factor. Third, the reliability of Honesty, Discipline, Responsibility, Decency, Care, and Self-Confidence in limited, main, and extended testing meets the criteria above 0.70 for both composite reliability and Cronbach’s alpha scores. Fourth, the number of indicators at preresearch was 53, and 10 indicators were rejected in the limited testing, and four indicators were rejected in the main testing, and one indicator was rejected in the extended testing.

Developing a Measurement Tool for Assessing Physiotherapy Students' Self-Efficacy: A Pilot Study

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Jones, Anne; Sheppard, Lorraine

2012-01-01

The aim of this research was to determine if self-efficacy can be correlated with prior academic achievement and whether self-efficacy can be an outcome measure of education. A self-efficacy instrument was developed and administered to physiotherapy students following completion of their pre-clinical theory experience. The questionnaire results…

A randomized trial of telemedicine efficacy and safety for nonacute headaches.

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Müller, Kai I; Alstadhaug, Karl B; Bekkelund, Svein I

2017-07-11

To evaluate long-term treatment efficacy and safety of one-time telemedicine consultations for nonacute headaches. We randomized, allocated, and consulted nonacute headache patients via telemedicine (n = 200) or in a traditional manner (n = 202) in a noninferiority trial. Efficacy endpoints, assessed by questionnaires at 3 and 12 months, included change from baseline in Headache Impact Test-6 (HIT-6) (primary endpoint) and pain intensity (visual analogue scale [VAS]) (secondary endpoint). The primary safety endpoint, assessed via patient records, was presence of secondary headache within 12 months after consultation. We found no differences between telemedicine and traditional consultations in HIT-6 ( p = 0.84) or VAS ( p = 0.64) over 3 periods. The absolute difference in HIT-6 from baseline was 0.3 (95% confidence interval [CI] -1.26 to 1.82, p = 0.72) at 3 months and 0.2 (95% CI -1.98 to 1.58, p = 0.83) at 12 months. The absolute change in VAS was 0.4 (95% CI -0.93 to 0.22, p = 0.23) after 3 months and 0.3 (95% CI -0.94 to 0.29, p = 0.30) at 12 months. We found one secondary headache in each group at 12 months. The estimated number of consultations needed to miss one secondary headache with the use of telemedicine was 20,200. Telemedicine consultation for nonacute headache is as efficient and safe as a traditional consultation. NCT02270177. This study provides Class III evidence that a one-time telemedicine consultation for nonacute headache is noninferior to a one-time traditional consultation regarding long-term treatment outcome and safety. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Gender fairness in self-efficacy? A Rasch-based validity study of the General Academic Self-efficacy scale (GASE)

DEFF Research Database (Denmark)

Nielsen, Tine; Vang, Maria Louison; Dammeyer, Jesper

2018-01-01

Studies have reported gender differences in academic self-efficacy. However, how and if academic self-efficacy questionnaires are gender-biased has not been psychometrically investigated. The psychometric properties of a general version of The Physics Self-Efficacy Questionnaire – the General...... Academic Self-Efficacy Scale (GASE) – were analyzed using Rasch measurement models, with data from 1018 Danish university students (psychology and technical), focusing on gender invariance and the sufficiency of the score. The short 4-item GASE scale was found to be essentially objective and construct...... valid and satisfactorily reliable, though differential item functioning was found relative to gender and academic discipline, and can be used to assess students’ general academic self-efficacy. Research on gender and self-efficacy needs to take gender into account and equate scores appropriately...

Efficacy of microwave ablation for severe secondary hyperparathyroidism in subjects undergoing hemodialysis.

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Diao, Zongli; Wang, Liyan; Li, Dishan; Liu, Wenhu

2017-11-01

Severe secondary hyperparathyroidism (SHPT) is a serious problem in patients undergoing hemodialysis. The efficacy and safety of microwave ablation (MWA), a minimally invasive treatment, for severe SHPT are as yet unclear. To clarify the role of MWA, we administered it to patients with severe SHPT and assessed its efficacy and safety. This was a prospective, single-center, single-arm, clinical trial. We enrolled patients with severe SHPT attending our hemodialysis center who met the inclusion and exclusion criteria. We then assessed primary outcome measures (serum concentrations of intact parathyroid hormone) and secondary outcome measures (serum concentrations of calcium and phosphorus). Twenty-six patients were enrolled in this study, 10 of whom (38.46%) were responsive to MWA and 16 (61.54%) of whom were not. The main complication was hypocalcemia (10 cases, 38.46%), which had occurred in all cases by one week after administration of MWA. Responding patients with hypocalcemia all achieved normal serum calcium concentrations within seven months and non-responding patients within three months. There were no changes in serum phosphorus concentrations after MWA in either responders or non-responders. Microwave ablation is relatively ineffective in patients with severe SHPT undergoing maintaining hemodialysis and should not be the initial therapy in such cases.

The reliability of prayer-based self-efficacy scale to assess self-confidence of Muslims with low back pain.

Science.gov (United States)

Al-Obaidi, Saud; Wall, James C; Mulekar, Madhuri S; Al-Mutairie, Rebecca

2012-06-01

Low back pain (LBP) may challenge an individual's self-confidence to perform usual daily activities such as Islamic daily prayer. Existing self-efficacy scales may not be appropriate to assess individual's self-confidence to perform Islamic prayers. This study aimed to develop a scale to assess self-confidence to prepare and perform Islamic prayer in the presence of LBP, the Islamic Prayer-based Self-efficacy Scale (IpbSeS), and to determine its consistency. The IpbSeS consists of three parts: pre-prayer preparation, getting to and from the mosque, and positions and movements during prayer. On a scale of 0 to 6, 0 indicates 'not at all confident' and 6 'fully confident'. Sixty individuals with LBP gave their responses on two different visits. Pain intensity was assessed by the Visual Analogue Scale (VAS), and the pain intensity changes were assessed using a seven-point global patient rating scale. Descriptive statistics, Pearson's correlation coefficient, Wilcoxon test and t-test were used in the analysis (alpha set at 0.05). VAS scores did not differ significantly between visits. No association was found between VAS and age (r = 0.039, p = 0.77) and between VAS and body mass index (BMI; r = 0.06, p = 0. 67). All 28 questions have consistent responses on two visits (0.75 ≤ r ≤ 0.99, p Muslims in the presence of LBP to pray. Copyright © 2011 John Wiley & Sons, Ltd.

Adalimumab for nail psoriasis: Efficacy and safety from the first 26 weeks of a phase 3, randomized, placebo-controlled trial.

Science.gov (United States)

Elewski, Boni E; Okun, Martin M; Papp, Kim; Baker, Christopher S; Crowley, Jeffrey J; Guillet, Gérard; Sundaram, Murali; Poulin, Yves; Gu, Yihua; Geng, Ziqian; Williams, David A; Rich, Phoebe A

2018-01-01

Previous clinical trials have not evaluated improvement in nail psoriasis as a primary end point. This phase 3 trial evaluated the safety and efficacy of adalimumab in patients with moderate-to-severe fingernail psoriasis and moderate-to-severe plaque psoriasis. Patients were randomized 1:1 to 40 mg adalimumab every other week or placebo. The primary efficacy end point was at least 75% improvement in total-fingernail modified Nail Psoriasis Severity Index (NAPSI75) response rate at week 26. Ranked secondary end point scores evaluated at week 26 were total-fingernail NAPSI and modified NAPSI, nail pain, Nail Psoriasis Physical Functioning Severity, Brigham Scalp Nail Inverse Palmo-Plantar Psoriasis Index, and Physician's Global Assessment (fingernail psoriasis). Of the 217 randomized patients (108 received placebo and 109 received adalimumab), 188 (86.6%) completed 26 weeks of treatment (period A) or escaped early to the open-label period. The study met the primary end point (response rate of 3.4% with placebo vs 46.6% with adalimumab [P psoriasis versus with placebo and no new safety risks were identified. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Efficacy, safety and tolerability of sildenafil in Brazilian hypertensive patients on multiple antihypertensive drugs

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Denilson C. Albuquerque

2005-08-01

Full Text Available OBJECTIVE: To evaluate the efficacy, safety and tolerability of sildenafil among Brazilian patients with hypertension treated with combinations of anti-hypertensive drugs. MATERIALS AND METHODS: One hundred twenty hypertensive men aged 30 to 81 years old under treatment with 2 or more anti-hypertensive drugs and with erectile dysfunction (ED lasting for at least 6 months were enrolled at 7 research centers in Brazil. Patients were randomized to receive treatment with either sildenafil or placebo taken 1 hour before sexual intercourse (initial dose of 50 mg, adjusted to 25 mg or 100 mg according to efficacy and toxicity. During the following 8 weeks, patients were evaluated regarding vital signs, adverse events, therapeutic efficacy, satisfaction with treatment and use of concurrent medications. RESULTS: The primary evaluation of efficacy, which was based on responses to questions 3 and 4 of the International Index of Erectile Function, showed significant differences regarding treatment with sildenafil (p = 0.0002 and p < 0.0001, respectively. In the assessment of global efficacy, 87% of the patients treated with sildenafil reported improved erections, as compared with 37% of patients given placebos (p < 0.0001. The other secondary evaluations supported the results favoring sildenafil. The most frequent adverse events among patients treated with sildenafil were headaches (11.4%, vasodilation (11.4% and dyspepsia (6.5%. There were no significant changes in blood pressure measurements in both groups. CONCLUSION: Sildenafil is efficacious and safe for the treatment of hypertensive patients with ED who receive concurrent combinations of anti-hypertensive drugs.

Primary blast survival and injury risk assessment for repeated blast exposures.

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Panzer, Matthew B; Bass, Cameron R Dale; Rafaels, Karin A; Shridharani, Jay; Capehart, Bruce P

2012-02-01

The widespread use of explosives by modern insurgents and terrorists has increased the potential frequency of blast exposure in soldiers and civilians. This growing threat highlights the importance of understanding and evaluating blast injury risk and the increase of injury risk from exposure to repeated blast effects. Data from more than 3,250 large animal experiments were collected from studies focusing on the effects of blast exposure. The current study uses 2,349 experiments from the data collection for analysis of the primary blast injury and survival risk for both long- and short-duration blasts, including the effects from repeated exposures. A piecewise linear logistic regression was performed on the data to develop survival and injury risk assessment curves. New injury risk assessment curves uniting long- and short-duration blasts were developed for incident and reflected pressure measures and were used to evaluate the risk of injury based on blast over pressure, positive-phase duration, and the number of repeated exposures. The risk assessments were derived for three levels of injury severity: nonauditory, pulmonary, and fatality. The analysis showed a marked initial decrease in injury tolerance with each subsequent blast exposure. This effect decreases with increasing number of blast exposures. The new injury risk functions showed good agreement with the existing experimental data and provided a simplified model for primary blast injury risk. This model can be used to predict blast injury or fatality risk for single exposure and repeated exposure cases and has application in modern combat scenarios or in setting occupational health limits. .Copyright © 2012 by Lippincott Williams & Wilkins

Patient satisfaction is biased by renovations to the interior of a primary care office: a pretest-posttest assessment.

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Tièche, Raphaël; da Costa, Bruno R; Streit, Sven

2016-08-11

Measuring quality of care is essential to improve primary care. Quality of primary care for patients is usually assessed by patient satisfaction questionnaires. However, patients may not be able to judge quality of care without also reflecting their perception of the environment. We determined the effect that redesigning a primary care office had on patient satisfaction. We hypothesized that renovating the interior would make patients more satisfied with the quality of medical care. We performed a Pretest-Posttest analysis in a recently renovated single-practice primary care office in Grenchen, Switzerland. Before and after renovation, we distributed a questionnaire to assess patient satisfaction in four domains. We chose a Likert scale (1 = very poor to 6 = very good), and 12 quality indicators, and included two consecutive samples of patients presenting at the primary care office before (n = 153) and after (n = 153) interior design renovation. Response rate was high (overall 85 %). The sample was similar to the enlisted patient collective, but the sample population was older (60 years) than the collective (52 years). Patient satisfaction was higher for all domains after the office was renovated (p patient satisfaction, including satisfaction in domains otherwise unchanged. Physician skills and patient satisfaction sometimes depend on surrounding factors that may bias the ability of patients to assess the quality of medical care. These biases should be taken into account when quality assessment instruments are designed for patients.

Self-Efficacy of Teacher Candidates for Teaching First Reading and Writing

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Gündogmus, Hatice Degirmenci

2018-01-01

The purpose of this study is to determine by different variables the self-efficacy of a teacher candidate for teaching first reading and writing in their 3rd and 4th year in the department of primary school teaching. In line with the purpose of the study, the self-efficacy levels of teacher candidates for teaching first reading and writing were…

Efficacy of the excretory urogram in the staging of gynecologic malignancies

International Nuclear Information System (INIS)

Hillman, B.J.; Clark, R.L.; Babbitt, G.

1984-01-01

It is common for patients suspected of having a gynecologic malignancy to be referred for excretory urography as part of their preoperative staging evaluation. This study investigated the efficacy of this practice using prospective and experimental retrospective interpretations of 88 urograms obtained for this clinical indication. The results indicate that excretory urography reliably depicts the ureters in most cases. However, the urogram is quite insensitive in demonstrating the extention of malignancy. The excretory urogram is useful for locating the position of the ureters and demonstrating the presence of obstruction or unsuspected urinary tract abnormalities. Nonetheless, this information also may be obtained by computed tomography, which can more accurately assess the primary mass and indicate the presence of malignant extension

Item response modeling: a psychometric assessment of the children's fruit, vegetable, water, and physical activity self-efficacy scales among Chinese children.

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Wang, Jing-Jing; Chen, Tzu-An; Baranowski, Tom; Lau, Patrick W C

2017-09-16

This study aimed to evaluate the psychometric properties of four self-efficacy scales (i.e., self-efficacy for fruit (FSE), vegetable (VSE), and water (WSE) intakes, and physical activity (PASE)) and to investigate their differences in item functioning across sex, age, and body weight status groups using item response modeling (IRM) and differential item functioning (DIF). Four self-efficacy scales were administrated to 763 Hong Kong Chinese children (55.2% boys) aged 8-13 years. Classical test theory (CTT) was used to examine the reliability and factorial validity of scales. IRM was conducted and DIF analyses were performed to assess the characteristics of item parameter estimates on the basis of children's sex, age and body weight status. All self-efficacy scales demonstrated adequate to excellent internal consistency reliability (Cronbach's α: 0.79-0.91). One FSE misfit item and one PASE misfit item were detected. Small DIF were found for all the scale items across children's age groups. Items with medium to large DIF were detected in different sex and body weight status groups, which will require modification. A Wright map revealed that items covered the range of the distribution of participants' self-efficacy for each scale except VSE. Several self-efficacy scales' items functioned differently by children's sex and body weight status. Additional research is required to modify the four self-efficacy scales to minimize these moderating influences for application.

Developing a Multi-Dimensional Early Elementary Mathematics Screener and Diagnostic Tool: The Primary Mathematics Assessment.

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Brendefur, Jonathan L; Johnson, Evelyn S; Thiede, Keith W; Strother, Sam; Severson, Herb H

2018-01-01

There is a critical need to identify primary level students experiencing difficulties in mathematics to provide immediate and targeted instruction that remediates their deficits. However, most early math screening instruments focus only on the concept of number, resulting in inadequate and incomplete information for teachers to design intervention efforts. We propose a mathematics assessment that screens and provides diagnostic information in six domains that are important to building a strong foundation in mathematics. This article describes the conceptual framework and psychometric qualities of a web-based assessment tool, the Primary Math Assessment (PMA). The PMA includes a screener to identify students at risk for poor math outcomes and a diagnostic tool to provide a more in-depth profile of children's specific strengths and weaknesses in mathematics. The PMA allows teachers and school personnel to make better instructional decisions by providing more targeted analyses.

Physical activity and self-efficacy in normal and over-fat children.

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Suton, Darijan; Pfeiffer, Karin A; Feltz, Deborah L; Yee, Kimbo E; Eisenmann, Joey C; Carlson, Joseph J

2013-09-01

To examine the independent and combined association of self-efficacy and fatness with physical activity in 5(th) grade children. Participants were 281 students (10.4 ± 0.7 years). Physical activity was assessed using a self-report question. Self-efficacy to be physically active was assessed using a 5-point scale. Body fatness was assessed by bioelectrical impedance. Descriptive statistics, ANOVA, and t-tests were used. There were no differences in reported days of physical activity between boys and girls, and normal-fat and over-fat children. However, children with high self-efficacy participated in significantly more physical activity compared to their low self-efficacy counterparts (3.4 ± 2.0 days vs. 5.4 ± 1.8 days, respectively, p < .001). Only physical activity self-efficacy was related to physical activity, fatness was not.

Assessing the Efficacy of a Student Expectations Questionnaire

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Warwick, Jon

2012-01-01

This article uses Rasch analysis to explore the efficacy of a questionnaire designed to assist university teaching staff in identifying those Level 4 students most in need of mathematics support. The students were all taking a mathematics module as part of their first year Computing curriculum, and the questionnaire explores the students' previous…

Risk assessment practice within primary mental health care: A logics perspective.

Science.gov (United States)

Flintoff, Adam; Speed, Ewen; McPherson, Susan

2018-04-01

From the 1980s onwards, discourses of risk have continued to grow, almost in ubiquity. Ideas and practices of risk and risk aversion have extended to UK mental health care where services are expected to assess and manage risks, and high-quality clinical assessment has been revised to incorporate risk assessment. This article problematises practices of risk assessment in mental health provision, focussing on the base-rate problem. It presents an analysis of audio recordings of risk assessments completed within a primary care mental health service. The analysis is informed by a critical logics approach which, using ideas from discourse theory as well as Lacanian psychoanalysis, involves developing a set of logics to describe, analyse and explain social phenomena. We characterise the assessments as functioning according to social logics of well-oiled administration and preservation, whereby bureaucratic processes are prioritised, contingency ironed out or ignored, and a need to manage potential risks to the service are the dominant operational frames. These logics are considered in terms of their beatific and horrific fantasmatic dimensions, whereby risk assessment is enacted as infallible (beatific) until clients become threats (horrific), creating a range of potential false negatives, false positives and so forth. These processes function to obscure or background problems with risk assessment, by generating practices that favour and offer protection to assessors, at the expense of those being assessed, thus presenting a challenge to the stated aim of risk assessment practice.

Drug utilization research in primary health care as exemplified by physicians' quality assessment groups.

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von Ferber, L; Luciano, A; Köster, I; Krappweis, J

1992-11-01

Drugs in primary health care are often prescribed for nonrational reasons. Drug utilization research investigates the prescription of drugs with an eye to medical, social and economic causes and consequences of the prescribed drug's utilization. The results of this research show distinct differences in drug utilization in different age groups and between men and women. Indication and dosage appear irrational from a textbook point of view. This indicates nonpharmacological causes of drug utilization. To advice successfully changes for the better quality assessment groups of primary health care physicians get information about their established behavior by analysis of their prescriptions. The discussion and the comparisons in the group allow them to recognize their irrational prescribing and the social, psychological and economic reasons behind it. Guidelines for treatment are worked out which take into account the primary health care physician's situation. After a year with 6 meetings of the quality assessment groups the education process is evaluated by another drug utilization analysis on the basis of the physicians prescription. The evaluation shows a remarkable improvement of quality and cost effectiveness of the drug therapy of the participating physicians.

