WorldWideScience

Sample records for primary efficacy measure

  1. Development and Application of an Instrument to Measure Greek Primary Education Teachers' Biology Teaching Self-Efficacy Beliefs

    Science.gov (United States)

    Mavrikaki, Evangelia; Athanasiou, Kyriacos

    2011-01-01

    The self-efficacy beliefs of in-service elementary school teachers in Greece were examined in an attempt to evaluate their biology teaching skills. For this purpose, we constructed a valid and reliable instrument consisting of a Likert-type questionnaire that was distributed to the target population and to which 202 teachers responded. Results…

  2. Measuring School Psychology Trainee Self-Efficacy

    Science.gov (United States)

    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…

  3. Primary headaches interfere with the efficacy of temporomandibular disorders management.

    Science.gov (United States)

    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.

  4. Primary headaches interfere with the efficacy of temporomandibular disorders management

    Directory of Open Access Journals (Sweden)

    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.

  5. Tumor Necrosis Factor Inhibitor Primary Failure Predicts Decreased Ustekinumab Efficacy in Psoriasis Patients.

    Science.gov (United States)

    Sorensen, Eric P; Fanucci, Kristina A; Saraiya, Ami; Volf, Eva; Au, Shiu-chung; Argobi, Yahya; Mansfield, Ryan; Gottlieb, Alice B

    2015-08-01

    Additional studies are needed to examine the efficacy of ustekinumab in psoriasis patients who have previously been exposed to tumor necrosis factor inhibitors (TNFi). To examine the predictive effect of TNFi primary failure and the number of TNFi exposures on the efficacy of ustekinumab in psoriasis treatment. This retrospective study examined 44 psoriasis patients treated at the Tufts Medical Center Department of Dermatology between January 2008 and July 2014. Patients were selected if they were treated with ustekinumab and had ≥ 1 previous TNFi exposure. The following subgroups were compared: patients with vs without a previous TNFi primary failure, and patients with one vs multiple previous TNFi exposures. The efficacy measure used was the previously validated Simple Measure for Assessing Psoriasis Activity (S-MAPA), which is calculated by the product of the body surface area and physician global assessment. The primary outcome was the percentage improvement S-MAPA from course baseline at week 12 of ustekinumab treatment. Secondary outcomes were the psoriasis clearance, primary failure, and secondary failure rates with ustekinumab treatment. Patients with a previous TNFi primary failure had a significantly lower percentage improvement in S-MAPA score at week 12 of ustekinumab treatment compared with patients without TNFi primary failure (36.2% vs 61.1%, P=.027). Multivariate analysis demonstrated that this relationship was independent of patient demographics and medical comorbidities. Patients with multiple TNFi exposures had a non-statistically significant lower percentage S-MAPA improvement at week 12 (40.5% vs 52.9%, P=.294) of ustekinumab treatment compared with patients with a single TNFi exposure. Among psoriasis patients previously exposed to TNFi, a history of a previous TNFi primary failure predicts a decreased response to ustekinumab independent of patient demographics and medical comorbidities.

  6. Primary School Teacher Perceived Self-Efficacy to Teach Fundamental Motor Skills

    Science.gov (United States)

    Callea, Micarle B.; Spittle, Michael; O'Meara, James; Casey, Meghan

    2008-01-01

    Fundamental Movement Skills (FMS) are a part of the school curricula, yet many Australian primary-age children are not mastering FMS. One reason may be a lack of perceived self-efficacy of primary teachers to teach FMS. This study investigated the level of perceived self-efficacy of primary school teachers to teach FMS in Victoria, Australia. A…

  7. 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

  8. Changes in Science Teaching Self-Efficacy among Primary Teacher Education Students

    Science.gov (United States)

    Palmer, David; Dixon, Jeanette; Archer, Jennifer

    2015-01-01

    Many preservice primary teachers have low self-efficacy for science teaching. Although science methods courses have often been shown to enhance self-efficacy, science content courses have been relatively ineffective in this respect. This study investigated whether a tailored science content course would enhance self-efficacy. The participants were…

  9. Teacher Training and Pre-Service Primary Teachers' Self-Efficacy for Science Teaching

    Science.gov (United States)

    Velthuis, Chantal; Fisser, Petra; Pieters, Jules

    2014-01-01

    This study focuses on the improvement of pre-service teachers' self-efficacy for teaching science by including science courses within the teacher training program. Knowing how efficacy beliefs change over time and what factors influence the development by pre-service primary teachers of positive science teaching efficacy beliefs may be useful for…

  10. Influencing Science Teaching Self-Efficacy Beliefs of Primary School Teachers: A Longitudinal Case Study

    Science.gov (United States)

    McKinnon, Merryn; Lamberts, Rod

    2014-01-01

    The science teaching self-efficacy beliefs of primary school teachers influence teaching practice. The purpose of this research was to determine if informal education institutions, such as science centres, could provide professional development that influences the science teaching self-efficacy beliefs of pre-service and in-service primary school…

  11. Measuring teachers’ interpersonal self-efficacy: relationship with realized interpersonal aspirations, classroom management efficacy and age

    NARCIS (Netherlands)

    Veldman, Ietje; Admiraal, Wilfried; Mainhard, Tim; Wubbels, Theo; Van Tartwijk, Jan

    2017-01-01

    In this study, we present the development and validation of an instrument for measuring teachers’ interpersonal self-efficacy: the Questionnaire on Teacher Interaction-Self-Efficacy (QTI-SE). We used the Questionnaire on Teacher Interaction as a basis to construct items. Current scales on teacher

  12. Teacher Training and Pre-service Primary Teachers’ Self-Efficacy for Science Teaching

    NARCIS (Netherlands)

    Velthuis, C.H.; Fisser, Petra; Pieters, Julius Marie

    2014-01-01

    This study focuses on the improvement of pre-service teachers’ self-efficacy for teaching science by including science courses within the teacher training program. Knowing how efficacy beliefs change over time and what factors influence the development by pre-service primary teachers of positive

  13. The Efficacy of Zinc Administration in the Treatment of Primary Dysmenorrhea

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Do Local Contributions Affect the Efficacy of Public Primary Schools?

    Science.gov (United States)

    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,…

  16. Primary Education Teachers' Self-Efficacy Beliefs for Teaching Geography Lessons

    Science.gov (United States)

    Bent, Gert Jan; Bakx, Anouke; den Brok, Perry

    2017-01-01

    This study was carried out to investigate the primary education teachers' self-efficacy regarding geography education, their beliefs regarding the classroom learning environment, and how these beliefs were related to each other and to teachers' background characteristics. Questionnaire data were collected from 489 Dutch primary school teachers.…

  17. Dignity Impact as a Primary Outcome Measure for Dignity Therapy.

    Science.gov (United States)

    Scarton, Lisa; Oh, Sungho; Sylvera, Ashley; Lamonge, Ralph; Yao, Yingwei; Chochinov, Harvey; Fitchett, George; Handzo, George; Emanuel, Linda; Wilkie, Diana

    2018-01-01

    Feasibility of dignity therapy (DT) is well established in palliative care. Evidence of its efficacy, however, has been inconsistent and may stem from DT's primary effects differing from the outcomes measured in previous studies. We proposed that DT effects were in the spiritual domain and created a new outcome measure, Dignity Impact Scale (DIS), from items previously used in a large randomized controlled trial (RCT). The purpose of this secondary analysis study was to examine properties of a new measure of dignity impact. Using the DIS, we conducted reanalysis of posttest data from a large 3-arm, multi-site RCT study. Participants were receiving hospice/palliative care (n = 326, 50.6% female, mean age = 65.1 years, 89.3% white, all with a terminal illness with 6 months or less life expectancy). They had been randomized to standard palliative care (n = 111), client-centered care (n = 107), or DT (n = 108). The 7-item DIS was derived from selected items in a posttest DT Patient Feedback Questionnaire. The DIS had strong internal consistency (α = 0.85). The DT group mean DIS score (21.4 ± 5.0) was significantly higher than the usual care group mean score (17.7 ± 5.5; t = 5.2, df = 216, P death, and life completion tasks. We propose that the DIS be used as the primary outcome measure in evaluating the effects of DT.

  18. From Students to Teachers: Investigating the Science Teaching Efficacy Beliefs and Experiences of Graduate Primary Teachers

    Science.gov (United States)

    Deehan, James; Danaia, Lena; McKinnon, David H.

    2018-03-01

    The science achievement of primary students, both in Australia and abroad, has been the subject of intensive research in recent decades. Consequently, much research has been conducted to investigate primary science education. Within this literature, there is a striking juxtaposition between tertiary science teaching preparation programs and the experiences and outcomes of both teachers and students alike. Whilst many tertiary science teaching programs covary with positive outcomes for preservice teachers, reports of science at the primary school level continue to be problematic. This paper begins to explore this apparent contradiction by investigating the science teaching efficacy beliefs and experiences of a cohort of graduate primary teachers who had recently transitioned from preservice to inservice status. An opportunity sample of 82 primary teachers responded to the science teaching efficacy belief instrument A (STEBI-A), and 10 graduate teachers provided semi-structured interview data. The results showed that participants' prior science teaching efficacy belief growth, which occurred during their tertiary science education, had remained durable after they had completed their teaching degrees and began their careers. Qualitative data showed that their undergraduate science education had had a positive influence on their science teaching experiences. The participants' school science culture, however, had mixed influences on their science teaching. The findings presented within this paper have implications for the direction of research in primary science education, the design and assessment of preservice primary science curriculum subjects and the role of school contexts in the development of primary science teachers.

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

    Science.gov (United States)

    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.

  20. The Efficacy of Stuttering Measurement Training: Evaluating Two Training Programs

    Science.gov (United States)

    Bainbridge, Lauren A.; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J.

    2015-01-01

    Purpose: Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Method: Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of…

  1. Turkish Preservice Primary School Teachers' Science Teaching Efficacy Beliefs and Attitudes toward Science: The Effect of a Primary Teacher Education Program

    Science.gov (United States)

    Bayraktar, Sule

    2011-01-01

    The main purpose of this study was to investigate the effectiveness of a primary teacher education program in improving science teaching efficacy beliefs (personal science teaching efficacy beliefs and outcome expectancy beliefs) of preservice primary school teachers. The study also investigated whether the program has an effect on student…

  2. Primary education teachers' self-efficacy beliefs for teaching geography lessons

    NARCIS (Netherlands)

    Bent, G.J.W.; Bakx, A.W.E.A.; den Brok, P.J.

    2017-01-01

    This study was carried out to investigate the primary education teachers' self-efficacy regarding geography education, their beliefs regarding the classroom learning environment, and how these beliefs were related to each other and to teachers' background characteristics. Questionnaire data were

  3. Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad

    Directory of Open Access Journals (Sweden)

    Gomes Natalie

    2007-02-01

    Full Text Available Abstract Background The increasing global popularity of herbal remedies requires further investigation to determine the probable factors driving this burgeoning phenomenon. We propose that the users' perception of efficacy is an important factor and assessed the perceived efficacy of herbal remedies by users accessing primary health facilities throughout Trinidad. Additionally, we determined how these users rated herbal remedies compared to conventional allopathic medicines as being less, equally or more efficacious. Methods A descriptive cross-sectional study was undertaken at 16 randomly selected primary healthcare facilities throughout Trinidad during June-August 2005. A de novo, pilot-tested questionnaire was interviewer-administered to confirmed herbal users (previous or current. Stepwise multiple regression analysis was done to determine the influence of predictor variables on perceived efficacy and comparative efficacy with conventional medicines. Results 265 herbal users entered the study and cited over 100 herbs for the promotion of health/wellness and the management of specific health concerns. Garlic was the most popular herb (in 48.3% of the sample and was used for the common cold, cough, fever, as 'blood cleansers' and carminatives. It was also used in 20% of hypertension patients. 230 users (86.8% indicated that herbs were efficacious and perceived that they had equal or greater efficacy than conventional allopathic medicines. Gender, ethnicity, income and years of formal education did not influence patients' perception of herb efficacy; however, age did (p = 0.036. Concomitant use of herbs and allopathic medicines was relatively high at 30%; and most users did not inform their attending physician. Conclusion Most users perceived that herbs were efficacious, and in some instances, more efficacious than conventional medicines. We suggest that this perception may be a major contributing factor influencing the sustained and increasing

  4. Measuring Collective Efficacy: A Multilevel Measurement Model for Nested Data

    Science.gov (United States)

    Matsueda, Ross L.; Drakulich, Kevin M.

    2016-01-01

    This article specifies a multilevel measurement model for survey response when data are nested. The model includes a test-retest model of reliability, a confirmatory factor model of inter-item reliability with item-specific bias effects, an individual-level model of the biasing effects due to respondent characteristics, and a neighborhood-level…

  5. Measuring and Supporting Pre-Service Teachers' Self-Efficacy towards Computers, Teaching, and Technology Integration

    Science.gov (United States)

    Killi, Carita; Kauppinen, Merja; Coiro, Julie; Utriainen, Jukka

    2016-01-01

    This paper reports on two studies designed to examine pre-service teachers' self-efficacy beliefs. Study I investigated the measurement properties of a self-efficacy beliefs questionnaire comprising scales for computer self-efficacy, teacher self-efficacy, and self-efficacy towards technology integration. In Study I, 200 pre-service teachers…

  6. The Development of a Leadership Self-Efficacy Measure

    Science.gov (United States)

    2010-03-01

    ix  I. Introduction ......................................................................................................................1...DEVELOPMENT OF A LEADERSHIP SELF-EFFICACY MEASURE I. Introduction Understanding why some people are more effective leaders than others has been a topic...Relationships and Their Conswquences." Academy of  Mangement  Review (2005): 96‐112.  Hoyle, R. H. "Confirmatory factor analysis." Brown, H.E.A. Tinsley

  7. Outcome measures for primary Sjogren's syndrome

    NARCIS (Netherlands)

    Seror, Raphaele; Bootsma, Hendrika; Bowman, Simon J.; Doerner, Thomas; Gottenberg, Jacques-Eric; Mariette, Xavier; Ramos-Casals, Manel; Ravaud, Philippe; Theander, Elke; Tzioufas, Athanasios; Vitali, Claudio

    Lymphocytic infiltration of different exocrine and non-exocrine epithelia is the pathological hallmark of primary Sjogren's syndrome, whereas involvement of salivary and lachrymal glands with the clinical counterpart of dry eye and dry mouth are the predominant features of the disease, together with

  8. 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.

  9. A Template Analysis of Writing Self-Efficacy Measures.

    Science.gov (United States)

    Mitchell, Kim M; Rieger, Kendra L; McMillan, Diana E

    2017-08-01

    This investigation reviews the item content of writing selfefficacy (WSE) measures developed for undergraduate students. Bandura's self-efficacy theory and a writing theory by Flower and Hayes informed the a priori themes used to develop a template of WSE categories critical to the concept. Articles describing WSE measures were identified through Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Education Resources Information Center (ERIC), PubMed, Scopus, and Google Scholar (1984-2015). A template analysis method was used to analyze 182 individual items present on 11 WSE instruments. A nursing perspective was applied. The analysis identified 16 categories influencing WSE as well as gaps in current measurement items. The theoretical examination of WSE is the first step toward the development of a WSE measure specific to the nursing context and contributes to nursing education by advancing the measurement of WSE.

  10. From efficacy to effectiveness and beyond: what next for brief interventions in primary care?

    Directory of Open Access Journals (Sweden)

    Amy eO'Donnell

    2014-08-01

    Full Text Available Background: Robust evidence supports the effectiveness of screening and brief alcohol interventions in primary healthcare. However lack of understanding about their ‘active ingredients’ and concerns over the extent to which current approaches remain faithful to their original theoretical roots, has led some to demand a cautious approach to future roll-out pending further research. Against this background, this paper provides a timely overview of the development of the brief alcohol intervention evidence base in order to assess the extent to which it has achieved the four key levels of intervention research: efficacy; effectiveness; implementation; and demonstration.Methods: Narrative overview based on:(1 results of a review of systematic reviews and meta-analyses of the effectiveness of brief alcohol intervention in primary healthcare;(2 synthesis of the findings of key additional primary studies on the improvement and evaluation of brief alcohol intervention implementation in routine primary healthcare.Results: The brief intervention field seems to constitute an almost perfect example of the evaluation of a complex intervention. Early evaluations of screening and brief intervention approaches included more tightly controlled efficacy trials and have been followed by more pragmatic trials of effectiveness in routine clinical practice. Most recently, attention has shifted to dissemination, implementation and wider-scale roll-out. However, delivery in routine primary health remains inconsistent, with an identified knowledge gap around how to successfully embed brief alcohol intervention approaches in mainstream care, and as yet unanswered questions concerning what specific intervention component prompt the positive changes in alcohol consumption.Conclusion: Both the efficacy and effectiveness of brief alcohol interventions have been comprehensively demonstrated, and intervention effects seem replicable and stable over time, and across

  11. Creating a measure of portion control self-efficacy.

    Science.gov (United States)

    Fast, Lindsey C; Harman, Jennifer J; Maertens, Julie A; Burnette, Jeni L; Dreith, Francesca

    2015-01-01

    Over the last few decades, food portion sizes have steadily increased by as much as 700% (Young & Nestle, 2002). Food portions are often much larger than dietary guidelines recommend, leaving individuals to manage their food consumption on their own and making it necessary to understand individual factors impacting food consumption. In the current paper, we focus on self-efficacy for portion control. Specifically, across three studies, we developed and validated a new measure of portion control self-efficacy (PCSE). The PCSE measure yielded good fit statistics and had acceptable test-retest reliability using two cross-sectional surveys (Studies 1(a) and 1(b)). Results from Study 2 demonstrated construct and predictive validity of the PCSE using the Food Amount Rating Scale (FARS; Dohm, & Striegel-Moore, 2002). Study 3 offered additional support for reliability and validity with a sample of overweight and obese adults currently trying to lose weight. Overall, findings indicate that the new PCSE measure is reliable and valid. Individuals often make inaccurate food portion estimates (Slawson & Eck, 1997; Yuhas, Bolland, & Bolland, 1989) which can lead to overeating and weight-gain. Thus, the discussion centers on the need to incorporate PCSE in future research and intervention work targeting weight loss, health, and food consumption. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Data assimilation and PWR primary measurement

    International Nuclear Information System (INIS)

    Mercier, Thibaud

    2015-01-01

    A Pressurized Water Reactor (PWR) Reactor Coolant System (RCS) is a highly complex physical process: heterogeneous power, flow and temperature distributions are difficult to be accurately measured, since instrumentations are limited in number, thus leading to the relevant safety and protection margins. EDF R and D is seeking to assess the potential benefits of applying Data Assimilation to a PWR's RCS (Reactor Coolant System) measurements, in order to improve the estimators for parameters of a reactor's operating setpoint, i.e. improving accuracy and reducing uncertainties and biases of measured RCS parameters. In this thesis, we define a 0D semi-empirical model for RCS, satisfying the description level usually chosen by plant operators, and construct a Monte-Carlo Method (inspired from Ensemble Methods) in order to use this model with Data Assimilation tools. We apply this method on simulated data in order to assess the reduction of uncertainties on key parameters: results are beyond expectations, however strong hypothesis are required, implying a careful preprocessing of input data. (author)

  13. 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

  14. 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.

  15. 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

  16. The efficacy of viscocanalostomy for uncontrollable primary open-angle glaucoma in a developing country

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  19. 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.)

  20. Psychometric properties of the exercise self-efficacy scale in Dutch primary care patients with type 2 diabetes mellitus

    NARCIS (Netherlands)

    van der Heijden, M.M.P.; Pouwer, F.; Pop, V.J.M.

    2014-01-01

    Background Excercise self-efficacy is believed to influence physical activity bahavior. Purpose The purpose of this study is to assess the psychometric aspects of the Exercise Self-efficacy Scale (ESS) in a type 2 diabetes Dutch Primary care sample. Method Type 2 diabetes patients (n = 322; <80

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

    Science.gov (United States)

    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…

  2. Using Video Feedback to Measure Self-Efficacy

    Science.gov (United States)

    Bobo, Linda; Andrews, Amanda

    2010-01-01

    When a student has a high sense of self-efficacy, foreseeing success and providing positive guides and supports for performing the skill will usually occur. A low self-efficacy tends to predict failure and anticipation of what could go wrong. Videotape feedback provided to students has reported favorable outcomes. Self-efficacy could alter…

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. The efficacy of stuttering measurement training: evaluating two training programs.

    Science.gov (United States)

    Bainbridge, Lauren A; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J

    2015-04-01

    Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of stuttering events on eight 3-min audiovisual speech samples from adults and children who stutter. Stuttering judgment training involved use of either the Stuttering Measurement System (SMS), Stuttering Measurement Assessment and Training (SMAAT) programs, or no training. To test for the reliability of any training effect, SMS training was repeated with the 4th group. Both SMS-trained groups produced approximately 34% improvement, significantly better than no training or the SMAAT program. The SMAAT program produced a mixed result. The SMS program was shown to produce a "medium" effect size improvement in the accuracy of stuttering event counts, and this improvement was almost perfectly replicated in a 2nd group. Half of the SMAAT judges produced a 36% improvement in accuracy, but the other half showed no improvement. Additional studies are needed to demonstrate the durability of the reported improvements, but these positive effects justify the importance of stuttering measurement training.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  8. The flow measurement plan for the primary system of SMART

    International Nuclear Information System (INIS)

    Lee, Jun; Seo, J. K.; Park, C. T.; Yoon, J. H.; Cho, B. H.; Lee, D. J.

    2001-08-01

    It is the common features of the integrated reactor that the main components of the primary system are installed within the reactor vessel, and so there are no any flow pipes connecting the reactor coolant pumps or steam generators. Due to no any flow pipes, it is impossible to measure the differential pressure at the primary system of the integrated reactor, and it also makes impossible measure the primary coolant flow rate. SMART is also a integrated reactor type, and have a problem as same as the above case. The objective of the study is to draw up the flow measurement plan for the primary system of SMART. In this study, firstly we reviewed the flow measurement methods at the primary system for the existing commercial nuclear power reactors. As a result of the review, we selected preliminarily the 3 methods which is a good possibility of application to SMART. The 3 methods are as follows. Flow measurement method by MCP rotation speed, flow measurement method by HBM, flow measurement method by pump motor power. For the above methods, we have evaluated whether they actually can be applied to SMART, and also have set up the concrete methodology. Finally we have made a selection of the above methods as the flow measurement plan for the primary system of SMART. Peculiarly, we did not found out a precedent which the direct pump motor power-flow rate curve is used as the flow measurement method in the existing commercial nuclear power reactors. Therefore, to use this method for SMART, it is needed to bear the follow-up measures in mind. The follow-up measures is included in this report

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

    Science.gov (United States)

    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…

  10. 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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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…

  13. 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.

  14. Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure

    Directory of Open Access Journals (Sweden)

    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.

  15. Temporal acoustic measures distinguish primary progressive apraxia of speech from primary progressive aphasia.

    Science.gov (United States)

    Duffy, Joseph R; Hanley, Holly; Utianski, Rene; Clark, Heather; Strand, Edythe; Josephs, Keith A; Whitwell, Jennifer L

    2017-05-01

    The purpose of this study was to determine if acoustic measures of duration and syllable rate during word and sentence repetition, and a measure of within-word lexical stress, distinguish speakers with primary progressive apraxia of speech (PPAOS) from nonapraxic speakers with the agrammatic or logopenic variants of primary progressive aphasia (PPA), and control speakers. Results revealed that the PPAOS group had longer durations and reduced rate of syllable production for most words and sentences, and the measure of lexical stress. Sensitivity and specificity indices for the PPAOS versus the other groups were highest for longer multisyllabic words and sentences. For the PPAOS group, correlations between acoustic measures and perceptual ratings of AOS were moderately high to high. Several temporal measures used in this study may aid differential diagnosis and help quantify features of PPAOS that are distinct from those associated with PPA in which AOS is not present. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Growth Trajectories of Exercise Self-Efficacy in Older Adults: Influence of Measures and Initial Status

    Science.gov (United States)

    McAuley, Edward; Mailey, Emily L.; Mullen, Sean P.; Szabo, Amanda N.; Wójcicki, Thomas R.; White, Siobhan M.; Gothe, Neha; Olson, Erin A.; Kramer, Arthur F.

    2012-01-01

    Objective This study examines differential trajectories of exercise-related self-efficacy beliefs across a 12-month randomized controlled exercise trial. Methods Previously inactive older adults (N = 144; M age = 66.5) were randomly assigned to one of two exercise conditions (walking, flexibility-toning-balance) and completed measures of barriers self-efficacy (BARSE), exercise self-efficacy (EXSE), and self-efficacy for walking (SEW) across a 12-month period. Changes in efficacy were examined according to efficacy type and inter-individual differences. Latent growth curve modeling was employed to (a) examine average levels and change in each type of efficacy for the collapsed sample and by intervention condition, and (b) explore subpopulations (i.e., latent classes) within the sample that differ in their baseline efficacy and trajectory. Results Analyses revealed two negative trends in BARSE and EXSE at predicted transition points, in addition to a positive linear trend in SEW. Two subgroups with unique baseline efficacy and trajectory profiles were also identified. Conclusions These results shed new light on the relationship between exercise and self-efficacy in older adults, and highlight the need for strategies for increasing and maintaining efficacy within interventions, namely targeting participants who start with a disadvantage (lower efficacy) and integrating efficacy-boosting strategies for all participants prior to program end. PMID:21038962

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Kinematic Measures of Imitation Fidelity in Primary School Children

    Science.gov (United States)

    Williams, Justin H. G.; Casey, Jackie M.; Braadbaart, Lieke; Culmer, Peter R.; Mon-Williams, Mark

    2014-01-01

    We sought to develop a method for measuring imitation accuracy objectively in primary school children. Children imitated a model drawing shapes on the same computer-tablet interface they saw used in video clips, allowing kinematics of model and observers' actions to be directly compared. Imitation accuracy was reported as a correlation reflecting…

  4. Measuring ICT Use and Contributing Conditions in Primary Schools

    Science.gov (United States)

    Vanderlinde, Ruben; Aesaert, Koen; van Braak, Johan

    2015-01-01

    Information and communication technology (ICT) use became of major importance for primary schools across the world as ICT has the potential to foster teaching and learning processes. ICT use is therefore a central measurement concept (dependent variable) in many ICT integration studies. This data paper presents two datasets (2008 and 2011) that…

  5. Comparison of antibacterial efficacy of intracanal medicaments in multiple visit pulpectomies in primary molars-an in vivo study

    Directory of Open Access Journals (Sweden)

    Lele G

    2010-03-01

    Full Text Available Antibacterial efficacy of formocresol, 2% gluteraldehyde and iodine-potassium iodide was assessed by obtaining cultures at consecutive appointments in multiple visit pulpectomies in primary molars. Formocresol and 2% gluteraldehyde were more effective as intracanal medicaments and caused significant reduction in the counts of aerobic and anaerobic microorganisms, thereby supporting the need for placing intracanal medicaments with antibacterial properties, in multiple visit pulpectomies in primary molars.

  6. Measuring University Students' Perceived Self-Efficacy in Science Communication in Middle and High Schools

    Science.gov (United States)

    Chi, Shaohui; Liu, Xiufeng; Gardella, Joseph A.