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS project: An open-label pragmatic randomised control trial comparing the efficacy of differing therapeutic agents for primary care detoxification from either street heroin or methadone [ISRCTN07752728

Directory of Open Access Journals (Sweden)

Sheard Laura

2004-04-01

Full Text Available Abstract Background Heroin is a synthetic opioid with an extensive illicit market leading to large numbers of people becoming addicted. Heroin users often present to community treatment services requesting detoxification and in the UK various agents are used to control symptoms of withdrawal. Dissatisfaction with methadone detoxification 8 has lead to the use of clonidine, lofexidine, buprenorphine and dihydrocodeine; however, there remains limited evaluative research. In Leeds, a city of 700,000 people in the North of England, dihydrocodeine is the detoxification agent of choice. Sublingual buprenorphine, however, is being introduced. The comparative value of these two drugs for helping people successfully and comfortably withdraw from heroin has never been compared in a randomised trial. Additionally, there is a paucity of research evaluating interventions among drug users in the primary care setting. This study seeks to address this by randomising drug users presenting in primary care to receive either dihydrocodeine or buprenorphine. Methods/design The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS project is a pragmatic randomised trial which will compare the open use of buprenorphine with dihydrocodeine for illicit opiate detoxification, in the UK primary care setting. The LEEDS project will involve consenting adults and will be run in specialist general practice surgeries throughout Leeds. The primary outcome will be the results of a urine opiate screening at the end of the detoxification regimen. Adverse effects and limited data to three and six months will be acquired.

Manometric assessment of esophageal motor function in patients with primary biliary cirrhosis.

Science.gov (United States)

Bektas, Mehmet; Seven, Gulseren; Idilman, Ramazan; Yakut, Mustafa; Doğanay, Beyza; Kabacam, Gökhan; Ustun, Yusuf; Korkut, Esin; Kalkan, Çağdaş; Sahin, Günay; Cetinkaya, Hulya; Bozkaya, Hakan; Yurdaydin, Cihan; Bahar, Kadir; Cinar, Kubilay; Soykan, Irfan

2014-03-01

Primary biliary cirrhosis is associated with other autoimmune diseases including Sjögren's syndrome, and scleroderma. Esophageal dysmotility is well known in scleroderma, and Sjögren's syndrome. The aim of this study is to investigate whether any esophageal motor dysfunction exists in patients with primary biliary cirrhosis. The study was performed in 37 patients (36 women, mean age: 56.29 ± 10.01 years) who met diagnostic criteria for primary biliary cirrhosis. Thirty-seven functional dyspepsia patients, were also included as a control group. Patients entering the study were asked to complete a symptom questionnaire. Distal esophageal contraction amplitude, and lower esophageal sphincter resting pressure were assessed. Manometric findings in primary biliary cirrhosis patients vs. controls were as follows: Median lower esophageal sphincter resting pressure (mmHg): (24 vs 20, p=0.033); median esophageal contraction amplitude (mmHg): (71 vs 56, p=0.050); mean lower esophageal sphincter relaxation duration (sc, x ± SD): (6.10 ± 1.18 vs 8.29 ± 1.92, pesophageal sphincter relaxation (%) (96 vs 98, p=0.019); respectively. No significant differences were evident in median peak velocity (sc) (3.20 vs 3.02, p=0.778) between patients with primary biliary cirrhosis and the functional dyspepsia patients. Esophageal dysmotility was found in 17 (45.9%) primary biliary cirrhosis patients (non-specific esophageal motor disorder in ten patients, hypomotility of esophagus in five patients, nutcracker esophagus in one patient and hypertensive lower esophageal sphincter in one patient). Esophageal dysmotility was detected in 45.9% of patients. The study suggests that subclinic esophageal dysmotility is frequent in patients with primary biliary cirrhosis. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

Safety and efficacy of AMG 334 for prevention of episodic migraine

DEFF Research Database (Denmark)

Sun, Hong Yan; Dodick, David W; Silberstein, Stephen D

2016-01-01

BACKGROUND: The calcitonin gene-related peptide (CGRP) pathway is a promising target for preventive therapies in patients with migraine. We assessed the safety and efficacy of AMG 334, a fully human monoclonal antibody against the CGRP receptor, for migraine prevention. METHODS: In this multicentre...... in monthly migraine days from baseline to the last 4 weeks of the 12-week double-blind treatment phase. The primary endpoint was calculated using the least squares mean at each timepoint from a generalised linear mixed-effect model for repeated measures. Safety endpoints were adverse events, clinical...... laboratory values, vital signs, and anti-AMG 334 antibodies. The study is registered with ClinicalTrials.gov, number NCT01952574. An open-label extension phase of up to 256 weeks is ongoing and will assess the long-term safety of AMG 334. FINDINGS: From Aug 6, 2013, to June 30, 2014, 483 patients were...

Efficacy of the oral pentavalent rotavirus vaccine in Mali.

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Sow, Samba O; Tapia, Milagritos; Haidara, Fadima C; Ciarlet, Max; Diallo, Fatoumata; Kodio, Mamoudou; Doumbia, Moussa; Dembélé, Rokiatou D; Traoré, Oumou; Onwuchekwa, Uma U; Lewis, Kristen D C; Victor, John C; Steele, A Duncan; Neuzil, Kathleen M; Kotloff, Karen L; Levine, Myron M

2012-04-27

The oral, pentavalent rotavirus vaccine (PRV), RotaTeq was assessed for prevention of severe rotavirus gastroenteritis (RVGE) in young children in two multi-site, randomized, placebo-controlled field trials; one in Asia (Vietnam and Bangladesh) and the other in sub-Saharan Africa (Ghana, Kenya and Mali). The efficacy results for the Mali site of the multi-country trial are presented here. We randomly assigned infants in a 1:1 ratio to receive 3 doses of PRV/placebo at approximately 6, 10, and 14 weeks of age. Gastroenteritis episodes were captured passively at the local health centers and by home visits. The primary study outcome was severe RVGE, as defined by a score of ≥ 11 using the Vesikari Clinical Scoring System occurring ≥ 14 days after the third dose until the end of the study. Other efficacy analyses included efficacy against severe RVGE through the first year and during the second years of life, as well as efficacy after receiving at least one dose of vaccine. In total, 1960 infants were enrolled in the trial at the Mali site and sera were collected on a subset of infants (approximately 150) for immunogenicity testing. In the first year of follow-up, largely due to cultural practices to visit traditional healers as the first point of care, the point estimate of efficacy was unreliable: the per protocol vaccine efficacy against severe RVGE was 1% (95% confidence interval [CI]: -431.7, 81.6); the intention-to-treat vaccine efficacy was 42.9% (95% CI: -125.7, 87.7). During the second year of follow-up, after the surveillance system was modified to adapt to local customs and health care seeking practices, the point estimate of per-protocol vaccine efficacy was 19.2% (95% CI: -23.1,47.3%). 82.5% of Malian infants (95% CI: 70.1,91.3%) who received PRV mounted a seroresponse (≥ 3-fold rise from baseline (prevaccination) to post-dose 3 vaccination) of anti-rotavirus immunoglobulin A antibody, with a post third-dose geometric mean titer (GMT) of 31.3 units

Efficacy and safety of vedolizumab as a treatment option for moderate to severe refractory ulcerative colitis in two patients after liver transplant due to primary sclerosing cholangitis

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Raúl Vicente Olmedo-Martín

Full Text Available Vedolizumab is a humanized IgG1 monoclonal antibody that selectively blocks the lymphocyte integrin α4β7 and prevents its interaction with endothelial adhesion molecules and subsequent transmigration to the gastrointestinal tract. The drug was approved in 2014 for the induction and maintenance treatment of ulcerative colitis and moderate to severe Crohn's disease that is refractory or intolerant to conventional treatment with corticoids and immunosuppressants and/or anti-TNFα drugs. However, inflammatory bowel disease has a variable behavior following liver transplant. One third of patients with ulcerative colitis associated with primary sclerosing cholangitis are expected to deteriorate despite receiving immunosuppression to prevent rejection. There is limited experience with anti-TNFα agents in patients with inflammatory bowel disease in the setting of liver transplantation and the studies to date involve a limited number of cases. The efficacy and safety data of vedolizumab in this situation are unreliable and very preliminary. We present two cases with the aim to present the efficacy and safety of vedolizumab after one year of treatment in two patients who underwent a transplant due to primary sclerosing cholangitis. One case had de novo post-transplant ulcerative colitis refractory to two anti-TNFα drugs (golimumab and infliximab. The other patient had a colostomy due to fulminant colitis and developed severe ulcerative proctitis refractory to infliximab after reconstruction with an ileorectal anastomosis.

[Assessment of antibacterial efficacy of ozone therapy in treatment of caries at the white spot stage].

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Makeeva, I M; Turkina, A Yu; Margaryan, E G; Paramonov, Yu O; Polyakova, M A

Effect on cariogenic flora is the key toremineralizing therapy efficacy in treatment of initial caries (at the white spot stage). Ozone in dentistry is used as a highly effective antibacterial agent. Treatment of white spot lesions with the ozone-air mixture leads to significant increase of efficacy in non-invasive treatment of initial caries. clinical and microbiological assessment of antibacterial efficacy of ozone therapy in treatment of caries at the white spot stage. The trial recruited 86 patients for non-invasive treatment of caries at the white spot stage which included the complex of professional oral hygiene, medicamental treatment of white spot lesions with hydrogen peroxide 3% and chlorhexidinedigluconate 0,2%, treatment with the ozone-air mixture and application of hydroxyapatite Са2+. Material for microbiological study was received before the treatment, after the complex of professional oral hygiene and medicamental treatment of white spot lesions conducted as well as after the treatment with the ozone-air mixture. Before the treatment up to 16 kinds of microorganisms on the surface of white spot lesion were detected with the following shares: S. mutans (19.9%), S. salivarius (15.1%), S. epidermidis (8.7%), S. mitis (6.5%), Lactobacillus (6.5%) and different kinds of staphylococci (10.8%). After the complex of professional oral hygiene and medicamental treatment conducted decrease in number of cariogenic microorganisms was indicated as follows: S. mutans - from 1·105 to 1·104, S. salivarius - from 1·107 to 1·106, S. epidermidis - from 1·105 to 1·104, S. mitis - from 1·104 to 1·103, Lactobacillus - from 1·104 tо 1·103. After the treatment of tooth enamel with the ozone-air mixture increase in microorganisms was not observed. The efficacy of ozone on cariogenic microorganisms exceeds significantly the efficacy of 3% hydrogen peroxide and 0,2% chlorhexidinedigluconate. It is strongly advisable to include ozone in protocol of non

Development of the Informing Relatives Inventory (IRI): Assessing Index Patients' Knowledge, Motivation and Self-Efficacy Regarding the Disclosure of Hereditary Cancer Risk Information to Relatives.

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de Geus, Eveline; Aalfs, Cora M; Menko, Fred H; Sijmons, Rolf H; Verdam, Mathilde G E; de Haes, Hanneke C J M; Smets, Ellen M A

2015-08-01

Despite the use of genetic services, counselees do not always share hereditary cancer information with at-risk relatives. Reasons for not informing relatives may be categorized as a lack of: knowledge, motivation, and/or self-efficacy. This study aims to develop and test the psychometric properties of the Informing Relatives Inventory, a battery of instruments that intend to measure counselees' knowledge, motivation, and self-efficacy regarding the disclosure of hereditary cancer risk information to at-risk relatives. Guided by the proposed conceptual framework, existing instruments were selected and new instruments were developed. We tested the instruments' acceptability, dimensionality, reliability, and criterion-related validity in consecutive index patients visiting the Clinical Genetics department with questions regarding hereditary breast and/or ovarian cancer or colon cancer. Data of 211 index patients were included (response rate = 62%). The Informing Relatives Inventory (IRI) assesses three barriers in disclosure representing seven domains. Instruments assessing index patients' (positive) motivation and self-efficacy were acceptable and reliable and suggested good criterion-related validity. Psychometric properties of instruments assessing index patients knowledge were disputable. These items were moderately accepted by index patients and the criterion-related validity was weaker. This study presents a first conceptual framework and associated inventory (IRI) that improves insight into index patients' barriers regarding the disclosure of genetic cancer information to at-risk relatives. Instruments assessing (positive) motivation and self-efficacy proved to be reliable measurements. Measuring index patients knowledge appeared to be more challenging. Further research is necessary to ensure IRI's dimensionality and sensitivity to change.

Efficacy and safety of Cinacalcet on secondary hyperparathyroidism in Chinese chronic kidney disease patients receiving hemodialysis.

Science.gov (United States)

Mei, Changlin; Chen, Nan; Ding, Xiaoqiang; Yu, Xueqing; Wang, Li; Qian, Jiaqi; Wang, Mei; Jiang, Gengru; Li, Xuemei; Hou, Fanfan; Zuo, Li; Wang, Niansong; Liu, Hong

2016-10-01

Introduction Secondary hyperparathyroidism (SHPT) develops in patients with chronic renal failure. Cinacalcet hydrochloride has been used successfully in U.S., Europe, and Japan in the treatment of SHPT, while maintaining serum levels of calcium and phosphorus. The efficacy and safety profile of Cinacalcet treatment vs. conventional treatments has been of great interest in clinical practice. In this recent phase III study conducted in China, efficacy and safety of a calcimimetic agent, Cinacalcet (Kyowa Hakko Kirin Co., Ltd.), were assessed for SHPT treatment in stable chronic renal disease patients on hemodialysis. Methods In this double-blind, multicenter, placebo-controlled, randomized phase III study, 238 subjects were enrolled in 12 centers and randomly divided into a Cinacalcet group and a placebo group. The percentage of patients achieving a serum parathyroid hormone (PTH) level ≤250 pg/mL was the primary efficacy end point. Serum calcium and phosphorus levels were measured. Adverse events and serious adverse events were recorded, and causal analysis performed. Findings In primary analysis, 25.4% of the Cinacalcet group and 3.5% of the placebo group achieved the primary end point (PTH ≤250 pg/mL). Calcium and phosphorus levels and calcium-phosphorus product were lower in the Cinacalcet group compared with the placebo group. Eleven serious adverse events were reported and considered to be not related to study drugs. Mild to moderate hypocalcemia and reduced calcium levels were reported and considered to be Cinacalcet related. Discussion This phase III study demonstrated that Cinacalcet is effective and well tolerated in treating SHPT in Chinese chronic kidney disease patients on hemodialysis, and in a patient population with much higher baseline PTH levels. © 2016 International Society for Hemodialysis.

Assessing the critical behavioral competencies of outstanding managed care primary care physicians.

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Duberman, T L

1999-03-01

This study used job competence assessment to identify the behavioral characteristics that distinguish outstanding job performances of primary care physicians (PCPs) within a network-model HMO. Primary care physicians were chosen for the study based on six standard performance measures: (1) member satisfaction, (2) utilization, (3) patient complaints, (4) emergency room referrals, (5) out-of-network referrals, and (6) medical record completeness. Outstanding PCPs (N = 16) were identified as those performing within one standard deviation above the mean on all six of the performance measures. A control group of typical PCPs (N = 10) was selected from those performing outside the peer group mean on at least two performance measures. Subjects were administered the Behavioral Event Interview and the Picture Story Exercise. Higher overall competency levels of achievement orientation, concern for personal influence, empathic caregiving, and empowerment drive distinguished outstanding from typical PCPs. Outstanding PCPs also had higher overall frequency of competency in building team effectiveness and interpersonal understanding when compared with typical PCPs. This study suggests that PCP performance is the product of measurable competencies that are potentially amenable to improvement. Competency assessment and development of PCPs may benefit both organizational efficiency and physician and patient satisfaction.

A randomized double-blind phase III study of nimorazole as a hypoxic radiosensitizer of primary radiotherapy in supraglottic larynx and pharynx carcinoma. Results of the Danish Head and Neck Cancer Study (DAHANCA) Protocol 5-85

DEFF Research Database (Denmark)

Overgaard, J; Hansen, Hanne Sand; Overgaard, Marie

1998-01-01

A multicenter randomized and balanced double-blind trial with the objective of assessing the efficacy and tolerance of nimorazole given as a hypoxic radiosensitizer in conjunction with primary radiotherapy of invasive carcinoma of the supraglottic larynx and pharynx....

Supervision and Increasing Self-Efficacy in the Therapist-Trainee.

Science.gov (United States)

Shanklin, Jennifer E.

This work includes a discussion of the concept of self-efficacy, originally introduced by Albert Bandura, as it pertains to the therapist-trainee. Therapist self-efficacy has only recently gained attention theoretically as well as empirically. Measures used to assess the self-efficacy of the therapist are highlighted as well as factors…

A randomized trial comparing primary angioplasty versus stent placement for symptomatic intracranial stenosis

Science.gov (United States)

Qureshi, Adnan I; Chaudhry, Saqib A; Siddiq, Farhan; Majidi, Shahram; Rodriguez, Gustavo J; Suri, M Fareed K

2013-01-01

Background: Both primary angioplasty alone and angioplasty with a self-expanding stent have been compared in non-randomized concurrent clinical studies that suggest equivalent results. However, there is no randomized trial that has compared the two procedures in patients with symptomatic high grade intracranial stenosis. Objective: The primary aim of the randomized trial was to compare the clinical and angiographic efficacy of primary angioplasty and angioplasty followed by stent placement in preventing restenosis, stroke, requirement for second treatment, and death in patients with symptomatic intracranial stenosis. Methods: The study prospectively evaluated efficacy and safety of the two existing neurointerventional techniques for treatment of moderate intracranial stenosis (stenosis ≥ 50%) with documented failure of medical treatment or severe stenosis (≥70%) with or without failure of medical treatment. Results: A total of 18 patients were recruited in the study (mean age [±SD] was 64.7 ± 15.1 years); out of these, 12 were men. Of these 18, 10 were treated with primary angioplasty and 8 were treated with angioplasty followed by self-expanding stent. The technical success rates of intracranial angioplasty and stent placements defined as ability to achieve <30% residual stenosis when assessed by immediate post-procedure angiography was 5 of 10 and 5 of 8 patients, respectively. The total fluoroscopic time (mean [±SD]) was lower in patients undergoing primary angioplasty 37 [±11] min versus those undergoing angioplasty followed by self-expanding stent 42 [±15] min, P = 0.4321. The stroke and death rate within 1 month was very low in both patient groups (1 of 10 versus 0 of 8 patients). One patient randomized to stent placement continued to have recurrent ischemic symptoms requiring another angioplasty in the vertebral artery on post-procedure Day 2. Conclusions: The trial suggests that a randomized trial comparing primary angioplasty to angioplasty

Measurement procedure to assess exposure to extremely low-frequency fields: A primary school case study

International Nuclear Information System (INIS)

Alonso, A.; Bahillo, A.; De la Rosa, R.; Carrera, A.; Duran, R. J.; Fernandez, P.

2012-01-01

How to correctly measure the exposure of general public to extremely low-frequency (ELF) radiation is a key issue for ELF epidemiological studies. This paper proposes a measurement procedure to accurately assess the exposure of people to electric and magnetic field in the frequency band from 5 Hz to 100 kHz in buildings and their premises. As ELF radiation could be particularly harmful to children, the measurement procedure is focused on exposure to ELF in schools. Thus, the students' exposure to ELF fields can be assessed by correlating the ELF measurements to the hours of school activity. In this paper, the measurement protocol was applied to study the ELF exposure on students from Garcia Quintana primary school in Valladolid, Spain. The campaign of measurements for ELF exposure assessment in this primary school was of great interest for the Regional Council of Public Health because of the social alarm generated by the presence of a significant number cancer cases in children. (authors)

Screening of Dementia in Portuguese Primary Care: Methodology, Assessment Tools, and Main Results

Directory of Open Access Journals (Sweden)

Laetitia Teixeira

2017-11-01

Full Text Available The objectives of this article are as follows: (1 to describe the assessment protocol used to outline people with probable dementia in Primary Health Care; (2 to show the methodological design and procedure to obtain a representative sample of patients with probable dementia; and (3 to report the main characteristics of the sample collected in the context of the study “Characteristics and needs of people with probable dementia.” The study protocol was based on the “Community Assessment of Risk and Treatment Strategies (CARTS Program” and is composed by a set of instruments that allow the assessment of older adults with probable dementia in several areas (health, psychological, functionality, and other. Descriptive analysis was used to characterize the final sample (n = 436. The study protocol as well as the methodological procedure to obtain the referral of research participants and data collection on the condition of people with probable dementia in Primary Health Care proved to be a valuable tool to obtain a sample of patients distributed by the full range of probable dementia in a large geographical area. Results may allocate the design of care pathways for old people with cognitive disorders to prevent, delay impairment, and/or optimize quality of life of patients.

Does a perceptuomotor skills assessment have added value to detect talent for table tennis in primary school children?

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Faber, Irene R; Pion, Johan; Munivrana, Goran; Faber, Niels R; Nijhuis-Van der Sanden, Maria W G

2017-04-18

Talent detection intends to support lifelong sports participation, reduce dropouts and stimulate sports at the elite level. For this purpose it is important to reveal the specific profile which directs children to the sports that connect to their strengths and preferences. This study evaluated a perceptuomotor skills assessment as part of talent detection for table tennis, a sport in which perceptuomotor skills are considered essential to cope with the difficult technical aspects. Primary school children (n = 121) and gifted young table tennis players (n = 146) were assessed using the Dutch perceptuomotor skills assessment measuring "ball control" and "gross motor function". A discriminant function analysis confirmed the added value by identifying primary school children fitting the table tennis perceptuomotor profile of the young gifted table tennis players (28%). General linear model analyses for the assessment's individual test items showed that the table tennis players outperformed their primary school peers on all "ball control" items (P talent detection in table tennis at this young age. Longitudinal studies need to reveal the predictive value for sports participation and elite sports.

Hidden consequences of political efficacy: Testing an efficacy-apathy model of political mobilization.

Science.gov (United States)

Osborne, Danny; Yogeeswaran, Kumar; Sibley, Chris G

2015-10-01

Political efficacy-the belief that one can influence politics-is a key predictor of people's involvement in social movements. Political institutions that are open to change should, however, be seen as just. Thus, political efficacy may ironically undermine minority group members' support for collective action by simultaneously increasing their belief in the fairness of the system. The current study aims to examine this possibility in a national sample of Māori-New Zealand's indigenous minority population. Participants (N = 399) were Māori (Mage = 44.22; SD = 13.30) women (n = 272) and men (n = 115; unreported = 12) who completed a survey assessing their levels of (a) political efficacy, (b) system justification, and (c) support for the political mobilization of their group, as well as relevant demographic covariates. Consistent with past research, political efficacy had a positive direct effect on participants' support for the political mobilization of Māori. Nevertheless, political efficacy also had a negative indirect effect on political mobilization support via increases in system justification. These results held after controlling for participants' ethnic identification, self-efficacy, and conservatism. Our findings uncover a hidden consequence of political efficacy and show that, while believing that the political system is receptive to change predicts political mobilization, it can also undermine minorities' support for the mobilization of their group. Thus, our results uncover a previously unknown process that maintains inequality between ethnic minority and majority group members. (c) 2015 APA, all rights reserved).

Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen.

Science.gov (United States)

Webair, Hana H; Al-Assani, Salwa S; Al-Haddad, Reema H; Al-Shaeeb, Wafa H; Bin Selm, Manal A; Alyamani, Abdulla S

2015-10-13

Patient safety culture in primary care is the first step to achieve high quality health care. This study aims to provide a baseline assessment of patient safety culture in primary care settings in Al-Mukala, Yemen as a first published study from a least developed country. A survey was conducted in primary healthcare centres and units in Al-Mukala District, Yemen. A comprehensive sample from the available 16 centres was included. An Arabic version of the Medical Office Survey on Patient Safety Culture was distributed to all health workers (110). Participants were physicians, nurses and administrative staff. The response rate from the participating centres was 71 %. (N = 78). The percent positive responses of the items is equal to the percentage of participants who answered positively. Composite scores were calculated by averaging the percent positive response on the items within a dimension. Positive safety culture was defined as 60 % or more positive responses on items or dimensions. Patient safety culture was perceived to be generally positive with the exception of the dimensions of 'Communication openness', 'Work pressure and pace' and 'Patient care tracking/follow-up', as the percent positive response of these dimensions were 58, 57, and 52 % respectively. Overall, positive rating on quality and patient safety were low (49 and 46 % respectively). Although patient safety culture in Al-Mukala primary care setting is generally positive, patient safety and quality rating were fairly low. Implementation of a safety and quality management system in Al-Mukala primary care setting are paramount. Further research is needed to confirm the applicability of the Medical Office Survey on Patient Safety Culture (MOSPSC) for Al-Mukala primary care.

Auditing and benchmarking of azithromycin utilization in primary care military clinics.

Science.gov (United States)

Kopylov, Uri; Admon, Gil; Borer, Abraham; Schlaeffer, Francisc; Aviram, Eliad E; Gilad, Jacob

2007-10-01

Despite widespread azithromycin use, no audit has targeted this drug to date. Azithromycin was audited in primary military clinics between July 1, 2003 and December 31, 2003 (period 1). Consumption (defined daily doses/1000 visits) and economic expenditure of penicillin V, amoxicillin, erythromycin, and azithromycin were evaluated. An educational intervention was performed (dissemination of local guideline regarding indications for azithromycin use) and its impact was assessed between July 1, 2004 and December 31, 2004 (period 2). During periods 1 and 2, 105 and 31 patients were prescribed azithromycin. Azithromycin was appropriately chosen in 5.7% vs. 70.9% of cases (p amoxicillin consumption (20.2%). Intervention decreased azithromycin consumption and expenditure but its effect was offset by increased consumption of other agents, mainly amoxicillin. Interventions in primary care settings should target prescribing behavior through a multifaceted approach to increase efficacy while preventing a trade-off effect.

Reliability and validity of the parent efficacy for child healthy weight behaviour (PECHWB) scale.

Science.gov (United States)

Palmer, F; Davis, M C

2014-05-01

Interventions for childhood overweight and obesity that target parents as the agents of change by increasing parent self-efficacy for facilitating their child's healthy weight behaviours require a reliable and valid tool to measure parent self-efficacy before and after interventions. Nelson and Davis developed the Parent Efficacy for Child Healthy Weight Behaviour (PECHWB) scale with good preliminary evidence of reliability and validity. The aim of this research was to provide further psychometric evidence from an independent Australian sample. Data were provided by a convenience sample of 261 primary caregivers of children aged 4-17 years via an online survey. PECHWB scores were correlated with scores on other self-report measures of parenting efficacy and 2- to 4-week test-retest reliability of the PECHWB was assessed. The results of the study confirmed the four-factor structure of the PECHWB (Fat and Sugar, Sedentary Behaviours, Physical Activity, and Fruit and Vegetables) and provided strong evidence of internal consistency and test-retest reliability, as well as good evidence of convergent validity. Future research should investigate the properties of the PECHWB in a sample of parents of overweight or obese children, including measures of child weight and actual child healthy weight behaviours to provide evidence of the concurrent and predictive validity of PECHWB scores. © 2013 John Wiley & Sons Ltd.

Telmisartan in daily clinical practice: Factors affecting efficacy in treatment of primary arterial hypertension

Directory of Open Access Journals (Sweden)

Bergovac M

2009-01-01

Full Text Available Background: Telmisartan provides effective treatment of hypertension in a broad spectrum of patients. Aims: To evaluate factors affecting the efficacy of telmisartan in daily clinical practice. Setting and Design: Prospective practice-based 12-week uncontrolled cohort study. Materials and Methods: Consecutive incident/prevalent outpatients with mild to moderate essential hypertension were started on telmisartan 40 mg/day with optional up-titration to 80 mg/day in order to achieve seated systolic (SSBP and diastolic (SDBP blood pressure < 140/90 mm Hg. Intent-to-treat (ITT, N=282 and per protocol (PP, N=275 efficacy assessment was based on SSBP/SDBP reduction and delivered doses. Results: SSBP/SDBP decreased (165.2±13.1 / 98.3±6.7 mm Hg to 137.9±13.2 / 82.6±7.3 mm Hg, whilst telmisartan was up-titrated in 40.5% of patients during the study. Multivariate (practically identical ITT and PP analysis indicated poorer response in obese vs. non-obese patients: lesser SDBP reduction (by around 2.2-2.3 mm Hg, P < 0.05 with higher odds of dose up-titration (odds ratio, OR around 1.90, P < 0.05; and better response in: a patients started on telmisartan monotherapy than when added to a preexisting treatment: greater SSBP/SDBP reduction (by around 4.0 and 3.0 mm Hg, respectively, P < 0.05 with comparable odds of up-titration; b diabetics vs. non-diabetics: greater SDBP reduction (by around 3.6-3.7 mm Hg, P < 0.05 with comparable odds of up-titration; c men vs. women: slightly greater SDBP reduction (by around 1.2 mm Hg, 0.05 P < 0.1 with lower odds of up-titration (OR around 0.51, P < 0.05. Conclusion: Previous unsuccessful treatment, obesity, diabetes and gender should be considered in order to optimize the use of telmisartan for mild to moderate essential hypertension in daily clinical practice.

Development and Validation of a Rubric for Self-Assessment of 21st Century Skills at Primary Schools

NARCIS (Netherlands)

Sandink-de Mare, Dianne; Rusman, Ellen

2017-01-01

There are little or none suitable assessment instruments available for 21st century skills at primary school level. Therefore a rubric has been developed and validated for a number of 21st century skills at primary school level. The aim of this study was to determine whether the rubric enabled

Efficacy of combination therapy of anti-TNF-α antibody infliximab and methotrexate in refractory entero-Behçet's disease.

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Iwata, Shigeru; Saito, Kazuyoshi; Yamaoka, Kunihiro; Tsujimura, Shizuyo; Nawata, Masao; Hanami, Kentaro; Tanaka, Yoshiya

2011-04-01

It is often difficult to manage refractory gastrointestinal tract complications of Behçet's disease (entero-BD) by conventional therapy. In this study, we assessed the short- and long-term efficacy and safety of the combination therapy of infliximab, an anti-tumor-necrosis-factor (TNF)-α antibody, and methotrexate in ten patients with refractory entero-BD refractory to conventional therapies. The short- (weeks) and long-term (by 2 years) effects of infliximab at 3-5 mg/kg body weight every 8 weeks on the clinical course and intestinal manifestations were assessed by abdominal computed tomography (CT) and colonoscopy. The primary endpoint was the rate of disappearance of ileocecal ulceration at 12 months of therapy. All patients showed improvement of gastrointestinal symptoms and disease-associated complications within 4 weeks. Furthermore, the rate of disappearance of ileocecal ulcerations was 50% (5/10 patients) at 6 months and 90% (9/10 patients) at 12 months, and, therefore 90% of patients were satisfied with the primary endpoint. Furthermore, corticosteroid dose was significantly reduced from 22.0 to 1.8 mg/day at 24 months. No severe adverse effects were observed during the 24 months of follow-up. We provide evidence for the rapid and excellent efficacy of infliximab in patients with refractory entero-BD and that the combination of infliximab and methotrexate brings about long-term alleviation of entero-BD and excellent tolerability.

Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study.

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Cunningham, Frances C; Ferguson-Hill, Sue; Matthews, Veronica; Bailie, Ross

2016-10-18

Assessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs. The mixed methods approach involved a review of documents and internal reports relating to experience with use of the SAT since its development in 2002 and a survey of key informants on their experience with using the SAT. The paper drew from documents and internal reports to describe the SAT development and application in primary health care services from 2002 to 2014. Survey feedback highlighted the benefit to the whole primary health care team from participating in the SAT, bringing to light issues that might not emerge with separate individual tool completion. A majority of respondents reported changes in their health centres as a result of using the SAT. Good organisational and management support assisted with ensuring allocation of time and resources for SAT conduct. Respondents identified the importance of having a skilled, external facilitator. Originally designed as a measurement tool, the SAT rapidly evolved to become an important development tool, assisting teams in learning about primary health care system functioning, applying best practice and contributing to team strengthening. It is valued by primary health care centres as a lever in implementing improvements to strengthen centre delivery systems, and has potential for further adaptation and wider application in Australia and internationally.

Comparative assessment of the efficacy and safety of sertaconazole (2%) cream versus terbinafine cream (1%) versus luliconazole (1%) cream in patients with dermatophytoses: a pilot study.

Science.gov (United States)

Jerajani, Hr; Janaki, C; Kumar, Sharath; Phiske, Meghana

2013-01-01

Sertaconazole is a new, broad spectrum, fungicidal and fungistatic imidazole with added antipruritic and anti-inflammatory activity that would provide greater symptomatic relief and hence would be beneficial in improving the quality of life for the patient with dermatophytoses. To compare efficacy and safety of sertaconazole, terbinafine and luliconazole in patients with dermatophytoses. 83 patients with tinea corporis and tinea cruris infections were enrolled in this multicentre, randomized, open label parallel study. The initial 'Treatment Phase' involved three groups receiving either sertaconazole 2% cream applied topically twice daily for four weeks, terbinafine 1% cream once daily for two weeks, luliconazole 1% cream once daily for two weeks. At the end of treatment phase, there was a 'Follow-up Phase' at end of 2 weeks, where the patients were assessed clinically and mycologically for relapse. Of the 83 patients, 62 completed the study, sertaconazole (n = 20), terbinafine (n = 22) and luliconazole (n = 20). The primary efficacy variables including change in pruritus, erythema, vesicle, desquamation and mycological cure were significantly improved in all the three groups, as compared to baseline, in the Treatment and Follow-up phase. Greater proportion of patients in sertaconazole group (85%) showed resolution of pruritus as compared to terbinafine (54.6%); and luliconazole (70%), (P terbinafine). There was a greater reduction in mean total composite score (pruritus, erythema, vesicle and desquamation) in sertaconazole group (97.1%) as compared to terbinafine (91.2%) and luliconazole (92.9%). All groups showed equal negative mycological assessment without any relapses. All three study drugs were well tolerated. Only one patient in sertaconazole group withdrew from the study due to suspected allergic contact dermatitis. Sertaconazole was better than terbinafine and luliconazole in relieving signs and symptoms during study and follow up period. At the end of

Comparative assessment of the efficacy and safety of sertaconazole (2% cream versus terbinafine cream (1% versus luliconazole (1% cream in patients with dermatophytoses: A pilot study

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H R Jerajani

2013-01-01

Full Text Available Background : Sertaconazole is a new, broad spectrum, fungicidal and fungistatic imidazole with added antipruritic and anti-inflammatory activity that would provide greater symptomatic relief and hence would be beneficial in improving the quality of life for the patient with dermatophytoses. Aims and Objectives : To compare efficacy and safety of sertaconazole, terbinafine and luliconazole in patients with dermatophytoses. Materials and Methods : 83 patients with tinea corporis and tinea cruris infections were enrolled in this multicentre, randomized, open label parallel study. The initial ′Treatment Phase′ involved three groups receiving either sertaconazole 2% cream applied topically twice daily for four weeks, terbinafine 1% cream once daily for two weeks, luliconazole 1% cream once daily for two weeks. At the end of treatment phase, there was a ′Follow-up Phase′ at end of 2 weeks, where the patients were assessed clinically and mycologically for relapse. Results : Of the 83 patients, 62 completed the study, sertaconazole (n = 20, terbinafine (n = 22 and luliconazole (n = 20. The primary efficacy variables including change in pruritus, erythema, vesicle, desquamation and mycological cure were significantly improved in all the three groups, as compared to baseline, in the Treatment and Follow-up phase. Greater proportion of patients in sertaconazole group (85% showed resolution of pruritus as compared to terbinafine (54.6%; and luliconazole (70%, (P < 0.05 sertaconazole vs terbinafine. There was a greater reduction in mean total composite score (pruritus, erythema, vesicle and desquamation in sertaconazole group (97.1% as compared to terbinafine (91.2% and luliconazole (92.9%. All groups showed equal negative mycological assessment without any relapses. All three study drugs were well tolerated. Only one patient in sertaconazole group withdrew from the study due to suspected allergic contact dermatitis. Conclusion : Sertaconazole was

Self-efficacy as a health-protective resource in teachers? A biopsychological approach.

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Schwerdtfeger, Andreas; Konermann, Leslie; Schönhofen, Katja

2008-05-01

To examine the psychobiological correlates of self-efficacy in teachers. Study 1 examined associations between teacher self-efficacy and cardiac activation on a working day and Study 2 assessed the cortisol morning response in teachers with varying levels of teacher self-efficacy. Teacher self-efficacy was assessed by questionnaire. In Study 1 heart rate, heart rate variability, and locomotor activity were recorded by 22 hours ambulatory monitoring and subjective measures of stress and strain were obtained. Study 2 assessed the cortisol response to awakening to obtain a measure of HPA-axis activation and teachers filled in a questionnaire on physical complaints. Study 1 found that self-efficacy proved protective for psychological well-being. Moreover, after controlling for locomotor activity, demographic, and lifestyle variables, self-efficacy was associated with elevated heart rate and attenuated heart rate variability during school and leisure time, respectively, but not during the night, thus questioning the health-implications of self-efficacy. Study 2 found that teachers high in self-efficacy exhibited an attenuated cortisol response to awakening and fewer cardiac complaints. The results of both studies are compatible with the view that teacher self-efficacy might act as a physiological toughening agent with possibly favorable health outcomes.

Validation of the Sexual Communication Self-Efficacy Scale.

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Quinn-Nilas, Christopher; Milhausen, Robin R; Breuer, Rebecca; Bailey, Julia; Pavlou, Menelaos; DiClemente, Ralph J; Wingood, Gina M

2016-04-01

This study assessed a newly developed Sexual Communication Self-Efficacy Scale designed to measure the sexual communication self-efficacy of adolescent men and women. Three-hundred and seventy-four U.K. adolescents completed this new scale, along with several other validity measures. Factor analysis revealed that the Sexual Communication Self-Efficacy Scale consisted of five underlying factors: contraception communication, positive sexual messages, negative sexual messages, sexual history, and condom negotiation. These factors demonstrated high internal consistency and presents evidence to support construct validity. This scale may have utility in assessing the effectiveness of interventions designed to enhance sexual communication and sexual health behaviors among young people. © 2015 Society for Public Health Education.

The validity of visual acuity assessment using mobile technology devices in the primary care setting.

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O'Neill, Samuel; McAndrew, Darryl J

2016-04-01

The assessment of visual acuity is indicated in a number of clinical circumstances. It is commonly conducted through the use of a Snellen wall chart. Mobile technology developments and adoption rates by clinicians may potentially provide more convenient methods of assessing visual acuity. Limited data exist on the validity of these devices and applications. The objective of this study was to evaluate the assessment of distance visual acuity using mobile technology devices against the commonly used 3-metre Snellen chart in a primary care setting. A prospective quantitative comparative study was conducted at a regional medical practice. The visual acuity of 60 participants was assessed on a Snellen wall chart and two mobile technology devices (iPhone, iPad). Visual acuity intervals were converted to logarithm of minimum angle of resolution (logMAR) scores and subjected to intraclass correlation coefficient (ICC) assessment. The results show a high level of general agreement between testing modality (ICC 0.917 with a 95% confidence interval of 0.887-0.940). The high level of agreement of visual acuity results between the Snellen wall chart and both mobile technology devices suggests that clinicians can use this technology with confidence in the primary care setting.

Assessment of efficacy and safety of various adjuvant formulations with a total soluble extract of Trichinella spiralis

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Aucouturier J.