    2016-01-01

    Service learning typically involves university students in teaching and learning activities for middle and high school students, however, measurement of university students' self-efficacy in science communication is still lacking. In this study, an instrument to measure university students' perceived self-efficacy in communicating science to…

  7. Randomized Clinical Trial to Assess the Efficacy of Radiotherapy in Primary Mediastinal Large B-Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Aviles, Agustin, E-mail: agustin.aviles@imss.gob.mx [Oncology Research Unit, Oncology Hospital, National Medical Center, IMSS, Mexico, D. F. (Mexico); Neri, Natividad [Department of Hematology, Oncology Hospital, National Medical Center, IMSS, Mexico, D. F. (Mexico); Fernandez, Raul [Department of Radiation Therapy, Oncology Hospital, National Medical Center, IMSS, Mexico, D. F. (Mexico); Huerta-Guzman, Judith; Nambo, Maria J. [Department of Hematology, Oncology Hospital, National Medical Center, IMSS, Mexico, D. F. (Mexico)

    2012-07-15

    Purpose: We developed a controlled clinical trial to assess the efficacy and toxicity of adjuvant-involved field radiotherapy (IFRT) in patients with primary mediastinal B-cell lymphoma that achieved complete response after the patients were treated with cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab (R-CHOP-14). Methods and Materials: Between January 2001 and June 2004, 124 consecutive patients who were in complete remission after dose dense chemotherapy and rituximab administration (R-CHOP14) were randomly assigned to received IFRT (30 Gy). Sixty-three patients received IFR, and 61 patients did not (control group). Results: The study aimed to include 182 patients in each arm but was closed prematurely because in a security analysis (June 2004), progression and early relapse were more frequent in patients that did not received IFRT. Patients were followed until March 2009, at which point actuarial curves at 10 years showed that progression free-survival was 72% in patients who received IFR and 20% in the control group (p < 0.001), overall survival was 72% and 31%, respectively (p < 0.001). Acute toxicity was mild and well tolerated. Discussion: Adjuvant radiotherapy to sites of bulky disease was the only difference to have an improvement in outcome in our patients; the use of rituximab during induction did not improve complete response rates and did affect overall survival; patients who received rituximab but not IFRT had a worse prognosis. Conclusions: The use of IFRT in patients with primary mediastinal B-cell lymphoma who achieved complete response remain as the best treatment available, even in patients that received rituximab during induction.

  8. Randomized Clinical Trial to Assess the Efficacy of Radiotherapy in Primary Mediastinal Large B-Lymphoma

    International Nuclear Information System (INIS)

    Avilés, Agustin; Neri, Natividad; Fernández, Raúl; Huerta-Guzmán, Judith; Nambo, María J.

    2012-01-01

    Purpose: We developed a controlled clinical trial to assess the efficacy and toxicity of adjuvant-involved field radiotherapy (IFRT) in patients with primary mediastinal B-cell lymphoma that achieved complete response after the patients were treated with cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab (R-CHOP-14). Methods and Materials: Between January 2001 and June 2004, 124 consecutive patients who were in complete remission after dose dense chemotherapy and rituximab administration (R-CHOP14) were randomly assigned to received IFRT (30 Gy). Sixty-three patients received IFR, and 61 patients did not (control group). Results: The study aimed to include 182 patients in each arm but was closed prematurely because in a security analysis (June 2004), progression and early relapse were more frequent in patients that did not received IFRT. Patients were followed until March 2009, at which point actuarial curves at 10 years showed that progression free-survival was 72% in patients who received IFR and 20% in the control group (p < 0.001), overall survival was 72% and 31%, respectively (p < 0.001). Acute toxicity was mild and well tolerated. Discussion: Adjuvant radiotherapy to sites of bulky disease was the only difference to have an improvement in outcome in our patients; the use of rituximab during induction did not improve complete response rates and did affect overall survival; patients who received rituximab but not IFRT had a worse prognosis. Conclusions: The use of IFRT in patients with primary mediastinal B-cell lymphoma who achieved complete response remain as the best treatment available, even in patients that received rituximab during induction.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Neutron activation analysis: A primary method of measurement

    Energy Technology Data Exchange (ETDEWEB)

    Greenberg, Robert R., E-mail: robert.greenberg@nist.gov [National Institute of Standards and Technology, Gaithersburg, MD 20899-8395 (United States); Bode, Peter, E-mail: p.bode@tudelft.nl [Delft University of Technology, Delft (Netherlands); De Nadai Fernandes, Elisabete A., E-mail: lis@cena.usp.br [Centro de Energia Nuclear na Agricultura, Universidade de Sao Paulo, Piracicaba, SP (Brazil)

    2011-03-15

    Neutron activation analysis (NAA), based on the comparator method, has the potential to fulfill the requirements of a primary ratio method as defined in 1998 by the Comite Consultatif pour la Quantite de Matiere - Metrologie en Chimie (CCQM, Consultative Committee on Amount of Substance - Metrology in Chemistry). This thesis is evidenced in this paper in three chapters by: demonstration that the method is fully physically and chemically understood; that a measurement equation can be written down in which the values of all parameters have dimensions in SI units and thus having the potential for metrological traceability to these units; that all contributions to uncertainty of measurement can be quantitatively evaluated, underpinning the metrological traceability; and that the performance of NAA in CCQM key-comparisons of trace elements in complex matrices between 2000 and 2007 is similar to the performance of Isotope Dilution Mass Spectrometry (IDMS), which had been formerly designated by the CCQM as a primary ratio method.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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...

  13. A Meta-Analysis of the Relation between Creative Self-Efficacy and Different Creativity Measurements

    Science.gov (United States)

    Haase, Jennifer; Hoff, Eva V.; Hanel, Paul H. P.; Innes-Ker, Åse

    2018-01-01

    This meta-analysis investigated the relations between creative self-efficacy (CSE) and creativity measures and hypothesized that self-assessed questionnaires would have a different relation to self-efficacy beliefs compared to other creativity tests. The meta-analysis synthesized 60 effect sizes from 41 papers (overall N = 17226). Taken as a…

  14. Research Design and the Predictive Power of Measures of Self-Efficacy

    Science.gov (United States)

    Moriarty, Beverley

    2014-01-01

    The purpose of this enquiry was to examine how research design impacts on the predictive power of measures of self-efficacy. Three cautions for designing research into self-efficacy drawn from the seminal work of Albert Bandura (1986) and a further caution proposed by the current author together form the analytical framework for this enquiry. For…

  15. Measuring the Academic Self-Efficacy of First-Year Accounting Students

    Science.gov (United States)

    Byrne, Marann; Flood, Barbara; Griffin, Julie

    2014-01-01

    This study measured the levels of academic self-efficacy of first-year accounting students. It also investigated whether there were any gender differences and the extent to which efficacy levels explained variation in academic performance. Overall the analysis revealed that many students lacked the confidence to participate fully in the academic…

  16. 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)

  17. 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...

  18. Developing and validating an instrument for measuring mobile computing self-efficacy.

    Science.gov (United States)

    Wang, Yi-Shun; Wang, Hsiu-Yuan

    2008-08-01

    IT-related self-efficacy has been found to have a critical influence on system use. However, traditional measures of computer self-efficacy and Internet-related self-efficacy are perceived to be inapplicable in the context of mobile computing and commerce because they are targeted primarily at either desktop computer or wire-based technology contexts. Based on previous research, this study develops and validates a multidimensional instrument for measuring mobile computing self-efficacy (MCSE). This empirically validated instrument will be useful to researchers in developing and testing the theories of mobile user behavior, and to practitioners in assessing the mobile computing self-efficacy of users and promoting the use of mobile commerce systems.

  19. Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures.

    Science.gov (United States)

    Mash, D C; Kovera, C A; Pablo, J; Tyndale, R F; Ervin, F D; Williams, I C; Singleton, E G; Mayor, M

    2000-09-01

    Ibogaine is an indole alkaloid found in the roots of Tabernanthe Iboga (Apocynaceae family), a rain forest shrub that is native to western Africa. Ibogaine is used by indigenous peoples in low doses to combat fatigue, hunger and thirst, and in higher doses as a sacrament in religious rituals. Members of American and European addict self-help groups have claimed that ibogaine promotes long-term drug abstinence from addictive substances, including psychostimulants and opiates. Anecdotal reports attest that a single dose of ibogaine eliminates opiate withdrawal symptoms and reduces drug craving for extended periods of time. The purported efficacy of ibogaine for the treatment of drug dependence may be due in part to an active metabolite. The majority of ibogaine biotransformation proceeds via CYP2D6, including the O-demethylation of ibogaine to 12-hydroxyibogamine (noribogaine). Blood concentration-time effect profiles of ibogaine and noribogaine obtained for individual subjects after single oral dose administrations demonstrate complex pharmacokinetic profiles. Ibogaine has shown preliminary efficacy for opiate detoxification and for short-term stabilization of drug-dependent persons as they prepare to enter substance abuse treatment. We report here that ibogaine significantly decreased craving for cocaine and heroin during inpatient detoxification. Self-reports of depressive symptoms were also significantly lower after ibogaine treatment and at 30 days after program discharge. Because ibogaine is cleared rapidly from the blood, the beneficial aftereffects of the drug on craving and depressed mood may be related to the effects of noribogaine on the central nervous system.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  2. Measuring social networks in British primary schools through scientific engagement

    Science.gov (United States)

    Conlan, A. J. K.; Eames, K. T. D.; Gage, J. A.; von Kirchbach, J. C.; Ross, J. V.; Saenz, R. A.; Gog, J. R.

    2011-01-01

    Primary schools constitute a key risk group for the transmission of infectious diseases, concentrating great numbers of immunologically naive individuals at high densities. Despite this, very little is known about the social patterns of mixing within a school, which are likely to contribute to disease transmission. In this study, we present a novel approach where scientific engagement was used as a tool to access school populations and measure social networks between young (4–11 years) children. By embedding our research project within enrichment activities to older secondary school (13–15) children, we could exploit the existing links between schools to achieve a high response rate for our study population (around 90% in most schools). Social contacts of primary school children were measured through self-reporting based on a questionnaire design, and analysed using the techniques of social network analysis. We find evidence of marked social structure and gender assortativity within and between classrooms in the same school. These patterns have been previously reported in smaller studies, but to our knowledge no study has attempted to exhaustively sample entire school populations. Our innovative approach facilitates access to a vitally important (but difficult to sample) epidemiological sub-group. It provides a model whereby scientific communication can be used to enhance, rather than merely complement, the outcomes of research. PMID:21047859

  3. Ignition delay time measurements of primary reference fuel blends

    KAUST Repository

    Alabbad, Mohammed

    2017-02-07

    Ignition delay times of four different primary reference fuels (PRF), mixtures of n-heptane and iso-octane, were measured behind reflected shock waves in a high-pressure shock tube facility. The PRFs were formulated to match the RON of two high-octane gasolines (RON 95 and 91) and two prospective low-octane naphtha fuels (RON 80 and 70). Experiments were carried out over a wide range of temperatures (700–1200K), pressures (10, 20, and 40bar) and equivalence ratios (0.5 and 1). Kinetic modeling predictions from four chemical kinetic mechanisms are compared with the experimental data. Ignition delay correlations are developed to reproduce the measured ignition delay times. Brute force sensitivity analyses are carried out to identify reactions that affect ignition delay times at specific temperature, pressure and equivalence ratio. The large experimental data set provided in the current work will serve as a benchmark for the validation of chemical kinetic mechanisms of primary reference fuel blends.

  4. Ignition delay time measurements of primary reference fuel blends

    KAUST Repository

    Alabbad, Mohammed; Javed, Tamour; Khaled, Fathi; Badra, Jihad; Farooq, Aamir

    2017-01-01

    Ignition delay times of four different primary reference fuels (PRF), mixtures of n-heptane and iso-octane, were measured behind reflected shock waves in a high-pressure shock tube facility. The PRFs were formulated to match the RON of two high-octane gasolines (RON 95 and 91) and two prospective low-octane naphtha fuels (RON 80 and 70). Experiments were carried out over a wide range of temperatures (700–1200K), pressures (10, 20, and 40bar) and equivalence ratios (0.5 and 1). Kinetic modeling predictions from four chemical kinetic mechanisms are compared with the experimental data. Ignition delay correlations are developed to reproduce the measured ignition delay times. Brute force sensitivity analyses are carried out to identify reactions that affect ignition delay times at specific temperature, pressure and equivalence ratio. The large experimental data set provided in the current work will serve as a benchmark for the validation of chemical kinetic mechanisms of primary reference fuel blends.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  7. ANTHROPOMETRIC MEASUREMENT OF PRIMARY SCHOOL GOING CHILDREN IN KARACHI

    Directory of Open Access Journals (Sweden)

    Kashmala Khan

    2016-04-01

    Full Text Available Background: Children were major part of our society and their health issues were too much, so it’s necessary that child should b healthy so their health assessment is important worldwide the acceptable method for assessment of health status is anthropometry (weight & height. This study was done to assess the anthropometric measurement of primary school going children of Karachi, sindh Pakistan, and evaluate how much students were underweight. Methods: The study was done in different primary school of Karachi including private semiprivate and government. The study design was cross sectional study. The sample size of our study was 240, including both genders male& female with range between 7-12 years. Result: The result shows that 34.9% were underweight (below 5th percentile, 63.44% were normal weight (between 5-95th percentile and only0.8% overweight (above 95th percentile.The result showed male-female ratio was 51.5% boys and 48.5% were underweight. The prevalence of underweight in private sector was only 9.5% but in government it was 45.5%.The height of student also calculated and 26.3% children were below the 5th percentile of height for the age, 62.8% were between 5th to 95th percentile and 10.9% above 95thpercentile. Conclusion: The prevalence of underweight in primary school going children in Karachi shows the dietary requirements of children are not fulfilled properly and this may lead to many sever pathological conditions, so it is necessary to take positive steps regarding awareness of proper diet, hygiene and growth & development of child.

  8. Introducing care pathway commissioning to primary dental care: measuring performance.

    Science.gov (United States)

    Harris, R; Bridgman, C; Ahmad, M; Bowes, L; Haley, R; Saleem, S; Singh, R; Taylor, S

    2011-12-09

    Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper focuses on reporting a secondary use of care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care.

  9. Measuring Efficacy of Information Security Policies : A Case Study of UAE based company

    OpenAIRE

    Qureshi, Muhammad Sohail

    2012-01-01

    Nowadays information security policies are operative in many organizations. Currently few organizations take the pain of verifying the efficacy of these policies. Different standards and procedures exist about methods of measuring efficacy of information security policies. Choosing and implementing them depends mainly on the key performance indicators (KPIs) and key risk indicators (KRIs) of any particular organization. This thesis is a case study of an organization in United Arab Emirates (U...

  10. The efficacy and durability of radon remedial measures

    International Nuclear Information System (INIS)

    Cliff, K.D.; Naismith, S.P.; Scivyer, C.; Stephen, R.

    1994-01-01

    In the UK, over 16,000 homes, from an estimated 100,000, with annual average radon concentrations exceeding the UK Action Level of 200 Bq.m -3 have been discovered. Some 600 householders who have taken action have sought confirmatory measurements from NRPB. Results for 345 such homes are discussed. A number of remedied homes are being remeasured annually to determine the durability of the remedies: results for the first year follow-up measurements are given. In a separate exercise, homes having the highest radon levels known in the UK have been enrolled in a research programme of the Building Research Establishment. The results for 53 homes in which BRE surveyed, designed and supervised remedial work are presented. (author)

  11. Validation of the PROMIS® measures of self-efficacy for managing chronic conditions.

    Science.gov (United States)

    Gruber-Baldini, Ann L; Velozo, Craig; Romero, Sergio; Shulman, Lisa M

    2017-07-01

    The Patient-Reported Outcomes Measurement Information System ® (PROMIS ® ) was designed to develop, validate, and standardize item banks to measure key domains of physical, mental, and social health in chronic conditions. This paper reports the calibration and validation testing of the PROMIS Self-Efficacy for Managing Chronic Conditions measures. PROMIS Self-Efficacy for Managing Chronic Conditions item banks comprise five domains, Self-Efficacy for Managing: Daily Activities, Symptoms, Medications and Treatments, Emotions, and Social Interactions. Banks were calibrated in 1087 subjects from two data sources: 837 patients with chronic neurologic conditions (epilepsy, multiple sclerosis, neuropathy, Parkinson disease, and stroke) and 250 subjects from an online Internet sample of adults with general chronic conditions. Scores were compared with one legacy scale: Self-Efficacy for Managing Chronic Disease 6-Item scale (SEMCD6) and five PROMIS short forms: Global Health (Physical and Mental), Physical Function, Fatigue, Depression, and Anxiety. The sample was 57% female, mean age = 53.8 (SD = 14.7), 76% white, 21% African American, 6% Hispanic, and 76% with greater than high school education. Full-item banks were created for each domain. All measures had good internal consistency and correlated well with SEMCD6 (r  = 0.56-0.75). Significant correlations were seen between the Self-Efficacy measures and other PROMIS short forms (r  > 0.38). The newly developed PROMIS Self-Efficacy for Managing Chronic Conditions measures include five domains of self-efficacy that were calibrated across diverse chronic conditions and show good internal consistency and cross-sectional validity.

  12. Costs and efficacy of management measures to improve udder health on Dutch dairy farms

    NARCIS (Netherlands)

    Huijps, K.; Hogeveen, H.; Lam, T.J.G.M.; Oude Lansink, A.G.J.M.

    2010-01-01

    Many different management measures are available to control mastitis, a very costly disease in the dairy sector. The objective of this paper was to evaluate the costs and efficacies of 18 of these management measures, for contagious and environmental pathogens, and their effect on bulk tank somatic

  13. 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...

  14. Is Collective Efficacy Age Graded? The Development and Evaluation of a New Measure of Collective Efficacy for Older Adults

    Directory of Open Access Journals (Sweden)

    Adena M. Galinsky

    2012-01-01

    Full Text Available Objectives. Community processes are key determinants of older adults’ ability to age in place, but existing scales measuring these constructs may not provide accurate, unbiased measurements among older adults because they were designed with the concerns of child-rearing respondents in mind. This study examines the properties of a new theory-based measure of collective efficacy (CE that accounts for the perspectives of older residents. Methods. Data come from the population-based Chicago Neighborhood Organization, Aging and Health study (N = 1,151, which surveyed adults aged 65 to 95. Using descriptive statistics, correlations, and factor analysis, we explored the acceptability, reliability, and validity of the new measure. Results. Principal component analysis indicated that the new scale measures a single latent factor. It had good internal consistency reliability, was highly correlated with the original scale, and was similarly associated with neighborhood exchange and disorder, self-rated health, mobility, and loneliness. The new scale also showed less age-differentiated nonresponse compared to the original scale. Discussion. The older adult CE scale has reliability and validity equivalent to that of the existing measure but benefits from a more developed theoretical grounding and reduced likelihood of age-related differential nonresponse.

  15. Time Resolved Measurements of Primary Biogenic Aerosol Particles in Amazonia

    Science.gov (United States)

    Wollny, A. G.; Garland, R.; Pöschl, U.

    2009-04-01

    Biogenic aerosols are ubiquitous in the Earth's atmosphere and they influence atmospheric chemistry and physics, the biosphere, climate, and public health. They play an important role in the spread of biological organisms and reproductive materials, and they can cause or enhance human, animal, and plant diseases. Moreover, they influence the Earth's energy budget by scattering and absorbing radiation, and they can initiate the formation of clouds and precipitation as cloud condensation and ice nuclei. The composition, abundance, and origin of biogenic aerosol particles and components are, however, still not well understood and poorly quantified. Prominent examples of primary biogenic aerosol particles, which are directly emitted from the biosphere to the atmosphere, are pollen, bacteria, fungal spores, viruses, and fragments of animals and plants. During the Amazonian Aerosol Characterization Experiment (AMAZE-08) a large number of aerosol and gas-phase measurements were taken on a remote site close to Manaus, Brazil, during a period of five weeks in February and March 2008. This presented study is focused on data from an ultraviolet aerodynamic particle sizer (UVAPS, TSI inc.) that has been deployed for the first time in Amazonia. In this instrument, particle counting and aerodynamic sizing over the range of 0.5-20 µm are complemented by the measurement of UV fluorescence at 355 nm (excitation) and 420-575 nm (emission), respectively. Fluorescence at these wavelengths is characteristic for reduced pyridine nucleotides (e.g., NAD(P)H) and for riboflavin, which are specific for living cells. Thus particles exhibiting fluorescence signals can be regarded as "viable aerosols" or "fluorescent bioparticles" (FBAP), and their concentration can be considered as lower limit for the actual abundance of primary biogenic aerosol particles. Data from the UVAPS were averaged over 5 minute time intervals. The presence of bioparticles in the observed size range has been

  16. 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

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

    Directory of Open Access Journals (Sweden)

    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

  18. Systematic review of measurement properties of questionnaires measuring somatization in primary care patients.

    Science.gov (United States)

    Sitnikova, Kate; Dijkstra-Kersten, Sandra M A; Mokkink, Lidwine B; Terluin, Berend; van Marwijk, Harm W J; Leone, Stephanie S; van der Horst, Henriëtte E; van der Wouden, Johannes C

    2017-12-01

    The aim of this review is to critically appraise the evidence on measurement properties of self-report questionnaires measuring somatization in adult primary care patients and to provide recommendations about which questionnaires are most useful for this purpose. We assessed the methodological quality of included studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. To draw overall conclusions about the quality of the questionnaires, we conducted an evidence synthesis using predefined criteria for judging the measurement properties. We found 24 articles on 9 questionnaires. Studies on the Patient Health Questionnaire-15 (PHQ-15) and the Four-Dimensional Symptom Questionnaire (4DSQ) somatization subscale prevailed and covered the broadest range of measurement properties. These questionnaires had the best internal consistency, test-retest reliability, structural validity, and construct validity. The PHQ-15 also had good criterion validity, whereas the 4DSQ somatization subscale was validated in several languages. The Bodily Distress Syndrome (BDS) checklist had good internal consistency and structural validity. Some evidence was found for good construct validity and criterion validity of the Physical Symptom Checklist (PSC-51) and good construct validity of the Symptom Check-List (SCL-90-R) somatization subscale. However, these three questionnaires were only studied in a small number of primary care studies. Based on our findings, we recommend the use of either the PHQ-15 or 4DSQ somatization subscale for somatization in primary care. Other questionnaires, such as the BDS checklist, PSC-51 and the SCL-90-R somatization subscale show promising results but have not been studied extensively in primary care. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Measuring Progress toward Universal Primary Education: An Examination of Indicators

    Science.gov (United States)

    Langsten, Ray

    2014-01-01

    The Education Millennium Development Goal of universal primary education (UPE) states that "by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling." The 2008 midterm Global Monitoring Report claims that "A country's distance from UPE appears most clearly in terms of the net…

  20. Measuring the strength of primary care systems in Europe.

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.G.W.

    2009-01-01

    Background: The investment in primary care (PC) reforms to improve the overall performance of health care systems has been substantial in Europe. There is however a lack of up to date comparable information to evaluate the development and strength of PC systems. This EU-funded Primary Health Care

  1. 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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  4. The therapeutic efficacy of propranolol in children with recurrent primary epistaxis

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  6. Measuring progress towards a primary care-led NHS.

    Science.gov (United States)

    Miller, P; Craig, N; Scott, A; Walker, A; Hanlon, P

    1999-07-01

    The push towards a 'primary care-led' National Health Service (NHS) has far-reaching implications for the future structure of the NHS. The policy involves both a growing emphasis on the role of primary care practitioners in the commissioning of health services, and a change from hospital to primary and community settings for a range of services and procedures. Although the terminology has changed, this emphasis remains in the recent Scottish Health Service White Paper and its English counterpart. To consider three questions in relation to this policy goal. First, does the evidence base support the changes? Secondly, what is the scale of the changes that have occurred? Thirdly, what are the barriers to the development of a primary care-led NHS? Programme budgets were compiled to assess changes over time in the balance of NHS resource allocation with respect to primary and secondary care. Total NHS revenue expenditure for the 15 Scottish health boards was grouped into four blocks or 'programmes': primary care, secondary care, community services, and a residual. The study period was 1991/2 to 1995/6. Expenditure data were supplied by the Scottish Office. Ambiguity of definitions and the absence of good data cause methodological difficulties in evaluating the scale and the appropriateness of the shift. The data that are available suggest that, at the aggregate level, there have been changes over time in the balance of resource allocation between care settings: relative investment into primary care has increased. It would appear that this investment is relatively small and from growth money rather than a 'shift' from secondary care. In addition, the impact of GP-led commissioning is variable but limited. General practitioners' (GPs') attitudes to the policy suggest that progress towards a primary care-led NHS will continue to be patchy. The limited shift to date, alongside evidence of ambivalent attitudes to the shift on the part of GPs, suggest that this is a policy

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

    Directory of Open Access Journals (Sweden)

    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.

  8. The efficacy of mindfulness-based interventions in primary care: A meta-analytic review.

    NARCIS (Netherlands)

    Demarzo, M.M.P.; Montero- Marin, J.; Cuijpers, P.; Zabaleta-del-Olmo, E.; Mahtani, K.R.; Vellinga, A.; Vicens, C.; Lopez-del-Hoyo, Y.; Garcia-Campayo, J.

    2015-01-01

    PURPOSE 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

  9. Examining Measurement Properties of an English Self-Efficacy Scale for English Language Learners in Korea

    Science.gov (United States)

    Wang, Chuang; Kim, Do-Hong; Bong, Mimi; Ahn, Hyun Seon

    2013-01-01

    This study provides evidence for the validity of the Questionnaire of English Self-Efficacy in a sample of 167 college students in Korea. Results show that the scale measures largely satisfy the Rasch model for unidimensionality. The rating scale appeared to function effectively. The item hierarchy was consistent with the expected item order. The…

  10. The Role of Practitioner Self-Efficacy, Training, Program and Workplace Factors on the Implementation of an Evidence-Based Parenting Intervention in Primary Care

    Science.gov (United States)

    Turner, Karen M. T.; Nicholson, Jan M.; Sanders, Matthew R.

    2011-01-01

    This study examines factors affecting the implementation by primary care practitioners (nursing, education, allied health, and medical) of a brief parenting and family support intervention (the Primary Care Triple P--Positive Parenting Program) following professional training. It assesses the impact of prior experience, self-efficacy, program…

  11. Efficacy of laser peripheral iridoplasty and iridotomy on medically refractory patients with acute primary angle closure: a three year outcome

    Institute of Scientific and Technical Information of China (English)

    FU Jing; QING Guo-ping; WANG Ning-li; WANG Huai-zhou

    2013-01-01

    Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (IOP) of patients with mild acute primary angle closure (APAC).It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC.This study aimed to evaluate the IOP-lowering efficacy of ALPI and laser peripheral iridotomy (LPI) on patients with refractory APAC,who have previously responded poorly to intensive medical therapy.Methods Thirty-six patients (8 men and 28 women) were identified as medically refractory APAC,who still had ocular pain,red eye,hazy cornea,closed anterior chamber (AC) angle,and IOP of not less than 21 mmHg after two days or more of anti-glaucoma medication.All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity (VA),best corrected VA (BCVA),IOP,biomicroscopy,and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes.Results All patients were affected unilaterally,with average age of (54.6±11.7) (range,37.0-75.0) years old.The mean IOP value of the affected eyes dropped from (31.6±7.7) (range,21.0-39.0) mmHg at enrollment to (18.4±8.7) (range,10.0-27.0) mmHg 2 hours after ALPI.At follow-up day 7,the mean IOP value maintained at (14.8±4.2) (range,9.0-21.0)mmHg,which was significantly different (P=0.000) compared with baseline.The average decrease of IOP in the APAC eyes was (16.8±7.4) (range,12.0-21.0) mmHg.At follow-up three years later,the mean IOP of the APAC eyes stabilized at (16.3±3.2) (range,9.0-20.0) mmHg with at least 180° of AC angle opened.Conclusion ALPI and LPI lower the IOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.

  12. 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

  13. Hope and General Self-efficacy: Two Measures of the Same Construct?

    Science.gov (United States)

    Zhou, Mingming; Kam, Chester Chun Seng

    2016-07-03

    The aim of this study was to test the extent to which hope measure is equivalent to general self-efficacy measure. Questionnaire data on these two constructs and other external variables were collected from 199 Chinese college students. The factor analytic results suggested that hope and self-efficacy items measured the same construct. The unidimensional model combining hope items and GSE items fit the data as well as the bidimensional model, indicating that their corresponding items measured the same underlying construct. Further analyses showed that hope and GSE did not correlate with external variables differently in a systematic manner. Most of these correlational differences were non-significant and negligible. These findings suggested that the literatures studying GSE and hope could be considered to be integrated and that researchers need to recognize and acknowledge the conceptual and operational similarities among these constructs in the literature.

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

    Directory of Open Access Journals (Sweden)

    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

  15. Efficacy of musculoskeletal injections given by primary care providers in the office

    Directory of Open Access Journals (Sweden)

    Eghbal Eftekhaari T

    2013-09-01

    Full Text Available Tasnim Eghbal Eftekhaari,1 Mirzaali Nazarnezhad,1 Iman Ghasemzadeh2 1Clinical Research Development Unit, Hormozgan University of Medical Sciences Bandar Abbas, Iran; 2Infectious Disease Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IranPatients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians qualified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints.1 However, patients usually present to a primary care physician and embark on treatment there, despite having the option of referral to a subspecialist fully trained in this procedure.View original paper by Bhagra and colleagues.