2001-06-01

Full Text Available Trichinellosis, a re-emerging zoonosis in several countries and pig, is the main species responsible for its transmission to human. Vaccination of swine could be an alternative to prevent the risk of human contamination. In order to develop an efficient and safe inactivate vaccine, the choice of the adjuvant is an important issue. The aim of this study was to develop and select potent and safe adjuvants by screening them in an experimental model with a crude soluble antigen from L1 muscular larvae (ML of Trichinella spiralis (Ts. The efficacy was checked by the quantification of specific antibody levels. Specific and non-specific IgE antibody levels were also assessed. Safety was checked by the assessment of the local reaction at the injection site.Various Montanide® ISA adjuvant formulations including water in oil, oil in water and multiphasic emulsions, but also nanoparticles or microbeads were tested. The results clearly showed differences between the antibody responses induced by the adjuvants and demonstrated the necessity to use an adjuvant to obtain a specific IgG (IgG1or lgG2a response directed against the total soluble extract of Ts. All the formulations enhanced the humoral immune response. The origin of the oil contained in the emulsions played an important role on the efficacy. Indeed emulsions based on mineral oils were more efficient than those based on metabolisable oils. However it was linked with stronger local reactions. Multiphasic and oil in water emulsions but also nanoparticles failed to induce 1gG2a antibody levels. Microbeads and water in oil formulations based on mineral oils were more efficient. This experimentation allowed then the selection of several adjuvants which efficacy will be further Investigated by a challenge test and an analysis of the cellular populations involved in the mechanism of the immune response.

Dental radiography: efficacy in the assessment of intraosseous lesions of the face and jaws in asymptomatic patients

International Nuclear Information System (INIS)

Zeichner, S.J.; Ruttimann, U.E.; Webber, R.L.

1987-01-01

In this investigation the efficacy of dental radiography for the detection of occult intraosseous lesions of the face and jaws was evaluated. An analysis of 30 million health insurance records indicated that the period prevalence of malignant lesions was less than 5 cases/million/year, and for benign lesions approximately 100 cases/million/year. Data from a controlled observer-performance study showed that radiographic sensitivities ranged between 50% and 80%. The cost per true-positive finding was estimated to be +8.6 million per malignant case and +430,000 per benign case. An assessment of the dosimetric literature indicated that the benefits of radiographic screening as a means for early detection of a malignancy appear to be counterbalanced by the risk of causing a radiation-induced malignancy. Taken together, these data demonstrate that dental radiography is not efficacious for the purpose of detecting occult lesions

Efficacy of human papillomavirus l1 protein vaccines (cervarix and gardasil in reducing the risk of cervical intraepithelial neoplasia: A meta-analysis

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Mohammad Reza Haghshenas

2017-01-01

Full Text Available Human papillomavirus (HPV can induce cervical intraepithelial neoplasia (CIN. Vaccination against HPV can play an important role in CIN prevention. This study aims to estimate the efficacy of L1 protein vaccines (Cervarix and Gardasil in CIN 1, 2, 3 risk reduction using meta-analysis. Relevant articles were identified by two independent researchers searching international databanks. After application of inclusion/exclusion criteria and quality assessment, eligible articles were entered into the final meta-analysis. Inverse variance method and fixed effect model were used to combine the results of the primary studies. The heterogeneity between the results was assessed using Cochrane and I2 indices. Of 11,530 evidence identified during the primary search, three papers were found eligible for meta-analysis, including 7213 participants in the intervention groups and 7170 healthy controls. The efficacy (95% confidence interval of HPV 6, 11, 16, 18 monovalent and quadrivalent vaccines against CIN 1, CIN 2, and CIN 3 were estimated as of 95% (88–98, 97% (85–99, and 95% (78–99, respectively. This study showed that L1 protein vaccines Cervarix and Gardasil are highly protective vaccines playing an effective role in the prevention of HPV 6, 11, 16, 18 which are responsible for CIN 1, CIN 2, and CIN 3.

The Good Life: Assessing the Relative Importance of Physical, Psychological, and Self-Efficacy Statuses on Quality of Well-Being in Osteoarthritis Patients

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Charles Van Liew

2013-01-01

Full Text Available Background and Purpose. The purpose of the present study was to examine the interrelationships among physical dysfunction, self-efficacy, psychological distress, exercise, and quality of well-being for people with osteoarthritis. It was predicted that exercise would mediate the relationships between physical dysfunction, self-efficacy, psychological distress, and quality of well-being. Methods. Participants were 363 individuals with osteoarthritis who were 60 years of age or older. Data were collected from the baseline assessment period prior to participating in a social support and education intervention. A series of structural equation models was used to test the predicted relationships among the variables. Results. Exercise did not predict quality of well-being and was not related to self-efficacy or psychological distress; it was significantly related to physical dysfunction. When exercise was removed from the model, quality of life was significantly related to self-efficacy, physical dysfunction, and psychological distress. Conclusions. Engagement in exercise was directly related to physical functioning, but none of the other latent variables. Alternatively, treatment focused on self-efficacy and psychological distress might be the most effective way to improve quality of well-being.

Ursodeoxycholic acid for treatment of primary sclerosing cholangitis: a placebo-controlled trial

NARCIS (Netherlands)

Beuers, U.; Spengler, U.; Kruis, W.; AYDEMIR, U.; WIEBECKE, B.; HELDWEIN, W.; WEINZIERL, M.; Pape, G. R.; Sauerbruch, T.; Paumgartner, G.

1992-01-01

The efficacy and safety of ursodeoxycholic acid for the treatment of primary sclerosing cholangitis were evaluated in a prospective, randomized, double-blind, placebo-controlled trial. Fourteen patients with primary sclerosing cholangitis documented by cholestatic serum enzyme pattern, liver

Clinical and bacteriological efficacy of twice daily topical retapamulin ointment 1% in the management of impetigo and other uncomplicated superficial skin infections.

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Bohaty, Benjamin R; Choi, Sangbum; Cai, Chunyan; Hebert, Adelaide A

2015-02-01

Cutaneous bacterial infections are common in children and adults and frequently are caused by Staphylococcus aureus ( S. aureus ). Treatment failures with topical agents are not uncommon and have been shown to be secondary to bacterial resistance. To determine clinical and bacteriological efficacy of retapamulin ointment 1% in treatment of patients with cutaneous bacterial infections caused by methicillin-resistant S. aureus (MRSA) and other bacteria. Prospective, nonrandomized, uncontrolled, open label, single center trial conducted between April 2008 and November 2012 that evaluated efficacy of retapamulin ointment 1% in the treatment of impetigo, folliculitis, and other minor soft tissue infections in children and adults. Fifty patients, who presented to a dermatology outpatient clinic and were clinically diagnosed with impetigo, folliculitis, or minor soft tissue infection suitable for treatment with a topical antibiotic, were screened. Thirty-eight patients were enrolled and received treatment: topical retapamulin ointment 1% twice daily for 5 days. Seven patients were MRSA positive and qualified for the primary efficacy population. One patient withdrew due to an adverse event. Clinical and microbiological exams were performed at baseline and follow-up 5 to 7 days later to assess clinical, microbiological, and therapeutic responses. Primary outcome was clinical response at follow-up in primary efficacy population with MRSA isolated as the baseline pathogen. Secondary outcomes included clinical, microbiologic, and therapeutic responses in patients who were culture positive for any species of bacteria. Clinical response at follow-up in the primary efficacy population (MRSA-positive patients) was not sufficiently powered to demonstrate significance; however, outcomes were excellent, with 7 of 7 patients demonstrating clinical success (5 of 7) or clinical improvement (2 of 7) at follow-up. Barring lack of significance due to small total sample size for patients

The efficacy of viscocanalostomy for uncontrollable primary open-angle glaucoma in a developing country

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Khodadad Moradian

2013-01-01

Full Text Available Purpose: To evaluate the safety and efficacy of viscocanalostomy in the management of medically uncontrollable primary open-angle glaucoma (POAG in a developing country. Materials and Methods: This is a prospective, non-randomized case series of 14 consecutive eyes with medically uncontrollable POAG, all subjected to viscocanalostomy. The main outcome measure was success rate based on the intraocular pressure (IOP level achieved post-operatively. The procedure was considered a complete success if IOP was less than 21 mmHg without any anti-glaucoma medication. Qualified success was defined as IOP of less than 21 mmHg with anti-glaucoma medication. All patients had a regular follow-up of at least 12 months. Results: IOP was reduced from a mean baseline value of 27.9 ± 7.3 mmHg (range: 21-40 mmHg to a mean final value of 16.0 ± 2.7 mmHg (range: 13-22 mmHg, which was statistically highly significant (P < 0.005. The mean number of pre-operative anti-glaucoma medications was 3.0 ± 0.4 (range: 2-4, which was reduced significantly (P < 0.0001 to 0.3 ± 0.6 (range: 0-2 at the last follow-up visit. One year post-operatively, complete success was achieved in 71% and qualified success was observed in 21.4% of patients, summing up to an overall success rate of 92.4%. There were no major complications in any of the patients. Conclusion: Viscocanalostomy could be performed effectively and safely for control of POAG in developing countries.

Exercise self-efficacy correlates in people with psychosis.

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Vancampfort, Davy; Gorczynski, Paul; De Hert, Marc; Probst, Michel; Naisiga, Annetie; Basangwa, David; Mugisha, James

2018-04-01

Despite the recognition of the importance of exercise self-efficacy in exercise adoption and maintenance, previous investigations on exercise self-efficacy in people with psychosis is scarce. The present study aimed to (1) explore if exercise self-efficacy differed between stages of behavior change in Ugandan outpatients with psychosis, and (2) assess sociodemographic, clinical and motivational correlates of exercise self-efficacy. In total, 48 patients (24 women) completed the Exercise Self-Efficacy Scale (ESES), the Patient-centered Assessment and Counseling for Exercise questionnaire, the Brief Symptoms Inventory-18 (BSI-18), and questions pertaining to intrinsic motivation in the Behavioral Regulation in Exercise Questionnaire-2. Additionally, participants were asked about their exercise behavior in the past 7 days and screened for cardio-metabolic risk factors. Higher ESES-scores were observed in those in the maintenance (n = 17) versus those in the pre-action stage (n = 17) of behavior change. Higher ESES-scores were also significantly associated with lower BSI-18 somatization and higher intrinsic motivation scores. Our data indicated that health care professionals should assist patients with psychosis in interpreting physiological states during exercise. Future research should explore whether bolstering such sources of information might directly or indirectly effect exercise self-efficacy. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial.

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Capeding, Maria Rosario; Tran, Ngoc Huu; Hadinegoro, Sri Rezeki S; Ismail, Hussain Imam H J Muhammad; Chotpitayasunondh, Tawee; Chua, Mary Noreen; Luong, Chan Quang; Rusmil, Kusnandi; Wirawan, Dewa Nyoman; Nallusamy, Revathy; Pitisuttithum, Punnee; Thisyakorn, Usa; Yoon, In-Kyu; van der Vliet, Diane; Langevin, Edith; Laot, Thelma; Hutagalung, Yanee; Frago, Carina; Boaz, Mark; Wartel, T Anh; Tornieporth, Nadia G; Saville, Melanie; Bouckenooghe, Alain

2014-10-11

An estimated 100 million people have symptomatic dengue infection every year. This is the first report of a phase 3 vaccine efficacy trial of a candidate dengue vaccine. We aimed to assess the efficacy of the CYD dengue vaccine against symptomatic, virologically confirmed dengue in children. We did an observer-masked, randomised controlled, multicentre, phase 3 trial in five countries in the Asia-Pacific region. Between June 3, and Dec 1, 2011, healthy children aged 2-14 years were randomly assigned (2:1), by computer-generated permuted blocks of six with an interactive voice or web response system, to receive three injections of a recombinant, live, attenuated, tetravalent dengue vaccine (CYD-TDV), or placebo, at months 0, 6, and 12. Randomisation was stratified by age and site. Participants were followed up until month 25. Trial staff responsible for the preparation and administration of injections were unmasked to group allocation, but were not included in the follow-up of the participants; allocation was concealed from the study sponsor, investigators, and parents and guardians. Our primary objective was to assess protective efficacy against symptomatic, virologically confirmed dengue, irrespective of disease severity or serotype, that took place more than 28 days after the third injection. The primary endpoint was for the lower bound of the 95% CI of vaccine efficacy to be greater than 25%. Analysis was by intention to treat and per procotol. This trial is registered with ClinicalTrials.gov, number NCT01373281. We randomly assigned 10,275 children to receive either vaccine (n=6851) or placebo (n=3424), of whom 6710 (98%) and 3350 (98%), respectively, were included in the primary analysis. 250 cases of virologically confirmed dengue took place more than 28 days after the third injection (117 [47%] in the vaccine group and 133 [53%] in the control group). The primary endpoint was achieved with 56·5% (95% CI 43·8-66·4) efficacy. We recorded 647 serious adverse

How to objectively assess jugular primary venous obstruction

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Paolo Zamboni

2014-12-01

Full Text Available Last January The Lancet published the article by Traboulsee et al. Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their sibilings, and unrelated healthy controls: a blinded, case control study. These Authors confirmed the presence of chronic cerebrospinal venous insufficiency with a high prevalence of about 70% in the Canadian population, but without significant differences between patients and healthy controls, yet. However, they used a criterion never published to assess stenosis, in alternative to the classic measurement of the diameter in the segment immediately preceding the narrowest point. Traboulsee et al. measure the stenosis along the entire length of the internal jugular vein, by comparing the maximum diameter with the narrowest point. It has been demonstrated, from normal anatomy findings, how the jugular bulb diameter normally exceeds 50% of the minimum diameter of the internal jugular vein, clearly showing the reason why Traboulsee et al. did not find significant differences between people with multiple sclerosis, their sibilings, and unrelated healthy controls. Furthermore, as the outcome measure of Traboulsee et al., wall stenosis is a neglected part of primary venous obstruction, because in the majority of cases obstruction is the consequence of intraluminal obstacles, as a considerable part of truncular venous malformations, and/or compression; rarely of external hypoplasia. Finally, several recently published methods can be adopted for objective assessment of restricted jugular flow in course of chronic cerebrospinal venous insufficiency, by the means of non invasive magnetic resonance imaging, ultrasound and plethysmography. This may help us in improving the assessment of cerebral venous return in the near future.

World Association for the Advancement of Veterinary Parasitology (WAAVP): Guideline for the evaluation of drug efficacy against non-coccidial gastrointestinal protozoa in livestock and companion animals.

Science.gov (United States)

Geurden, T; Olson, M E; O'Handley, R M; Schetters, T; Bowman, D; Vercruysse, J

2014-08-29

The current guideline was written to aid in the design, implementation and interpretation of studies for the assessment of drug efficacy against non-coccidial gastrointestinal protozoan parasites, with Giardia spp. as the leading example. The information provided in this guideline deals with aspects of how to conduct controlled studies using experimental infection models (dose determination and dose confirmation) and efficacy studies in commercial facilities (field effectiveness studies). Furthermore, the selection of suitable animals, housing, infection procedure, choice of diagnostic technique and data analysis are discussed. This guideline is intended to assist investigators in conducting specific studies, to provide specific information for registration authorities involved in the decision-making process, to assist in the approval and registration of new drugs and to facilitate the worldwide adoption of uniform procedures. The primary parameter for drug efficacy is the reduction in either parasite excretion or parasite counts and a minimum efficacy of 90% is required against non-coccidial gastrointestinal protozoa. A supporting efficacy parameter is a significant difference in the proportion of infected animals between treated and non-treated groups. Persistent efficacy is considered as an additional claim to therapeutic efficacy. Copyright © 2014 Elsevier B.V. All rights reserved.

Developing a Questionnaire to Assess the Probability Content Knowledge of Prospective Primary School Teachers

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Gómez-Torres, Emilse; Batanero, Carmen; Díaz, Carmen; Contreras, José Miguel

2016-01-01

In this paper we describe the development of a questionnaire designed to assess the probability content knowledge of prospective primary school teachers. Three components of mathematical knowledge for teaching and three different meanings of probability (classical, frequentist and subjective) are considered. The questionnaire content is based on…

The safety and efficacy of robotic image-guided radiosurgery system treatment for intra- and extracranial lesions: A systematic review of the literature

International Nuclear Information System (INIS)

Calcerrada Diaz-Santos, Nieves; Blasco Amaro, Juan Antonio; Cardiel, Gloria Ariza; Andradas Aragones, Elena

2008-01-01

Background: The CyberKnife is a new, frameless stereotactic radiosurgery system. This work reviews its safety and efficacy in the treatment of intra- and extracranial lesions. Methods: A literature search was made of the Medline, Embase, Pascal Biomed, CINAHL and Cancerlit databases. Health technology assessment reports on stereotactic radiosurgery systems were also consulted. All searches were made in June 2007. Data on efficacy and safety were extracted and then synthesized into the present review. Results: Thirty five clinical studies were identified, the majority of which included no patient comparison group. These studies assessed the use of the CyberKnife mainly in the treatment of primary and metastatic intracranial and spinal tumours. Conclusions: The CyberKnife system allows to carry out standard radiosurgical and fractionated stereotactic radiotherapy procedures. The use of this system offers an alternative for the treatment of inoperable tumours, and of lesions located close to critical structures that cannot be treated using other types of stereotactic radiosurgery system. Unfortunately, the quality of the reviewed papers still does not allow definite conclusions to be drawn regarding the safety and efficacy of these treatments

Assessment of postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose

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Takanobu Utsumi

2014-10-01

Conclusion: The defined daily dose is a useful tool for assessing total changes in the consumption of antihypertensive drugs in patients with primary aldosteronism. Using the defined daily dose, clinicians could explain in detail to patients with primary aldosteronism the predicted postoperative change in antihypertensive drug consumption.

Strategies for Fostering the Efficacy of School-Based Management ...

African Journals Online (AJOL)

The study examined community participation in the School-Based Management Committees (SBMC), the challenges hindering participation, and strategies for fostering efficacy of the School Based Management Committee. The number 340 schools were selected from the population of 2543 public primary schools in ...

Efficacy and safety of histamine-2 receptor antagonists

NARCIS (Netherlands)

van der Pol, Rachel; Langendam, Miranda; Benninga, Marc; van Wijk, Michiel; Tabbers, Merit

2014-01-01

Histamine-2 receptor antagonists (H2RAs) are frequently used in the treatment of gastroesophageal reflux disease (GERD) in children; however, their efficacy and safety is questionable. To systematically review the literature to assess the efficacy and safety of H2RAs in pediatric GERD. PubMed,

Efficacy and safety of almorexant in adult chronic insomnia: a randomized placebo-controlled trial with an active reference.

Science.gov (United States)

Black, Jed; Pillar, Giora; Hedner, Jan; Polo, Olli; Berkani, Ouali; Mangialaio, Sara; Hmissi, Abdel; Zammit, Gary; Hajak, Goran

2017-08-01

The orally active dual OX 1 R and OX 2 R antagonist, almorexant, targets the orexin system for the treatment of primary insomnia. This clinical trial assessed the effect of almorexant on sleep maintenance and other sleep endpoints, and its safety and tolerability in adults. Prospective, randomized, double-blind, placebo-controlled, active referenced trial in male and female adults aged 18-64 years with chronic, primary insomnia. Patients were randomized 1:1:1:1 to receive placebo, almorexant 100 mg, almorexant 200 mg, or zolpidem 10 mg (active reference) for 16 days. Primary efficacy assessments were objective (polysomnography-measured) and subjective (patient-recorded) wake time after sleep onset (WASO). Further sleep variables were also evaluated. From 709 randomized patients, 707 (mean age 45.4 years; 61.7% female) received treatment and 663 (93.8%) completed the study. A significant decrease versus placebo in median objective WASO was observed with almorexant 200 mg at the start and end of randomized treatment (-26.8 min and -19.5 min, respectively; both p system in insomnia disorder. CLINICALTRIALS. NCT00608985. Copyright © 2017 Elsevier B.V. All rights reserved.