  16. 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.

  17. Outcome measures for primary Sjogren's syndrome : A comprehensive review

    NARCIS (Netherlands)

    Seror, Raphaele; Theander, Elke; Bootsma, Hendrika; Bowman, Simon J.; Tzioufas, Athanasios; Gottenberg, Jacques-Eric; Ramos-Casals, Manel; Doerner, Thomas; Ravaud, Philippe; Mariette, Xavier; Vitali, Claudio

    Lymphocytic infiltration of different exocrine and non-exocrine epithelia is the pathological hallmark of primary Sjogren's syndrome, whereas involvement of salivary and lachrymal glands with the clinical counterpart of dry eye and dry mouth are the predominant features of the disease, together with

  18. 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.

  19. Comparative nucleic acid transfection efficacy in primary hepatocytes for gene silencing and functional studies

    Directory of Open Access Journals (Sweden)

    Morral Núria

    2011-01-01

    Full Text Available Abstract Background Primary hepatocytes are the best resource for in vitro studies directed at understanding hepatic processes at the cellular and molecular levels, necessary for novel drug development to treat highly prevalent diseases such as non-alcoholic steatohepatitis, cardiovascular disease and type 2 diabetes. There is a need to identify simple methods to genetically manipulate primary hepatocytes and conduct functional studies with plasmids, small interfering RNA (siRNA or microRNA (miRNA. New lipofection reagents are available that have the potential to yield higher levels of transfection with reduced toxicity. Findings We have tested several liposome-based transfection reagents used in molecular biology research. We show that transfection efficiency with one of the most recently developed formulations, Metafectene Pro, is high with plasmid DNA (>45% cells as well as double stranded RNA (>90% with siRNA or microRNA. In addition, negligible cytotoxicity was present with all of these nucleic acids, even if cells were incubated with the DNA:lipid complex for 16 hours. To provide the proof of concept that these conditions can be used not only for overexpression of a gene of interest, but also in RNA interference applications, we targeted two liver expressed genes, Sterol Regulatory Element-Binding Protein-1 and Fatty Acid Binding Protein 5 using plasmid-mediated short hairpin RNA expression. In addition, similar transfection conditions were used to optimally deliver siRNA and microRNA. Conclusions We have identified a lipid-based reagent for primary hepatocyte transfection of nucleic acids currently used in molecular biology laboratories. The conditions described here can be used to expedite a large variety of research applications, from gene function studies to microRNA target identification.

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. 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.

  3. 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.

  4. The efficacy of primary care chaplaincy compared with antidepressants: a retrospective study comparing chaplaincy with antidepressants.

    Science.gov (United States)

    Macdonald, Gordon

    2017-07-01

    Aim To determine the effectiveness of primary care chaplaincy (PCC) when used as the sole intervention, with outcomes being compared directly with those of antidepressants. This was to be carried out in a homogenous study population reflective of certain demographics in the United Kingdom. Increasing numbers of patients are living with long-term conditions and 'modern maladies' and are experiencing loss of well-being and depression. There is an increasing move to utilise non-pharmacological interventions such as 'talking therapies' within this context. Chaplaincy is one such 'talking therapy' but within primary care its evidence base is sparse with only one quantitative study to date. There is therefore a need to evaluate PCC excluding those co-prescribed antidepressants, as this is not evidenced in the literature as yet. PCC also needs to be directly compared with the use of antidepressants to justify its use as a valid alternative treatment for loss of well-being and depression. This was a retrospective observational study based on routinely collected data. There were 107 patients in the PCC group and 106 in the antidepressant group. Socio-demographic data were collected. Their pre- and post-intervention (either chaplaincy or antidepressant) well-being was assessed, by the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) which is a validated Likert scale. Findings The majority of both groups were female with both groups showing marked ethnic homogeneity. PCC was associated with a significant and clinically meaningful improvement in well-being at a mean follow-up of 80 days. This treatment effect was maintained after those co-prescribed antidepressants were removed. PCC was associated with an improvement in well-being similar to that of antidepressants with no significant difference between the two groups.

  5. 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.

  6. Measurement Noninvariance of Safer Sex Self-Efficacy Between Heterosexual and Sexual Minority Black Youth.

    Science.gov (United States)

    Gerke, Donald; Budd, Elizabeth L; Plax, Kathryn

    2016-01-01

    Black and lesbian, gay, bisexual, or questioning (LGBQ) youth in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs). Although self-efficacy is strongly, positively associated with safer sex behaviors, no studies have examined the validity of a safer sex self-efficacy scale used by many federally funded HIV/STD prevention programs. This study aims to test factor validity of the Sexual Self-Efficacy Scale by using confirmatory factor analysis (CFA) to determine if scale validity varies between heterosexual and LGBQ Black youth. The study uses cross-sectional data collected through baseline surveys with 226 Black youth (15 to 24 years) enrolled in community-based HIV-prevention programs. Participants use a 4-point Likert-type scale to report their confidence in performing 6 healthy sexual behaviors. CFAs are conducted on 2 factor structures of the scale. Using the best-fitting model, the scale is tested for measurement invariance between the 2 groups. A single-factor model with correlated errors of condom-specific items fits the sample well and, when tested with the heterosexual group, the model demonstrates good fit. However, when tested with the LGBQ group, the same model yields poor fit, indicating factorial noninvariance between the groups. The Sexual Self-Efficacy Scale does not perform equally well among Black heterosexual and LGBQ youth. Study findings suggest additional research is needed to inform development of measures for safer sex self-efficacy among Black LGBQ youth to ensure validity of conceptual understanding and to accurately assess effectiveness of HIV/STD prevention interventions among this population.

  7. 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.

  8. Clinical observation on the therapeutic efficacy of CyberKnife for primary or metastatic retroperitoneal tumors

    International Nuclear Information System (INIS)

    Zhuang Hongqing; Yuan Zhiyong; Wang Ping

    2012-01-01

    Objective: To evaluate the early response rate and radiation toxicity of CyberKnife in the treatment of primary or metastatic retroperitoneal tumors. Methods: Twenty-eight patients with retroperitoneal tumors were treated with CyberKnife. The total doses were 2000-6000 cGy (median 4500 cGy) and biological effective doses were 3750-10080 cGy (median 7680 cGy) in 2-10 fractions (median 5). Of all patients, 3 received three dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT) boost, 1 was treated as second-course radiotherapy, and others were treated with CyberKnife only. The survival rates were calculated by Kaplan-Meier method and compared with Logrank test. Results: The complete response, stable disease and progression disease rates were 43% (12/28), 6% (10/28), 18% (5/28), 4%, (1/28), respectively. The overall response rate was 96%. The number of patients who were followed up more than 1, 2, 3 years were 17, 9, 7, respectively. The 1-, 2- and 3-year local control rates were 92%, 86%, and 86%, respectively. The 1-, 2- and 3-year overall survival rates were 60%, 49% and 49%, respectively. The difference between local progression-free survival and overall survival was not significant (median 9.5 and 12.0 months, χ 2 =0.17, P=0.680), Moreover, if the patients did not have metastasis elsewhere and local treatment was effective, there was no significant difference between local progression-free survival and progression free survival (median 17 and 11 months, χ 2 =0.13, P=0.720), Acute radiation-induced side effects (≥ 2 grade) such as fatigue, anorexia, nausea, vomiting and epigastric discomfort occurred in 9, 9, 7, 7 and 2 patients, respectively. Intestinal stenosis of 1 grade occurred in 1 patients. Conclusions: Radiotherapy for retroperitoneal tumors with CyberKnife has provided a high response rate with minimal side effects. It is a safe and effective local treatment method for retroperitoneal tumors. (authors)

  9. Localized Orbital Mucosa-Associated Lymphoma Tissue Lymphoma Managed With Primary Radiation Therapy: Efficacy and Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Goda, Jayant Sastri [Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Le, Lisa W. [Biostatistics, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Lapperriere, Normand J.; Millar, Barbara-Ann; Payne, David; Gospodarowicz, Mary K.; Wells, Woodrow; Hodgson, David C.; Sun, Alexander [Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Simpson, Rand [Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Tsang, Richard W., E-mail: richard.tsang@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada)

    2011-11-15

    Purpose: To evaluate the clinical outcomes and late effects of radiation therapy (RT) in localized primary orbital mucosa-associated lymphoma tissue (MALT) lymphoma (POML). Methods and Materials: From 1989 to 2007, 89 patients with Stage IE POML received RT. The median age was 56 years old. Sites involved conjunctiva (59 patients [66%]), lacrimal gland (20 patients [23%]), and soft tissue (10 patients [11%]). Megavoltage beam(s) was used in 91%, electrons in 7%, and orthovoltage in 2% of cases. The dose given was 25 Gy in 97% and 30 Gy in 3% of patients. Lens shielding was possible in 57% of patients. Results: The median follow-up was 5.9 years. Complete response or unconfirmed complete response was seen in 88 patients (99%). Relapse occurred in 22 patients (25%). First relapse sites were local (2 patients [9%]), in the contralateral orbit (5 patients [23%]), and distant (15 patients [68%]). The 7-year overall survival (OS), cause-specific survival (CSS), relapse-free survival (RFS), and local control (LC) rates were 91%, 96%, 64%, and 97%, respectively. Radiation-related late sequelae were documented in 40 patients (45%). Cataracts were observed in 22 patients (Grade 1 in 2 patients; Grade 3 in 20 patients). The incidence of Grade 3 cataract at 7 years was 25%. Other late sequelae (n = 28) were dry eye(s) (22 patients [Grade 1 in 14 patients; Grade 2 in 2 patients; Grade 3 in 2 patients; n/s in 4 patients), keratitis (3 patients), macular degeneration/cystoid edema (2 patients), and vitreous detachment (1 patient). Five patients developed Grade 3 noncataract late effects. Lens shielding reduced the incidence of Grade 3 cataract and all Grade {>=}2 late sequelae. Seventeen patients (16 with cataracts) underwent surgery; 23 patients were treated conservatively. The outcome for managing late effects was generally successful, with 30 patients completely improved, and 9 patients with persisting late sequelae (10%). Conclusions: POML responds favorably to moderate doses

  10. The Quest for Comparability: Studying the Invariance of the Teachers? Sense of Self-Efficacy (TSES) Measure across Countries

    OpenAIRE

    Scherer, Ronny; Jansen, Malte; Nilsen, Trude; Areepattamannil, Shaljan; Marsh, Herbert W.

    2016-01-01

    Teachers’ self-efficacy is an important motivational construct that is positively related to a variety of outcomes for both the teachers and their students. This study addresses challenges associated with the commonly used ‘Teachers’ Sense of Self-Efficacy (TSES)’ measure across countries and provides a synergism between substantive research on teachers’ self-efficacy and the novel methodological approach of exploratory structural equation modeling (ESEM). These challenges include adequately ...

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

    Science.gov (United States)

    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.

  12. The efficacy of lapatinib in metastatic breast cancer with HER2 non-amplified primary tumors and EGFR positive circulating tumor cells: a proof-of-concept study.

    Directory of Open Access Journals (Sweden)

    Justin Stebbing

    Full Text Available Analysis of circulating tumor cells (CTCs provides real-time measures of cancer sub-populations with potential for CTC-directed therapeutics. We examined whether lapatinib which binds both HER2 and EGFR could induce depletion of the EGFR-positive pool of CTCs, which may in turn lead to clinical benefits.Patients with metastatic breast cancer and HER2 non-amplified primary tumors with EGFR-positive CTCs were recruited and lapatinib 1500 mg daily was administered, in a standard two step phase 2 trial.There were no responses leading to termination at the first analysis with 16 patients recruited out of 43 screened. In 6 out of 14 (43% individuals eligible for the efficacy analysis, a decrease in CTCs was observed with most of these having a greater decrease in their EGFR-positive CTC pool.This is one of the first studies of CTC-directed therapeutics and suggests that lapatinib monotherapy is not having any demonstrable clinical effects by reducing the EGFR-positive pool of CTCs in HER2 non-amplified primary tumors. Our attempt to expand the pool of patients eligible for a targeted therapy was unsuccessful; the role of clonal populations in cancer biology and therapeutic strategies to control them will require extensive evaluation in years to come.Clinical trials.gov NCT00820924.

  13. Clinical Efficacy and Safety of Total Glucosides of Paeony for Primary Sjögren’s Syndrome: A Systematic Review

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Altered brain network measures in patients with primary writing tremor

    Energy Technology Data Exchange (ETDEWEB)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant [National Institute of Mental Health and Neurosciences, Department of Clinical Neurosciences, Bangalore, Karnataka (India); National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore, Karnataka (India); Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn [National Institute of Mental Health and Neurosciences, Department of Neuroimaging and Interventional Radiology, Bangalore, Karnataka (India); Yadav, Ravi; Pal, Pramod Kumar [National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore, Karnataka (India)

    2017-10-15

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results. (orig.)

  16. Altered brain network measures in patients with primary writing tremor

    International Nuclear Information System (INIS)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant; Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn; Yadav, Ravi; Pal, Pramod Kumar

    2017-01-01

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results. (orig.)

  17. Altered brain network measures in patients with primary writing tremor.

    Science.gov (United States)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant; Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn; Yadav, Ravi; Pal, Pramod Kumar

    2017-10-01

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results.

  18. Cross-Cultural Validation of Teachers' Sense of Efficacy Scale in Three Asian Countries: Test of Measurement Invariance

    Science.gov (United States)

    Ruan, Jiening; Nie, Youyan; Hong, Ji; Monobe, Gumiko; Zheng, Guomin; Kambara, Hitomi; You, Sula

    2015-01-01

    The purpose of this study is to validate the widely adopted Teachers' Sense of Efficacy Scale (TSES) for the East Asian context. The researchers seek to find out whether TSES holds validity and reliability and is appropriate for use to measure teacher efficacy in China, Korea, and Japan. 489 teachers from the three countries participated in the…

  19. Development and Validation of a Scale for Measuring Mathematics Teaching Self-Efficacy for Teachers in the Sultanate of Oman

    Science.gov (United States)

    Alkharusi, Hussain; Aldhafri, Said; Al-Hosni, Khoula; Al-Busaidi, Saleh; Al-Kharusi, Bader; Ambusaidi, Abdullah; Alrajhi, Marwa

    2017-01-01

    A scale for measuring self-efficacy for teaching mathematics in grades 5 to 10 was developed in this study for teachers in Oman. The participants were 328 mathematics teachers randomly selected from five educational governorates in the Sultanate of Oman. Factorial structure of the scale revealed three subscales: self-efficacy for understanding the…

  20. 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…

  1. 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...

  2. Efficacy measures associated to a plantar pressure based classification system in diabetic foot medicine.

    Science.gov (United States)

    Deschamps, Kevin; Matricali, Giovanni Arnoldo; Desmet, Dirk; Roosen, Philip; Keijsers, Noel; Nobels, Frank; Bruyninckx, Herman; Staes, Filip

    2016-09-01

    The concept of 'classification' has, similar to many other diseases, been found to be fundamental in the field of diabetic medicine. In the current study, we aimed at determining efficacy measures of a recently published plantar pressure based classification system. Technical efficacy of the classification system was investigated by applying a high resolution, pixel-level analysis on the normalized plantar pressure pedobarographic fields of the original experimental dataset consisting of 97 patients with diabetes and 33 persons without diabetes. Clinical efficacy was assessed by considering the occurence of foot ulcers at the plantar aspect of the forefoot in this dataset. Classification efficacy was assessed by determining the classification recognition rate as well as its sensitivity and specificity using cross-validation subsets of the experimental dataset together with a novel cohort of 12 patients with diabetes. Pixel-level comparison of the four groups associated to the classification system highlighted distinct regional differences. Retrospective analysis showed the occurence of eleven foot ulcers in the experimental dataset since their gait analysis. Eight out of the eleven ulcers developed in a region of the foot which had the highest forces. Overall classification recognition rate exceeded 90% for all cross-validation subsets. Sensitivity and specificity of the four groups associated to the classification system exceeded respectively the 0.7 and 0.8 level in all cross-validation subsets. The results of the current study support the use of the novel plantar pressure based classification system in diabetic foot medicine. It may particularly serve in communication, diagnosis and clinical decision making. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Negative cooperativity in binding of muscarinic receptor agonists and GDP as a measure of agonist efficacy.

    Science.gov (United States)

    Jakubík, J; Janíčková, H; El-Fakahany, E E; Doležal, V

    2011-03-01

    Conventional determination of agonist efficacy at G-protein coupled receptors is measured by stimulation of guanosine-5'-γ-thiotriphosphate (GTPγS) binding. We analysed the role of guanosine diphosphate (GDP) in the process of activation of the M₂ muscarinic acetylcholine receptor and provide evidence that negative cooperativity between agonist and GDP binding is an alternative measure of agonist efficacy. Filtration and scintillation proximity assays measured equilibrium binding as well as binding kinetics of [³⁵S]GTPγS and [³H]GDP to a mixture of G-proteins as well as individual classes of G-proteins upon binding of structurally different agonists to the M₂ muscarinic acetylcholine receptor. Agonists displayed biphasic competition curves with the antagonist [³H]-N-methylscopolamine. GTPγS (1 µM) changed the competition curves to monophasic with low affinity and 50 µM GDP produced a similar effect. Depletion of membrane-bound GDP increased the proportion of agonist high-affinity sites. Carbachol accelerated the dissociation of [³H]GDP from membranes. The inverse agonist N-methylscopolamine slowed GDP dissociation and GTPγS binding without changing affinity for GDP. Carbachol affected both GDP association with and dissociation from G(i/o) G-proteins but only its dissociation from G(s/olf) G-proteins. These findings suggest the existence of a low-affinity agonist-receptor conformation complexed with GDP-liganded G-protein. Also the negative cooperativity between GDP and agonist binding at the receptor/G-protein complex determines agonist efficacy. GDP binding reveals differences in action of agonists versus inverse agonists as well as differences in activation of G(i/o) versus G(s/olf) G-proteins that are not identified by conventional GTPγS binding. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  4. A double-blind, randomized, comparative study to evaluate the efficacy and safety of zaleplon versus zolpidem in shortening sleep latency in primary insomnia.

    Science.gov (United States)

    Huang, Yu-Shu; Hsu, Shih-Chieh; Liu, Shen-Ing; Chen, Chih-Ken

    2011-01-01

    Benzodiazepines cause a high proportion of adverse effects while non-benzodiazepine compounds have demonstrated high efficacy and less adverse effects in patients with insomnia. The objective of this study was to compare the effectiveness and safety of non-BZ zaleplon and zolpidem in primary insomnia. This was a randomized, double-blind, active-controlled, double-dummy, comparative study. A total of 48 patients were enrolled, of which 45 patients completed the study. Patients who entered the study were required to take the study drug orally once daily at bedtime for two weeks. Each patient kept a sleep diary and answered a questionnaire. We used these documents to measure and evaluate changes from baseline to Week 2 in sleep latency, duration and quality of sleep, the number of awakenings and incidence of rebound insomnia. The data revealed a significant decrease in sleep latency from baseline to Week 2 for patients receiving zaleplon 10 mg and zolpidem 10 mg. Patients receiving zaleplon exhibited a marginally greater, but not statistically significant, reduction in sleep latency than those who received zolpidem. There was no significant difference in the frequency of adverse effects between the zaleplon and zolpidem groups; however, during this clinical trial there was one lethal event caused by a traffic accident in the zaleplon group. There was no significant difference between zaleplon and zolpidem in the efficacy of reducing sleep latency or adverse effects. A large pharmacovigilance study is needed before concluding that either zolpidem or zaleplon is free from next-day residual effects.

  5. Experiences of activity measurements of primary circuit materials in a WWR-SM research reactor

    International Nuclear Information System (INIS)

    Elek, A.; Toth, M.; Bakos, L.; Vizdos, G.

    1980-01-01

    The activity of water and gas samples taken from the primary circuit have been measured nondestructively for more than two years to monitor the technological parameters of the reactor. In the primary water samples 17 fission products and seven activated traces, as well as six radioactive conponents in the gas samples were determined routinely by Ge/Li gamma-spectrometry. (author)

  6. Flowing-water optical power meter for primary-standard, multi-kilowatt laser power measurements

    Science.gov (United States)

    Williams, P. A.; Hadler, J. A.; Cromer, C.; West, J.; Li, X.; Lehman, J. H.

    2018-06-01

    A primary-standard flowing-water optical power meter for measuring multi-kilowatt laser emission has been built and operated. The design and operational details of this primary standard are described, and a full uncertainty analysis is provided covering the measurement range from 1–10 kW with an expanded uncertainty of 1.2%. Validating measurements at 5 kW and 10 kW show agreement with other measurement techniques to within the measurement uncertainty. This work of the U.S. Government is not subject to U.S. copyright.

  7. Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis

    International Nuclear Information System (INIS)

    Guckenberger, Matthias; Mantel, Frederick; Gerszten, Peter C; Flickinger, John C; Sahgal, Arjun; Létourneau, Daniel; Grills, Inga S; Jawad, Maha; Fahim, Daniel K; Shin, John H; Winey, Brian; Sheehan, Jason; Kersh, Ron

    2014-01-01

    To evaluate patient selection criteria, methodology, safety and clinical outcomes of stereotactic body radiotherapy (SBRT) for treatment of vertebral metastases. Eight centers from the United States (n = 5), Canada (n = 2) and Germany (n = 1) participated in the retrospective study and analyzed 301 patients with 387 vertebral metastases. No patient had been exposed to prior radiation at the treatment site. All patients were treated with linac-based SBRT using cone-beam CT image-guidance and online correction of set-up errors in six degrees of freedom. 387 spinal metastases were treated and the median follow-up was 11.8 months. The median number of consecutive vertebrae treated in a single volume was one (range, 1-6), and the median total dose was 24 Gy (range 8-60 Gy) in 3 fractions (range 1-20). The median EQD2 10 was 38 Gy (range 12-81 Gy). Median overall survival (OS) was 19.5 months and local tumor control (LC) at two years was 83.9%. On multivariate analysis for OS, male sex (p < 0.001; HR = 0.44), performance status <90 (p < 0.001; HR = 0.46), presence of visceral metastases (p = 0.007; HR = 0.50), uncontrolled systemic disease (p = 0.007; HR = 0.45), >1 vertebra treated with SBRT (p = 0.04; HR = 0.62) were correlated with worse outcomes. For LC, an interval between primary diagnosis of cancer and SBRT of ≤30 months (p = 0.01; HR = 0.27) and histology of primary disease (NSCLC, renal cell cancer, melanoma, other) (p = 0.01; HR = 0.21) were correlated with worse LC. Vertebral compression fractures progressed and developed de novo in 4.1% and 3.6%, respectively. Other adverse events were rare and no radiation induced myelopathy reported. This multi-institutional cohort study reports high rates of efficacy with spine SBRT. At this time the optimal fractionation within high dose practice is unknown

  8. [Adolescents' affectivity and sexuality: a randomized trial of the efficacy of a school health promotion intervention in a primary school].

    Science.gov (United States)

    Del Prete, Giuseppe; Giraldi, Guglielmo; Miccoli, Silvia; Salamone, Velia; Speranza, Mariangela; Vita, Michela; Osborn, John Frederick; Boccia, Antonio; La Torre, Giuseppe

    2012-01-01

    A cluster randomised trial was conducted to evaluate the efficacy of a health promotion intervention aimed at improving knowledge and preventing sexually transmitted diseases (STD) amongst Grade 9 primary school students in Salerno (Italy). Students were randomized to either one of two groups: intervention group or control group. The intervention group was required to attend three meetings, each lasting one and a half hours. A questionnaire was then administered to both groups to evaluate knowledge of STD, contraception, sexuality, affectivity, satisfaction with interpersonal relationships with family, social groups and healthcare professionals. Variations of knowledge in the two groups were evaluated through calculation of odds ratios. Three hundred twenty-two students participated in the study. All students who received the study intervention were able to identify at least one STD post-intervention, while 2.5% of students in the control group did not indicate any. Students in the intervention group were more likely to select condoms as the most suitable contraception for young people (OR 5.54; 95% CI 3.27 -9.38), compared to controls (OR 1.91; 95% CI 1.20 - 3.05) (p = 0.002). They were also better aware of the possibility of contracting a STD even after incomplete sexual intercourse (OR 0.21, 95% CI 0.13 to 0.35), with a statistically significant difference (p <0.001) compared to the control group (OR 0.71, 95% CI 0.45 to 1.11). In addition, students in the intervention group were more likely to turn to their own parents when having doubts about sexual issues (p = 0.004) and female students to consider their gynecologist as a reference figure. In conclusion, the findings indicate that students randomized to the intervention group were more informed and aware of issues related to sexuality and its associated risks.

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

    Science.gov (United States)

    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.

  10. What role does measuring medication compliance play in evaluating the efficacy of naltrexone?

    Science.gov (United States)

    Baros, Alicia M; Latham, Patricia K; Moak, Darlene H; Voronin, Konstantin; Anton, Raymond F

    2007-04-01

    Compliance with medication in pharmacotherapy trials of alcoholism has been shown to be equal to, or more, important than in other areas of medicine. Research has suggested that naltrexone's effectiveness can be greatly influenced by the compliance of participants in clinical trials. Presently, we compare 2 compliance measurement methods [urine riboflavin and medication event monitoring system (MEMS)] used simultaneously to evaluate naltrexone's efficacy and the impact of compliance on the size of observable treatment effects. One hundred and thirty-seven of 160 randomized alcoholic patients completed 12-weeks (84 days) of naltrexone or placebo and cognitive behavioral therapy (CBT) or motivational enhancement therapy (MET). Urine riboflavin was determined during study weeks 2, 6, and 12. The MEMS provided a detailed computerized record of when a participant opened their medication bottle throughout the trial. Baseline predictors of MEMS (80% openings) and urine riboflavin (>or=1,500 ng/mL by fluorimetry) compliance were examined. The effects of the treatments in the compliant participants defined by one, the other, or both methods were compared and contrasted with a previously reported intent-to-treat analysis where compliance was not taken into account. Age was predictive of compliance. 105 participants were deemed compliant via urine riboflavin criteria, 87 via MEMS, and 77 when both criteria were met, with no significant differences between treatment groups. The most compliant participants showed a significant medication by therapy interaction. Those treated with naltrexone/CBT showed more abstinence days (pcompliance measurement methods. Compliance measurement does appear to influence the evaluation of the efficacy of naltrexone within the context of CBT. Treatment effect sizes approximately doubled in the most compliant individuals. Measuring compliance by either of 2 distinct methods provides approximately similar results. As compliance with naltrexone

  11. Development of an instrument to measure self-efficacy in caregivers of people with advanced cancer.

    Science.gov (United States)

    Ugalde, Anna; Krishnasamy, Meinir; Schofield, Penelope

    2013-06-01

    Informal caregivers of people with advanced cancer experience many negative impacts as a result of their role. There is a lack of suitable measures specifically designed to assess their experience. This study aimed to develop a new measure to assess self-efficacy in caregivers of people with advanced cancer. The development and testing of the new measure consisted of four separate, sequential phases: generation of issues, development of issues into items, pilot testing and field testing. In the generation of issues, 17 caregivers were interviewed to generate data. These data were analysed to generate codes, which were then systematically developed into items to construct the instrument. The instrument was pilot tested with 14 health professionals and five caregivers. It was then administered to a large sample for field testing to establish the psychometric properties, with established measures including the Brief Cope and the Family Appraisals for Caregiving Questionnaire for Palliative Care. Ninety-four caregivers completed the questionnaire booklet to establish the factor structure, reliability and validity. The factor analysis resulted in a 21-item, four-factor instrument, with the subscales being termed Resilience, Self-Maintenance, Emotional Connectivity and Instrumental Caregiving. The test-retest reliability and internal consistency were both excellent, ranging from 0.73 to 0.85 and 0.81 to 0.94, respectively. Six convergent and divergent hypotheses were made, and five were supported. This study has developed a new instrument to assess self-efficacy in caregivers of people with advanced cancer. The result is a four-factor, 21-item instrument with demonstrated reliability and validity. Copyright © 2012 John Wiley & Sons, Ltd.

  12. Measurement of transient hydrodynamic characteristics of the reactor RA primary cooling system

    International Nuclear Information System (INIS)

    Jovic, L.; Majstorovic, D.; Zeljkovic, I.

    1987-01-01

    Experimental study of transient hydrodynamic characteristics of the research nuclear reactor RA by simultaneous measurements of fluid flow and pressure on several locations of the RA primary coolant system is done. Loss of electric power transient on the main circulation pumps is simulated. measurement methodology, data processing and results of measured data analysis are given. (author)

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  15. The flow measurement methods for the primary system of integral reactors

    International Nuclear Information System (INIS)

    Lee, J.; Seo, J. K.; Lee, D. J.

    2001-01-01

    It is the common features of the integral reactors that the main components of the primary system are installed within the reactor vessel, and so there are no any flow pipes connecting the reactor coolant pumps or steam generators. Due to no any flow pipes, it is impossible to measure the differential pressure at the primary system of the integral reactors, and it also makes impossible measure the primary coolant flow rate. The objective of the study is to draw up the flow measurement methods for the primary system of integral reactors. As a result of the review, we have made a selection of the flow measurement method by pump speed, bt HBM, and by pump motor power as the flow measurement methods for the primary system of integral reactors. Peculiarly, we did not found out a precedent which the direct pump motor power-flow rate curve is used as the flow measurement method in the existing commercial nuclear power reactors. Therefore, to use this method for integral reactors, it is needed to bear the follow-up measures in mind. The follow-up measures is included in this report

  16. Associations between structural capabilities of primary care practices and performance on selected quality measures.

    Science.gov (United States)

    Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Zaslavsky, Alan M; Schneider, Eric C

    2009-10-06

    Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown. To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures. Cross-sectional analysis. Massachusetts. 412 primary care practices. During 2007, 1 physician from each participating primary care practice (median size, 4 physicians) was surveyed about structural capabilities of the practice (responses representing 308 practices were obtained). Data on practice structural capabilities were linked to multipayer performance data on 13 Healthcare Effectiveness Data and Information Set (HEDIS) process measures in 4 clinical areas: screening, diabetes, depression, and overuse. Frequently used multifunctional electronic health records were associated with higher performance on 5 HEDIS measures (3 in screening and 2 in diabetes), with statistically significant differences in performance ranging from 3.1 to 7.6 percentage points. Frequent meetings to discuss quality were associated with higher performance on 3 measures of diabetes care (differences ranging from 2.3 to 3.1 percentage points). Physician awareness of patient experience ratings was associated with higher performance on screening for breast cancer and cervical cancer (1.9 and 2.2 percentage points, respectively). No other structural capabilities were associated with performance on more than 1 measure. No capabilities were associated with performance on depression care or overuse. Structural capabilities of primary care practices were assessed by physician survey. Among the investigated structural capabilities of primary care practices, electronic health records were associated with higher performance across multiple HEDIS measures. Overall, the modest magnitude and

  17. Psychometric Characteristics of a New Scale for Measuring Self-efficacy in the Regulation of Gambling Behavior

    Directory of Open Access Journals (Sweden)

    Claudio Barbaranelli

    2017-06-01

    Full Text Available Since its introduction in 1977, self-efficacy has proven to be a fundamental predictor of positive adjustment and achievement in many domains. In problem gambling studies, self-efficacy has been defined mainly as an individual's ability to avoid gambling in risky situations. The interest in this construct developed mainly with regard to treatment approaches, where abstinence from gambling is required. Very little is known, however, regarding self-efficacy as a protective factor for problem gambling. This study aims to fill this gap, proposing a new self-efficacy scale which measures not only the ability to restrain oneself from gambling but also the ability to self-regulate one's gambling behavior. Two studies were conducted in which the data from two Italian prevalence surveys on problem gambling were considered. A total of about 6,000 participants were involved. In the first study, the psychometric characteristics of this new self-efficacy scale were investigated through exploratory and confirmatory factor analyses. The results indicated the presence of two different factors: self-efficacy in self-regulating gambling behavior and self-efficacy in avoiding risky gambling behavior. The second study confirmed the replicability of the two-factor solution and displayed high correlations among these two self-efficacy dimensions and different measures of gambling activities as well as other psychological variables related to gambling (gambling beliefs, gambling motivation, risk propensity, and impulsiveness. The results of logistic regression analyses showed the particular importance of self-regulating gaming behavior in explaining problem gambling as measured by Problem Gambling Severity Index and South Oaks Gambling Screen, thus proving the role of self-efficacy as a pivotal protective factor for problem gambling.

  18. Efficacies of prevention and control measures applied during an outbreak in Southwest Madrid, Spain.

    Directory of Open Access Journals (Sweden)

    Anaiá da Paixão Sevá

    Full Text Available Leishmaniasis is a vector-borne disease of worldwide distribution, currently present in 98 countries. Since late 2010, an unusual increase of human visceral and cutaneous leishmaniasis cases has been observed in the south-western Madrid region, totaling more than 600 cases until 2015. Some hosts, such as human, domestic dog and cat, rabbit (Oryctolagus cuniculus, and hare (Lepus granatensis, were found infected by the parasite of this disease in the area. Hares were described as the most important reservoir due to their higher prevalence, capacity to infect the vector, and presence of the same strains as in humans. Various measures were adopted to prevent and control the disease, and since 2013 there was a slight decline in the human sickness. We used a mathematical model to evaluate the efficacy of each measure in reducing the number of infected hosts. We identified in the present model that culling both hares and rabbits, without immediate reposition of the animals, was the best measure adopted, decreasing the proportion of all infected hosts. Particularly, culling hares was more efficacious than culling rabbits to reduce the proportion of infected individuals of all hosts. Likewise, lowering vector contact with hares highly influenced the reduction of the proportion of infected hosts. The reduction of the vector density per host in the park decreased the leishmaniasis incidence of hosts in the park and the urban areas. On the other hand, the reduction of the vector density per host of the urban area (humans, dogs and cats decreased only their affected population, albeit at a higher proportion. The use of insecticide-impregnated collar and vaccination in dogs affected only the infected dogs' population. The parameters related to the vector contact with dog, cat or human do not present a high impact on the other hosts infected by Leishmania. In conclusion, the efficacy of each control strategy was determined, in order to direct future actions

  19. Primary production measurements at three reservoirs in the state of Sao Paulo, Brazil

    International Nuclear Information System (INIS)

    Jureidini, P.; Chinez, S.J.; Agudo, E.G.

    1983-01-01

    Primary production measurements were carried out at three reservoirs in the state of Sao Paulo, Barra Bonita, Paiva Castro and Ponte nova using the 14 C technique. Meanwhile, several physical and chemical parameters of these water were also evaluated, in order to find out the limnological conditions of these reservoirs. Primary production rates ranged from 7,6mg C/m 3 d at Ponte Nova, to 247,2mg C/m 3 d at Barra Bonita. There seems to be god correlation between water quality data and primary production measurements. Regarding the results, it may be stated that the Barra Bonita reservoir has reached the eutrophic level, while the other two exibit mesotrophic levels. As a way of testing the water quality data collected was used in Churchill and Nicholas model, issuing results in agreement with those of the primary production measurements. (Author) [pt

  20. Validating a Scale That Measures Scientists' Self-Efficacy for Public Engagement with Science

    Science.gov (United States)

    Robertson Evia, Jane; Peterman, Karen; Cloyd, Emily; Besley, John

    2018-01-01

    Self-efficacy, or the beliefs people hold about their ability to succeed in certain pursuits, is a long-established construct. Self-efficacy for science communication distinguishes scientists who engage with the public and relates to scientists' attitudes about the public. As such, self-efficacy for public engagement has the potential to serve as…

  1. Measuring and Examining General Self-Efficacy among Community College Students: A Structural Equation Modeling Approach

    Science.gov (United States)

    Chen, Yu; Starobin, Soko S.

    2018-01-01

    This study examined a psychosocial mechanism of how general self-efficacy interacts with other key factors and influences degree aspiration for students enrolled in an urban diverse community college. Using general self-efficacy scales, the authors hypothesized the General Self-efficacy model for Community College students (the GSE-CC model). A…

  2. The Quest for Comparability: Studying the Invariance of the Teachers’ Sense of Self-Efficacy (TSES) Measure across Countries

    Science.gov (United States)

    Scherer, Ronny; Jansen, Malte; Nilsen, Trude; Areepattamannil, Shaljan; Marsh, Herbert W.

    2016-01-01

    Teachers’ self-efficacy is an important motivational construct that is positively related to a variety of outcomes for both the teachers and their students. This study addresses challenges associated with the commonly used ‘Teachers’ Sense of Self-Efficacy (TSES)’ measure across countries and provides a synergism between substantive research on teachers’ self-efficacy and the novel methodological approach of exploratory structural equation modeling (ESEM). These challenges include adequately representing the conceptual overlap between the facets of self-efficacy in a measurement model (cross-loadings) and comparing means and factor structures across countries (measurement invariance). On the basis of the OECD Teaching and Learning International Survey (TALIS) 2013 data set comprising 32 countries (N = 164,687), we investigate the effects of cross-loadings in the TSES measurement model on the results of measurement invariance testing and the estimation of relations to external constructs (i.e., working experience, job satisfaction). To further test the robustness of our results, we replicate the 32-countries analyses for three selected sub-groups of countries (i.e., Nordic, East and South-East Asian, and Anglo-Saxon country clusters). For each of the TALIS 2013 participating countries, we found that the factor structure of the self-efficacy measure is better represented by ESEM than by confirmatory factor analysis (CFA) models that do not allow for cross-loadings. For both ESEM and CFA, only metric invariance could be achieved. Nevertheless, invariance levels beyond metric invariance are better achieved with ESEM within selected country clusters. Moreover, the existence of cross-loadings did not affect the relations between the dimensions of teachers’ self-efficacy and external constructs. Overall, this study shows that a conceptual overlap between the facets of self-efficacy exists and can be well-represented by ESEM. We further argue for the cross

  3. The Quest for Comparability: Studying the Invariance of the Teachers' Sense of Self-Efficacy (TSES) Measure across Countries.

    Science.gov (United States)

    Scherer, Ronny; Jansen, Malte; Nilsen, Trude; Areepattamannil, Shaljan; Marsh, Herbert W

    2016-01-01

    Teachers' self-efficacy is an important motivational construct that is positively related to a variety of outcomes for both the teachers and their students. This study addresses challenges associated with the commonly used 'Teachers' Sense of Self-Efficacy (TSES)' measure across countries and provides a synergism between substantive research on teachers' self-efficacy and the novel methodological approach of exploratory structural equation modeling (ESEM). These challenges include adequately representing the conceptual overlap between the facets of self-efficacy in a measurement model (cross-loadings) and comparing means and factor structures across countries (measurement invariance). On the basis of the OECD Teaching and Learning International Survey (TALIS) 2013 data set comprising 32 countries (N = 164,687), we investigate the effects of cross-loadings in the TSES measurement model on the results of measurement invariance testing and the estimation of relations to external constructs (i.e., working experience, job satisfaction). To further test the robustness of our results, we replicate the 32-countries analyses for three selected sub-groups of countries (i.e., Nordic, East and South-East Asian, and Anglo-Saxon country clusters). For each of the TALIS 2013 participating countries, we found that the factor structure of the self-efficacy measure is better represented by ESEM than by confirmatory factor analysis (CFA) models that do not allow for cross-loadings. For both ESEM and CFA, only metric invariance could be achieved. Nevertheless, invariance levels beyond metric invariance are better achieved with ESEM within selected country clusters. Moreover, the existence of cross-loadings did not affect the relations between the dimensions of teachers' self-efficacy and external constructs. Overall, this study shows that a conceptual overlap between the facets of self-efficacy exists and can be well-represented by ESEM. We further argue for the cross

  4. The efficacy of intravitreal antivascular endothelial growth factor as primary treatment of retinopathy of prematurity: Experience from a tertiary hospital

    Directory of Open Access Journals (Sweden)

    H Kana

    2017-03-01

    Full Text Available Background. Retinopathy of prematurity (ROP is a vasoproliferative disease affecting premature babies and a major cause of blindness in childhood. Appropriate screening and treatment can prevent blindness. Objective. To report on the efficacy of using antivascular endothelial growth factor (bevacizumab as first-line therapy in ROP. Methods. This was a retrospective analysis of patients with ROP treated at St John Eye Hospital, Johannesburg, South Africa, over a 3-year period. Outcome measures were the clinical response to intravitreal bevacizumab (IVB as well as the economic impact of IVB therapy. Results. Twenty-three patients were treated for active ROP or type 1 disease, in 44 eyes. Two patients required treatment in one eye only. The mean birth weight of these patients was 1 074 g (range 810 - 1 480. Response to treatment outcome was available for 22 patients (43 eyes. The mean follow-up period was 9 months (range 1 - 18. Forty-one eyes (95.3% showed complete regression or non-progression of the disease. Two eyes (one eye each in two patients progressed to advanced disease. There were no short-term adverse events. A cost-effective model showed that IVB treatment was much more economical than laser therapy. Conclusion. IVB is a safe and effective first-line treatment for ROP and should be considered in resource-limited centres.

  5. Clinical efficacy of Trigonella foenum graecum (Fenugreek) and dry cupping therapy on intensity of pain in patients with primary dysmenorrhea.

    Science.gov (United States)

    Inanmdar, Wajida; Sultana, Arshiya; Mubeen, Umraz; Rahman, Khaleequr

    2016-05-25

    To determine the effificacy and safety of fenugreek seed and dry cupping on intensity of pain in primary dysmenorrhea. Sixty patients with primary dysmenorrhea were enrolled in this prospective, open-labeled, randomized, standard-controlled study, conducted in the National Institute of Unani Medicine Hospital between February 2010 and April 2011. In group A (20 cases), 3 g powder of fenugreek seed (3 capsules, 1 g each) was given orally twice daily from day 1 to 3 of menstrual cycle. Group B (20 cases) received the same dose of fenugreek seed as group A along with dry cupping therapy [two 4.2-cm and one 2.5-cm cups (internal diameter)], which was applied below the umbilicus for 15 min on day 1 and day 3 of menstrual cycle for 3 consecutive months. The control group C (20 cases) was given mefenamic acid, 500 mg twice daily, on the same protocol. The reduction in menstrual pain intensity was measured with well validated Visual Analogue Scale and safety of fenugreek seed was evaluated by clinical examination and laboratory investigations. Baseline characteristics and biochemical parameters were comparable and homogenous among all groups (P>0.05). The percentage reduction in lower abdominal pain was 66.89%, 66.49%, and 62.88% in A, B and C groups respectively at the end of the treatment. No adverse drug effects were noticed. The fenugreek seed and dry cupping are effificacious, safe, cost effective, and well tolerated.

  6. Change in Self-Efficacy as a Measure of Training Effectiveness at Squadron Officer School.

    Science.gov (United States)

    1992-09-01

    Note: Low scores indicate high self-efficacy SExt Sat E Sat ---X-- No Opin -0 Dissat • Ext Dissat Figure O.10.b Profile Plot for TALJOB 0-46...efficacy SExt Sat - Sat --X No Opin -& Dissat Ext Dissat Figure O.10.c Profile Plot for TALJOB 0-47 Communication Skills SATISFACTION WITH TALENT USE...PRE-TEST) Mean 35 Low Self-Efficacy 30 - 25l 20 ... . . 15 High Self-Efficacy 10 Before After Note: Low scores indicate high self-efficacy SExt Sat E

  7. Development of a Survey to Measure Self-Efficacy and Attitudes toward Web-Based Professional Development among Elementary School Teachers

    Science.gov (United States)

    Kao, Chia-Pin; Tsai, Chin-Chung; Shih, Meilun

    2014-01-01

    The major purpose of this study was to develop a survey to measure elementary school teachers' self-efficacy for web-based professional development. Based on interviews with eight elementary school teachers, three scales of web-based professional development self-efficacy (WPDSE) were formed, namely, general self-efficacy (measuring teachers'…

  8. Primary flow and temperature measurements in PWRS using non-invasive techniques

    International Nuclear Information System (INIS)

    Favennec, J.M.; Jossinet, G.; Thomas, P.

    1995-08-01

    PWR primary flow and temperature measurements are classically done with either indirect or invasive techniques. EDF has developed and installed non-invasive innovative techniques on an industrial nuclear power plant (Chooz N1 type PWR). Primary flow-rate is determined by measurement of velocity of primary water in the hot leg: the time fluctuation of γ-ray activity from Nitrogen-16 (produced by neutron activation of 016) is measured outside of the pipe by two specially-designed detectors. The signals from both detectors are then cross-correlated to determine the transit time of primary water between the two detectors; primary flow-rate is then deduced Primary temperature is determined by measurement of sound velocity in hot and cold leg: two pairs of ultrasonic transducers, installed on pipe outer wall, emit pulses periodically, for which the time of flight along the two pipes diameters are determined. The sound velocity thus computed (diameter over time of flight) is then converted into temperature, by use of a calibration formula relating sound velocity to temperature and pressure. This paper addresses metrological and technical aspects of the methods. Experience feedback on industrial PWRs is also presented. (author). 4 refs., 13 figs

  9. 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.

  10. The Measurement of Students' Achievement in Teaching Primary School Fifth Year Mathematics Classes

    Science.gov (United States)

    Doganay, Ahmet; Bal, Ayten Pinar

    2010-01-01

    The aim of this study was to investigate students' and teachers' point of views about preparing measurement tools used in mathematics classes, the level of learning that these tools are intended to measure, how often they are used and how they are scored in terms of assessing 5th grade primary school mathematic courses. The population of the study…

  11. Developing a measure of patient access to primary care: the access response index (AROS).

    NARCIS (Netherlands)

    Elwyn, G.; Jones, W.; Rhydderch, S.M.; Edwards, P.

    2003-01-01

    Access to appointments in primary care is not routinely measured, and there is no one standardized method for doing so. Any measurement tool has to take account of the dynamic status of appointment availability and the definitional problems of appointment types. The aim of this study was to develop

  12. Three Scales to Measure Burnout of Primary School Teachers: Empirical Evidence on Their Adequacy

    Science.gov (United States)

    Platsidou, Maria; Daniilidou, Athena

    2016-01-01

    This study aimed at comparing the psychometric properties of three measures of burnout administered in 320 Greek primary school teachers, namely the Maslach Burnout Inventory (Maslach and Jackson 1982), the Burnout Measure (Pines and Aronson 1988) and the Copenhagen Burnout Inventory (Kristensen et al. 2005). Confirmatory factor analysis tested a…

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

    Directory of Open Access Journals (Sweden)

    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

  14. Efficacy of reduced doses of bentazone assessed by instruments based on measurement of chlorophyll fluorescence

    Directory of Open Access Journals (Sweden)

    Vojtěch Kocurek

    2011-01-01

    Full Text Available Chlorophyll fluorescence is a type of radiation emitted by plants as unused part of energy absorbed from sunlight. Its intensity depends on many stress factors, nutrition, weather conditions etc. Methods based on chlorophyll fluorescence measurement have potential to be perspective for the assessment of herbicide efficacy, phytotoxicity or stress influence. Two fluorometers (FluorCam and handy FluorPen were used for measurements in laboratory experiments in 2007–2009. Herbicide Basagran super with active ingredient bentazone (480 g.l−1 was tested using a parameter called ‚Quantum yield of fluorescence‘ (QY in three different doses: the registered dose 2.0 l.ha−1 (100% and lower doses 1.5 l.ha−1 (75% and 1.0 l.ha−1 (50%. Treated experimental plants of redroot pigweed (Amaranthus retroflexus L. were measured in 0, 1, 2, 3, 6, 9 and 15 days after treatment and the results were compared with subjective assessment (estimation and growth parameters. The obtained results showed that the effect of bentazone measured by both devices was statistically significantly different from untreated control. We can also detect herbicide effect earlier by QY measurement than by other methods. Different doses showed significant differences 15 days after treatment for dose 2.0 l.ha−1 in comparison with both reduced doses. The subjective assessment showed significant differences in all terms of measurement (1–15 days after application except of the day of application. Regeneration of plants for which the youngest leaves were not treated by herbicide was observed for all doses. Difference of QY values between used devices was on average 0.119 (higher for FluorCam but statistically insignificant.

  15. Psychometrics of a brief measure of emotional self-efficacy among adolescents from the United States.

    Science.gov (United States)

    Valois, Robert F; Zullig, Keith J

    2013-10-01

    Preliminary data were collected to evaluate the psychometric properties of an emotional self-efficacy (ESE) measure in a sample of 3836 public high school adolescents who completed the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey in South Carolina. Principal axis factor analysis was followed by a 4-way between-groups analysis of variance (ANOVA) testing for differences in total score means on selected demographic estimates and their interactions. Relationships between total score and selected risk behaviors were examined through a series of 1-way ANOVA procedures and subsequent Tukey Honest Significant Difference (HSD) tests. Factor analysis results suggested that a 1-factor model best explained factor structure of the scale items (factor loadings .64 to .71, eigenvalue = 3.24, h(2)  = .46). Girls reported a significantly higher mean total ESE rating than boys; White students reported a significantly higher mean total ESE rating than Black students. Statistically significant lower mean total ESE ratings were also noted for those who reported physical fighting, lifetime alcohol use, and sexual intercourse. This 7-item scale is a reliable measure and could aid school health researchers and mental health practitioners in psychosocial screening and as an outcome of social and emotional learning as a brief measure of adolescent ESE. © 2013, American School Health Association.

  16. Efficacy of lung ventilation scintigram and exercise pulmonary hemodynamic measurement to evaluate operability for pulmonary resection

    International Nuclear Information System (INIS)

    Kaneda, Masanori; Hayashi, Takashi; Hiraiwa, Takane; Sakai, Takashi; Namikawa, Shoji; Kusakawa, Minoru.

    1989-01-01

    Preoperative evaluation of patients with lung cancer should include data concerning both resectability and operability. Operability addresses the question how much pulmonary tissue can be safely removed. The purpose of this study is to demonstrate an efficacy of the lung ventilation scintigram and measurement of exercise change in pulmonary hemodynamic parameters by detecting respiratory and circulatory reserve of pulmonary function. Predicted postoperative forced vital capacity (FVC) were calculated from the data of lung scintigram and preoperative spirometry by means of subsegmental formula. Accuracy of prediction was confirmed by spirometry 6 months after the operation. Correlation coefficient between predicted value and actually measured one was R=0.95, and simple regression formula was y=0.98x-10.4. It was recommended that the lower limit should be setted at 40% by the calculated postoperative %FVC. Exercise test were performed by means of bicycle ergometer with the measurement of pulmonary arterial pressure and cardiac output. Pulmonary arterial resistance index (PARI) were also calculated. In younger group rise of pulmonary arterial pressure during exercise was gentle, and PARI was settled between 150 to 200 in high output state. But in older group rise of pulmonary aerial pressure was steep and PARI was over 200 in some cases, just like the case of COLD. It should be recommended to set the upper limit of PARI at 400 in maximum exercise. (author)

  17. Efficacy of anthropometric measures for identifying cardiovascular disease risk in adolescents: review and meta-analysis.

    Science.gov (United States)

    Lichtenauer, Michael; Wheatley, Sean D; Martyn-St James, Marrissa; Duncan, Michael J; Cobayashi, Fernanda; Berg, Gabriela; Musso, Carla; Graffigna, Mabel; Soutelo, Jimena; Bovet, Pascal; Kollias, Anastasios; Stergiou, George S; Grammatikos, Evangelos; Griffiths, Claire; Ingle, Lee; Jung, Christian

    2018-04-12

    To compare the ability of body mass index (BMI), waist circumference (WC) and waist to height ratio (WHtR) to estimate cardiovascular disease (CVD) risk levels in adolescents. A systematic review and meta-analysis was performed after a database search for relevant literature (Cochrane, Centre for Review and Dissemination, PubMed, British Nursing Index, CINAHL, BIOSIS citation index, ChildData, metaRegister). 117 records representing 96 studies with 994,595 participants were included in the systematic review, 14 of which (13 studies, n=14,610) were eligible for the meta-analysis. The results of the meta-analysis showed that BMI was a strong indicator of systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin; but not total cholesterol, low-density lipoprotein or glucose. Few studies were eligible for inclusion in the meta-analysis considering WC or WHtR (n≤2). The narrative synthesis found measures of central adiposity to be consistently valid indicators of the same risk factors as BMI. BMI was an indicator of CVD risk. WC and WHtR were efficacious for indicating the same risk factors BMI performed strongly for, though there was insufficient evidence to judge the relative strength of each measure possibly due to heterogeneity in the methods for measuring and classifying WC.

  18. The primary exposure standard for Co-60 gamma radiation: characteristics and measurements procedures

    International Nuclear Information System (INIS)

    Laitano, R.F.; Toni, M.P.

    1983-01-01

    A description is given of a cavity ionization chamber used, as a primary exposure standard, at the Laboratorio di Metrologia delle Radiazioni Ionizzanti of the ENEA in Italy. The primary standard is designed to make absolute measurements of exposure due to the Co-60 gamma radiation. The procedures for the realizationof the exposure unit are also described. Finally results of some international comparisons are reported

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Measurement of the efficacy of 2% lipid in reversing bupivacaine- induced asystole in isolated rat hearts

    Science.gov (United States)

    2014-01-01

    Background The reversal efficacy of 2% lipid emulsion in cardiac asystole induced by different concentrations of bupivacaine is poorly defined and needs to be determined. Methods Forty-two male Sprague–Dawley rats were randomly divided into seven groups: B40, B60, B80, B100, B120, B140 and B160, n = 6. The Langendorff isolated heart perfusion model was used, which consisted of a balanced perfusion with Krebs-Henseleit solution for 25 minutes and a continuous infusion of 100 μmol/L bupivacaine until asystole had been induced for 3 minutes. The hearts in the seven groups were perfused with Krebs-Henseleit solution containing a 2% lipid emulsion, and 40, 60, 80, 100, 120, 140 or 160 μmol/L bupivacaine, respectively. Cardiac recovery was defined as a spontaneous and regular rhythm with a rate-pressure product > 10% of the baseline value for more than 1 minute. Our primary outcome was the rate-pressure product 25 minutes after cardiac recovery. Other cardiac function parameters were also recorded. Results All groups demonstrated cardiac recovery. During the recovery phase, heart rate, rate-pressure product, the maximum left ventricular pressure rise and decline in heart rate in the B120-B160 groups was significantly lower than those in the B40-B80 groups (P bupivacaine and the reversal effects of a 2% lipid emulsion showed a typical transoid S-shaped curve, R2 = 0.9983, IC50 value was 102.5 μmol/L (95% CI: 92.44 - 113.6). Conclusions There is a concentration-response relationship between the concentrations of bupivacaine and the reversal effects of 2% lipid emulsion. PMID:25089118

  1. Contextualized Measurement of Self-Efficacy and College Students' Perceived Sources of Self-Efficacy in Introductory Plant Science Courses

    Science.gov (United States)

    Keefe, Lisa Madalon

    2013-01-01

    Institutions of higher learning are recently being held more accountable for the learning outcomes of their students. As such, universities have begun to actively measure and evaluate student learning and motivational outcomes in an effort to improve the successful outcomes of their students. To support this work, two studies were conducted to…

  2. A Scale to Measure Teachers' Self-Efficacy in Deaf-Blindness Education

    Science.gov (United States)

    Hartmann, Elizabeth

    2012-01-01

    Introduction: The Teacher Efficacy in Deafblindness Education Scale (TEDE) was developed to expand the construct of self-efficacy to teach children with deaf-blindness. Methods: Eighty-seven special educators in the United States were asked to rate their confidence to perform a variety of tasks that are associated with teaching children who are…

  3. Measuring the Sources of Self-Efficacy among Secondary School Music Students

    Science.gov (United States)

    Zelenak, Michael S.