A randomized Phase III clinical trial to assess the efficacy of a bovine-human reassortant pentavalent rotavirus vaccine in Indian infants.

Science.gov (United States)

Kulkarni, Prasad S; Desai, Sajjad; Tewari, Tushar; Kawade, Anand; Goyal, Nidhi; Garg, Bishan Swarup; Kumar, Dinesh; Kanungo, Suman; Kamat, Veena; Kang, Gagandeep; Bavdekar, Ashish; Babji, Sudhir; Juvekar, Sanjay; Manna, Byomkesh; Dutta, Shanta; Angurana, Rama; Dewan, Deepika; Dharmadhikari, Abhijeet; Zade, Jagdish K; Dhere, Rajeev M; Fix, Alan; Power, Maureen; Uprety, Vidyasagar; Parulekar, Varsha; Cho, Iksung; Chandola, Temsunaro R; Kedia, Vikash K; Raut, Abhishek; Flores, Jorge

2017-10-27

Rotavirus is the most common cause of moderate-to-severe infant diarrhoea in developing countries, resulting in enormous morbidity, mortality, and economic burden. A bovine-human reassortant pentavalent rotavirus vaccine (BRV-PV) targeting the globally most common strains was developed in India and tested in a randomized, double-blind, placebo-controlled end-point driven Phase III efficacy clinical trial implemented at six sites across India. Infants 6 to 8weeks of age were randomized (1:1) to receive three oral doses of BRV-PV or placebo at 6, 10, and 14weeks of age along with routine vaccines. Home visit surveillance was conducted to detect severe rotavirus gastroenteritis (SRVGE) and safety outcomes until the children reached two years of age. A total of 3749 infants received BRV-PV while 3751 received placebo. At the time of the primary end-point (when the minimum number of cases needed for analysis were accrued) the vaccine efficacy against SRVGE was 36% (95% CI 11.7, 53.6, p=0.0067) in the per protocol (PP) analysis, and 41.9% (95% CI 21.1, 57.3, p=0.0005) in the intent to treat (ITT) analysis. Vaccine efficacy over the entire follow-up period (until children reached two years of age) was 39.5% (95% CI 26.7, 50, protavirus cases (VSRVGE, Vesikari score≥16) was 60.5% (95% CI 17.7, 81, p=0.0131) at the time of the primary analysis and 54.7% (95% CI 29.7, 70.8, p=0.0004) for the complete follow-period in the PP population. The incidence of solicited, unsolicited, and serious adverse events were similar in both the vaccine and placebo groups. Likewise, the number of intussusceptions and deaths were similar between both groups. Thus, BRV-PV is an effective, well tolerated and safe vaccine in Indian infants. (Trial registration: Clinical Trials.Gov [NCT 02133690] and Clinical Trial Registry of India [CTRI/2013/05/003667]). Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Efficacy of an internet-based problem-solving training for teachers: results of a randomized controlled trial.

Science.gov (United States)

Ebert, David Daniel; Lehr, Dirk; Boß, Leif; Riper, Heleen; Cuijpers, Pim; Andersson, Gerhard; Thiart, Hanne; Heber, Elena; Berking, Matthias

2014-11-01

The primary purpose of this randomized controlled trial (RCT) was to evaluate the efficacy of internet-based problem-solving training (iPST) for employees in the educational sector (teachers) with depressive symptoms. The results of training were compared to those of a waitlist control group (WLC). One-hundred and fifty teachers with elevated depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D ≥16) were assigned to either the iPST or WLC group. The iPST consisted of five lessons, including problem-solving and rumination techniques. Symptoms were assessed before the intervention began and in follow-up assessments after seven weeks, three months, and six months. The primary outcome was depressive symptom severity (CES-D). Secondary outcomes included general and work-specific self-efficacy, perceived stress, pathological worries, burnout symptoms, general physical and mental health, and absenteeism. iPST participants displayed a significantly greater reduction in depressive symptoms after the intervention (d=0.59, 95% CI 0.26-0.92), after three months (d=0.37, 95% CI 0.05-0.70) and after six months (d=0.38, 95% CI 0.05-0.70) compared to the control group. The iPST participants also displayed significantly higher improvements in secondary outcomes. However, workplace absenteeism was not significantly affected. iPST is effective in reducing symptoms of depression among teachers. Disseminated on a large scale, iPST could contribute to reducing the burden of stress-related mental health problems among teachers. Future studies should evaluate iPST approaches for use in other working populations.

Parental self-efficacy and its measurement - an evaluation of a parental self-efficacy measurement scale.

Science.gov (United States)

Purssell, Edward; While, Alison

2013-05-01

To field test a parental self-efficacy scale regarding its acceptability and feasibility and to describe parental self-efficacy in a convenience sample of parents with children aged 6 years old or less. Self-care within families is increasingly emphasised in health policy as a means of maximising healthcare resources. This study reports the field testing of a scale designed to measure parental self-efficacy. Cross-sectional survey of parents of children aged 6 years old or less. Subjects were recruited through a parenting internet website (n = 84) and local parenting and community organisations (n = 68) and asked to complete a questionnaire containing the scale. Data collection took place between January and August 2011. The scale, previously validated with an expert panel of professionals, gathered information about parental self-efficacy when administered either directly or through an on-line data collection portal, although there were more missing data when administered via the Internet. Although convenience and self-selecting samples precluded parameter estimation, areas of concern highlighted were difficulties differentiating children with serious illnesses and the use of the Personal Child Health Record. Use of the Internet was widespread, as was use of community pharmacists and nursery staff. Although the primary purpose was not to collect specific data, the data indicated the continuing concern of parents regarding serious illness and where additional investment may be required to meet parental needs and expectations. The previously validated scale can be used to collect information about parental self-efficacy either through a paper questionnaire or the Internet. Although there was slightly more missing data from the Internet version, the ease of its administration makes this an attractive option. Parents generally reported high levels of self-efficacy and satisfaction with services; however, the scale was able to identify areas where further investment

Pitavastatin shows greater lipid-lowering efficacy over 12 weeks than pravastatin in elderly patients with primary hypercholesterolaemia or combined (mixed) dyslipidaemia

DEFF Research Database (Denmark)

Stender, Steen; Budinski, Dragos; Gosho, Masahiko

2013-01-01

randomized to six treatment groups (1, 2, or 4 mg pitavastatin vs. 10, 20, or 40 mg pravastatin) in a 12-week multicentre double-blind study. Patients (n = 942; men, 44.3%; Caucasian, 99.3%; mean age, 70 years; age range, 65-89 years) in all groups were well matched for duration of disease and diagnosis......Aim: To compare the safety and efficacy of once-daily pitavastatin (1, 2, and 4 mg) and pravastatin (10, 20, and 40 mg) in elderly patients (≥65 years of age) with primary hypercholesterolaemia or combined (mixed) dyslipidaemia.Design: After a 6-8-week washout/dietary period, patients were.......Results: Mean decreases in low-density lipoprotein cholesterol over 12 weeks were 31.4-44.3% with pitavastatin 1-4 mg and 22.4-34.0% with pravastatin 10-40 mg (p

Factors influencing primary health care professionals' physical activity promotion behaviors: A systematic review

NARCIS (Netherlands)

Huijg, J.M.; Gebhardt, W.A.; Verheijden, M.W.; Zouwe, N. van der; Vries, J.D. de; Middelkoop, B.J.C.; Crone, M.R.

2015-01-01

Background: Despite the promising findings related to the efficacy of interventions aimed at promoting physical activity (PA) in primary health care (PHC), the translation of these interventions to PHC practice does not always happen as desired. Purpose: To help understand why efficacious PHC-based

Self-Efficacy as Related to Career Aspirations Based on the Educational Quality Assessment Inventory.

Science.gov (United States)

Dentler, Donna J.

A study examined the relationship between the self-efficacy and career aspirations of 37,942 11th-grade students across the state of Pennsylvania. Using Albert Bandura's theory of self-efficacy, which states that the level and strength of self-efficacy of an individual will determine (1) whether or not the individual will initiate coping behavior,…

Cognitive Assessment Interview (CAI): Validity as a co-primary measure of cognition across phases of schizophrenia.

Science.gov (United States)

Ventura, Joseph; Subotnik, Kenneth L; Ered, Arielle; Hellemann, Gerhard S; Nuechterlein, Keith H

2016-04-01

Progress has been made in developing interview-based measures for the assessment of cognitive functioning, such as the Cognitive Assessment Interview (CAI), as co-primary measures that compliment objective neurocognitive assessments and daily functioning. However, a few questions remain, including whether the relationships with objective cognitive measures and daily functioning are high enough to justify the CAI as an co-primary measure and whether patient-only assessments are valid. Participants were first-episode schizophrenia patients (n=60) and demographically-similar healthy controls (n=35), chronic schizophrenia patients (n=38) and demographically similar healthy controls (n=19). Participants were assessed at baseline with an interview-based measure of cognitive functioning (CAI), a test of objective cognitive functioning, functional capacity, and role functioning at baseline, and in the first episode patients again 6 months later (n=28). CAI ratings were correlated with objective cognitive functioning, functional capacity, and functional outcomes in first-episode schizophrenia patients at similar magnitudes as in chronic patients. Comparisons of first-episode and chronic patients with healthy controls indicated that the CAI sensitively detected deficits in schizophrenia. The relationship of CAI Patient-Only ratings with objective cognitive functioning, functional capacity, and daily functioning were comparable to CAI Rater scores that included informant information. These results confirm in an independent sample the relationship of the CAI ratings with objectively measured cognition, functional capacity, and role functioning. Comparison of schizophrenia patients with healthy controls further validates the CAI as an co-primary measure of cognitive deficits. Also, CAI change scores were strongly related to objective cognitive change indicating sensitivity to change. Copyright © 2016 Elsevier B.V. All rights reserved.

Validation of the Sexual Communication Self-Efficacy Scale

Science.gov (United States)

Quinn-Nilas, Christopher; Milhausen, Robin R.; Breuer, Rebecca; Bailey, Julia; Pavlou, Menelaos; DiClemente, Ralph J.; Wingood, Gina M.

2016-01-01

This study assessed a newly developed Sexual Communication Self-Efficacy Scale designed to measure the sexual communication self-efficacy of adolescent men and women. Three-hundred and seventy-four U.K. adolescents completed this new scale, along with several other validity measures. Factor analysis revealed that the Sexual Communication…

Oral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation

DEFF Research Database (Denmark)

Jacobsen, Søren; Danneskiold-Samsøe, B; Andersen, R B

1991-01-01

S-adenosylmethionine is a relatively new anti-inflammatory drug with analgesic and anti-depressant effects. Efficacy of 800 mg orally administered s-adenosylmethionine daily versus placebo for six weeks was investigated in 44 patients with primary fibromyalgia in double-blind settings. Tender poi...... effects on primary fibromyalgia and could be an important option in the treatment hereof.......S-adenosylmethionine is a relatively new anti-inflammatory drug with analgesic and anti-depressant effects. Efficacy of 800 mg orally administered s-adenosylmethionine daily versus placebo for six weeks was investigated in 44 patients with primary fibromyalgia in double-blind settings. Tender point...... = 0.03) and mood evaluated by Face Scale (P = 0.006) in the actively treated group compared to placebo. The tender point score, isokinetic muscle strength, mood evaluated by Beck Depression Inventory and side effects did not differ in the two treatment groups. S-adenosylmethionine has some beneficial...

Systematic review and meta-analysis of the efficacy and safety of amfepramone and mazindol as a monotherapy for the treatment of obese or overweight patients.

Science.gov (United States)

Lucchetta, Rosa Camila; Riveros, Bruno Salgado; Pontarolo, Roberto; Radominski, Rosana Bento; Otuki, Michel Fleith; Fernandez-Llimos, Fernando; Correr, Cassyano Januário

2017-05-01

The aim of this study was to evaluate efficacy and safety of amfepramone, fenproporex and mazindol as a monotherapy for the treatment of obese or overweight patients. A systematic review of primary studies was conducted, followed by a direct meta-analysis (random effect) and mixed treatment comparison. Medline and other databases were searched. Heterogeneity was explored through I2 associated with a p-value. Of 739 identified publications, 25 were included in the meta-analysis. The global evaluation of Cochrane resulted in 19 studies with a high level of bias and six with unclear risk. Due to the lack of information in primary studies, direct meta-analyses were conducted only for amfepramone and mazindol. Compared to placebo, amfepramone resulted in higher weight loss in the short-term (obesity therapy assessments, this study found that the evaluated drugs showed poor evidence of efficacy in the treatment of overweight and obese patients. Robust safety data were not identified to suggest changes in their regulatory status.

A randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of neramexane in patients with moderate to severe subjective tinnitus

Directory of Open Access Journals (Sweden)

Jastreboff Pawel J

2011-01-01

Full Text Available Abstract Background Neramexane is a new substance that exhibits antagonistic properties at α9α10 cholinergic nicotinic receptors and N-methyl-D-aspartate receptors, suggesting potential efficacy in the treatment of tinnitus. Methods A total of 431 outpatients with moderate to severe subjective tinnitus (onset 3-18 months before screening were assigned randomly to receive either placebo or neramexane mesylate (25 mg/day, 50 mg/day and 75 mg/day for 16 weeks, with assessment at 4-week intervals. The primary (intention-to-treat efficacy analysis was based on the change from baseline in Week 16 in the total score of the adapted German short version of the validated Tinnitus Handicap Inventory questionnaire (THI-12. Results Compared with placebo, the largest improvement was achieved in the 50 mg/d neramexane group, followed by the 75 mg/d neramexane group. This treatment difference did not reach statistical significance at the pre-defined endpoint in Week 16 (p = 0.098 for 50 mg/d; p = 0.289 for 75 mg/d neramexane, but consistent numerical superiority of both neramexane groups compared with placebo was observed. Four weeks after the end of treatment, THI-12 scores in the 50 mg/d group were significantly better than those of the controls. Secondary efficacy variables supported this trend, with p values of Conclusions This study demonstrated the safety and tolerability of neramexane treatment in patients with moderate to severe tinnitus. The primary efficacy variable showed a trend towards improvement of tinnitus suffering in the medium- and high-dose neramexane groups. This finding is in line with consistent beneficial effects observed in secondary assessment variables. These results allow appropriate dose selection for further studies. Trial Registration ClinicalTrials.gov NCT00405886

Racial and gender disparities in sugar consumption change efficacy among first-year college students.

Science.gov (United States)

Bruce, Marino A; Beech, Bettina M; Thorpe, Roland J; Mincey, Krista; Griffith, Derek M

2017-02-01

Reducing excess dietary sugar intake among emerging adults involves replacing sugar sweetened beverages (SSBs) and sugary snacks (SSN) with healthier options. Few studies have assessed the perceived degree of difficulty associated with making lifestyle modifications among a diverse group of emerging adults. The purpose of this study was to assess race and gender disparities in SSB and SSN behavioral modification efficacy among African American and White first year college students. A self-administered, cross-sectional survey was completed by a subsample of freshmen (n = 499) at a medium-sized southern university. Key outcome variables were self-efficacy in reducing consumption of SSBs and SSNs, respectively. Primary independent variables were BMI, concerns about weight, and attempts to lose weight, takeout food consumption frequency, and physical activity. Half of the sample was African American (50.1%) and a majority of participants were female (59.3%). Fewer African Americans than Whites were very sure they could substitute SSBs with water (48.8% vs 64.7%, p vs 48.2%, p vs 60.5%, p < 0.04). African Americans (OR = 0.38, CI: 0.22-0.64) and males (OR = 0.49, CI: 0.27-0.88) had lower odds of being more confident in their ability to change their SSB intake. Race and gender differences were not present in models predicting confidence to reduce SSN consumption. These findings highlight the need to consider race and gender in interventions seeking to increase self-efficacy to make lifestyle modifications. Copyright © 2016 Elsevier Ltd. All rights reserved.

TEACHERS’ COMPUTER SELF-EFFICACY AND THEIR USE OF EDUCATIONAL TECHNOLOGY

Directory of Open Access Journals (Sweden)

Vehbi TUREL

2014-10-01

Full Text Available This study examined the use of educational technology by primary and subject teachers (i.e. secondary and high school teachers in a small town in the eastern part of Turkey in the spring of 2012. The study examined the primary, secondary and high school teachers’ Ø personal and computer related (demographic characteristics, Ø their computer self-efficacy perceptions, Ø their computer-using level in certain software, Ø their frequency of computer use for teaching, administrative and communication objectives, and Ø their use of educational technology preferences for preparation and teaching purposes. In this study, all primary, secondary and high school teachers in the small town were given the questionnaires to complete. 158 teachers (n=158 completed and returned them. The study was mostly quantitative and partly qualitative. The quantitative results were analysed with SPSS (i.e. mean, Std. Deviation, frequency, percentage, ANOVA. The qualitative data were analysed with examining the participants’ responses gathered from the open-ended questions and focussing on the shared themes among the responses. The results reveal that the teachers think that they have good computer self-efficacy perceptions, their level in certain programs is good, and they often use computers for a wide range of purposes. There are also statistical differences between; Ø their computer self-efficacy perceptions, Ø frequency of computer use for certain purposes, and Ø computer level in certain programs in terms of different independent variables.

Pivotal ERIVANCE basal cell carcinoma (BCC) study: 12-month update of efficacy and safety of vismodegib in advanced BCC.

Science.gov (United States)

Sekulic, Aleksandar; Migden, Michael R; Lewis, Karl; Hainsworth, John D; Solomon, James A; Yoo, Simon; Arron, Sarah T; Friedlander, Philip A; Marmur, Ellen; Rudin, Charles M; Chang, Anne Lynn S; Dirix, Luc; Hou, Jeannie; Yue, Huibin; Hauschild, Axel

2015-06-01

Primary analysis from the pivotal ERIVANCE BCC study resulted in approval of vismodegib, a Hedgehog pathway inhibitor indicated for treatment of adults with metastatic or locally advanced basal cell carcinoma (BCC) that has recurred after surgery or for patients who are not candidates for surgery or radiation. An efficacy and safety analysis was conducted 12 months after primary analysis. This was a multinational, multicenter, nonrandomized, 2-cohort study in patients with measurable and histologically confirmed locally advanced or metastatic BCC taking oral vismodegib (150 mg/d). Primary outcome measure was objective response rate (complete and partial responses) assessed by independent review facility. After 12 months of additional follow-up, median duration of exposure to vismodegib was 12.9 months. Objective response rate increased from 30.3% to 33.3% in patients with metastatic disease, and from 42.9% to 47.6% in patients with the locally advanced form. Median duration of response in patients with locally advanced BCC increased from 7.6 to 9.5 months. No new safety signals emerged with extended treatment duration. Limitations include low prevalence of advanced BCC and challenges of designing a study with heterogenous manifestations. The 12-month update of the study confirms the efficacy and safety of vismodegib in management of advanced BCC. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Prehospital Intubation and Outcome in Traumatic Brain Injury—Assessing Intervention Efficacy in a Modern Trauma Cohort

Directory of Open Access Journals (Sweden)

Rebecka Rubenson Wahlin

2018-04-01

Full Text Available BackgroundPrehospital intubation in traumatic brain injury (TBI focuses on limiting the effects of secondary insults such as hypoxia, but no indisputable evidence has been presented that it is beneficial for outcome. The aim of this study was to explore the characteristics of patients who undergo prehospital intubation and, in turn, if these parameters affect outcome.Material and methodsPatients ≥15 years admitted to the Department of Neurosurgery, Stockholm, Sweden with TBI from 2008 through 2014 were included. Data were extracted from prehospital and hospital charts, including prospectively collected Glasgow Outcome Score (GOS after 12 months. Univariate and multivariable logistic regression models were employed to examine parameters independently correlated to prehospital intubation and outcome.ResultsA total of 458 patients were included (n = 178 unconscious, among them, n = 61 intubated. Multivariable analyses indicated that high energy trauma, prehospital hypotension, pupil unresponsiveness, mode of transportation, and distance to the hospital were independently correlated with intubation, and among them, only pupil responsiveness was independently associated with outcome. Prehospital intubation did not add independent information in a step-up model versus GOS (p = 0.154. Prehospital reports revealed that hypoxia was not the primary cause of prehospital intubation, and that the procedure did not improve oxygen saturation during transport, while an increasing distance from the hospital increased the intubation frequency.ConclusionIn this modern trauma cohort, prehospital intubation was not independently associated with outcome; however, hypoxia was not a common reason for prehospital intubation. Prospective trials to assess efficacy of prehospital airway intubation will be difficult due to logistical and ethical considerations.

Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems.

Science.gov (United States)

de Lusignan, Simon; Pearce, Christopher; Munro, Neil

2013-01-01

Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user's preferences. The use of electronic patient record (EPR) systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences.

ISCOM-based equine influenza vaccine: Duration of immunity and randomised clinical trials to assess an accelerated schedule of immunisation and efficacy

Directory of Open Access Journals (Sweden)

R. Paillot

2015-01-01

Study 3: efficacy against Florida clade 2 EIV strain (randomised trial. Efficacy against the representative Florida clade 2 strain A/eq/Richmond/1/07 was also evaluated at the peak of immunity, shortly after 2nd vaccination (V2. Six ponies were vaccinated with EquipFT according to label (6-week interval between first and second injection and 6 control ponies received saline injections. Sixteen days after V2 (day 58, all animals were experimentally infected with A/eq/Richmond/1/07. Clinical signs of disease and virus shedding were assessed for 14 days and found to be significantly reduced in vaccinated animals.

Situated Self-efficacy in Introductory Physics Students

Science.gov (United States)

Henderson, Rachel; DeVore, Seth; Michaluk, Lynnette; Stewart, John

2017-01-01

Within the general university environment, students' perceived self-efficacy has been widely studied and findings suggest it plays a role in student success. The current research adapted a self-efficacy survey, from the ``Self-Efficacy for Learning Performance'' subscale of the Motivated Learning Strategies Questionnaire and administered it to the introductory, calculus-based physics classes (N=1005) over the fall 2015 and spring 2016 semesters. This assessment measured students' self-efficacy in domains including the physics class, other science and mathematics classes, and their intended future career. The effect of gender was explored with the only significant gender difference (p gender difference was not explained by a student's performance which was measured by test average. However, a mediation analysis showed that students' overall academic self-efficacy, measured by their math and science self-efficacy, acts as a mediator for the effect of test average on self-efficacy towards the physics class domain. This mediation effect was significant for both female (p < . 01) and male students (p < . 001) however, it was more pronounced for male students.

Motivational interviewing skills are positively associated with nutritionist self-efficacy.

Science.gov (United States)

Marley, Scott C; Carbonneau, Kira; Lockner, Donna; Kibbe, Debra; Trowbridge, Frederick

2011-01-01

To examine the relationships between physical and social self-concepts, motivational interviewing (MI), and nutrition assessment skills with dimensions of counseling self-efficacy. Cross-sectional survey. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics. Sixty-five WIC nutritionists. Counseling self-efficacy on topics related to physical activity and nutritional behaviors and in the presence of language and cultural differences. Multiple linear regression. Nutritionists' perception of their own MI skills was positively associated with their self-efficacy for counseling clients of a culture different than their own, when counseling about physical activity, and when counseling about nutrition behavior. Hispanic ethnicity and social self-concept were positively associated with counseling self-efficacy when culture differences were present. Physical self-concept was positively associated with self-efficacy related to physical activity topics. Nutrition assessment skill was negatively associated with self-efficacy for working with non-English-speaking clients. Development of MI skills and strategies to improve social and physical self-concept may increase WIC nutritionists' counseling self-efficacy, particularly when counseling clients from diverse backgrounds. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Evaluation of a Psychological Intervention for Patients with Chronic Pain in Primary Care.

Science.gov (United States)

Cano-García, Francisco J; González-Ortega, María Del Carmen; Sanduvete-Chaves, Susana; Chacón-Moscoso, Salvador; Moreno-Borrego, Roberto

2017-01-01

According to evidence from recent decades, multicomponent programs of psychological intervention in people with chronic pain have reached the highest levels of efficacy. However, there are still many questions left to answer since efficacy has mainly been shown among upper-middle class patients in English-speaking countries and in controlled studies, with expert professionals guiding the intervention and with a limited number of domains of painful experience evaluated. For this study, a program of multicomponent psychological intervention was implemented: (a) based on techniques with empirical evidence, but developed in Spain; (b) at a public primary care center; (c) among patients with limited financial resources and lower education; (d) by a novice psychologist; and (e) evaluating all domains of painful experience using the instruments recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). The aim of this study was to evaluate this program. We selected a consecutive sample of 40 patients treated for chronic non-cancer pain at a primary care center in Utrera (Seville, Spain), adults who were not in any employment dispute, not suffering from psychopathology, and not receiving psychological treatment. The patients participated in 10 psychological intervention sessions, one per week, in groups of 13-14 people, which addressed psychoeducation for pain; breathing and relaxation; attention management; cognitive restructuring; problem-solving; emotional management; social skills; life values and goal setting; time organization and behavioral activation; physical exercise promotion; postural and sleep hygiene; and relapse prevention. In addition to the initial assessment, measures were taken after the intervention and at a 6-month follow-up. We assessed the program throughout the process: before, during and after the implementation. Results were analyzed statistically (significance and effect size) and from a clinical

Personality Assessment Screener, Childhood Abuse, and Adult Partner Violence in African American Women Using Primary Care.

Science.gov (United States)

Porcerelli, John H; Hurrell, Kristen; Cogan, Rosemary; Jeffries, Keturah; Markova, Tsveti

2015-12-01

This study assessed the relationship between psychopathology with the Personality Assessment Screener (PAS) and childhood physical and sexual abuse and adult physical and sexual partner violence in a primary care sample of 98 urban-dwelling African American women. Patients completed the PAS, the Childhood Trauma Questionnaire, and the Conflict Tactics Scale. The PAS total score significantly correlated with all measures of childhood and adult abuse. Stepwise regression analyses revealed that PAS element scores of Suicidal Thinking and Hostile Control significantly predicted a history of childhood physical abuse; Suicidal Thinking, Hostile Control, and Acting Out significantly predicted a history of childhood sexual abuse; Suicidal Thinking, Negative Affect, and Alienation significantly predicted current adult partner physical violence; and Psychotic Features, Alcohol Problems, and Anger Control significantly predicted current adult sexual partner violence. The PAS appears to be a useful measure for fast-paced primary care settings for identifying patients who need a more thorough assessment for abuse. © The Author(s) 2015.

Methodologies to assess PWSCC susceptibility of primary component Alloy 600 locations in pressurized water reactors

International Nuclear Information System (INIS)

Rao, G.V.

1993-01-01

Methodologies to assess susceptibility to Primary Water Stress Corrosion Cracking (PWSCC) of Alloy 600 component locations in the Primary System of Pressurized Water Reactors are presented. The assessment methodologies are presented. The assessment methodologies are based on Relative Susceptibility Index (RSI) and Cumulative Susceptibility Index (CSI) models utilizing key contributing parameters such as service and residual stresses, yield strength, service temperature, material condition and microstructure, and the accumulated service time. To aid in the development of future inspection plans, a method of ranking of the assessed susceptibilities by 'bench marking' with respect to the susceptibility of a reference location of known PWSCC history of a reference location of known PWSCC history is presented. Means of utilizing the susceptibility ranking results in developing a prioritized inspection plan are discussed. A follow-up investigative plan to the initial inspection is proposed, which includes identification of critical sampling locations, sample extraction, sample investigations and testing to ensure that the potentially highest susceptibility locations are free from near term PWSCC and, further, to provide a basis for established schedules for future inspections. Finally, parametric considerations of the contributing factor are presented to help the utility choose suitable option to mitigate the PWSCC issue while minimizing the impact on continued service

Quality of Life in Patients With Primary and Metastatic Brain Tumors in the Literature as Assessed by the FACT-Br.

Science.gov (United States)

Chiu, Nicholas; Chiu, Leonard; Zeng, Liang; Zhang, Liying; Cella, David; Popovic, Marko; Chow, Ronald; Lam, Henry; Poon, Michael; Chow, Edward

2012-12-01

The Functional Assessment of Cancer Therapy-Brain (FACT-Br) is a quality of life (QOL) assessment tool that was originally developed for use in patients with primary brain tumors. However, the tool has also been used to assess QOL in patients with metastatic brain tumors. The purpose of this study is to compare the differences in QOL responses as assessed by the FACT-Br in patients with primary and metastatic brain neoplasms. A systematic literature search was conducted using the OvidSP platform in MEDLINE (1946 to July Week 2 2012) and EMBASE (1980 to 2012 Week 28). Articles in which the FACT-Br was used as a QOL assessment for patients with malignant brain tumors (both primary and metastatic) were included in the study. The weighted means of FACT-Br subscale and overall scores were calculated for the studies. To compare these scores, weighted analysis of variance was conducted and PROC GLM was performed for the data. A P-value of Br for assessment of QOL were identified. Social and functional well-being were significantly better in patients with primary brain tumors (weighted mean score of 22.2 vs. 10.7, P = 0.0026, 16.9 vs. 6.2, P = 0.0025, respectively). No other scale of the FACT-Br was significantly different between the two groups and the performance status of patients included in both groups was similar. Patients with primary brain cancer seemed to have better social and functional well-being scores than those with metastatic brain tumors. Other QOL domains were similar between these two groups. However, the heterogeneity in the included studies and the low sample size of included samples in patients with metastatic brain tumors could have confounded our findings.

Understanding reduced rotavirus vaccine efficacy in low socio-economic settings.

Directory of Open Access Journals (Sweden)

Benjamin A Lopman

Full Text Available Rotavirus vaccine efficacy ranges from >90% in high socio-economic settings (SES to 50% in low SES. With the imminent introduction of rotavirus vaccine in low SES countries, understanding reasons for reduced efficacy in these settings could identify strategies to improve vaccine performance.We developed a mathematical model to predict rotavirus vaccine efficacy in high, middle and low SES based on data specific for each setting on incidence, protection conferred by natural infection and immune response to vaccination. We then examined factors affecting efficacy.Vaccination was predicted to prevent 93%, 86% and 51% of severe rotavirus gastroenteritis in high, middle and low SES, respectively. Also predicted was that vaccines are most effective against severe disease and efficacy declines with age in low but not high SES. Reduced immunogenicity of vaccination and reduced protection conferred by natural infection are the main factors that compromise efficacy in low SES.The continued risk of severe disease in non-primary natural infections in low SES is a key factor underpinning reduced efficacy of rotavirus vaccines. Predicted efficacy was remarkably consistent with observed clinical trial results from different SES, validating the model. The phenomenon of reduced vaccine efficacy can be predicted by intrinsic immunological and epidemiological factors of low SES populations. Modifying aspects of the vaccine (e.g. improving immunogenicity in low SES and vaccination program (e.g. additional doses may bring improvements.

Understanding reduced rotavirus vaccine efficacy in low socio-economic settings.

Science.gov (United States)

Lopman, Benjamin A; Pitzer, Virginia E; Sarkar, Rajiv; Gladstone, Beryl; Patel, Manish; Glasser, John; Gambhir, Manoj; Atchison, Christina; Grenfell, Bryan T; Edmunds, W John; Kang, Gagandeep; Parashar, Umesh D

2012-01-01

Rotavirus vaccine efficacy ranges from >90% in high socio-economic settings (SES) to 50% in low SES. With the imminent introduction of rotavirus vaccine in low SES countries, understanding reasons for reduced efficacy in these settings could identify strategies to improve vaccine performance. We developed a mathematical model to predict rotavirus vaccine efficacy in high, middle and low SES based on data specific for each setting on incidence, protection conferred by natural infection and immune response to vaccination. We then examined factors affecting efficacy. Vaccination was predicted to prevent 93%, 86% and 51% of severe rotavirus gastroenteritis in high, middle and low SES, respectively. Also predicted was that vaccines are most effective against severe disease and efficacy declines with age in low but not high SES. Reduced immunogenicity of vaccination and reduced protection conferred by natural infection are the main factors that compromise efficacy in low SES. The continued risk of severe disease in non-primary natural infections in low SES is a key factor underpinning reduced efficacy of rotavirus vaccines. Predicted efficacy was remarkably consistent with observed clinical trial results from different SES, validating the model. The phenomenon of reduced vaccine efficacy can be predicted by intrinsic immunological and epidemiological factors of low SES populations. Modifying aspects of the vaccine (e.g. improving immunogenicity in low SES) and vaccination program (e.g. additional doses) may bring improvements.

Randomized control trial to assess the efficacy of metacognitive training compared with a psycho-educational group in people with a recent-onset psychosis.

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Ochoa, S; López-Carrilero, R; Barrigón, M L; Pousa, E; Barajas, A; Lorente-Rovira, E; González-Higueras, F; Grasa, E; Ruiz-Delgado, I; Cid, J; Birulés, I; Esteban-Pinos, I; Casañas, R; Luengo, A; Torres-Hernández, P; Corripio, I; Montes-Gámez, M; Beltran, M; De Apraiz, A; Domínguez-Sánchez, L; Sánchez, E; Llacer, B; Pélaez, T; Bogas, J L; Moritz, S

2017-07-01

Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.

The efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China.

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Liao, Yanhui; Wu, Qiuxia; Tang, Jinsong; Zhang, Fengyu; Wang, Xuyi; Qi, Chang; He, Haoyu; Long, Jiang; Kelly, Brian C; Cohen, Joanna

2016-08-19

Considering the extreme shortage of smoking cessation services in China, and the acceptability, feasibility and efficacy of mobile phone-based text message interventions for quitting smoking in other countries, here we propose a study of "the efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China". The primary objective of this proposed project is to assess whether a program of widely accessed mobile phone-based text message interventions ('Happy Quit') will be effective at helping people in China who smoke, to quit. Based on the efficacy of previous studies in smoking cessation, we hypothesize that 'Happy Quit' will be an effective, feasible and affordable smoking cessation program in China. In this single-blind, randomized trial, undertaken in China, about 2000 smokers willing to make a quit attempt will be randomly allocated, using an independent telephone randomization system that includes a minimization algorithm balancing for sex (male, female), age (19-34 or >34 years), educational level (≤ or >12 years), and Fagerstrom score for nicotine addiction (≤5, >5), to 'Happy Quit', comprising motivational messages and behavioral-change support, or to a control group that receives text messages unrelated to quitting. Messages will be developed to be suitable for Chinese. A pilot study will be conducted before the intervention to modify the library of messages and interventions. The primary outcome will be self-reported continuous smoking abstinence. A secondary outcome will be point prevalence of abstinence. Abstinence will be assessed at six time points (4, 8, 12, 16, 20 and 24 weeks post-intervention). A third outcome will be reductions in number of cigarettes smoked per day. The results will provide valuable insights into bridging the gap between need and services received for smoking cessation interventions and tobacco use prevention in China. It will also serve as mHealth model for extending the public

Exploring Science Teaching Efficacy of CASE Curriculum Teachers: A Post-Then-Pre Assessment

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Ulmer, Jonathan D.; Velez, Jonathan J.; Lambert, Misty D.; Thompson, Greg W.; Burris, Scott; Witt, Phillip A.

2013-01-01

This descriptive-correlational study sought to investigate teachers' levels of Personal Science Teaching Efficacy (PSTE) and Science Teaching Outcome Expectancy (STOE) using the Science Teaching Efficacy Beliefs Instrument (STEBI). The population included all teachers completing a CASE Institute training session during summer 2010. Assessments…

Career Development, Collective Efficacy, and Individual Task Performance

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Kellett, Janet B.; Humphrey, Ronald H.; Sleeth, Randall G.

2009-01-01

Purpose: The purpose of this paper is to test the hypothesis that perceived collective efficacy would mediate the effects of self-efficacy on individual task performance. Design/methodology/approach: An assessment center design with 147 participants in 49 three-person groups was used. Findings: It is found that for individuals working on an…

Readiness of healthcare providers for eHealth: the case from primary healthcare centers in Lebanon.

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Saleh, Shadi; Khodor, Rawya; Alameddine, Mohamad; Baroud, Maysa

2016-11-10

eHealth can positively impact the efficiency and quality of healthcare services. Its potential benefits extend to the patient, healthcare provider, and organization. Primary healthcare (PHC) settings may particularly benefit from eHealth. In these settings, healthcare provider readiness is key to successful eHealth implementation. Accordingly, it is necessary to explore the potential readiness of providers to use eHealth tools. Therefore, the purpose of this study was to assess the readiness of healthcare providers working in PHC centers in Lebanon to use eHealth tools. A self-administered questionnaire was used to assess participants' socio-demographics, computer use, literacy, and access, and participants' readiness for eHealth implementation (appropriateness, management support, change efficacy, personal beneficence). The study included primary healthcare providers (physicians, nurses, other providers) working in 22 PHC centers distributed across Lebanon. Descriptive and bivariate analyses (ANOVA, independent t-test, Kruskal Wallis, Tamhane's T2) were used to compare participant characteristics to the level of readiness for the implementation of eHealth. Of the 541 questionnaires, 213 were completed (response rate: 39.4 %). The majority of participants were physicians (46.9 %), and nurses (26.8 %). Most physicians (54.0 %), nurses (61.4 %), and other providers (50.9 %) felt comfortable using computers, and had access to computers at their PHC center (physicians: 77.0 %, nurses: 87.7 %, others: 92.5 %). Frequency of computer use varied. The study found a significant difference for personal beneficence, management support, and change efficacy among different healthcare providers, and relative to participants' level of comfort using computers. There was a significant difference by level of comfort using computers and appropriateness. A significant difference was also found between those with access to computers in relation to personal beneficence and

Motives of Cheating among Secondary Students: The Role of Self-Efficacy and Peer Influence

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Nora, Wong Lok Yan; Zhang, Kaili Chen

2010-01-01

A survey research study was conducted with a sample of 100 secondary students from a local secondary school about the motives of cheating. The primary focus of this study was the interplay among variables of self-efficacy, peer influence and cheating. The results showed that students with low self-efficacy were more likely to cheat than those who…

Effect of sampling and diagnostic effort on the assessment of schistosomiasis and soil-transmitted helminthiasis and drug efficacy: a meta-analysis of six drug efficacy trials and one epidemiological survey.

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Levecke, Bruno; Brooker, Simon J; Knopp, Stefanie; Steinmann, Peter; Sousa-Figueiredo, Jose Carlos; Stothard, J Russell; Utzinger, Jürg; Vercruysse, Jozef

2014-12-01

It is generally recommended to perform multiple stool examinations in order to improve the diagnostic accuracy when assessing the impact of mass drug administration programmes to control human intestinal worm infections and determining efficacy of the drugs administered. However, the collection and diagnostic work-up of multiple stool samples increases costs and workload. It has been hypothesized that these increased efforts provide more accurate results when infection and drug efficacy are summarized by prevalence (proportion of subjects infected) and cure rate (CR, proportion of infected subjects that become egg-negative after drug administration), respectively, but not when these indicators are expressed in terms of infection intensity and egg reduction rate (ERR). We performed a meta-analysis of six drug efficacy trials and one epidemiological survey. We compared prevalence and intensity of infection, CR and ERR based on collection of one or two stool samples that were processed with single or duplicate Kato-Katz thick smears. We found that the accuracy of prevalence estimates and CR was lowest with the minimal sampling effort, but that this was not the case for estimating infection intensity and ERR. Hence, a single Kato-Katz thick smear is sufficient for reporting infection intensity and ERR following drug treatment.