    2015-01-01

    The purpose of this study was to investigate the four sources of self-efficacy in music performance and examine responses from the Music Performance Self-Efficacy Scale (MPSES). Participants (N = 290) were middle and high school music students from 10 schools in two regions of the United States. Questions included the following: (1) How much…

  4. DREAMer-Ally Competency and Self-Efficacy: Developing Higher Education Staff and Measuring Lasting Outcomes

    Science.gov (United States)

    Cisneros, Jesus; Cadenas, German

    2017-01-01

    DREAMzone is an educational intervention designed to increase higher education professionals' competency and self-efficacy for working with undocumented students. Grounded in social learning theory, we developed the DREAMer-ally instrument to investigate the effects of DREAMzone on DREAMer-ally competency and self-efficacy. Findings support the…

  5. Self-Efficacy of Prospective Austrian and German Primary School Teachers Regarding the Implementation of Inclusive Education

    Science.gov (United States)

    Schwab, Susanne; Hellmich, Frank; Görel, Gamze

    2017-01-01

    This study examined the psychometric properties of the German version of the Teacher Inclusive Education Self-Efficacy Scale (TIESES). Five hundred and nineteen teacher education students from Austria and 765 teacher education students from Germany participated in the study. Results of a multiple-group confirmatory factor analysis (for the two…

  6. The English and Spanish Self-Efficacy to Manage Chronic Disease Scale measures were validated using multiple studies.

    Science.gov (United States)

    Ritter, Philip L; Lorig, Kate

    2014-11-01

    Self-efficacy theory, as developed by Bandura, suggests that self-efficacy is an important predictor of future behavior. The Chronic Disease Self-Management Program was designed to enhance self-efficacy as one approach to improving health behaviors and outcomes for people with varying chronic diseases. The six-item Self-Efficacy to Manage Chronic Disease Scale (SEMCD) and the four-item Spanish-language version (SEMCD-S) were developed to measure changes in self-efficacy in program participants and have been used in a numerous evaluations of chronic disease self-management programs. This study describes the development of the scales and their psychometric properties. Secondary analyses of questionnaire data from 2,866 participants in six studies are used to quantify and evaluate the SEMCD. Data from 868 participants in two studies are used for the SEMCD-S. Subjects consisted of individuals with various chronic conditions, who enrolled in chronic disease self-management programs (either small group or Internet based). Subjects came from United States, England, Canada, Mexico, and Australia. Descriptive statistics are summarized, reliability tested (Cronbach alpha), and principal component analyses applied to items. Baseline and change scores are correlated with baseline and change scores for five medical outcome variables that have been shown to be associated with self-efficacy measures in past studies. Principal component analyses confirmed the one-dimensional structure of the scales. The SEMCD had means ranging from 4.9 to 6.1 and the SEMCD-S 6.1 and 6.2. Internal consistency was high (Cronbach alpha, 0.88-0.95). The scales were sensitive to change and significantly correlated with health outcomes. The SEMCD and SEMCD-S are reliable and appear to be valid instruments for assessing self-efficacy for managing chronic disease. There was remarkable consistency across a range of studies from varying countries using two languages. Copyright © 2014 Elsevier Inc. All

  7. Measurement and evaluation of radioactive corrosion product behaviour in primary sodium circuits of JOYO

    International Nuclear Information System (INIS)

    Ito, K.; Iizawa, K.; Takahashi, K.; Zulquarnain, M.A.; Suzuki, S.; Kinjo, K.

    1992-01-01

    In the experimental fast reactor JOYO, the radioactive corrosion product (CP) measurement has been conducted in the primary sodium circuits during each annual inspection. The measured data has been analyzed by the computer code 'PSYCHE', which has been developed by PNC. Main results obtained from the measurements and/or calculations are as follows; (1) The dominant CP nuclide is 54 Mn followed by 60 Co and 58 Co. (2) Average surface gamma dose rate around the primary piping system at the 8th annual inspection is 0.96 mSv/h. The increasing rate of this value is 0.25 (mSv/h)/EFPY. (3) The calculated deposition densities of 54 Mn and 60 Co agree with measured ones within factor of 0.7 ∼ 1.7. (author)

  8. 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.

  9. 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.

  10. Preparation of gaseous CRMs from the primary system for "2"2"2Rn activity measurement

    International Nuclear Information System (INIS)

    Kim, B.J.; Kim, B.C.; Lee, K.B.; Lee, J.M.; Park, T.S.

    2016-01-01

    For disseminating the gaseous radon standard traceable to the KRISS primary system based on the defined solid angle counting method, two kinds of radon CRM (a glass ampule type and a stainless steel cylinder type) were developed. The activity of the CRM was certified by subtracting a residual activity from the measured activity by the primary system. After certification, the ampule CRM was used to calibrate a radon-monitoring instrument and the cylinder CRM to calibrate an HPGe system. We also improved the measurement procedure of the radon primary system. In a typical radon energy spectrum, the radon peak overlaps with the polonium peak. For more reliable and accurate measurement of radon activity, a fitting method was adopted for the evaluation of radon area in the alpha energy spectrum. The result of radon activity evaluated by using the fitting method is in good agreement with that by the previous integration method. - Highlights: • Preparation of gaseous Rn-222 CRMs from primary measurement system. • Convolution of 3 left-handed exponentials with a Gaussian function to count radon. • Calibration of continuous radon monitor using glass ampoule CRM. • Calibration of HPGe system as secondary standard for stainless steel cylinder CRM.

  11. Measurement of the primary and scatter dose in high energy photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Van der Linden, P M [Catharina Ziekenhuis, Eindhoven (Netherlands). Radiotherapy Dept.; Tiourina, T B; Dries, W

    1995-12-01

    A method is presented to measure the primary and scatter components separately in a water tank using a small cylindrical absorber. Results from this experiment are compared with Monte Carlo calculations. The measurement setup consists of a small cylindrical absorber placed on a central axis of the beam a few centimetres above the radiation detector. Both absorber and detector move along the central axis while absorbed dose is registered. As the primary radiation is fully blocked, only scatter component is measured when a cylindrical absorber is used. Measurements in open fields result in the total absorbed dose being the sum of primary and scatter components. The primary dose component can be derived by substraction. Absorbers with different diameters are used. With decreasing dimensions the relative contribution of the dose due to scatter radiation increases. A steep increase is observed when the range of laterally scattered electrons becomes comparable with the radius of the absorber. Two different Monte Carlo simulations have been performed: with and without secondary electron transport. The data obtained for the former case perfectly agrees with the experiment. The situation where the secondary electron is assumed zero (i.e. local energy deposition) simulates the Cunningham model. Our results show that the Cunningham model predicts lower scatter component under the block edge which can be important for these applications.

  12. Development of Population-Based Resilience Measures in the Primary School Setting

    Science.gov (United States)

    Sun, Jing; Stewart, Donald

    2007-01-01

    Purpose: The purpose of the population-based study in the paper is to report on progress in formulating instruments to measure children's resilience and associated protective factors in family, primary school and community contexts. Design/methodology/approach: In this paper a total of 2,794 students, 1,558 parents/caregivers, and 465 staff were…

  13. Validity and reliability of questionnaires measuring physical activity self-efficacy, enjoyment, social support among Hong Kong Chinese children

    Science.gov (United States)

    Physical activity (PA) correlates have not been extensively studied in Hong Kong children. The aim of this study is to assess the validity and reliability of translated scales to measure PA related self-efficacy, enjoyment and social support in Hong Kong Chinese children. Sample 1 (n=273, aged 8–12 ...

  14. Discriminant validity of a new measure of self-efficacy for reaching movements after stroke-induced hemiparesis.

    Science.gov (United States)

    Chen, Shuya; Lewthwaite, Rebecca; Schweighofer, Nicolas; Winstein, Carolee J

    2013-01-01

    Case-control study. After stroke, difficulties in motor control mediate spontaneous paretic arm use in real life. Along with the obvious motor impairments, self-efficacy has been shown to be an important modifier for physical function. However, a self-efficacy measure for arm reaching is lacking. The aim of this study was to develop such a measure and to examine its validity. Fifteen participants with hemiparesis and ten control participants were recruited. A measure of reaching self-efficacy (RSE) was developed using a two-dimensional center-out target array. For the control group, RSE was significantly correlated with target distance (r = -0.657) and location (r = -0.545), respectively. Additionally, average RSE was lower for the non-dominant than the dominant hand (p RSE was significantly correlated with target distance (r = -0.603) and location (r = -0.378), respectively. Finally, average RSE was lower for the paretic than the non-paretic hand (p validity for this new measure of reaching self-efficacy. 3b. Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  15. Measuring safety culture in Dutch primary care: psychometric characteristics of the SCOPE-PC questionnaire.

    Science.gov (United States)

    Verbakel, Natasha J; Zwart, Dorien L M; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula

    2013-09-17

    Patient safety has been a priority in primary healthcare in the last years. The prevailing culture is seen as an important condition for patient safety in practice and several tools to measure patient safety culture have therefore been developed. Although Dutch primary care consists of different professions, such as general practice, dental care, dietetics, physiotherapy and midwifery, a safety culture questionnaire was only available for general practices. The purpose of this study was to modify and validate this existing questionnaire to a generic questionnaire for all professions in Dutch primary care. A validated Dutch questionnaire for general practices was modified to make it usable for all Dutch primary care professions. Subsequently, this questionnaire was administered to a random sample of 2400 practices from eleven primary care professions. The instrument's factor structure, reliability and validity were examined using confirmatory and explorative factor analyses. 921 questionnaires were returned. Of these, 615 were eligible for factor analysis. The resulting SCOPE-PC questionnaire consisted of seven dimensions: 'open communication and learning from errors', 'handover and teamwork', 'adequate procedures and working conditions', 'patient safety management', 'support and fellowship', 'intention to report events' and 'organisational learning' with a total of 41 items. All dimensions had good reliability with Cronbach's alphas ranging from 0.70-0.90, and the questionnaire had a good construct validity. The SCOPE-PC questionnaire has sound psychometric characteristics for use by the different professions in Dutch primary care to gain insight in their safety culture.

  16. A review of instruments to measure interprofessional team-based primary care.

    Science.gov (United States)

    Shoemaker, Sarah J; Parchman, Michael L; Fuda, Kathleen Kerwin; Schaefer, Judith; Levin, Jessica; Hunt, Meaghan; Ricciardi, Richard

    2016-07-01

    Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/ ). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care settings.

  17. 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.

  18. 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....

  19. Testing the Efficacy of INSIGHTS on Student Disruptive Behavior, Classroom Management, and Student Competence in Inner City Primary Grades

    OpenAIRE

    McClowry, Sandra Graham; Snow, David L.; Tamis-LeMonda, Catherine S.; Rodriguez, Eileen T.

    2009-01-01

    A prevention trial tested the efficacy of INSIGHTS into Children?s Temperament as compared to a Read Aloud attention control condition in reducing student disruptive behavior and enhancing student competence and teacher classroom management. Participants included 116 first and second grade students, their parents, and their 42 teachers in six inner city schools. Teachers completed the Sutter-Eyberg Student Behavior Inventory (SESBI) and the Teacher?s Rating Scale of Child?s Actual Competence ...

  20. Accurate and reproducible measurements of RhoA activation in small samples of primary cells.

    Science.gov (United States)

    Nini, Lylia; Dagnino, Lina

    2010-03-01

    Rho GTPase activation is essential in a wide variety of cellular processes. Measurement of Rho GTPase activation is difficult with limited material, such as tissues or primary cells that exhibit stringent culture requirements for growth and survival. We defined parameters to accurately and reproducibly measure RhoA activation (i.e., RhoA-GTP) in cultured primary keratinocytes in response to serum and growth factor stimulation using enzyme-linked immunosorbent assay (ELISA)-based G-LISA assays. We also established conditions that minimize RhoA-GTP in unstimulated cells without affecting viability, allowing accurate measurements of RhoA activation on stimulation or induction of exogenous GTPase expression. Copyright 2009 Elsevier Inc. All rights reserved.

  1. A construct of the instrument for measuring junior high school mathematics teacher's self-efficacy

    Directory of Open Access Journals (Sweden)

    Rachmadi Widdiharto

    2017-08-01

    Full Text Available The aim of this study was to develop a construct of the instrument for junior high school mathematics teacher self-efficacy and its mapping in the Special Region of  Yogyakarta. The population was 816 junior high mathematics teacher and a sample of 274 teachers was selected through proportionate random sampling technique. The data were analyzed using Confirmatory Factor Analysis (CFA, using software Lisrel 8.80 through the first order and the second order stages. The result of data analysis toward four dimensions obtained: 11 fit items for dimension of personal efficacy (PE, 12 fit items for dimension of general teaching efficacy  (GTE, 13 fit  items for dimension of subject matter teaching efficacy (STE, and 8 fit items for dimension of outcome efficacy (OE. Afterward, the result of selecting 54 items in the first order stage was examined for the second order CFA which obtained Chi-Square = 297.58; df = 271; p-value = 0.12824; RMSEA = 0.019, which showed the model was fit to the data and obtained 25 fit items.  The loading factors for each dimension PE, GTE, STE, and OE consecutively were: 0.46; 0.84; 0.89, and 0.92, and mapping of mathematics teacher self-efficacy level, which showed: 43.07% in low category, 55.47% in medium category (55.47% and 1.46% in the high category.

  2. Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

    Science.gov (United States)

    Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

    2013-01-01

    Background Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. Methods One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. Results The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). Conclusion The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB. PMID:24098461

  3. Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.

    Science.gov (United States)

    Claassens, Mareli M; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J; Enarson, Donald A; Beyers, Nulda; Borgdorff, Martien W

    2013-01-01

    Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB.

  4. [Perceptions of primary care physicians in Madrid on the austerity measures in the health care system].

    Science.gov (United States)

    Heras-Mosteiro, Julio; Otero-García, Laura; Sanz-Barbero, Belén; Aranaz-Andrés, Jesús María

    2016-01-01

    To address the current economic crisis, governments have promoted austerity measures that have affected the taxpayer-funded health system. We report the findings of a study exploring the perceptions of primary care physicians in Madrid (Spain) on measures implemented in the Spanish health system. We carried out a qualitative study in two primary health care centres located in two neighbourhoods with unemployment and migrant population rates above the average of those in Madrid. Interviews were conducted with 12 primary health care physicians. Interview data were analysed by using thematic analysis and by adopting some elements of the grounded theory approach. Two categories were identified: evaluation of austerity measures and evaluation of decision-making in this process. Respondents believed there was a need to promote measures to improve the taxpayer-funded health system, but expressed their disagreement with the measures implemented. They considered that the measures were not evidence-based and responded to the need to decrease public health care expenditure in the short term. Respondents believed that they had not been properly informed about the measures and that there was adequate professional participation in the prioritization, selection and implementation of measures. They considered physician participation to be essential in the decision-making process because physicians have a more patient-centred view and have first-hand knowledge of areas requiring improvement in the system. It is essential that public authorities actively involve health care professionals in decision-making processes to ensure the implementation of evidence-based measures with strong professional support, thus maintaining the quality of care. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  5. Dynamic study of efficacy of transcatheter arterial chemoembolization (TACE) of primary liver carcinoma with the MR diffusion-weighted imaging (DWI)

    International Nuclear Information System (INIS)

    Shang Quanliang; Xiao Enhua; He Zhong; Tan Lihua; Situ Weijun; Bao Moliao; Yuan Shiwen; Du Wanping

    2006-01-01

    Objective: To dynamically evaluate the efficacy of treatment of primary liver carcinoma (PLC) by transcatheter arterial ehemoembolization(TACE) with the MR diffusion-weighted imaging(DWI). Methods: DWI and the measurement of mean apparent diffusion coeffecient (ADC) value were performed in 25 masses of PLC with the same SE-EPI sequence (b=800 s/mm 2 and 0) at 1.5 T MRI within the 24- 48 hours before TACE (group A) and 36-48 hours, 7-10 days, 30-38 days after TACE (group B, group C, group D). The differences of the mean ADC values of PLC between groups were analyzed. Results: The mean ADC values of the three groups after TACE the mean ADC value of group B: (1.598±0.012) x 10 -3 mm 2 /s, the mean ADC value of group C: (1.723±0.012) x 10 -3 mm 2 /s, the mean ADC value of group D: (1.684±0.012) x 10 -3 mm 2 /s were significantly greater than that of the group before TACE the mean ADC value of group A: (1.376±0.012) x 10 -3 mm 2 /s (p<0.05). The mean ADC values of the group C and the group D were significantly greater than that of the group B (P<0.05). The mean ADC values of the group D was lower than that of the group C (P<0.05). Through contrasting the digital subtraction angiography (DSA) imaging of the second TACE with that of the first TACE, we found that every PLC whose mean ADC value after 30-38 days of the TACE was lower than that after 7-10 days of the TACE could be found the recurrence, especially in those PLC whose mean ADC values were decreased greatly. Conclusion: With the measurement of ADC value of the different time of the PLC we could excellently evaluate the necrosis and the recurrence of the PLC after the operation of the TACE. (authors)

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Efficacy of syndromic management measured as symptomatic improvement in females with vaginal discharge syndrome.

    Science.gov (United States)

    Chauhan, Vidyalaxmi; Shah, Maitri C; Patel, Sangita V; Marfatia, Yogesh S; Zalavadiya, Dhara

    2016-01-01

    In spite of a few shortcomings such as over diagnosis and over treatment, syndromic management is a recommended practice in India for sexually transmitted infections (STIs). This study tries to find out the efficacy of syndromic management measured as symptomatic improvement in females with vaginal discharge syndrome. The objective of the study is to find out the effectiveness of syndromic management in terms of symptomatic improvement among females with vaginal discharge syndrome. A longitudinal study was conducted in Gynecology Department of Tertiary Care Hospital including 180 symptomatic females having vaginal discharge syndrome. Demographic profile, presenting complaints, menstrual history, obstetric history, partner history, and contraceptive history were noted. This was followed by clinical examination and specimen collection for laboratory tests and blood tests to find out type of STI including viral STI such as human immunodeficiency virus (HIV), herpes simplex virus (HSV), and hepatitis B surface antigen (HBsAg). Treatment was given according to syndromic management on the same day. All the participants were asked to come for follow-up after 15 days and their improvement in symptoms was noted as complete improvement, some improvement or no improvement on a five point scale. 63.9% cases showed complete improvement, while 36.1% showed some improvement. None of the patients was without any improvement. Vaginal discharge syndrome was most common between 20 and 30 years (43.4%), and 67.8% of symptomatic females with vaginal discharge syndrome belonged to the lower socioeconomic group. HSV infection was the most common (15%) associated viral infection with vaginal discharge syndrome, while hepatitis B infection was the least common (0.5%). HIV was reactive in 2.8% cases only. Syndromic management was found to be effective in relieving symptoms in most of the cases of vaginal discharge syndrome.

  8. Knowledge, attitudes, and first-aid measures about epilepsy among primary school teachers in northern Iran.

    Science.gov (United States)

    Kolahi, A-A; Ghorbanpur-Valukolaei, M; Abbasi-Kangevari, M; Farsar, A-R

    2018-07-01

    To assess knowledge, attitudes, and first-aid measures about epilepsy among primary school teachers. This cross-sectional study was conducted with participation of 342 primary school teachers during September 2016 to January 2017 in cities of Babol and Qaem-Shahr in Mazandaran Province in northern Iran. Primary schools were selected using simple random sampling. Data were collected through interviews using a structured questionnaire. The knowledge section included general knowledge, causes, symptoms, seizure triggers, first-aid measures, and recommended treatments. The Likert scale was used for the attitudes section. Answers about first-aid measures were categorized as helpful or harmful. The level of total knowledge score of 25 (7.7%) teachers was very high, 140 (43.3%) high, 141 (43.8%) moderate, and 17 (5.2%) low. The mean score about general knowledge was as follows: 6.1 (1.9), range = 0-9; causes 6.3 (1.9), range = 0-10; symptoms of seizures 8.5 (2.5), range = 0-12; and first-aid measures 6.8 (2.0), range = 0-11. Some 83% knew not taking anticonvulsants regularly could trigger seizures, and all teachers said a person with epilepsy should go see a physician. Attitudes were generally positive except for marriage and having children. The level of first-aid measures score of 8 (7.2) teachers was very high, 79 (70.5) high, 25 (22.3) low. Teachers with teaching experience at special schools took more helpful measures CONCLUSIONS: The knowledge of teachers about epilepsy was insufficient, attitudes toward people with epilepsy were generally positive, and first-aid measures at the last witnessed seizure were fairly helpful. Having teaching experience in special schools had a positive influence over knowledge and taking appropriate first-aid measure at time of the last witnessed seizure. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Potential for improved radiation thermometry measurement uncertainty through implementing a primary scale in an industrial laboratory

    Science.gov (United States)

    Willmott, Jon R.; Lowe, David; Broughton, Mick; White, Ben S.; Machin, Graham

    2016-09-01

    A primary temperature scale requires realising a unit in terms of its definition. For high temperature radiation thermometry in terms of the International Temperature Scale of 1990 this means extrapolating from the signal measured at the freezing temperature of gold, silver or copper using Planck’s radiation law. The difficulty in doing this means that primary scales above 1000 °C require specialist equipment and careful characterisation in order to achieve the extrapolation with sufficient accuracy. As such, maintenance of the scale at high temperatures is usually only practicable for National Metrology Institutes, and calibration laboratories have to rely on a scale calibrated against transfer standards. At lower temperatures it is practicable for an industrial calibration laboratory to have its own primary temperature scale, which reduces the number of steps between the primary scale and end user. Proposed changes to the SI that will introduce internationally accepted high temperature reference standards might make it practicable to have a primary high temperature scale in a calibration laboratory. In this study such a scale was established by calibrating radiation thermometers directly to high temperature reference standards. The possible reduction in uncertainty to an end user as a result of the reduced calibration chain was evaluated.

  10. Validation of the German version of the patient activation measure 13 (PAM13-D in an international multicentre study of primary care patients.

    Directory of Open Access Journals (Sweden)

    Katja Brenk-Franz

    Full Text Available The patients' active participation in their medical care is important for patients with chronic diseases. Measurements of patient activation are needed for studies and in clinical practice. This study aims to validate the Patient Activation Measure 13 (PAM13-D in German-speaking primary care patients. This international cross-sectional multicentre study enrolled consecutively patients from primary care practices in three German-speaking countries: Germany, Austria, and Switzerland. Patients completed the PAM13-D questionnaire. General Self-Efficacy scale (GSE was used to assess convergent validity. Furthermore Cronbach's alpha was performed to assess internal consistency. Exploratory factor analysis was used to evaluate the underlying factor structure of the items. We included 508 patients from 16 primary care practices in the final analysis. Results were internally consistent, with a Cronbach's alpha of 0.84. Factor analysis revealed one major underlying factor. The mean values of the PAM13-D correlated significantly (r = 0.43 with those of the GSE. The German PAM13 is a reliable and valid measure of patient activation. Thus, it may be useful in primary care clinical practice and research.

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. The role of self-efficacy in inflammatory bowel disease management: preliminary validation of a disease-specific measure.

    Science.gov (United States)

    Keefer, Laurie; Kiebles, Jennifer L; Taft, Tiffany H

    2011-02-01

    Inflammatory bowel diseases (IBDs) require self-management skills that may be influenced by self-efficacy (SE). Self-efficacy represents an individual's perception of his or her ability to organize and execute the behaviors necessary to manage disease. The goal of this study was to develop a valid and reliable measure of IBD-specific SE that can be used in clinical and research contexts. One hundred and twenty-two adults with a verified IBD diagnosis participated in the study. Data were pooled from 2 sources: patients from an outpatient university gastroenterology clinic (n=42) and a sample of online respondents (n=80). All participants (N=122) completed the IBD Self-Efficacy Scale (IBD-SES) and the Inflammatory Bowel Disease Questionnaire. Additionally, online participants completed the Brief Symptom Inventory-18 and the Rosenberg Self-Esteem Scale, whereas those in the clinic sample completed the Perceived Health Competence Scale, the Perceived Stress Questionnaire, and the Short Form Version 2 Health Survey. The IBD-SES was initially constructed to identify 4 distinct theoretical domains of self-efficacy: (1) managing stress and emotions, (2) managing medical care, (3) managing symptoms and disease, and (4) maintaining remission. The 29-item IBD-SES has high internal consistency (r=0.96), high test-retest reliability (r=0.90), and demonstrates strong construct and concurrent validity with established measures. The IBD-SES is a critical first step toward addressing an important psychological construct that could influence treatment outcomes in IBD.

  13. The added value of C-reactive protein measurement in diagnosing pneumonia in primary care

    DEFF Research Database (Denmark)

    Minnaard, Margaretha C; de Groot, Joris A H; Hopstaken, Rogier M

    2017-01-01

    BACKGROUND: C-reactive protein (CRP) is increasingly being included in the diagnostic work-up for community-acquired pneumonia in primary care. Its added diagnostic value beyond signs and symptoms, however, remains unclear. We conducted a meta-analysis of individual patient data to quantify...... to a basic signs-and-symptoms prediction model was assessed. Outcome measures were improvement in discrimination between patients with and without pneumonia in primary care and improvement in risk classification, both within the individual studies and across studies. RESULTS: Authors of 8 eligible studies (n...... = 5308) provided their data sets. In all of the data sets, discrimination between patients with and without pneumonia improved after CRP measurement was added to the prediction model (extended model), with a mean improvement in the area under the curve of 0.075 (range 0.02-0.18). In a hypothetical cohort...

  14. Measurement and calculation of radiation sources in the primary cooling system of JOYO

    International Nuclear Information System (INIS)

    Suzuki, S.; Iizawa, K.; Ohtani, N.; Kobayashi, T.; Horie, J.; Handa, H.

    1987-01-01

    Production and transfer of radiation sources in the primary cooling system are important consideration in the LMFBR plant from the viewpoint of radiation protection and shielding design. These items were evaluated with calculations and/or measurements in the Japanese experimental fast reactor JOYO. In this study, calculations were made with the DOT3.5 0 two-dimensional discrete ordinate transport code to determine the neutron flux and production rate distributions of radiation sources in the reactor vessel. Using the DOT results, the behavior in primary coolant sodium of the CP (radioactive corrosion products) which were released from the reactor structural material was also calculationally analyzed with the PSYCHE code developed by PNC. These analytical results were compared with the measured results to get the verification of analysis methods and to estimate the accuracy of calculations

  15. Measurement of the isotopic composition of the primary cosmic radiation for the elements B-Ne

    International Nuclear Information System (INIS)

    Bjarle, C.; Herrstroem, N-Y.; Jacobsson, L.; Joensson, G.; Kristiansson, K.

    1977-05-01

    The results are given from an investigation of the isotopic composition of primary cosmic ray B, C, N and O. Preliminary result is also given from an investigation of Ne. The mass measurements are made in nuclear emulsions exposed at about 3 g/cm 2 atmospheric depth. The results for B-O represented as quotients extrapolated to the top of the atmosphere, are: 11 B/B=0.61+-0.10; 13 C/C=0.06+-0.03; 15 N/N=0.33+-0.09; 17 O/O=0.05+-0.03; 18 O/O=0.08+-0.03. The preliminary result from the Ne-measurements shows that nuclei with masses larger than 20 exist among the primary neon nuclei. (Auth.)

  16. Dissolved stable noble gas measurements from primary water of Paks NPP

    International Nuclear Information System (INIS)

    Palcsu, L.; Molnar, M.; Szanto, Zs.; Svingor, E.; Futo, I.; Pinter, T.

    2001-01-01

    A sampling and measuring method of noble gases from the primary water circuit of a VVER type NPP was developed to provide relevant information about the kilter of heating rods and detailed additional information about some working parameters. The helium concentrations and 3 He/ 4 He ratios was used to estimate the content of tritium and alpha emitting isotopes of the primary water. By argon content measurements the air penetration and the required hydrazine amount for the oxygen absorption could be estimated with high accuracy. Continuous monitoring of the concentration and isotope ratios of Xe and Kr in the dissolved gas is proved to be a good tool for high sensitivity detection of small leakage of fuel elements. In case of block-3 xenon surplus was detected. The results indicate possible leakage of fuel rods.(author)

  17. 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)

  18. The Self-Efficacy of Primary Teachers in Supporting the Inclusion of Children with Autism Spectrum Disorder

    Science.gov (United States)

    Anglim, Johanna; Prendeville, Paula; Kinsella, William

    2018-01-01

    In the context of a trend towards inclusive practice in Irish primary schools, many teachers feel ill-equipped to cope with this new challenge. Scope exists within the Irish education system to transform mainstream schools into autistic spectrum disorder (ASD) friendly environments. Research into teacher perceptions of inclusion has found that…

  19. "Primary Connections" in a Provincial Queensland School System: Relationships to Science Teaching Self-Efficacy and Practices

    Science.gov (United States)

    Albion, Peter R.; Spence, Karen G.

    2013-01-01

    The teaching of science is important, both to meet the need for future workers in fields requiring scientific capability and to equip students for full participation in modern societies where many decisions depend upon knowledge of science. However, many teachers in Australian primary schools do not allocate science education sufficient amounts of…

  20. Analysis of the Construct Validity and Measurement Invariance of the Career Decision Self-Efficacy Scale

    DEFF Research Database (Denmark)

    Makransky, Guido; Rogers, Mary E.; Creed, Peter E.