Do Local Contributions Affect the Efficacy of Public Primary Schools?

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Jimenez, Emmanuel; Paqueo, Vicente

1996-01-01

Uses cost, financial sources, and student achievement data from Philippine primary schools (financed primarily from central sources) to discover if financial decentralization leads to more efficient schools. Schools that rely more heavily on local sources (contributions from local school boards, municipal government, parent-teacher associations,…

Women's perceptions of contraceptive efficacy and safety.

Science.gov (United States)

Kakaiya, Roshni; Lopez, Lia L; Nelson, Anita L

2017-01-01

Adoption of contraceptive implants and intrauterine devices has been less than might be expected given their superior efficacy and convenience. The purpose of this study was to assess knowledge and beliefs held by women, which may influence their contraceptive choices and theirongoing utilization of contraceptive methods. English speaking, nonpregnant, reproductive-age women, who were not surgically sterilized, were individually interviewed to obtain limited demographic characteristics and to assess their knowledge about the efficacy of various contraceptive methods in typical use and about the relative safety of oral contraceptives. A convenience sample of 500 women aged 18-45 years, with education levels that ranged from middle school to postdoctoral level was interviewed. The efficacy in typical use of both combined oral contraceptives and male condoms was correctly estimated by 2.2%; over two-thirds of women significantly over estimated the efficacy of each of those methods in typical use. Oral contraceptives were thought to be at least as hazardous to a woman's health as pregnancy by 56% of women. The majority of reproductive aged women surveyed substantially overestimated the efficacy of the two most popular contraceptive methods, often saying that they were 99% effective. Women with higher education levels were most likely to overestimate efficacy of oral contraceptives. Women of all ages and education levels significantly overestimated the health hazards of oral contraceptives compared to pregnancy. Overestimation of effectiveness of these methods of contraception, may contribute to lower adoption of implants and intrauterine devices. When individualizing patient counselling, misperceptions must be identified and addressed with women of all educational backgrounds. Not applicable.

The therapeutic efficacy of propranolol in children with recurrent primary epistaxis

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Bjelakovic, Bojko; Bojanovic, Mila; Lukic, Stevo; Saranac, Ljiljana; Vukomanovic, Vladislav; Prijic, Sergej; Zivkovic, Nikola; Randjelovic, Dusica

2013-01-01

We hypothesized that some characteristics of beta-blockers, including negative inotropic, peripheral vasoconstrictor, and antiangiogenic effects, might be potentially useful in treating children with epistaxis. From June 2010 to March 2012, a total of seven children with recurrent primary epistaxis resistant to conventional management were observed at our institution. An overall effectiveness of propranolol was noted in all seven children when given a dose of 1.5–2 mg/kg/day (divided into three doses) as a second line therapy for terminating epistaxis. Based on our first experience, we believe that propranolol could be a favorable treatment option for patients with primary epistaxis. PMID:23467483

Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems

Directory of Open Access Journals (Sweden)

Simon de Lusignan

2014-02-01

Full Text Available Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user’s preferences. The use of electronic patient record (EPR systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences.

Twelve evidence-based principles for implementing self-management support in primary care.

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Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H

2010-12-01

Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.

Pre-Primary Education and Long-Term Education Performance: Evidence from Programme for International Student Assessment (PISA) Thailand

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Pholphirul, Piriya

2017-01-01

Several research papers have assessed the long-term benefits of pre-primary education in terms of academic performance and labor market outcomes. This study analyzes data obtained from the Programme for International Student Assessment (PISA) to estimate the effects of preschool enrollment of Thai students on producing long-term benefits in their…

CAM therapies among primary care patients using opioid therapy for chronic pain

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Mundt Marlon P

2007-05-01

Full Text Available Abstract Background Complementary and alternative medicine (CAM is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. Method A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Results Patients were treated for a variety of pain problems including low back pain (38.4%, headaches (9.9%, and knee pain (6.5%; the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248, chiropractic treatment (17.8%, n = 162, acupuncture (7.6%, n = 69, yoga (6.1%, n = 55, herbs and supplements (6.8%, n = 62, and prolotherapy (5.9%, n = 54. CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8% and prolotherapy (87.7%, whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. Conclusion This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.

CAM therapies among primary care patients using opioid therapy for chronic pain.

Science.gov (United States)

Fleming, Sara; Rabago, David P; Mundt, Marlon P; Fleming, Michael F

2007-05-16

Complementary and alternative medicine (CAM) is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Patients were treated for a variety of pain problems including low back pain (38.4%), headaches (9.9%), and knee pain (6.5%); the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248), chiropractic treatment (17.8%, n = 162), acupuncture (7.6%, n = 69), yoga (6.1%, n = 55), herbs and supplements (6.8%, n = 62), and prolotherapy (5.9%, n = 54). CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8%) and prolotherapy (87.7%), whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.

Assessment of the anthelmintic efficacy of albendazole in school children in seven countries where soil-transmitted helminths are endemic.

Science.gov (United States)

Vercruysse, Jozef; Behnke, Jerzy M; Albonico, Marco; Ame, Shaali Makame; Angebault, Cécile; Bethony, Jeffrey M; Engels, Dirk; Guillard, Bertrand; Nguyen, Thi Viet Hoa; Kang, Gagandeep; Kattula, Deepthi; Kotze, Andrew C; McCarthy, James S; Mekonnen, Zeleke; Montresor, Antonio; Periago, Maria Victoria; Sumo, Laurentine; Tchuenté, Louis-Albert Tchuem; Dang, Thi Cam Thach; Zeynudin, Ahmed; Levecke, Bruno

2011-03-29

The three major soil-transmitted helminths (STH) Ascaris lumbricoides, Trichuris trichiura and Necator americanus/Ancylostoma duodenale are among the most widespread parasites worldwide. Despite the global expansion of preventive anthelmintic treatment, standard operating procedures to monitor anthelmintic drug efficacy are lacking. The objective of this study, therefore, was to define the efficacy of a single 400 milligram dose of albendazole (ALB) against these three STH using a standardized protocol. Seven trials were undertaken among school children in Brazil, Cameroon, Cambodia, Ethiopia, India, Tanzania and Vietnam. Efficacy was assessed by the Cure Rate (CR) and the Fecal Egg Count Reduction (FECR) using the McMaster egg counting technique to determine fecal egg counts (FEC). Overall, the highest CRs were observed for A. lumbricoides (98.2%) followed by hookworms (87.8%) and T. trichiura (46.6%). There was considerable variation in the CR for the three parasites across trials (country), by age or the pre-intervention FEC (pre-treatment). The latter is probably the most important as it had a considerable effect on the CR of all three STH. Therapeutic efficacies, as reflected by the FECRs, were very high for A. lumbricoides (99.5%) and hookworms (94.8%) but significantly lower for T. trichiura (50.8%), and were affected to different extents among the 3 species by the pre-intervention FEC counts and trial (country), but not by sex or age. Our findings suggest that a FECR (based on arithmetic means) of >95% for A. lumbricoides and >90% for hookworms should be the expected minimum in all future surveys, and that therapeutic efficacy below this level following a single dose of ALB should be viewed with concern in light of potential drug resistance. A standard threshold for efficacy against T. trichiura has yet to be established, as a single-dose of ALB is unlikely to be satisfactory for this parasite. ClinicalTrials.gov NCT01087099.

Improved assessment of gross and net primary productivity of Canada's landmass

Science.gov (United States)

Gonsamo, Alemu; Chen, Jing M.; Price, David T.; Kurz, Werner A.; Liu, Jane; Boisvenue, Céline; Hember, Robbie A.; Wu, Chaoyang; Chang, Kuo-Hsien

2013-12-01

assess Canada's gross primary productivity (GPP) and net primary productivity (NPP) using boreal ecosystem productivity simulator (BEPS) at 250 m spatial resolution with improved input parameter and driver fields and phenology and nutrient release parameterization schemes. BEPS is a process-based two-leaf enzyme kinetic terrestrial ecosystem model designed to simulate energy, water, and carbon (C) fluxes using spatial data sets of meteorology, remotely sensed land surface variables, soil properties, and photosynthesis and respiration rate parameters. Two improved key land surface variables, leaf area index (LAI) and land cover type, are derived at 250 m from Moderate Resolution Imaging Spectroradiometer sensor. For diagnostic error assessment, we use nine forest flux tower sites where all measured C flux, meteorology, and ancillary data sets are available. The errors due to input drivers and parameters are then independently corrected for Canada-wide GPP and NPP simulations. The optimized LAI use, for example, reduced the absolute bias in GPP from 20.7% to 1.1% for hourly BEPS simulations. Following the error diagnostics and corrections, daily GPP and NPP are simulated over Canada at 250 m spatial resolution, the highest resolution simulation yet for the country or any other comparable region. Total NPP (GPP) for Canada's land area was 1.27 (2.68) Pg C for 2008, with forests contributing 1.02 (2.2) Pg C. The annual comparisons between measured and simulated GPP show that the mean differences are not statistically significant (p > 0.05, paired t test). The main BEPS simulation error sources are from the driver fields.

Factor Structure of the Exercise Self-Efficacy Scale

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Cornick, Jessica E.

2015-01-01

The current study utilized exercise self-efficacy ratings from undergraduate students to assess the factor structure of the Self-Efficacy to Regulate Exercise Scale (Bandura, 1997, 2006). An exploratory factor analysis (n = 759) indicated a two-factor model solution and three separate confirmatory factor analyses (n = 1,798) supported this…

Efficacy of basal-bolus insulin regimens in the inpatient management of non-critically ill patients with type 2 diabetes

DEFF Research Database (Denmark)

Christensen, Merete B.; Gotfredsen, Anders; Nørgaard, Kirsten

2017-01-01

Hyperglycemia during hospitalization is associated with increased rates of complications and longer hospital stays. Various insulin regimens are used in the inpatient diabetes management of non-critically ill patients. In this systematic review and meta-analysis, we aimed to assess the efficacy...... with SSI therapy in hospitalized non-critically ill patients with type 2 diabetes. Primary outcome was mean daily blood glucose (BG) during admission. Secondary outcomes were incidence of hypoglycemia and length of hospital stay. Results of included randomized controlled trials (RCT) were pooled and meta......-analysed to provide estimates of the efficacy of BBI therapy. Five RCTs and seven observational studies were included in the review. Meta-analysis of RCTs showed significantly lower mean daily BG with BBI than SSI. Mean difference in daily BG between the two regimens ranged from 14 to 29 mg/dl. BBI therapy...

Primary stability and self-tapping blades: biomechanical assessment of dental implants in medium-density bone.

Science.gov (United States)

Kim, Yung-Soo; Lim, Young-Jun

2011-10-01

The aim of this biomechanical study was to assess the influence of self-tapping blades in terms of primary implant stability between implants with self-tapping blades and implants without self-tapping blades using five different analytic methods, especially in medium-density bone. Two different types of dental implants (4 × 10 mm) were tested: self-tapping and non-self-tapping. The fixture design including thread profiles was exactly the same between the two groups; the only difference was the presence of cutting blades on one half of the apical portion of the implant body. Solid rigid polyurethane blocks with corresponding densities were selected to simulate medium-density bone. Five mechanical assessments (insertion torque, resonance frequency analysis [RFA], reverse torque, pull-out and push in test) were performed for primary stability. Implants without self-tapping blades showed significantly higher values (P0.05). The outcomes of the present study indicate that the implant body design without self-tapping blades has a good primary stability compared with that with self-tapping blades in medium-density bone. Considering the RFA, a distinct layer of cortical bone on marginal bone will yield implant stability quotient values similar to those in medium-bone density when implants have the same diameter. © 2011 John Wiley & Sons A/S.

Assessment for Learning in Norway and Portugal: The Case of Primary School Mathematics Teaching

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Nortvedt, Guri A.; Santos, Leonor; Pinto, Jorge

2016-01-01

In this study, we aim to understand the forces driving assessment for learning (AfL) in primary school teaching. By applying a case study design, including the two cases of Norway and Portugal and using mathematics teaching as an example, available policy documents and research reports are analysed to identify the differences and similarities that…

Mathematics Teaching Anxiety and Self-Efficacy Beliefs toward Mathematics Teaching: A Path Analysis

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Peker, Murat

2016-01-01

The purpose of this study was to investigate the relationship between pre-service primary school teachers' mathematics teaching anxiety and their self-efficacy beliefs toward mathematics teaching through path analysis. There were a total of 250 pre-service primary school teachers involved in this study. Of the total, 202 were female and 48 were…

Efficacy of an integrated hospital-primary care program for heart failure: a population-based analysis of 56,742 patients.

Science.gov (United States)

Comín-Colet, Josep; Verdú-Rotellar, José María; Vela, Emili; Clèries, Montse; Bustins, Montserrat; Mendoza, Lola; Badosa, Neus; Cladellas, Mercè; Ferré, Sofía; Bruguera, Jordi

2014-04-01

The efficacy of heart failure programs has been demonstrated in clinical trials but their applicability in the real world practice setting is more controversial. This study evaluates the feasibility and efficacy of an integrated hospital-primary care program for the management of patients with heart failure in an integrated health area covering a population of 309,345. For the analysis, we included all patients consecutively admitted with heart failure as the principal diagnosis who had been discharged alive from all of the hospitals in Catalonia, Spain, from 2005 to 2011, the period when the program was implemented, and compared mortality and readmissions among patients exposed to the program with the rates in the patients of all the remaining integrated health areas of the Servei Català de la Salut (Catalan Health Service). We included 56,742 patients in the study. There were 181,204 hospital admissions and 30,712 deaths during the study period. In the adjusted analyses, when compared to the 54,659 patients from the other health areas, the 2083 patients exposed to the program had a lower risk of death (hazard ratio=0.92 [95% confidence interval, 0.86-0.97]; P=.005), a lower risk of clinically-related readmission (hazard ratio=0.71 [95% confidence interval, 0.66-0.76]; P<.001), and a lower risk of readmission for heart failure (hazard ratio=0.86 [95% confidence interval, 0.80-0.94]; P<.001). The positive impact on the morbidity and mortality rates was more marked once the program had become well established. The implementation of multidisciplinary heart failure management programs that integrate the hospital and the community is feasible and is associated with a significant reduction in patient morbidity and mortality. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Clinical Efficacy and Safety of Total Glucosides of Paeony for Primary Sjögren’s Syndrome: A Systematic Review

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Liang Jin

2017-01-01

Full Text Available Objective. To evaluate the clinical efficacy and safety of total glucosides of paeony (TGP for primary Sjögren’s syndrome (pSS. Methods. Eight electronic databases were searched from their inception to July 2016. Clinical randomized controlled trials (RCTs were included. The study quality was evaluated according to the standard suggested in the Cochrane Handbook. RevMan 5.1 was used for statistical analysis. Results. Seven RCTs involving 443 patients were included. The results showed that TGP combined with an immunosuppressant (IS showed greater efficacy for improving the saliva flow test of pSS compared to immunosuppressant alone (WMD −6.88, 95% CI −9.02 to −4.74, and P<0.00001. And the same trend favouring TGP-IS dual combination was found in Schirmer test (WMD 1.63, 95% CI 0.26 to 3.01, and P=0.02, ESR (WMD 7.33, 95% CI −10.08 to −4.59, and P<0.00001, CRP (WMD −6.00, 95% CI −7.17 to −4.83, and P<0.00001, IgM (WMD = −0.42, 95% CI −0.70 to 0.13, and P=0.004, and IgG (WMD −3.22, 95% CI −4.32 to −2.12, and P<0.00001 analysis. However, TGP did not affect IgA (WMD 0.53, 95% CI −1.34 to −0.29, and P=0.20. The adverse events manifested no significant differences between the two groups. Conclusions. The TGP-IS combination is superior to IS alone in the treatment of pSS. However, due to the low quality of included studies, high-quality RCTs are needed to confirm the beneficial effects of TGP.

Assessment of the efficacy of desmopressin in treatment of Primary ...

African Journals Online (AJOL)

Farida ElBaz

2015-03-31

Mar 31, 2015 ... Monosymptomatic Nocturnal Enuresis (PMNE) in Egyptian children. Method: The study .... short term memory and a composite score is derived from the area .... to 91%, but only 24.5% of subjects achieved long-term dryness.

Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial.

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Firoozabadi, Mohammad Dehghani; Navabzadeh, Maryam; Roudsari, Mohammad Khodashenas; Zahmatkash, Mohsen

2014-12-01

Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients) and conventional treatment group (30 patients). An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months). Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6) and 32.6 (±12.7) years, respectively (P = 0.45). After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80), frequency of migraine attacks (P = 0.63) and duration of attacks per hours (P = 0.48) were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

Efficacy of complex treatment of glaucoma optical neuropathy by Cortexin

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Shcherbinina I.V.

2010-12-01

Full Text Available The comparative analysis of efficacy of intranasal and intramuscular application of cortexin in combination with transcranial magnetotherapy in patients with primary open-angle glaucoma was conducted. 102 patients (182 eyes took part in research with primary open-angle glaucoma of I, II, III stages. The most considerable improvement of visual functions resulted from intramuscular and endonasal introductions of cortexin in combination with transcranial magnetotherapy; and longer stabilization of functional indicators was marked in this group

Medical student self-efficacy, knowledge and communication in adolescent medicine.

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Woods, Jennifer L; Pasold, Tracie L; Boateng, Beatrice A; Hense, Devon J

2014-08-20

To evaluate student self-efficacy, knowledge and communication with teen issues and learning activities. Data were collected during the 8-week pediatric rotation for third-year medical students at a local children's hospital. Students completed a self-efficacy instrument at the beginning and end of the rotation; knowledge and communication skills were evaluated during standardized patient cases as part of the objective structured clinical examination. Self-efficacy, knowledge and communication frequencies were described with descriptive statistics; differences between groups were also evaluated utilizing two-sample t-tests. Self-efficacy levels of both groups increased by the end of the pediatric rotation, but students in the two-lecture group displayed significantly higher self-efficacy in confidentiality with adolescents (t(35)=-2.543, p=0.02); interviewing adolescents, assessing risk, sexually transmitted infection risk and prevention counseling, contraception counseling were higher with marginal significance. No significant differences were found between groups for communication; assessing sexually transmitted infection risk was marginally significant for knowledge application during the clinical exam. Medical student self-efficacy appears to change over time with effects from different learning methods; this higher self-efficacy may increase future comfort and willingness to work with this high-risk, high-needs group throughout a medical career.

Significance of self-efficacy model in educational work with adolescents

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Milanović-Dobrota Biljana

2012-01-01

Full Text Available The frame of reference in this paper is based on Bandura's concept of self-efficacy. The theory of self-efficacy is based on the importance of subjective experience of personal competence in realizing different goals and tasks, rather than on real knowledge and skills. It supports reciprocal causation according to which a person is observed holistically through dynamic effect of personal factors (cognitive, emotional and biological, factors of the environment and behavior. Development of self-efficacy strongly determines future behavior of a person in achieving goals, since it initiates action, determines the amount of required effort, persistence in facing obstacles, and resilience in unwanted situations. Many different scales are used in assessing selfefficacy (e.g. Children's Self-Efficacy Scale, Parents' Self-Efficacy Scale, Teachers' Self-Efficacy Scale, etc.. They consist of several subscales that can greatly contribute to understanding adolescents and predicting their functioning, depending on the assessed contextual area. Previous researches confirmed the influence of students' selfefficacy on their academic achievements, professional aspirations, and prosocial behavior. In the last couple of years there have been more and more researches which analyze the role of self-efficacy in behavioral disorders, such as peer aggression, cigarette smoking, drug abuse, excessive use of the Internet, etc.