    2015-01-01

    The Career Decision Self-Efficacy Scale – Short Form (CDSE-SF) is one of the most frequently used instruments to assess individual levels of career-related self-efficacy. The present study used the partial credit model within the framework of item response theory to examine the content, structural......, substantive, and generalizability aspects of validity for the CDSE-SF in a sample of 534 Australian high school students aged between 14 and 19 years. The results showed clear evidence of multidimensionality for the CDSE-SF. Furthermore, there was strong support for the content, structural, and substantive...

  1. Measures of self-efficacy and norms for low-fat milk consumption are reliable and related to beverage consumption among 5th graders at school lunch

    Science.gov (United States)

    The objective was to determine the reliability and validity of scales measuring low-fat milk consumption self-efficacy and norms during school lunch among a cohort of 5th graders. Two hundred seventy-five students completed lunch food records and a psychosocial questionnaire measuring self-efficacy ...

  2. Development of a Primary Standard for Calibration of [18F]FDG Activity Measurement Systems

    International Nuclear Information System (INIS)

    Capogni, M; Felice, P De; Fazio, A; Simonelli, F; Abbas, K

    2006-01-01

    The 18 F national primary standard was developed by the INMRI-ENEA using the 4πβ Liquid Scintillation Spectrometry Method with 3 H-Standard Efficiency Tracing. Measurements were performed at JRCIspra under a scientific collaboration between the Institute for Health and Consumer Production, the Amersham Health and the National Institute for Occupational Safety and Prevention (ISPESL). The goal of the work was to calibrate, with minimum uncertainty, the INMRI-ENEA transfer standard portable well-type ionisation chamber as well as other JRC-Ispra and Amersham Health reference Ionising Chambers used for FDG activity measurement

  3. Development of a Primary Standard for Calibration of [{sup 18}F]FDG Activity Measurement Systems

    Energy Technology Data Exchange (ETDEWEB)

    Capogni, M [ENEA Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti (INMRI), Centro Ricerche Casaccia, I-00060 Rome (Italy); Felice, P De [ENEA Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti (INMRI), Centro Ricerche Casaccia, I-00060 Rome (Italy); Fazio, A [ENEA Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti (INMRI), Centro Ricerche Casaccia, I-00060 Rome (Italy); Simonelli, F [Institute for Health and Consumer Protection, Joint Research Centre (JRC), European Commission, I-21020 Ispra (Vatican City State, Holy See,), Italy; D' Ursi, V [Amersham Health Srl (AH), I-13040 Saluggia (Saint Vincent and the Grenadines), Italy; Pecorale, A [Amersham Health Srl (AH), I-13040 Saluggia (Saint Vincent and the Grenadines), Italy; Giliberti, C [Istituto Superiore per la Prevenzione e la Sicurezza del Lavoro (ISPESL), I-00184 Rome (Italy); Abbas, K [Institute for Health and Consumer Protection, Joint Research Centre (JRC), European Commission, I-21020 Ispra (Vatican City State, Holy See,), Italy

    2006-05-15

    The {sup 18}F national primary standard was developed by the INMRI-ENEA using the 4{pi}{beta} Liquid Scintillation Spectrometry Method with {sup 3}H-Standard Efficiency Tracing. Measurements were performed at JRCIspra under a scientific collaboration between the Institute for Health and Consumer Production, the Amersham Health and the National Institute for Occupational Safety and Prevention (ISPESL). The goal of the work was to calibrate, with minimum uncertainty, the INMRI-ENEA transfer standard portable well-type ionisation chamber as well as other JRC-Ispra and Amersham Health reference Ionising Chambers used for FDG activity measurement.

  4. Proceedings: Primary water stress corrosion cracking: 1989 EPRI remedial measures workshop

    International Nuclear Information System (INIS)

    Gorman, J.A.

    1990-04-01

    A meeting on ''PWSCC Remedial Measures'' was organized to give those working in this area an opportunity to share their results, ideas and plans with regard to development and application of remedial measures directed against the primary water stress corrosion cracking (PWSCC) phenomenon affecting alloy 600 steam generator tubes. Topics discussed included: utility experience and strategies; nondestructive examination (NDE) methods for PWSCC; technical topics ranging from predictive methods for occurrence of PWSCC to results of corrosion tests; and services provided by vendors that can help prevent the occurrence of PWSCC or can help address problems caused by PWSCC once it occurs

  5. Comparison of the efficacy and safety of fixed combination travoprost/timolol and dorzolamide/timolol in patients with primary open-angle glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Babić Nikola

    2013-01-01

    Full Text Available Introduction. Combining two medications in one bottle may improve compliance by reducing the time required to administer drops and the frequency of the total number of medication bottles. Objective. To compare the efficacy of reduced intraocular pressure (IOP and safety of fixed combination travoprost 0.004%/timolol 0.5% vs. fixed combination dorzolamide 2%/timolol 0.5% in patients with primary open-angle glaucoma or ocular hypertension. Methods. Prospective randomized clinical study included 60 patients divided into 2 groups. Follow-up was done at day 14 and 45 and month 3. IOP measurements were taken at each follow-up examination at 8 am, 10 am and 4 pm. Results. Both fixed combinations reduced IOP significantly compared to initial values at all follow-ups (p<0.001. Mean pooled IOP at all visits and time points was slightly lower in the travoprost/timolol group compared with the dorzolamide/timolol group (16.13 mmHg vs. 16.15 mmHg. Mean IOP reduction from baseline ranged from -7.46 mmHg to -9.92 mmHg in the travoprost/timolol group and from -6.93 mmHg to -8.93 mmHg for the dorzolamide/timolol group. Mean (±standard error of the mean reduction in diurnal IOP from baseline to 3rd month was 8.96±2.79 in the travoprost/timolol group versus 8.07±2.91 in patients receiving dorzolamide/timolol fixed combination (p=0.196. The most frequent treatment-related adverse events were conjunctival hyperemia in the travoprost/timolol group, and dry eye and foreign body sensation in the dorzolamide/timolol group. Conclusion. Travoprost/timolol fixed combination was slightly more effective than dorzolamide/timolol fixed combination in reducing mean diurnal IOP. Travoprost/timolol group resulted in an IOP reduction for up to 1.07 mmHg higher than dorzolamide/timolol group. Both fixed combinations were well tolerated and safe.

  6. Office blood pressure measurement alone often misclassifies treatment status in children with primary hypertension.

    Science.gov (United States)

    Samuel, Joyce P; Bell, Cynthia S; Hebert, Sean A; Varughese, Arun; Samuels, Joshua A; Tyson, Jon E

    2017-12-01

    Clinicians frequently rely on office blood pressure (BP) measurements alone to assess hypertension control, despite widespread acceptance of 24-h ambulatory blood pressure monitoring (ABPM) as the reference standard in the initial diagnosis of hypertension. This study was designed to investigate how often the hypertensive status differed between concurrent office BP versus ABPM measurements, and whether any patient-specific characteristics predict the risk for misclassification by office BP. This study evaluated 42 children with primary hypertension who underwent repeated ambulatory monitoring (190 total recordings) with concurrent office BP measurement as part of their participation in n-of-1 trials. In nearly 40% of the visits, the treatment status by office measurement was opposite to the status by ambulatory monitoring. Office BP underestimated the ambulatory hypertensive status (masked uncontrolled hypertension) in 25% of visits and overestimated ambulatory BP (white coat effect) in 14% of visits. The difference between office BP and ambulatory monitoring was consistent within patients across repeated visits. Patients whose office measurement underestimated or overestimated the ambulatory BP at the first visit were more likely to show persistent discrepancy at subsequent visits. The underuse of ambulatory monitoring in management decisions of children treated for primary hypertension may result in systematic misclassification of hypertension control.

  7. Best methods for evaluating educational impact: a comparison of the efficacy of commonly used measures of library instruction.

    Science.gov (United States)

    Schilling, Katherine; Applegate, Rachel

    2012-10-01

    Libraries are increasingly called upon to demonstrate student learning outcomes and the tangible benefits of library educational programs. This study reviewed and compared the efficacy of traditionally used measures for assessing library instruction, examining the benefits and drawbacks of assessment measures and exploring the extent to which knowledge, attitudes, and behaviors actually paralleled demonstrated skill levels. An overview of recent literature on the evaluation of information literacy education addressed these questions: (1) What evaluation measures are commonly used for evaluating library instruction? (2) What are the pros and cons of popular evaluation measures? (3) What are the relationships between measures of skills versus measures of attitudes and behavior? Research outcomes were used to identify relationships between measures of attitudes, behaviors, and skills, which are typically gathered via attitudinal surveys, written skills tests, or graded exercises. Results provide useful information about the efficacy of instructional evaluation methods, including showing significant disparities between attitudes, skills, and information usage behaviors. This information can be used by librarians to implement the most appropriate evaluation methods for measuring important variables that accurately demonstrate students' attitudes, behaviors, or skills.

  8. Evaluating Self-Efficacy Expected of Polytechnic Engineering Students as a Measure of Employability

    Science.gov (United States)

    Ojonugwa, Oguche Innocent; Hamzah, Ramlah; Bakar, AB Rahim; Rashid, Abdullah Mat

    2015-01-01

    In the face of increasing unemployment partly due to decreasing employability skills of Nigeria polytechnic students, many graduates of Nigeria polytechnic have a dwindle self-efficacy. 420 HND 2 polytechnic engineering students in north central states of Nigeria were surveyed. Data were collected using questionnaire consisting of 4 Likert-type…

  9. Development of an Instrument for Measuring Self-Efficacy in Cell Biology

    Science.gov (United States)

    Reeve, Suzanne; Kitchen, Elizabeth; Sudweeks, Richard R.; Bell, John D.; Bradshaw, William S.

    2011-01-01

    This article describes the development of a ten-item scale to assess biology majors' self-efficacy towards the critical thinking and data analysis skills taught in an upper-division cell biology course. The original seven-item scale was expanded to include three additional items based on the results of item analysis. Evidence of reliability and…

  10. Student Team Projects in Information Systems Development: Measuring Collective Creative Efficacy

    Science.gov (United States)

    Cheng, Hsiu-Hua; Yang, Heng-Li

    2011-01-01

    For information systems development project student teams, learning how to improve software development processes is an important training. Software process improvement is an outcome of a number of creative behaviours. Social cognitive theory states that the efficacy of judgment influences behaviours. This study explores the impact of three types…

  11. A Measurement Invariance Analysis of the General Self-Efficacy Scale on Two Different Cultures

    Science.gov (United States)

    Teo, Timothy; Kam, Chester

    2014-01-01

    The 10-item General Self-Efficacy Scale (GSES) was developed to assess an individual's beliefs to cope with a variety of situations in life. Despite the GSES being used in numerous research from researchers in different countries and presented in different languages, little is known about the use of its validity in an Asian culture. The aim of the…

  12. Development of a Short-Form Measure of Science and Technology Self-efficacy Using Rasch Analysis

    Science.gov (United States)

    Lamb, Richard L.; Vallett, David; Annetta, Leonard

    2014-10-01

    Despite an increased focus on science, technology, engineering, and mathematics (STEM) in U.S. schools, today's students often struggle to maintain adequate performance in these fields compared with students in other countries (Cheek in Thinking constructively about science, technology, and society education. State University of New York, Albany, 1992; Enyedy and Goldberg 2004; Mandinach and Lewis 2006). In addition, despite considerable pressure to promote the placement of students into STEM career fields, U.S. placement is relatively low (Sadler et al. in Sci Educ 96(3):411-427, 2012; Subotnik et al. in Identifying and developing talent in science, technology, engineering, and mathematics (STEM): an agenda for research, policy and practice. International handbook, part XII, pp 1313-1326, 2009). One explanation for the decline of STEM career placement in the U.S. rests with low student affect concerning STEM concepts and related content, especially in terms of self-efficacy. Researchers define self-efficacy as the internal belief that a student can succeed in learning, and that understanding student success lies in students' externalized actions or behaviors (Bandura in Psychol Rev 84(2):191-215, 1977). Evidence suggests that high self-efficacy in STEM can result in student selection of STEM in later educational endeavors, culminating in STEM career selection (Zeldin et al. in J Res Sci Teach 45(9):1036-1058, 2007). However, other factors such as proficiency play a role as well. The lack of appropriate measures of self-efficacy can greatly affect STEM career selection due to inadequate targeting of this affective trait and loss of opportunity for early intervention by educators. Lack of early intervention decreases selection of STEM courses and careers (Valla and Williams in J Women Minor Sci Eng 18(1), 2012; Lent et al. in J Couns Psychol 38(4), 1991). Therefore, this study developed a short-form measure of self-efficacy to help identify students in need of

  13. Anticedents to entrepreneurial intentions: Testing for measurement invariance for cultural values, attitudes and self-efficacy beliefs across ethnic groups

    Directory of Open Access Journals (Sweden)

    Boris Urban

    2008-10-01

    Full Text Available Building on previous research on antecedents of entrepreneurial intentions, various measures were tested across different ethnic groups in South Africa. Factorial homogeneity is an important attribute for any scale intended for use in multicultural research, and since tests of equivalency are not routinely applied, this article hypothesised measurement invariance across ethnic groups. Theoretical discussions on Hofstede’s (2001 value survey module (VSM 94, attitudes towards and beliefs about entrepreneurial intentions, general self-efficacy (GSE, and entrepreneurial self-efficacy (ESE preceded the use of statistical analysis. Confirmatory factor analysis based on 210 respondents indicated that equivalence for the underlying factors across the different ethnic groups could not be established, and that the three groups demonstrated different underlying structures. In conclusion, stereotypic declarations of an integrated South African culture were not supported by this research in terms of entrepreneurial intentions and their antecedents.

  14. Testing the Efficacy of INSIGHTS on Student Disruptive Behavior, Classroom Management, and Student Competence in Inner City Primary Grades.

    Science.gov (United States)

    McClowry, Sandra Graham; Snow, David L; Tamis-Lemonda, Catherine S; Rodriguez, Eileen T

    2010-03-01

    A prevention trial tested the efficacy of INSIGHTS into Children's Temperament as compared to a Read Aloud attention control condition in reducing student disruptive behavior and enhancing student competence and teacher classroom management. Participants included 116 first and second grade students, their parents, and their 42 teachers in six inner city schools. Teachers completed the Sutter-Eyberg Student Behavior Inventory (SESBI) and the Teacher's Rating Scale of Child's Actual Competence and Social Acceptance (TRS) at baseline and again upon completion of the intervention. Boys participating in INSIGHTS, compared with those in the Read Aloud program, showed a significant decline in attentional difficulties and overt aggression toward others. Teachers in INSIGHTS, compared to those in the attention control condition, reported significantly fewer problems managing the emotional-oppositional behavior, attentional difficulties, and covert disruptive behavior of their male students. They also perceived the boys as significantly more cognitively and physically competent.

  15. Modeling strategy to identify patients with primary immunodeficiency utilizing risk management and outcome measurement.

    Science.gov (United States)

    Modell, Vicki; Quinn, Jessica; Ginsberg, Grant; Gladue, Ron; Orange, Jordan; Modell, Fred

    2017-06-01

    This study seeks to generate analytic insights into risk management and probability of an identifiable primary immunodeficiency defect. The Jeffrey Modell Centers Network database, Jeffrey Modell Foundation's 10 Warning Signs, the 4 Stages of Testing Algorithm, physician-reported clinical outcomes, programs of physician education and public awareness, the SPIRIT® Analyzer, and newborn screening, taken together, generates P values of less than 0.05%. This indicates that the data results do not occur by chance, and that there is a better than 95% probability that the data are valid. The objectives are to improve patients' quality of life, while generating significant reduction of costs. The advances of the world's experts aligned with these JMF programs can generate analytic insights as to risk management and probability of an identifiable primary immunodeficiency defect. This strategy reduces the uncertainties related to primary immunodeficiency risks, as we can screen, test, identify, and treat undiagnosed patients. We can also address regional differences and prevalence, age, gender, treatment modalities, and sites of care, as well as economic benefits. These tools support high net benefits, substantial financial savings, and significant reduction of costs. All stakeholders, including patients, clinicians, pharmaceutical companies, third party payers, and government healthcare agencies, must address the earliest possible precise diagnosis, appropriate intervention and treatment, as well as stringent control of healthcare costs through risk assessment and outcome measurement. An affected patient is entitled to nothing less, and stakeholders are responsible to utilize tools currently available. Implementation offers a significant challenge to the entire primary immunodeficiency community.

  16. Assessing the impact of primary measures for NOx reduction on the thermal power plant steam boiler

    International Nuclear Information System (INIS)

    Stupar, Goran; Tucaković, Dragan; Živanović, Titoslav; Belošević, Srdjan

    2015-01-01

    The European normatives prescribe content of 200 mg/Nm 3 NO x for pulverized coal combusting power plants. In order to reduce content of NO x in Serbian thermal power plant (TPP) 'Kostolac B' it's necessary to implement particular measures until 2016. The mathematical model of lignite combustion in the steam boiler furnace is defined and applied to analyze the possibility of implementing certain primary measures for reducing nitrogen oxides and their effects on the steam boiler operation. This model includes processes in the coal-fired furnace and defines radiating reactive two-phase turbulent flow. The model of turbulent flow also contains sub-model of fuel and thermal NO x formation and destruction. This complex mathematical model is related to thermal and aerodynamic calculations of the steam boiler within a unified calculation system in order to analyze the steam boiler overall work. This system provides calculations with a number of influential parameters. The steam boiler calculations for unit 1 (350 MWe) of TPP 'Kostolac B' are implemented for existing and modified combustion system in order to achieve effective, reliable and ecological facility work. The paper presents the influence analysis of large number of parameters on the steam boiler operation with an accepted concept of primary measures. Presented system of calculations is verified against measurements in TPP 'Kostolac B'. - Highlights: • Modern steam boilers need to operate according to ecological standards. • Possibility of applying some of the primary measures of NO x reduction. • Conventional calculations have no possibility to estimate sub-stoichiometric combustion. • Develop a new method of connecting the calculations. • Analysis shows the most favorable operation boiler regime (efficiency and ecology)

  17. Evaluative Measurement Properties of the Patient-Specific Functional Scale for Primary Shoulder Complaints in Physical Therapy Practice

    NARCIS (Netherlands)

    Koehorst, Marije L. S.; van Trijffel, Emiel; Lindeboom, Robert

    2014-01-01

    STUDY DESIGN: Clinical measurement, longitudinal. OBJECTIVES: To assess the test-retest reliability, construct validity, and responsiveness of the Patient-Specific Functional Scale (PSFS) in patients with a primary shoulder complaint. BACKGROUND: Health measurement outcomes have become increasingly

  18. Preoperative measurement of canine primary bone tumors, using radiography and bone scintigraphy

    International Nuclear Information System (INIS)

    Lamb, C.R.; Berg, J.; Bengston, A.E.

    1990-01-01

    Specimens of 20 canine primary bone tumors (18 osteosarcoma, 2 fibrosarcoma) were examined to compare the maximal axial length of gross tumor with the length of the lesion seen on preoperative radiographs and 99mTc methylene diphosphonate bone scintigraphic images. Radiographs defined the length of the tumor to within +/- 10% of the gross measurement for 6 (30%), underestimated it for 12 (60%), and overestimated it for 2 (10%) specimens. Bone scintigraphy defined tumor length within +/- 10% for 8 (40%), underestimated it for 1 (5%), and overestimated it for the remaining 11 (55%) specimens. Use of radiographic evaluation alone could result in underestimation of the diaphyseal extent of a primary bone tumor, with risk of incomplete resection. Bone scan images tend to overestimate tumor length and, therefore, may provide safer resection guidelines

  19. Detecting recurrent major depressive disorder within primary care rapidly and reliably using short questionnaire measures.

    Science.gov (United States)

    Thapar, Ajay; Hammerton, Gemma; Collishaw, Stephan; Potter, Robert; Rice, Frances; Harold, Gordon; Craddock, Nicholas; Thapar, Anita; Smith, Daniel J

    2014-01-01

    Major depressive disorder (MDD) is often a chronic disorder with relapses usually detected and managed in primary care using a validated depression symptom questionnaire. However, for individuals with recurrent depression the choice of which questionnaire to use and whether a shorter measure could suffice is not established. To compare the nine-item Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory, and the Hospital Anxiety and Depression Scale against shorter PHQ-derived measures for detecting episodes of DSM-IV major depression in primary care patients with recurrent MDD. Diagnostic accuracy study of adults with recurrent depression in primary care predominantly from Wales Scores on each of the depression questionnaire measures were compared with the results of a semi-structured clinical diagnostic interview using Receiver Operating Characteristic curve analysis for 337 adults with recurrent MDD. Concurrent questionnaire and interview data were available for 272 participants. The one-month prevalence rate of depression was 22.2%. The area under the curve (AUC) and positive predictive value (PPV) at the derived optimal cut-off value for the three longer questionnaires were comparable (AUC = 0.86-0.90, PPV = 49.4-58.4%) but the AUC for the PHQ-9 was significantly greater than for the PHQ-2. However, by supplementing the PHQ-2 score with items on problems concentrating and feeling slowed down or restless, the AUC (0.91) and the PPV (55.3%) were comparable with those for the PHQ-9. A novel four-item PHQ-based questionnaire measure of depression performs equivalently to three longer depression questionnaires in identifying depression relapse in patients with recurrent MDD.

  20. 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.

  1. Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

    Science.gov (United States)

    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

    2017-01-01

    Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries

  2. Measuring the impact of multiple sclerosis on psychosocial functioning: the development of a new self-efficacy scale.

    Science.gov (United States)

    Airlie, J; Baker, G A; Smith, S J; Young, C A

    2001-06-01

    To develop a scale to measure self-efficacy in neurologically impaired patients with multiple sclerosis and to assess the scale's psychometric properties. Cross-sectional questionnaire study in a clinical setting, the retest questionnaire returned by mail after completion at home. Regional multiple sclerosis (MS) outpatient clinic or the Clinical Trials Unit (CTU) at a large neuroscience centre in the UK. One hundred persons with MS attending the Walton Centre for Neurology and Neurosurgery and Clatterbridge Hospital, Wirral, as outpatients. Cognitively impaired patients were excluded at an initial clinic assessment. Patients were asked to provide demographic data and complete the self-efficacy scale along with the following validated scales: Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, Impact, Stigma and Mastery and Rankin Scales. The Rankin Scale and Barthel Index were also assessed by the physician. A new 11-item self-efficacy scale was constructed consisting of two domains of control and personal agency. The validity of the scale was confirmed using Cronbach's alpha analysis of internal consistency (alpha = 0.81). The test-retest reliability of the scale over two weeks was acceptable with an intraclass correlation coefficient of 0.79. Construct validity was investigated using Pearson's product moment correlation coefficient resulting in significant correlations with depression (r= -0.52) anxiety (r =-0.50) and mastery (r= 0.73). Multiple regression analysis demonstrated that these factors accounted for 70% of the variance of scores on the self-efficacy scale, with scores on mastery, anxiety and perceived disability being independently significant. Assessment of the psychometric properties of this new self-efficacy scale suggest that it possesses good validity and reliability in patients with multiple sclerosis.

  3. Seasonal rates of benthic primary production in a Greenland fjord measured by aquatic eddy correlation

    DEFF Research Database (Denmark)

    M. Attard, Karl; Glud, Ronnie; McGinnis, Daniel F.

    2014-01-01

    -quality multiple-day EC data sets document the presence of a year-round productive benthic phototrophic community. The shallow-water sites were on average autotrophic during the spring and summer months, up to 43.6 mmol O2 m22 d21, and heterotrophic or close to metabolic balance during the autumn and winter....... Substantial benthic gross primary production (GPP) was measured year-round. The highest GPP rates were measured during the spring, up to 5.7 mmol O2 m22 h21 (136.8 mmol O2 m22 d21), and even at low light levels (, 80 mmol quanta m22 s21) during late autumn and winter we measured rates of up to 1.8 mmol O2 m22...

  4. Systematic review of self-concept measures for primary school aged children with cerebral palsy.

    Science.gov (United States)

    Cheong, Sau Kuan; Johnston, Leanne M

    2013-10-01

    This study involved a systematic review aimed to identify self-concept measures that provided published psychometrics for primary school aged children (8-12 years) with cerebral palsy (CP). Six electronic databases (PubMed, MEDLINE, CINAHL, PsycINFO, PsycARTICLES and Web of Science) were searched to identify assessments that (1) measured self-concept; (2) in children aged 8-12 years; (3) with CP; (4) with psychometrics available. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist was used to evaluate psychometric properties and the CanChild Outcome Measure Rating Form was used to evaluate clinical utility. Search yielded 271 papers, of which five met inclusion criteria. These papers reported five measures of self-concept with psychometric properties for the target population: the Rosenberg Self-Esteem Index, Self-Description Questionnaire-I, Self-Perception Profile for Children (original) and two separate modifications of the Self-Perception Profile for Children. Currently, no self-concept measures published in English had sufficient psychometric data for children with CP. The Self-Description Questionnaire-I and the Self-Perception Profile for Children were promising options. Further research is required (a) to determine self-concept construct components important for children with CP and (b) to examine the relative strength, validity, reliability and clinical utility of self-concept measures for the target population. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. The evidence for efficacy of osteoporosis treatment in men with primary osteoporosis: a systematic review and meta-analysis of antiresorptive and anabolic treatment in men

    DEFF Research Database (Denmark)

    Schwarz, Peter; Jorgensen, Niklas Rye; Mosekilde, Leif

    2011-01-01

    of antiresorptive treatment were included. All studies showed an increase in BMD, but there was only a nonsignificant trend in the reduction of clinical fractures. Three BMD studies of anabolic treatment with teriparatide were also included. These showed a significant mean increase in spine BMD and for vertebral...... treatment in men. Methods. This study was a systematic review of the published literature on the clinical efficacy of medical osteoporosis therapy in the reduction of fracture risk in men (age > 50 years). Studies included were randomised, placebo-controlled trials of men. Results. Five BMD studies...... fractures a non-significant trend towards a reduction was seen. Conclusion. The evidence of medical osteoporosis treatment in men is scant and inconclusive due to the lack of prospective RCT studies with fracture prevention as primary end point. So far, all evidence is based on BMD increases in small RCT...

  6. 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

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

    Science.gov (United States)

    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.

  8. Defining Primary Care Shortage Areas: Do GIS-based Measures Yield Different Results?

    Science.gov (United States)

    Daly, Michael R; Mellor, Jennifer M; Millones, Marco

    2018-02-12

    To examine whether geographic information systems (GIS)-based physician-to-population ratios (PPRs) yield determinations of geographic primary care shortage areas that differ from those based on bounded-area PPRs like those used in the Health Professional Shortage Area (HPSA) designation process. We used geocoded data on primary care physician (PCP) locations and census block population counts from 1 US state to construct 2 shortage area indicators. The first is a bounded-area shortage indicator defined without GIS methods; the second is a GIS-based measure that measures the populations' spatial proximity to PCP locations. We examined agreement and disagreement between bounded shortage areas and GIS-based shortage areas. Bounded shortage area indicators and GIS-based shortage area indicators agree for the census blocks where the vast majority of our study populations reside. Specifically, 95% and 98% of the populations in our full and urban samples, respectively, reside in census blocks where the 2 indicators agree. Although agreement is generally high in rural areas (ie, 87% of the rural population reside in census blocks where the 2 indicators agree), agreement is significantly lower compared to urban areas. One source of disagreement suggests that bounded-area measures may "overlook" some shortages in rural areas; however, other aspects of the HPSA designation process likely mitigate this concern. Another source of disagreement arises from the border-crossing problem, and it is more prevalent. The GIS-based PPRs we employed would yield shortage area determinations that are similar to those based on bounded-area PPRs defined for Primary Care Service Areas. Disagreement rates were lower than previous studies have found. © 2018 National Rural Health Association.

  9. 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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

    Science.gov (United States)

    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.

  11. 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.

  12. [Efficacy and safety of rituximab in the treatment of primary antiphospholipid syndrome: analysis of 24 cases from the bibliography review].