Environmental health assessment of primary schools in southeastern Nigeria: implication for a healthy school environment in developing countries.

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Ezeonu, C T; Anyansi, M N

2010-01-01

In this cross-sectional descriptive study, we used a validated school health program evaluation scale (SHPE) to assess the environmental health status of primary schools in Ebonyi State, southeastern Nigeria. Parameters assessed included water supply, sewage and refuse disposal, school building ventilation, lighting and seating, as well as the availability of toilet tissue, basins for washing hands, regular cleaning of toilets, and so forth. Of all the schools assessed, only two schools, both private, attained the minimum acceptable SHPE score of 57. The mean SHPE score of the private schools (50.40) was significantly higher than that of the public schools (28.69) (t-test, p=.00). Policy reforms are needed that would ensure a healthy primary school environment in Nigeria and in other developing countries with similar settings.

The relationship between maternal self-efficacy and parenting practices: implications for parent training.

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Sanders, M R; Woolley, M L

2005-01-01

The present study examined the relationship between maternal self-efficacy, dysfunctional discipline practices and child conduct problems. Specifically, three levels of self-efficacy, global, domain and task-specific self-efficacy, were assessed in mothers of 2- to 8-year-old children with conduct problems (clinic group, n=45) and non-clinic mothers from the community (non-clinic group, n=79). Measures of global, domain and task-specific self-efficacy were completed by mothers. Clinic mothers reported significantly lower self-efficacy than non-clinic mothers for all but one of the parenting tasks assessed. Both groups of mothers reported lowest self-efficacy for similar parenting tasks. In the sample as a whole self-efficacy measures were significant predictors of maternal discipline style after controlling for other parent, child and risk factors. Of the self-efficacy variables behavioural self-efficacy was the best predictor of mothers discipline style. The findings support the importance of developing parenting strategies that enable parents to generalize their parenting skills to a diverse range of diverse parenting contexts both in the home and in the community.

Entrepreneurial Self-Efficacy of University Students: A Cross-Cultural Study

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Oguz Basol

2017-03-01

Full Text Available The present study investigated the entrepreneurial self-efficacy perceptions among university students across two countries, i.e., Poland and Turkey. Data were obtained through questionnaires designed to assess the perceptions of entrepreneurial self-efficacy. In all, 365 Polish and 278 Turkish students completed the questionnaires. Results indicated that Polish and Turkish students did not differ significantly in regard to the overall measure of entrepreneurial self-efficacy. Our study contributed to the entrepreneurship literature by performing a cross-cultural comparison of the perceptions of entrepreneurial self-efficacy. Thus, it provided recommendations for fostering entrepreneurial self efficacy among university students.

Efficacy and safety of oral alitretinoin in severe oral lichen planus--results of a prospective pilot study.

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Kunz, M; Urosevic-Maiwald, M; Goldinger, S M; Frauchiger, A L; Dreier, J; Belloni, B; Mangana, J; Jenni, D; Dippel, M; Cozzio, A; Guenova, E; Kamarachev, J; French, L E; Dummer, R

2016-02-01

Patients with severe oral lichen planus refractory to standard topical treatment currently have limited options of therapy suitable for long-term use. Oral alitretinoin (9-cis retinoic acid) was never systematically investigated in clinical trials, although case reports suggest its possible efficacy. To assess the efficacy and safety of oral alitretinoin taken at 30 mg once daily for up to 24 weeks in the treatment of severe oral lichen planus refractory to standard topical therapy. We conducted a prospective open-label single arm pilot study to test the efficacy and safety of 30 mg oral alitretinoin once daily for up to 24 weeks in severe oral lichen planus. Ten patients were included in the study. Primary end point was reduction in signs and symptoms measured by the Escudier severity score. Secondary parameters included pain and quality of life scores. Safety parameters were assessed during a follow-up period of 5 weeks. A substantial response at the end of treatment, i.e. >50% reduction in disease severity measured by the Escudier severity score, was apparent in 40% of patients. Therapy was well tolerated. Adverse events were mild and included headache, mucocutaneous dryness, musculoskeletal pain, increased thyroid-stimulating hormone and dyslipidaemia. Alitretinoin given at 30 mg daily reduced disease severity of severe oral lichen planus in a substantial proportion of patients refractory to standard treatment, was well tolerated and may thus represent one therapeutic option for this special group of patients. © 2015 European Academy of Dermatology and Venereology.

The water footprint of energy consumption: an assessment of water requirements of primary energy carriers

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Gerbens-Leenes, P.W.; Hoekstra, A.Y.; Van der Meer, T.H.

2007-01-01

Gerbens-Leenes, P.W., Hoekstra, A.Y., Van der Meer, T.H., 2007. The water footprint of energy consumption: an assessment of water requirements of primary energy carriers. In: proceedings ‘First World Water Sustainability-Renewable Energy Congress and Exhibition’. 25-28 November 2007, Maastricht, the

Preparation and efficacy assessment of malva nut polysaccharide for skin hydrating products.

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Kanlayavattanakul, M; Fungpaisalpong, K; Pumcharoen, M; Lourith, N

2017-11-01

Scaphium scaphigerum or malva nut has long been served in Chinese medicine. However, the use of this herb in modern health care applications has, to date, been rarely reported. Maceration of the herb in water afforded malva nut polysaccharide which was standardized. Safety and skin hydrating efficacy of the polysaccharide and products were evaluated in human volunteers. Malva nut polysaccharide (41.71±0.64%) having 36.58±0.51% total sugar content was isolated, with further analysis quantifying ash, carbohydrate, reducing sugar and moisture contents to be 6.05±0.00, 40.06±1.00, 12.20±0.05 and 12.64±0.31%, respectively. The polysaccharide exhibited swelling and hydrating capacities of 0.46±0.01% and 54.46±0.02g/g, with L*, a* and b* of 52.56±0.04, 9.02±0.06 and 18.42±0.03, respectively, and a viscosity of 1263.00±2.00 cps. Accelerated testing indicated the biopolysaccharide to be stable, resulting in no skin irritation in 15 human volunteers. The skin hydrating efficacy as assessed via a randomized single-blind, placebo-controlled study in 24 volunteers highlighted the superior performance of malva nut over the vehicle (moisture retainment for 70min as examined by Corneometer ® CM 825). A stable skin moisturizing gel containing malva nut was developed and was shown to exhibit improved performance over benchmark tamarind and algae polysaccharide gels (after 180min observation). Malva nut polysaccharide has potential as a key ingredient in skin hydrating products, which should encourage its further development. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Self-Efficacy as Predictor of Collective Self-Efficacy among Preschool Teachers in Turkey

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Arslan, Emel

2017-01-01

This study investigates the effect of preschool teachers' collective self-efficacy. A study group consists of 172 preschool teachers who are working in public preschools affiliated with the Ministry of National Education in different cities of Turkey. In this study, teacher self-efficiency scale is employed to assess professional efficiency…

5 year efficacy of a bivalent killed whole-cell oral cholera vaccine in Kolkata, India: a cluster-randomised, double-blind, placebo-controlled trial.

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Bhattacharya, Sujit K; Sur, Dipika; Ali, Mohammad; Kanungo, Suman; You, Young Ae; Manna, Byomkesh; Sah, Binod; Niyogi, Swapan K; Park, Jin Kyung; Sarkar, Banwarilal; Puri, Mahesh K; Kim, Deok Ryun; Deen, Jacqueline L; Holmgren, Jan; Carbis, Rodney; Dhingra, Mandeep Singh; Donner, Allan; Nair, G Balakrish; Lopez, Anna Lena; Wierzba, Thomas F; Clemens, John D

2013-12-01

Efficacy and safety of a two-dose regimen of bivalent killed whole-cell oral cholera vaccine (Shantha Biotechnics, Hyderabad, India) to 3 years is established, but long-term efficacy is not. We aimed to assess protective efficacy up to 5 years in a slum area of Kolkata, India. In our double-blind, cluster-randomised, placebo-controlled trial, we assessed incidence of cholera in non-pregnant individuals older than 1 year residing in 3933 dwellings (clusters) in Kolkata, India. We randomly allocated participants, by dwelling, to receive two oral doses of modified killed bivalent whole-cell cholera vaccine or heat-killed Escherichia coli K12 placebo, 14 days apart. Randomisation was done by use of a computer-generated sequence in blocks of four. The primary endpoint was prevention of episodes of culture-confirmed Vibrio cholerae O1 diarrhoea severe enough for patients to seek treatment in a health-care facility. We identified culture-confirmed cholera cases among participants seeking treatment for diarrhoea at a study clinic or government hospital between 14 days and 1825 days after receipt of the second dose. We assessed vaccine protection in a per-protocol population of participants who had completely ingested two doses of assigned study treatment. 69 of 31 932 recipients of vaccine and 219 of 34 968 recipients of placebo developed cholera during 5 year follow-up (incidence 2·2 per 1000 in the vaccine group and 6·3 per 1000 in the placebo group). Cumulative protective efficacy of the vaccine at 5 years was 65% (95% CI 52-74; pcholera vaccines. Established long-term efficacy of this vaccine could assist policy makers formulate rational vaccination strategies to reduce overall cholera burden in endemic settings. Bill & Melinda Gates Foundation and the governments of South Korea and Sweden. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of '11+ Kids': A Warm-Up Programme to Prevent Injuries in Children's Football.

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Rössler, Roland; Junge, Astrid; Bizzini, Mario; Verhagen, Evert; Chomiak, Jiri; Aus der Fünten, Karen; Meyer, Tim; Dvorak, Jiri; Lichtenstein, Eric; Beaudouin, Florian; Faude, Oliver

2018-06-01

The objective of this study was to assess the efficacy of a newly developed warm-up programme ('11+ Kids') regarding its potential to reduce injuries in children's football. Children's football teams (under 9 years, under 11 years, and under 13 years age groups) from Switzerland, Germany, the Czech Republic and the Netherlands were invited. Clubs were randomised to an intervention group and a control group, and followed for one season. The intervention group replaced their usual warm-up by '11+ Kids', while the control group warmed up as usual. The primary outcome was the overall risk of football-related injuries. Secondary outcomes were the risks of severe and lower extremity injuries. We calculated hazard ratios using extended Cox models, and performed a compliance analysis. In total, 292,749 h of football exposure of 3895 players were recorded. The mean age of players was 10.8 (standard deviation 1.4) years. During the study period, 374 (intervention group = 139; control group = 235) injuries occurred. The overall injury rate in the intervention group was reduced by 48% compared with the control group (hazard ratio 0.52; 95% confidence interval 0.32-0.86). Severe (74% reduction, hazard ratio 0.26; 95% confidence interval 0.10-0.64) and lower extremity injuries (55% reduction, hazard ratio 0.45; 95% confidence interval 0.24-0.84) were also reduced. Injury incidence decreased with increasing compliance. '11+ Kids' is efficacious in reducing injuries in children's football. We observed considerable effects for overall, severe and lower extremity injuries. The programme should be performed at least once per week to profit from an injury preventive effect. However, two sessions per week can be recommended to further increase the protective benefit. ClinicalTrials.gov identifier: NCT02222025.

Efficacy and Safety of Oritavancin Relative to Vancomycin for Patients with Acute Bacterial Skin and Skin Structure Infections (ABSSSI) in the Outpatient Setting: Results From the SOLO Clinical Trials.

Science.gov (United States)

Lodise, Thomas P; Redell, Mark; Armstrong, Shannon O; Sulham, Katherine A; Corey, G Ralph

2017-01-01

The objective of this analysis was to evaluate the efficacy and safety of oritavancin compared with vancomycin for patients with acute bacterial skin and skin structure infections (ABSSSIs) who received treatment in the outpatient setting in the Phase 3 SOLO clinical trials. SOLO I and SOLO II were 2 identically designed comparative, multicenter, double-blind, randomized studies to evaluate the efficacy and safety of a single 1200-mg dose of intravenous (IV) oritavancin versus 7-10 days of twice-daily IV vancomycin for the treatment of ABSSSI. Protocols were amended to allow enrolled patients to complete their entire course of antimicrobial therapy in an outpatient setting. The primary efficacy outcome was a composite endpoint (cessation of spread or reduction in size of the baseline lesion, absence of fever, and no rescue antibiotic at early clinical evaluation [ECE]) (48 to 72 hours). Key secondary endpoints included investigator-assessed clinical cure 7 to 14 days after end of treatment (posttherapy evaluation [PTE]) and 20% or greater reduction in lesion area at ECE. Safety was assessed until day 60. Seven hundred ninety-two patients (oritavancin, 392; vancomycin, 400) received entire course of treatment in the outpatient setting. Efficacy response rates at ECE and PTE were similar (primary composite endpoint at ECE: 80.4% vs 77.5% for oritavancin and vancomycin, respectively) as was incidence of adverse events. Five patients (1.3%) who received oritavancin and 9 (2.3%) vancomycin patients were subsequently admitted to a hospital. Oritavancin provides a single-dose alternative to multidose vancomycin for treatment of ABSSSI in the outpatient setting. © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Post-marketing assessment of content and efficacy of preservatives in artemisinin-derived antimalarial dry suspensions for paediatric use

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Plaizier-Vercammen Jacqueline

2007-01-01

Full Text Available Abstract Background Artemisinin-derivative formulations are now widely used to treat falciparum malaria. However, the dry powder suspensions developed for children are few and/or are of poor quality. In addition to the active compound, the presence of a suitable preservative in these medicines is essential. In this study, an evaluation of the preservative content and efficacy in some dry suspensions available on the Kenyan market was performed. Method UV spectrophotometry was used to identify the preservatives in each sample while HPLC-UV was used for quantification. After reconstitution of the powders in water, the dissolution of the preservatives was followed for 7 days. Antimicrobial efficacy of the preservatives was assessed by conducting a preservative efficacy test (PET following the European pharmacopoeia standards. Results Four different preservatives were identified namely methylparahydroxybenzoate (MP, propylparahydroxybenzoate (PP, benzoic acid and sorbic acid. MP and PP were identified in Artesiane® (artemether 300 mg/100 ml, Alaxin® (dihydroartemisinin 160 mg/80 ml andGvither ® (artemether 300 mg/100 ml respectively. Sorbic acid was presentin Artenam® (artemether 180 mg/60 ml while benzoic acid was identified in Santecxin® (dihydroartemisinin 160 mg/80 ml andArtexin® (dihydroartemisinin 160 mg/80 ml respectively. Cotecxin® (dihydroartemisinin 160 mg/80 ml did not contain any of the above preservatives. After reconstitution in water, preservativesin 50%(3/6 of the products did not completely dissolve and the PET results revealed that only Artenam® and Gvither® met the requirements for antimicrobial efficacy. The other products did not conform. Conclusion These results show that paediatric antimalarial dry powder formulations on the market may contain ineffective or incorrect amounts of preservatives. This is a potential risk to the patient. Studies conducted on the dry powder suspensions should include the analysis of both

Interactive virtual reality Wii in geriatric day hospital: a study to assess its feasibility, acceptability and efficacy.

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Chan, Tuen Ching; Chan, Fei; Shea, Yat Fung; Lin, Oi Yee; Luk, James Ka Hay; Chan, Felix Hon Wai

2012-10-01

Rehabilitation using interactive virtual reality Wii (Wii-IVR) was shown to be feasible in patients with different medical problems, but there was no study examining its use in a geriatric day hospital (GDH). The aim of the present study was to test the feasibility, acceptability and efficacy of Wii-IVR in GDH. It was a clinical trial with matched historic controls. Patients of a GDH were recruited to participate in Wii-IVR by playing "Wii Fit". Participants used a Wii controller to carry out movements involved in an arm ergometer. Each participant received eight sessions of Wii-IVR in addition to conventional GDH rehabilitation. Feasibility was assessed by the total time receiving Wii-IVR, the percentage of maximal heart rate reserve (%MHR) and Borg perceived exertion scale (BS) after participating in Wii-IVR. %MHR and BS were compared with those after carrying out an arm ergometer for the same duration. Acceptability was assessed by an interviewer-administered questionnaire. Efficacy was assessed by comparing improvements in Functional Independence Measure (FIM) between participants and matched historic controls, who received conventional GDH rehabilitations only. A total of 30 patients completed the study. Participants completed a total of 1941 min of event-free Wii-IVR. The mean %MHR was 15.9% ± 9.9% and the mean BS was 7.9 ± 2.3. There was no significant difference in %MHR and BS between participating in Wii-IVR and arm ergometer. Most participants found Wii-IVR similar to the arm ergometer, and would like to continue Wii-IVR if they had Wii at home. Improvements in FIM of participants were significantly more than that of historic controls. Wii-IVR in GDH was feasible and most participants accepted it. Participants had more improvements in FIM. © 2012 Japan Geriatrics Society.

Exercise self-efficacy intervention in overweight and obese women.

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Buckley, Jude

2016-06-01

This study investigated the effects of a brief tailored intervention on self-efficacy beliefs and exercise energy expenditure in active and inactive overweight and obese women. Participants were randomly assigned to either control (N = 50) or intervention (N = 47) conditions, and their exercise self-efficacy was assessed three times over a 12-week period. Results showed that the intervention increased schedule, physical, exercise-worries efficacy, and energy expenditure in the previously inactive group. The results suggest that self-efficacy interventions are effective at increasing exercise energy expenditure in inactive overweight and obese women. © The Author(s) 2014.

Efficacy of a Low-Cost, Heat-Stable Oral Rotavirus Vaccine in Niger.

Science.gov (United States)

Isanaka, Sheila; Guindo, Ousmane; Langendorf, Celine; Matar Seck, Amadou; Plikaytis, Brian D; Sayinzoga-Makombe, Nathan; McNeal, Monica M; Meyer, Nicole; Adehossi, Eric; Djibo, Ali; Jochum, Bruno; Grais, Rebecca F

2017-03-23

Each year, rotavirus gastroenteritis is responsible for about 37% of deaths from diarrhea among children younger than 5 years of age worldwide, with a disproportionate effect in sub-Saharan Africa. We conducted a randomized, placebo-controlled trial in Niger to evaluate the efficacy of a live, oral bovine rotavirus pentavalent vaccine (BRV-PV, Serum Institute of India) to prevent severe rotavirus gastroenteritis. Healthy infants received three doses of the vaccine or placebo at 6, 10, and 14 weeks of age. Episodes of gastroenteritis were assessed through active and passive surveillance and were graded on the basis of the score on the Vesikari scale (which ranges from 0 to 20, with higher scores indicating more severe disease). The primary end point was the efficacy of three doses of vaccine as compared with placebo against a first episode of laboratory-confirmed severe rotavirus gastroenteritis (Vesikari score, ≥11) beginning 28 days after dose 3. Among the 3508 infants who were included in the per-protocol efficacy analysis, there were 31 cases of severe rotavirus gastroenteritis in the vaccine group and 87 cases in the placebo group (2.14 and 6.44 cases per 100 person-years, respectively), for a vaccine efficacy of 66.7% (95% confidence interval [CI], 49.9 to 77.9). Similar efficacy was seen in the intention-to-treat analyses, which showed a vaccine efficacy of 69.1% (95% CI, 55.0 to 78.7). There was no significant between-group difference in the risk of adverse events, which were reported in 68.7% of the infants in the vaccine group and in 67.2% of those in the placebo group, or in the risk of serious adverse events (in 8.3% in the vaccine group and in 9.1% in the placebo group); there were 27 deaths in the vaccine group and 22 in the placebo group. None of the infants had confirmed intussusception. Three doses of BRV-PV, an oral rotavirus vaccine, had an efficacy of 66.7% against severe rotavirus gastroenteritis among infants in Niger. (Funded by M