    Science.gov (United States)

    Pons, Isaac; Espinosa, Gerard; Cervera, Ricard

    2015-02-02

    Antiphospholipid syndrome (APS) is characterized by the presence of antiphospholipid antibodies (aPL) and thrombotic and/or obstetric manifestations. Patients without another associated autoimmune disease are considered to have primary APS. Some patients develop thrombosis recurrence despite anticoagulant treatment and some clinical features do not respond to standard therapy. Rituximab may be an alternative in these cases. We review the published scientific evidence on the use of rituximab in the treatment of primary APS. Description of a case and review of the literature with descriptive analysis of the demographic, clinical, and immunologic features, treatment and outcome of patients. We identified 24 patients (15 women [62.5%]), with a mean age of 37.0 ± 13.4 years. The reasons for the use of rituximab were thrombocytopenia (41.7%), skin involvement (33.3%), neurologic and heart valve involvement (12.5%), hemolytic anemia (8.3%) and pulmonary and renal involvement (4.2%). Lupus anticoagulant was present in 72.7% of the cases, the IgG and IgM isotypes of anticardiolipin antibodies in 75 and 50%, respectively, and the anti-β2GPI (IgG e IgM) antibodies in 80% of patients. Thirteen (54.1%) patients received 2 doses of 1,000 mg of rituximab fortnightly, 10 (41.7%) 4 doses of 375 mg/m(2) weekly and one (4.2%) 8 doses of 375 mg/m(2) weekly. Eleven (45.8%) patients presented a complete clinical response, 7 (29.2%) a partial response and 6 (25%) did not respond to rituximab. Four patients with clinical improvement presented with aPL titer decrease and in one patient, aPL levels did not change. In one patient without clinical response, aPL remained positive. A clinical-immunologic dissociation existed in 2 additional cases. The results obtained suggest a possible potential benefit of rituximab in the treatment of some clinical manifestations of primary APS such as thrombocytopenia, skin and heart valve involvement. Copyright © 2013 Elsevier España, S.L.U. All rights

  13. The primary exposure standard of ENEA for medium energy X-ray: characteristics and measurements procedures

    International Nuclear Information System (INIS)

    Laitano, R.F.; Toni, M.P.

    1983-01-01

    A description is given of a medium energy X-ray free-air chamber used, as primary exposure standard, at the Laboratorio di Metrologia delle Radiazioni Ionizzanti of the Enea in Italy. The main features of an X-ray facility for the production of radiation between 40 KeV and 400 KeV are also described. The measurements procedures are then analyzed with respect to the realization of the exposure unit in the relevant energy range. Finally the results of some international comparisons are reported

  14. Efficacy and Toxicity of Chemoradiotherapy Using Intensity-Modulated Radiotherapy for Unknown Primary of Head and Neck

    International Nuclear Information System (INIS)

    Sher, David J.; Balboni, Tracy A.; Haddad, Robert I.; Norris, Charles M.; Posner, Marshall R.; Wirth, Lori J.; Goguen, Laura A.; Annino, Donald; Tishler, Roy B.

    2011-01-01

    Purpose: No single standard treatment paradigm is available for head-and-neck squamous cell carcinoma of an unknown primary (HNCUP). Bilateral neck radiotherapy with mucosal axis irradiation is widely used, with or without chemotherapy and/or surgical resection. Intensity-modulated radiotherapy (IMRT) is a highly conformal method for delivering radiation that is becoming the standard of care and might reduce the long-term treatment-related sequelae. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for HNCUP. Patients and Materials: A retrospective study of all patients treated at the Dana-Farber Cancer Institute for HNCUP with IMRT between August 2004 and January 2009. The primary endpoint was overall survival; the secondary endpoints were locoregional and distant control, and acute and chronic toxicity. Results: A total of 24 patients with HNCUP were included. Of these patients, 22 had Stage N2 disease or greater. All patients underwent neck computed tomography, positron emission tomography-computed tomography, and examination under anesthesia with directed biopsies. Of the 24 patients, 22 received concurrent chemotherapy, and 7 (29%) also underwent induction chemotherapy. The median involved nodal dose was 70 Gy, and the median mucosal dose was 60 Gy. With a median follow-up of 2.1 years, the 2-year actuarial overall survival and locoregional control rate was 92% and 100%, respectively. Only 25% of the patients had Grade 2 xerostomia, although 11 patients (46%) required esophageal dilation for stricture. Conclusion: In a single-institution series, IMRT-based chemoradiotherapy for HNCUP was associated with superb overall survival and locoregional control. The xerostomia rates were promising, but the aggressive therapy was associated with significant rates of esophageal stenosis.

  15. Development and validation of a short form of the self-efficacy measurement tool for Iranian patients with myocardial infarction

    Directory of Open Access Journals (Sweden)

    Soleiman Zand

    2017-09-01

    Full Text Available To assess efficacy in patients with heart failure need to have a scientific tool based on psychometric features is evident. The researchers developed a scientific tool based on psychometric principles for assessing self-efficacy beliefs in patients with Myocardial Infarction (MI as the only tool of its kind; however, Due to the large number of questions in the questionnaire, respondents may not desire to complete it accuracy. The present study was conducted to develop and validate a short form of this tool. This study was conducted on a sample of 311 patients diagnosed with MI by a cardiologist and selected through convenience sampling. The 80-20 rule was used for evaluating the 60 items of the short-form MI Self-Efficacy Measurement Tool (SF-SEMT and for eliminating items without an adequate sensitivity and accuracy. The factor analysis revealed 5 factors that explained a total of 87.92% the variance; the kaiser-meyer-olkin index was calculated as 0.915 with a probable significance level of 0.001. A total of 22 items and 5 factors were extracted for this short-form tool. The reliability of the tool was confirmed with Cronbach’s alpha coefficients of 0.96 to 0.97 for the factors and 0.97 for the entire tool. The short-form MI self-efficacy measurement tool has better psychometric features than the original long form, as the former was found to have a better factor structure compared to the latter

  16. Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

    Directory of Open Access Journals (Sweden)

    Szecsenyi Joachim

    2011-04-01

    Full Text Available Abstract Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD, patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio, we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey. Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare.

  17. Process measures or patient reported experience measures (PREMs) for comparing performance across providers? A study of measures related to access and continuity in Swedish primary care.

    Science.gov (United States)

    Glenngård, Anna H; Anell, Anders

    2018-01-01

    Aim To study (a) the covariation between patient reported experience measures (PREMs) and registered process measures of access and continuity when ranking providers in a primary care setting, and (b) whether registered process measures or PREMs provided more or less information about potential linkages between levels of access and continuity and explaining variables. Access and continuity are important objectives in primary care. They can be measured through registered process measures or PREMs. These measures do not necessarily converge in terms of outcomes. Patient views are affected by factors not necessarily reflecting quality of services. Results from surveys are often uncertain due to low response rates, particularly in vulnerable groups. The quality of process measures, on the other hand, may be influenced by registration practices and are often more easy to manipulate. With increased transparency and use of quality measures for management and governance purposes, knowledge about the pros and cons of using different measures to assess the performance across providers are important. Four regression models were developed with registered process measures and PREMs of access and continuity as dependent variables. Independent variables were characteristics of providers as well as geographical location and degree of competition facing providers. Data were taken from two large Swedish county councils. Findings Although ranking of providers is sensitive to the measure used, the results suggest that providers performing well with respect to one measure also tended to perform well with respect to the other. As process measures are easier and quicker to collect they may be looked upon as the preferred option. PREMs were better than process measures when exploring factors that contributed to variation in performance across providers in our study; however, if the purpose of comparison is continuous learning and development of services, a combination of PREMs and

  18. Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

    Directory of Open Access Journals (Sweden)

    Green Michael E

    2012-07-01

    Full Text Available Abstract Purpose To evaluate the appropriateness of potential data sources for the population of performance indicators for primary care (PC practices. Methods This project was a cross sectional study of 7 multidisciplinary primary care teams in Ontario, Canada. Practices were recruited and 5-7 physicians per practice agreed to participate in the study. Patients of participating physicians (20-30 were recruited sequentially as they presented to attend a visit. Data collection included patient, provider and practice surveys, chart abstraction and linkage to administrative data sets. Matched pairs analysis was used to examine the differences in the observed results for each indicator obtained using multiple data sources. Results Seven teams, 41 physicians, 94 associated staff and 998 patients were recruited. The survey response rate was 81% for patients, 93% for physicians and 83% for associated staff. Chart audits were successfully completed on all but 1 patient and linkage to administrative data was successful for all subjects. There were significant differences noted between the data collection methods for many measures. No single method of data collection was best for all outcomes. For most measures of technical quality of care chart audit was the most accurate method of data collection. Patient surveys were more accurate for immunizations, chronic disease advice/information dispensed, some general health promotion items and possibly for medication use. Administrative data appears useful for indicators including chronic disease diagnosis and osteoporosis/ breast screening. Conclusions Multiple data collection methods are required for a comprehensive assessment of performance in primary care practices. The choice of which methods are best for any one particular study or quality improvement initiative requires careful consideration of the biases that each method might introduce into the results. In this study, both patients and providers were

  19. Incorporating PROMIS Symptom Measures into Primary Care Practice-a Randomized Clinical Trial.

    Science.gov (United States)

    Kroenke, Kurt; Talib, Tasneem L; Stump, Timothy E; Kean, Jacob; Haggstrom, David A; DeChant, Paige; Lake, Kittie R; Stout, Madison; Monahan, Patrick O

    2018-04-05

    Symptoms account for more than 400 million clinic visits annually in the USA. The SPADE symptoms (sleep, pain, anxiety, depression, and low energy/fatigue) are particularly prevalent and undertreated. To assess the effectiveness of providing PROMIS (Patient-Reported Outcome Measure Information System) symptom scores to clinicians on symptom outcomes. Randomized clinical trial conducted from March 2015 through May 2016 in general internal medicine and family practice clinics in an academic healthcare system. Primary care patients who screened positive for at least one SPADE symptom. After completing the PROMIS symptom measures electronically immediately prior to their visit, the 300 study participants were randomized to a feedback group in which their clinician received a visual display of symptom scores or a control group in which scores were not provided to clinicians. The primary outcome was the 3-month change in composite SPADE score. Secondary outcomes were individual symptom scores, symptom documentation in the clinic note, symptom-specific clinician actions, and patient satisfaction. Most patients (84%) had multiple clinically significant (T-score ≥ 55) SPADE symptoms. Both groups demonstrated moderate symptom improvement with a non-significant trend favoring the feedback compared to control group (between-group difference in composite T-score improvement, 1.1; P = 0.17). Symptoms present at baseline resolved at 3-month follow-up only one third of the time, and patients frequently still desired treatment. Except for pain, clinically significant symptoms were documented less than half the time. Neither symptom documentation, symptom-specific clinician actions, nor patient satisfaction differed between treatment arms. Predictors of greater symptom improvement included female sex, black race, fewer medical conditions, and receiving care in a family medicine clinic. Simple feedback of symptom scores to primary care clinicians in the absence of

  20. Measurement of the Cosmic Ray primary spectrum with ARGO-YBJ experiment

    International Nuclear Information System (INIS)

    Panico, B; Iuppa, R; Di Sciascio, G

    2013-01-01

    The study of cosmic ray physic of 10 12 – 10 15 primary cosmic energy is one of the main goals of ARGO-YBJ experiment. The detector, located at the Yangbajing Cosmic Ray Laboratory (Tibet, 4300 m a.s.l., 606 g/cm 2 ), is an EAS array consisting of a continuous carpet of RPCs. The low energy threshold of the detector allows to study an energy region characterized by the transition from the direct to the indirect measurements. In this talk we will report on the measurement of the cosmic ray energy spectrum at different zenith angles. The phenomenology of horizontal air shower (θ > 70°) will be described and discussed.

  1. New Primary Standards for Establishing SI Traceability for Moisture Measurements in Solid Materials

    Science.gov (United States)

    Heinonen, M.; Bell, S.; Choi, B. Il; Cortellessa, G.; Fernicola, V.; Georgin, E.; Hudoklin, D.; Ionescu, G. V.; Ismail, N.; Keawprasert, T.; Krasheninina, M.; Aro, R.; Nielsen, J.; Oğuz Aytekin, S.; Österberg, P.; Skabar, J.; Strnad, R.

    2018-01-01

    A European research project METefnet addresses a fundamental obstacle to improving energy-intensive drying process control: due to ambiguous reference analysis methods and insufficient methods for estimating uncertainty in moisture measurements, the achievable accuracy in the past was limited and measurement uncertainties were largely unknown. This paper reports the developments in METefnet that provide a sound basis for the SI traceability: four new primary standards for realizing the water mass fraction were set up, analyzed and compared to each other. The operation of these standards is based on combining sample weighing with different water vapor detection techniques: cold trap, chilled mirror, electrolytic and coulometric Karl Fischer titration. The results show that an equivalence of 0.2 % has been achieved between the water mass fraction realizations and that the developed methods are applicable to a wide range of materials.

  2. Perspectives of patients and professionals on the use of patient reported outcome measures in primary care

    DEFF Research Database (Denmark)

    Porter, Ian; Gangannagaripalli, Jaheeda; Davey, Antoinette

    2017-01-01

    /or healthcare professional’s perspectives on the clinical utility of using PROMs in clinical practice. Results: 19 studies met the inclusion criteria (4 after 2012), 11 of which were conducted in the UK, reporting on the views of professionals (8), patients (5), and both (7). The majority of studies (12...... communication it was also noted that they undermined the human element of consultations, along with professional intuition and judgement. Burden on GP time was also noted. Conclusions: Patients and professionals highlighted a number of benefits of using PROMs in clinical practice, particularly in terms......A71 Perspectives of patients and professionals on the use of patient-reported outcome measures in primary care: a systematic review of qualitative studies Background: Although the use of patient-reported outcome measures (PROMs) in healthcare settings has increased substantially over recent years...

  3. Measurements of the solar UVR protection provided by shade structures in New Zealand primary schools.

    Science.gov (United States)

    Gies, Peter; Mackay, Christina

    2004-01-01

    To reduce ultraviolet radiation (UVR) exposure during childhood, shade structures are being erected in primary schools to provide areas where children can more safely undertake outdoor activities. This study to evaluate the effectiveness of existing and purpose built shade structures in providing solar UVR protection was carried out on 29 such structures in 10 schools in New Zealand. Measurements of the direct and scattered solar UVR doses within the central region of the shade structures were made during the school lunch break period using UVR-sensitive polysulfone film badges. These measurements indicate that many of the structures had UVR protection factors (PF) of 4-8, which was sufficient to provide protection during the school lunch hour. However, of the 29 structures examined, only six would meet the suggested requirements of UVR PF greater than 15 required to provide all-day protection.

  4. Fact and fiction in ECP measurement and control in boiling water reactor primary coolant circuits

    International Nuclear Information System (INIS)

    Macdonald, D.D.

    2005-01-01

    A review is presented of various electrochemical potentials, including the electrochemical corrosion potential (ECP), that are used in the mitigation of stress corrosion cracking in the primary coolant circuits of boiling water reactors (BWRs). Attention is paid to carefully defining each potential in terms of fundamental electrochemical concepts, so as to counter the confusion that has arisen due to the misuse of previously accepted terminology. A brief discussion is also included of reference electrodes and it is shown on the basis of experimental data that the use of a platinum redox sensor as a reference electrode in the monitoring of ECP in BWR primary coolant circuits is inappropriate and should be discouraged. If platinum is used as a reference electrode, because of extenuating circumstances (e.g., potential measurements in high dose regions in a reactor core), the onus must be placed on the user to demonstrate quantitatively that the electrode behaves as an equilibrium electrode under the specified conditions and/or that its potential is invariant with changes in the independent variables of the system. Preferably, a means should also be demonstrated of transferring the measured potential to the standard hydrogen electrode (SHE) scale. (orig.)

  5. Measurements of high energy photons in Z-pinch experiments on primary test stand

    International Nuclear Information System (INIS)

    Si, Fenni; Zhang, Chuanfei; Xu, Rongkun; Yuan, Xi; Huang, Zhanchang; Xu, Zeping; Ye, Fan; Yang, Jianlun; Ning, Jiamin; Hu, Qingyuan; Zhu, Xuebin

    2015-01-01

    High energy photons are measured for the first time in wire-array Z-pinch experiments on the Primary Test Stand (PTS) which delivers a current up to 8 MA with a rise time of 70 ns. A special designed detecting system composed of three types of detectors is used to measure the average energy, intensity, and pulse waveform of high energy photons. Results from Pb-TLD (thermoluminescence dosimeter) detector indicate that the average energy is 480 keV (±15%). Pulse shape of high energy photons is measured by the photodiode detector consisted of scintillator coupled with a photodiode, and it is correlated with soft x-ray power by the same timing signal. Intensity is measured by both TLD and the photodiode detector, showing good accordance with each other, and it is 10 10 cm −2 (±20%) at 2 m in the horizontal direction. Measurement results show that high energy photons are mainly produced in pinch regions due to accelerated electrons. PTS itself also produces high energy photons due to power flow electrons, which is one order smaller in amplitude than those from pinch region

  6. Evaluation of the efficacy of laser peripheral iridoplasty in reversing the darkroom provocative test result in Chinese patients with primary angle closure status post laser iridotomy

    Directory of Open Access Journals (Sweden)

    Ping Huang

    2015-06-01

    Full Text Available AIM: To investigate the efficacy and safety of krypton laser peripheral iridoplasty (LPIP for Chinese patients with primary angle closure (PAC or primary angle-closure glaucoma (PACG status post laser iridotomy in reversing the positive results of the dark room provocative test (DRPT.METHODS:This study was prospective, noncomparative, interventional case series. Thirty-three patients (thirty-eight eyes with PAC or PACG status post patent laser iridotomy and maintained normal intraocular pressure (IOP but with positive DRPT results were enrolled. All the subjects were treated with krypton LPIP. DRPT was repeated after krypton LPIP. Results of DRPT were recorded. The visual acuity, IOP and gonioscopy were analyzed before and after krypton LPIP. A minimum time limit for follow-up was 6mo.RESULTS:Thirty-three patients (thirty-eight eyes were followed for 17.7±8.37mo (range 7-41mo after LPIP. Positive results of DRPT decreased from 38 eyes to 9 eyes (23.7% after LPIP. Peripheral anterior synechiae of angle in 34 of 38 eyes (89.5% remained unchanged at dynamic gonioscopy throughout the follow-up period after LPIP.CONCLUSION:LPIP decreased positive rates of the DRPT significantly. The mechanism may be that LPIP minimized contact between the peripheral iris and trabecular meshwork, which is a key factor for developing peripheral anterior synechiae.

  7. Evaluation of the efficacy of laser peripheral iridoplasty in reversing the darkroom provocative test result in Chinese patients with primary angle closure status post laser iridotomy

    Institute of Scientific and Technical Information of China (English)

    Ping; Huang; Ling-Ling; Wu

    2015-01-01

    AIM: To investigate the efficacy and safety of krypton laser peripheral iridoplasty(LPIP) for Chinese patients with primary angle closure(PAC) or primary angle-closure glaucoma(PACG) status post laser iridotomy in reversing the positive results of the dark room provocative test(DRPT).METHODS: This study was prospective, noncomparative,interventional case series. Thirty-three patients(thirty-eight eyes) with PAC or PACG status post patent laser iridotomy and maintained normal intraocular pressure(IOP) but with positive DRPT results were enrolled. All the subjects were treated with krypton LPIP. DRPT was repeated after krypton LPIP. Results of DRPT were recorded. The visual acuity, IOP and gonioscopy were analyzed before and after krypton LPIP. A minimum time limit for follow-up was 6mo.RESULTS: Thirty-three patients(thirty-eight eyes)were followed for 17.7 ±8.37mo(range 7-41mo) after LPIP. Positive results of DRPT decreased from 38 eyes to9 eyes(23.7%) after LPIP. Peripheral anterior synechiae of angle in 34 of 38 eyes(89.5%) remained unchanged at dynamic gonioscopy throughout the follow-up period after LPIP.CONCLUSION: LPIP decreased positive rates of the DRPT significantly. The mechanism may be that LPIP minimized contact between the peripheral iris and trabecular meshwork, which is a key factor for developing peripheral anterior synechiae.

  8. Repeated serum creatinine measurement in primary care: Not all patients have chronic renal failure.

    Science.gov (United States)

    Gentille Lorente, Delicia; Gentille Lorente, Jorge; Salvadó Usach, Teresa

    2015-01-01

    To assess the prevalence of kidney failure in patients from a primary care centre in a basic healthcare district with laboratory availability allowing serum creatinine measurements. An observational descriptive cross-sectional study. A basic healthcare district serving 23,807 people aged ≥ 18 years. Prevalence of kidney failure among 17,240 patients having at least one laboratory measurement available was 8.5% (mean age 77.6 ± 12.05 years). In 33.2% of such patients an occult kidney failure was found (98.8% were women). Prevalence of chronic kidney failure among 10,011 patients having at least 2 laboratory measurements available (≥ 3 months apart) was 5.5% with mean age being 80.1 ± 10.0 years (most severely affected patients were those aged 75 to 84); 59.7% were men and 76.3% of cases were in stage 3. An occult kidney failure was found in 5.3% of patients with women being 86.2% of them (a glomerular filtration rate<60 ml/min was estimated for plasma creatinine levels of 0.9 mg/dl or higher). Comparison of present findings to those previously reported demonstrates the need for further studies on the prevalence of overall (chronic and acute) kidney failure in Spain in order to estimate the real scope of the disease. Primary care physicians play a critical role in disease detection, therapy, control and recording (in medical records). MDRD equation is useful and practical to estimate glomerular filtration rate. Copyright © 2015 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

  9. Measuring kidney patients' motivation to pursue living donor kidney transplant: development of stage of change, decisional balance and self-efficacy measures.

    Science.gov (United States)

    Waterman, Amy D; Robbins, Mark L; Paiva, Andrea L; Peipert, John D; Davis, LaShara A; Hyland, Shelley S; Schenk, Emily A; Baldwin, Kari A; Amoyal, Nicole R

    2015-02-01

    While educational interventions to increase patient motivation to pursue living donor kidney transplant have shown success in increasing living donor kidney transplant rates, there are no validated, theoretically consistent measures of Stage of Change, a measure of readiness to pursue living donor kidney transplant; Decisional Balance, a weighted assessment of living donor kidney transplant's advantages/disadvantages; and Self-Efficacy, a measure of belief that patients can pursue living donor kidney transplant in difficult circumstances. This study developed and validated measures of these three constructs. In two independent samples of kidney patients (N 1 = 279 and N 2 = 204), results showed good psychometric properties and support for their use in the assessment of living donor kidney transplant interventions. © The Author(s) 2013.

  10. Validating Common Measures of Self-Efficacy and Career Attitudes within Informal Health Education for Middle and High School Students.

    Science.gov (United States)

    Peterman, Karen; Withy, Kelley; Boulay, Rachel

    2018-06-01

    A common challenge in the evaluation of K-12 science education is identifying valid scales that are an appropriate fit for both a student's age and the educational outcomes of interest. Though many new scales have been validated in recent years, there is much to learn about the appropriate educational contexts and audiences for these measures. This study investigated two such scales, the DEVISE Self-Efficacy for Science scale and the Career Interest Questionnaire (CIQ), within the context of two related health sciences projects. Consistent patterns were found in the reliability of each scale across three age groups (middle school, high school, early college) and within the context of each project. As expected, self-efficacy and career interest, as measured through these scales, were found to be correlated. The pattern of results for CIQ scores was also similar to that reported in other literature. This study provides examples of how practitioners can validate established measures for new and specific contexts and provides some evidence to support the use of the scales studied in health science education contexts.

  11. Measuring primary teachers' attitudes toward teaching science: development of the dimensions of attitude toward science (DAS) instrument

    NARCIS (Netherlands)

    van Aalderen-Smeets, Sandra; Walma van der Molen, Julie Henriëtte

    2013-01-01

    In this article, we present a valid and reliable instrument which measures the attitude of in-service and pre-service primary teachers toward teaching science, called the Dimensions of Attitude Toward Science (DAS) Instrument. Attention to the attitudes of primary teachers toward teaching science is

  12. Measuring Primary Teachers' Attitudes toward Teaching Science: Development of the Dimensions of Attitude toward Science (DAS) Instrument

    Science.gov (United States)

    van Aalderen-Smeets, Sandra; Walma van der Molen, Juliette

    2013-01-01

    In this article, we present a valid and reliable instrument which measures the attitude of in-service and pre-service primary teachers toward teaching science, called the Dimensions of Attitude Toward Science (DAS) Instrument. Attention to the attitudes of primary teachers toward teaching science is of fundamental importance to the…

  13. Tear osmolarity measurements in dry eye related to primary Sjögren's syndrome.

    Science.gov (United States)

    Utine, Canan Asli; Bıçakçıgil, Müge; Yavuz, Sule; Çiftçi, Ferda

    2011-08-01

    To evaluate the tear osmolarity in patients with dry eye syndrome related to primary Sjögren's Syndrome (SS). Twenty eyes of 10 patients with dry eye and primary SS (Group 1) and 20 eyes of 20 subjects who do not have dry eye syndrome (Group 2) were included in this cross-sectional study. In all eyes, ophthalmic examination was performed in the same order: International Ocular Surface Disease Index survey, visual acuity assessment, conjunctival hyperemia scoring, tear osmolarity measurement with TearLab(™) Osmolarity System, tear film break-up time assessment, corneal fluorescein staining scoring, ocular surface Lissamine Green staining scoring, anesthetized Schirmer test. Dry eye severity was graded according to Dry Eye Workshop (DEWS) classification system. Four eyes with grade 1, four eyes with grade 2, seven eyes with grade 3, and five eyes with grade 4 dryness, according to DEWS system, were included. The mean tear osmolarity value was 301.9 ± 11.40 mOsm/L (range: 290-328) in Group 1, and 294.85 ± 8.33 mOsm/L (range: 283-311) in Group 2 (p = 0.03). In Group 1, tear osmolarity values were positively correlated with OSDI scores (r(18) = 0.55, r(2) = 0.31, p = 0.01), DEWS classification grades (r(18) = 0.73, r(2) = 0.54, p dry eye syndrome related to primary SS compared to control subjects, and positively correlated with the severity of dry eye.

  14. Intraocular pressure measurement by three different tonometers in primary congenital glaucoma

    Directory of Open Access Journals (Sweden)

    Athar Zareei

    2015-01-01

    Full Text Available Purpose: To determine the agreement between intraocular pressure (IOP measurements using an automated non-contact tonometer (NCT, Goldmann applanation tonometer (GAT, and the ocular response analyzer (ORA in subjects with primary congenital glaucoma (PCG. Methods: Twenty-nine eyes of 17 PCG patients underwent IOP measurements using NCT, GAT and ORA. Variables obtained by the ORA were corneal-compensated IOP (IOPcc, Goldmann-correlated IOP (IOPg, corneal hysteresis (CH, and corneal resistance factor (CRF. A difference more than 1.5 mmHg for IOP was considered as clinically relevant. Results: Mean age of the patients was 12 years. Mean IOP (±standard deviation, SD was 15.3 ± 2.8 mmHg (GAT, 15.5 ± 6.0 (NCT, 19.2 ± 7.0 (IOPg, and 21.1 ± 7.9 (IOPcc; (P = 0.001. Except for NCT vs. GAT (P = 1.0, the average IOP difference between each pair of measurements was clinically relevant. The 95% limits of agreements were − 10.2 to 10.3 mmHg (NCT vs. GAT, −7.8 to 15.3 (IOPg vs. GAT, and − 8.1 to 19.0 (IOPcc vs. GAT. The differences in IOP measurements increased significantly with higher average IOP values (r = 0.715, P = 0.001, for NCT vs. GAT; r = 0.802, P < 0.001, for IOPg vs. GAT; and r = 0.806, P < 0.001, for IOPcc vs. GAT. CH showed a significant association with differences in IOP measurements only for IOPcc vs. GAT (r = 0.830, P < 0.001. Conclusion: Mean IOP obtained by NCT was not significantly different from that of GAT, but ORA measured IOPs were significantly higher than both other devices.

  15. Intraocular pressure measurement by three different tonometers in primary congenital glaucoma.

    Science.gov (United States)

    Zareei, Athar; Razeghinejad, Mohammad Reza; Nowroozzadeh, Mohammad Hosein; Mehrabi, Yadollah; Aghazadeh-Amiri, Mohammad

    2015-01-01

    To determine the agreement between intraocular pressure (IOP) measurements using an automated non-contact tonometer (NCT), Goldmann applanation tonometer (GAT), and the ocular response analyzer (ORA) in subjects with primary congenital glaucoma (PCG). Twenty-nine eyes of 17 PCG patients underwent IOP measurements using NCT, GAT and ORA. Variables obtained by the ORA were corneal-compensated IOP (IOPcc), Goldmann-correlated IOP (IOPg), corneal hysteresis (CH), and corneal resistance factor (CRF). A difference more than 1.5 mmHg for IOP was considered as clinically relevant. Mean age of the patients was 12 years. Mean IOP (±standard deviation, SD) was 15.3 ± 2.8 mmHg (GAT), 15.5 ± 6.0 (NCT), 19.2 ± 7.0 (IOPg), and 21.1 ± 7.9 (IOPcc); (P = 0.001). Except for NCT vs. GAT (P = 1.0), the average IOP difference between each pair of measurements was clinically relevant. The 95% limits of agreements were - 10.2 to 10.3 mmHg (NCT vs. GAT), -7.8 to 15.3 (IOPg vs. GAT), and - 8.1 to 19.0 (IOPcc vs. GAT). The differences in IOP measurements increased significantly with higher average IOP values (r = 0.715, P = 0.001, for NCT vs. GAT; r = 0.802, P < 0.001, for IOPg vs. GAT; and r = 0.806, P < 0.001, for IOPcc vs. GAT). CH showed a significant association with differences in IOP measurements only for IOPcc vs. GAT (r = 0.830, P < 0.001). Mean IOP obtained by NCT was not significantly different from that of GAT, but ORA measured IOPs were significantly higher than both other devices.

  16. 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.

  17. Development and validation of a self-efficacy questionnaire (SE-12) measuring the clinical communication skills of health care professionals.

    Science.gov (United States)

    Axboe, Mette K; Christensen, Kaj S; Kofoed, Poul-Erik; Ammentorp, Jette

    2016-10-18

    The outcome of communication training is widely measured by self-efficacy ratings, and different questionnaires have been used. Nevertheless, none of these questionnaires have been formally validated through systematic measurement of assessment properties. Consequently, we decided to further develop a self-efficacy questionnaire which has been used in previous studies. This study aims to examine the content, internal structure, and relations with other variables of the new version of the self-efficacy questionnaire (SE-12). The questionnaire was developed on the basis of the theoretical approach applied in the communication course, statements from former course participants, teachers, and experts in the field. The questionnaire was initially validated through face-to-face interviews with 9 staff members following a test-retest including 195 participants. After minor adjustments, the SE-12 questionnaire demonstrated evidence of content validity. An explorative factor analysis indicated unidimensionality with highly correlated items. A Cronbach's α of 0.95 and a Loevinger's H coefficient of 0.71 provided evidence of statistical reliability and scalability. The test-retest reliability had a value of 0.71 when evaluated using intra-class correlation. Expected relations with other variables were partially confirmed in two of three hypotheses, but a ceiling effect was present in 9 of 12 items. The SE-12 scale should be regarded a reliable and partially valid instrument. We consider the questionnaire useful for self-evaluation of clinical communication skills; the SE-12 is user-friendly and can be administered as an electronic questionnaire. However, future research should explore potential needs for adjustments to reduce the identified ceiling effect.

  18. Non-invasive treatment efficacy evaluation for high-intensity focused ultrasound therapy using magnetically induced magnetoacoustic measurement

    Science.gov (United States)

    Guo, Gepu; Wang, Jiawei; Ma, Qingyu; Tu, Juan; Zhang, Dong

    2018-04-01

    Although the application of high intensity focused ultrasound (HIFU) has been demonstrated to be a non-invasive treatment technology for tumor therapy, the real-time temperature monitoring is still a key issue in the practical application. Based on the temperature-impedance relation, a fixed-point magnetically induced magnetoacoustic measurement technology of treatment efficacy evaluation for tissue thermocoagulation during HIFU therapy is developed with a sensitive indicator of critical temperature monitoring in this study. With the acoustic excitation of a focused transducer in the magnetoacoustic tomography with the magnetic induction system, the distributions of acoustic pressure, temperature, electrical conductivity, and acoustic source strength in the focal region are simulated, and the treatment time dependences of the peak amplitude and the corresponding amplitude derivative under various acoustic powers are also achieved. It is proved that the strength peak of acoustic sources is generated by tissue thermocoagulation with a sharp conductivity variation. The peak amplitude of the transducer collected magnetoacoustic signal increases accordingly along with the increase in the treatment time under a fixed acoustic power. When the temperature in the range with the radial and axial widths of about ±0.46 mm and ±2.2 mm reaches 69 °C, an obvious peak of the amplitude derivative can be achieved and used as a sensitive indicator of the critical status of treatment efficacy. The favorable results prove the feasibility of real-time non-invasive temperature monitoring and treatment efficacy evaluation for HIFU ablation using the magnetically induced magnetoacoustic measurement, and might provide a new strategy for accurate dose control during HIFU therapy.

  19. 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.

  20. Current /sup 14/C methods for measuring primary production: gross underestimates in oceanic waters

    Energy Technology Data Exchange (ETDEWEB)

    Gieskes, W W.C.; Kraay, G W; Baars, M A [Netherlands Institute for Sea Research, Texel, Netherlands

    1979-10-01

    The amount of organic matter produced through autotrophic processes in the euphotic zone of the tropical open ocean and available for respiration of autotrophs and heterotrophs was at least 5 to 15 times higher than values derived from the common /sup 14/C method suggested. The new estimates are based on measurements of /sup 14/C incorporation in organic matter of ocean samples incubated in bottles of up to 4 litres. Oceanic phytoplankton appeared to have a high growth rate, with generation times of hours, not days. High heterotrophic activity, finding its expression in high dark fixation rates of /sup 14/C, took place in conjunction with this high primary production of organic matter.

  1. A Tool Measuring Remaining Thickness of Notched Acoustic Cavities in Primary Reaction Control Thruster NDI Standards

    Science.gov (United States)

    Sun, Yushi; Sun, Changhong; Zhu, Harry; Wincheski, Buzz

    2006-01-01

    Stress corrosion cracking in the relief radius area of a space shuttle primary reaction control thruster is an issue of concern. The current approach for monitoring of potential crack growth is nondestructive inspection (NDI) of remaining thickness (RT) to the acoustic cavities using an eddy current or remote field eddy current probe. EDM manufacturers have difficulty in providing accurate RT calibration standards. Significant error in the RT values of NDI calibration standards could lead to a mistaken judgment of cracking condition of a thruster under inspection. A tool based on eddy current principle has been developed to measure the RT at each acoustic cavity of a calibration standard in order to validate that the standard meets the sample design criteria.

  2. An updated h-index measures both the primary and total scientific output of a researcher.

    Science.gov (United States)

    Bucur, Octavian; Almasan, Alex; Zubarev, Roman; Friedman, Mark; Nicolson, Garth L; Sumazin, Pavel; Leabu, Mircea; Nikolajczyk, Barbara S; Avram, Dorina; Kunej, Tanja; Calin, George A; Godwin, Andrew K; Adami, Hans-Olov; Zaphiropoulos, Peter G; Richardson, Des R; Schmitt-Ulms, Gerold; Westerblad, Håkan; Keniry, Megan; Grau, Georges E R; Carbonetto, Salvatore; Stan, Radu V; Popa-Wagner, Aurel; Takhar, Kasumov; Baron, Beverly W; Galardy, Paul J; Yang, Feng; Data, Dipak; Fadare, Oluwole; Yeo, Kt Jerry; Gabreanu, Georgiana R; Andrei, Stefan; Soare, Georgiana R; Nelson, Mark A; Liehn, Elisa A

    2015-01-01

    The growing interest in scientometry stems from ethical concerns related to the proper evaluation of scientific contributions of an author working in a hard science. In the absence of a consensus, institutions may use arbitrary methods for evaluating scientists for employment and promotion. There are several indices in use that attempt to establish the most appropriate and suggestive position of any scientist in the field he/she works in. A scientist's Hirsch-index (h-index) quantifies their total effective published output, but h-index summarizes the total value of their published work without regard to their contribution to each publication. Consequently, articles where the author was a primary contributor carry the same weight as articles where the author played a minor role. Thus, we propose an updated h-index named Hirsch(p,t)-index that informs about both total scientific output and output where the author played a primary role. Our measure, h(p,t) = h(p),h(t), is composed of the h-index h(t) and the h-index calculated for articles where the author was a key contributor; i.e. first/shared first or senior or corresponding author. Thus, a h(p,t) = 5,10 would mean that the author has 5 articles as first, shared first, senior or corresponding author with at least 5 citations each, and 10 total articles with at least 10 citations each. This index can be applied in biomedical disciplines and in all areas where the first and last position on an article are the most important. Although other indexes, such as r- and w-indexes, were proposed for measuring the authors output based on the position of researchers within the published articles, our simpler strategy uses the already established algorithms for h-index calculation and may be more practical to implement.

  3. Cross-cultural adaptation and measurement properties testing of the Iconographical Falls Efficacy Scale (Icon-FES).

    Science.gov (United States)

    Franco, Marcia Rodrigues; Pinto, Rafael Zambelli; Delbaere, Kim; Eto, Bianca Yumie; Faria, Maíra Sgobbi; Aoyagi, Giovana Ayumi; Steffens, Daniel; Pastre, Carlos Marcelo

    2018-02-14

    The Iconographical Falls Efficacy Scale (Icon-FES) is an innovative tool to assess concern of falling that uses pictures as visual cues to provide more complete environmental contexts. Advantages of Icon-FES over previous scales include the addition of more demanding balance-related activities, ability to assess concern about falling in highly functioning older people, and its normal distribution. To perform a cross-cultural adaptation and to assess the measurement properties of the 30-item and 10-item Icon-FES in a community-dwelling Brazilian older population. The cross-cultural adaptation followed the recommendations of international guidelines. We evaluated the measurement properties (i.e. internal consistency, test-retest reproducibility, standard error of the measurement, minimal detectable change, construct validity, ceiling/floor effect, data distribution and discriminative validity), in 100 community-dwelling people aged ≥60 years. The 30-item and 10-item Icon-FES-Brazil showed good internal consistency (alpha and omega >0.70) and excellent intra-rater reproducibility (ICC 2,1 =0.96 and 0.93, respectively). According to the standard error of the measurement and minimal detectable change, the magnitude of change needed to exceed the measurement error and variability were 7.2 and 3.4 points for the 30-item and 10-item Icon-FES, respectively. We observed an excellent correlation between both versions of the Icon-FES and Falls Efficacy Scale - International (rho=0.83, pmeasurement properties to evaluate concern about falling among the community-dwelling older population. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. The Pain Self-Efficacy Questionnaire: Cross-Cultural Adaptation into Italian and Assessment of Its Measurement Properties.

    Science.gov (United States)

    Chiarotto, Alessandro; Vanti, Carla; Ostelo, Raymond W; Ferrari, Silvano; Tedesco, Giuseppe; Rocca, Barbara; Pillastrini, Paolo; Monticone, Marco

    2015-11-01

    The Pain Self-Efficacy Questionnaire (PSEQ) is a patient self-reported measurement instrument that evaluates pain self-efficacy beliefs in patients with chronic pain. The measurement properties of the PSEQ have been tested in its original and translated versions, showing satisfactory results for validity and reliability. The aims of this study were 2 fold as follows: (1) to translate the PSEQ into Italian through a process of cross-cultural adaptation, (2) to test the measurement properties of the Italian PSEQ (PSEQ-I). The cross-cultural adaptation was completed in 5 months without omitting any item of the original PSEQ. Measurement properties were tested in 165 patients with chronic low back pain (CLBP) (65% women, mean age 49.9 years). Factor analysis confirmed the one-factor structure of the questionnaire. Internal consistency (Cronbach's α = 0.94) and test-retest reliability (ICCagreement  = 0.82) of the PSEQ-I showed good results. The smallest detectable change was equal to 15.69 scale points. The PSEQ-I displayed a high construct validity by meeting more than 75% of a priori hypotheses on correlations with measurement instruments assessing pain intensity, disability, anxiety, depression, pain catastrophizing, fear of movement, and coping strategies. Additionally, the PSEQ-I differentiated patients taking pain medication or not. The results of this study suggest that the PSEQ-I can be used as a valid and reliable tool in Italian patients with CLBP. © 2014 World Institute of Pain.

  5. Compliance of an elderly hip fracture population with secondary preventative measures. Efficacy of a simple clinical practice intervention.

    LENUS (Irish Health Repository)

    Street, John

    2012-02-03

    Secondary pharmaceutical measures are effective in all age groups for the prevention of osteoporotic fractures. This prospective study determines the demographics of 566 consecutive osteoporotic hip fractures presenting to a Level 1 Trauma Center. We examine the efficacy of simple treatment recommendations for pharmaceutical treatment of osteoporosis and the factors determining general practitioner and patient compliance with these recommendations in a community setting. One out of four patients (24.5%) had sustained a previous fragility fracture. Mean age was 80 years. Twenty five percent were resident in a nursing home and only 10% were taking anti-resorptive therapy preoperatively. In hospital mortality was 6%, and 39% of recruited patients were dead at 12 months. By this time more than half the survivors were resident in a nursing home. The compliance with anti-resorptive therapy had increased to over 70% consequent to our simple recommendations. Significant differences in GP and patient compliance were observed between nursing home and own residence dwellers. This study demonstrates the efficacy of a simple clinical practice intervention in increasing patient and GP compliance with secondary fracture prevention measures. We also discuss many of the confounding issues determining this compliance.

  6. Comparing the Efficacy of Excitatory Transcranial Stimulation Methods Measuring Motor Evoked Potentials

    Directory of Open Access Journals (Sweden)

    Vera Moliadze

    2014-01-01

    Full Text Available The common aim of transcranial stimulation methods is the induction or alterations of cortical excitability in a controlled way. Significant effects of each individual stimulation method have been published; however, conclusive direct comparisons of many of these methods are rare. The aim of the present study was to compare the efficacy of three widely applied stimulation methods inducing excitability enhancement in the motor cortex: 1 mA anodal transcranial direct current stimulation (atDCS, intermittent theta burst stimulation (iTBS, and 1 mA transcranial random noise stimulation (tRNS within one subject group. The effect of each stimulation condition was quantified by evaluating motor-evoked-potential amplitudes (MEPs in a fixed time sequence after stimulation. The analyses confirmed a significant enhancement of the M1 excitability caused by all three types of active stimulations compared to sham stimulation. There was no significant difference between the types of active stimulations, although the time course of the excitatory effects slightly differed. Among the stimulation methods, tRNS resulted in the strongest and atDCS significantly longest MEP increase compared to sham. Different time courses of the applied stimulation methods suggest different underlying mechanisms of action. Better understanding may be useful for better targeting of different transcranial stimulation techniques.

  7. An assessment of the efficacy and peak catch rates of emergence tents for measuring bee nesting.

    Science.gov (United States)

    Pane, Alexander M; Harmon-Threatt, Alexandra N

    2017-06-01

    Emergence tents are a new tool used to understand nesting ecology of ground nesting bee species. However, many questions remain about how to use tents effectively. We assessed (a) variance in tent capture rates over time, (b) the effects of site characteristics on proportion of tents capturing bees, and (c) the effect of soil characteristics on nest site choice. Emergence tents were placed out for one week in May, June, and August and checked daily. Soil, bee, and floral characteristics were recorded. Across all sites and months the average number of tents capturing bees was less than 20% during one week of sampling, but this varied between sites. Tent captures decreased after 48 h deployment, but accumulation differed seasonally, with slower accumulation of total bees caught in May than in June or August. Although capture rates were not affected by bee or floral abundance, soil moisture beneath a tent influenced where bees were captured. Effective use of emergence tents may require adjusting the length of deployment depending on season and will require a minimum of 48 h installation to help maximize efficacy. The overall low capture rates demonstrate the need to optimize emergence tent use.

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

    Science.gov (United States)

    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

  9. Development and validation of a self-efficacy questionnaire (SE-12) measuring the clinical communication skills of health care professionals

    DEFF Research Database (Denmark)

    Axboe, Mette K; Christensen, Kaj S; Kofoed, Poul-Erik

    2016-01-01

    of the theoretical approach applied in the communication course, statements from former course participants, teachers, and experts in the field. The questionnaire was initially validated through face-to-face interviews with 9 staff members following a test-retest including 195 participants. Results After minor......Background The outcome of communication training is widely measured by self-efficacy ratings, and different questionnaires have been used. Nevertheless, none of these questionnaires have been formally validated through systematic measurement of assessment properties. Consequently, we decided....... We consider the questionnaire useful for self-evaluation of clinical communication skills; the SE-12 is user-friendly and can be administered as an electronic questionnaire. However, future research should explore potential needs for adjustments to reduce the identified ceiling effect. Keyword...

  10. Team composition and chronic disease management within primary healthcare practices in eastern Ontario: an application of the Measuring Organizational Attributes of Primary Health Care Survey.

    Science.gov (United States)

    Lukewich, Julia; Edge, Dana S; VanDenKerkhof, Elizabeth; Williamson, Tyler; Tranmer, Joan

    2018-04-15

    Various organizational-level attributes are being implemented in primary healthcare to improve healthcare delivery. There is a need to describe the distribution and nature of these attributes and explore differences across practices.AimThe aim of this study was to better understand organizational attributes of primary care teams, focusing specifically on team composition, nursing roles, and strategies that support chronic disease management. We employed a cross-sectional survey design. Team composition, nursing roles, availability of health services, and chronic disease management activities were described using the 'Measuring Organizational Attributes of Primary Health Care Survey.'FindingsA total of 76% (n=26 out of 34) of practice locations completed the survey, including family health teams (FHT; n=21) and community health centers (CHC; n=4). Nurse practitioners (NPs) and registered nurses (RNs) were the most common non-physician providers, and CHCs had a greater proportion of non-physician providers than FHTs. There was overlap in roles performed by NPs and RNs, and registered practical nurses engaged in fewer roles compared with NPs and RNs. A greater proportion of FHTs had systematic chronic disease management services for hypertension, depression and Alzheimer's disease compared with CHC practices. The 'Measuring Organizational Attributes of Primary Health Care Survey' was a useful tool to highlight variability in organizational attributes across PHC practices. Nurses are prominent within PHC practices, engaging in a wide range of roles related to chronic disease management, suggesting a need to better understand their contributions to patient care to optimize their roles.

  11. 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.

  12. Accuracy of serum luteinizing hormone and serum testosterone measurements to assess the efficacy of medical castration in prostate cancer patients.

    Science.gov (United States)

    Morote, Juan; Comas, Imma; Ferrer, Roser; Planas, Jacques; Celma, Anna; Regis, Lucas

    2017-10-22

    Luteinizing hormone-releasing hormone (LH-RH) agonists are the standard for androgen deprivation therapy (ADT) in prostate cancer (PCa) patients. Current guidelines recommend serum testosterone measurement to assess the efficacy of ADT and to define castration resistance. However, serum testosterone does not reflect the exclusive effect of castration due to its extratesticular production. The aim of this study is to analyze if serum LH reflects better than serum testosterone the activity of LH-RH agonists. Serum LH and serum testosterone were measured with chemiluminescent immunoassay (CLIA) in a cohort study of 1091 participants: 488 PCa patients "on LH-RH agonists", 303 "off LH-RH agonist" in whom LH-RH agonists were withdrawn, and 350 men with PCa suspicion "no LH-RH agonist" who never received LH-RH agonists. In a validation cohort of 147 PCa patients, 124 on "LH-RH agonists" and 19 "off LH-RH agonists", serum testosterone was also measured with liquid chromatography and tandem mass spectrometry (LC MSMS). The area under the curve (AUC) to distinguish patients "on versus off LH-RH agonists" was 0.997 for serum LH and 0.740 for serum testosterone, P < 0.001. The 97.5 percentile of serum LH in patients "on LH-RH agonists" was 0.97 U/L, been the most efficient threshold 1.1 U/L. The AUCs for serum LH, testosterone measured with CLIA and with LC MSMS, in the validation cohort, were respectively 1.000, 0.646 and 0.814, P < 0.001. The efficacy to distinguish patients "on versus off LH-RH agonists" was 98.6%, 78.3%, and 89.5% respectively, using 1.1 U/L as threshold for serum LH and 50 ng/dL for serum testosterone regardless the method. Serum LH is more accurate than serum testosterone regardless the method, to distinguish patients "on versus off LH-RH agonists". The castrate level of serum LH is 1.1 U/l. These findings suggest that assessment of LH-RH agonist efficacy and castration resistance definition should be reviewed.

  13. Network Pharmacology-Based Approach to Investigate the Analgesic Efficacy and Molecular Targets of Xuangui Dropping Pill for Treating Primary Dysmenorrhea

    Directory of Open Access Journals (Sweden)

    Jihan Huang

    2017-01-01

    Full Text Available This study aimed to evaluate the clinical analgesic efficacy and identify the molecular targets of XGDP for treating primary dysmenorrhea (PD by a network pharmacology approach. Analysis of pain disappearance rate of XGDP in PD treatment was conducted based on data from phase II and III randomized, double-blind, double-simulation, and positive parallel controlled clinical trials. The bioactive compounds were obtained by the absorption, distribution, metabolism, and excretion processes with oral bioavailability (OB and drug-likeness (DL evaluation. Subsequently, target prediction, pathway identification, and network construction were employed to clarify the mechanisms of the analgesic effect of XGDP on PD. The pain disappearance rates in phase II and III clinical trials of XGDP in PD treatment were 62.5% and 55.8%, respectively, yielding a significant difference (P<0.05 when compared with the control group using Tongjingbao granules (TJBG. Among 331 compounds, 53 compounds in XGDP were identified as the active compounds related to PD through OB, DL, and target prediction. The active compounds and molecular targets of XGDP were identified, and our study showed that XGDP may exert its therapeutic effects on PD through the regulation of the targets related to anti-inflammation analgesia and central analgesia and relieving smooth muscle contraction.

  14. Pain measurement as part of primary healthcare of adult patients with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Andreza Aparecida Felix Signorelli

    2013-01-01

    Full Text Available OBJECTIVE: The aim of this exploratory, cross-sectional study was to evaluate pain in sickle cell disease patients and aspects related to primary healthcare. METHODS: Data were obtained through home interviews. The assessment instruments (body diagram, Numerical Pain Scale, McGill Pain Questionnaire collected information on the underlying disease and on pain. Data were analyzed using the Statistical Package for Social Sciences program for Windows. Associations between the subgroups of sickle cell disease patients (hemoglobin SS, hemoglobin SC, sickle β-thalassemia and others and pain were analyzed using contingency tables and non-parametric tests of association (classic chi-square, Fisher's and Kruskal-Wallis with a level of 5% (p-value < 0.05 being set for the rejection of the null hypothesis. RESULTS: Forty-seven over 18-year-old patients with sickle cell disease were evaluated. Most were black (78.7% and female (59.6% and the mean age was 30.1 years. The average number of bouts of pain annually was 7.02; pain was predominantly reported by individuals with sickle cell anemia (hemoglobin SS. The intensity of pain (Numeric Pain Scale was 5.5 and the quantitative index (McGill was 35.9. This study also shows that patients presented a high frequency of moderately painful crises in their own homes. CONCLUSION: According to these facts, it is essential that pain related to sickle cell disease is properly identified, quantified, characterized and treated at the three levels of healthcare. In primary healthcare, accurate measurement of pain combined with better care may decrease acute painful episodes and consequently minimize tissue damage, thus improving the patient's overall health.

  15. Considerations in choosing a primary endpoint that measures durability of virological suppression in an antiretroviral trial.

    Science.gov (United States)

    Gilbert, P B; Ribaudo, H J; Greenberg, L; Yu, G; Bosch, R J; Tierney, C; Kuritzkes, D R

    2000-09-08

    At present, many clinical trials of anti-HIV-1 therapies compare treatments by a primary endpoint that measures the durability of suppression of HIV-1 replication. Several durability endpoints are compared. Endpoints are compared by their implicit assumptions regarding surrogacy for clinical outcomes, sample size requirements, and accommodations for inter-patient differences in baseline plasma HIV-1-RNA levels and in initial treatment response. Virological failure is defined by the non-suppression of virus levels at a prespecified follow-up time T(early virological failure), or by relapse. A binary virological failure endpoint is compared with three time-to-virological failure endpoints: time from (i) randomization that assigns early failures a failure time of T weeks; (ii) randomization that extends the early failure time T for slowly responding subjects; and (iii) virological response that assigns non-responders a failure time of 0 weeks. Endpoint differences are illustrated with Agouron's trial 511. In comparing high with low-dose nelfinavir (NFV) regimens in Agouron 511, the difference in Kaplan-Meier estimates of the proportion not failing by 24 weeks is 16.7% (P = 0.048), 6.5% (P = 0.29) and 22.9% (P = 0.0030) for endpoints (i), (ii) and (iii), respectively. The results differ because NFV suppresses virus more quickly at the higher dose, and the endpoints weigh this treatment difference differently. This illustrates that careful consideration needs to be given to choosing a primary endpoint that will detect treatment differences of interest. A time from randomization endpoint is usually recommended because of its advantages in flexibility and sample size, especially at interim analyses, and for its interpretation for patient management.

  16. Logopenic and nonfluent variants of primary progressive aphasia are differentiated by acoustic measures of speech production.

    Directory of Open Access Journals (Sweden)

    Kirrie J Ballard

    Full Text Available Differentiation of logopenic (lvPPA and nonfluent/agrammatic (nfvPPA variants of Primary Progressive Aphasia is important yet remains challenging since it hinges on expert based evaluation of speech and language production. In this study acoustic measures of speech in conjunction with voxel-based morphometry were used to determine the success of the measures as an adjunct to diagnosis and to explore the neural basis of apraxia of speech in nfvPPA. Forty-one patients (21 lvPPA, 20 nfvPPA were recruited from a consecutive sample with suspected frontotemporal dementia. Patients were diagnosed using the current gold-standard of expert perceptual judgment, based on presence/absence of particular speech features during speaking tasks. Seventeen healthy age-matched adults served as controls. MRI scans were available for 11 control and 37 PPA cases; 23 of the PPA cases underwent amyloid ligand PET imaging. Measures, corresponding to perceptual features of apraxia of speech, were periods of silence during reading and relative vowel duration and intensity in polysyllable word repetition. Discriminant function analyses revealed that a measure of relative vowel duration differentiated nfvPPA cases from both control and lvPPA cases (r(2 = 0.47 with 88% agreement with expert judgment of presence of apraxia of speech in nfvPPA cases. VBM analysis showed that relative vowel duration covaried with grey matter intensity in areas critical for speech motor planning and programming: precentral gyrus, supplementary motor area and inferior frontal gyrus bilaterally, only affected in the nfvPPA group. This bilateral involvement of frontal speech networks in nfvPPA potentially affects access to compensatory mechanisms involving right hemisphere homologues. Measures of silences during reading also discriminated the PPA and control groups, but did not increase predictive accuracy. Findings suggest that a measure of relative vowel duration from of a polysyllable word

  17. Measuring hunger and satiety in primary school children. Validation of a new picture rating scale.

    Science.gov (United States)

    Bennett, Carmel; Blissett, Jackie

    2014-07-01

    Measuring hunger and satiety in children is essential to many studies of childhood eating behaviour. Few validated measures currently exist that allow children to make accurate and reliable ratings of hunger/satiety. Three studies aimed to validate the use of a new categorical rating scale in the context of estimated and real eating episodes. Forty-seven 6- to 8-year-olds participated in Study 1, which used a between-participant design. Results indicated that the majority of children were able to make estimated hunger/satiety ratings for a story character using the scale. No significant differences in the ratings of hunger/satiety of children measured before and after lunch were observed and likely causes are discussed. To account for inter-individual differences in hunger/satiety perceptions Study 2 employed a within-participant design. Fifty-four 5- to 7-year-olds participated and made estimated hunger/satiety ratings for a story character and real hunger/satiety ratings before and after lunch. The results indicated that the majority of children were able to use the scale to make estimated and real hunger and satiety ratings. Children were found to be significantly hungrier before compared to after lunch. As it was not possible to establish the types and quantities of food children ate for lunch a third study was carried out in a controlled laboratory environment. Thirty-six 6- to 9-year-olds participated in Study 3 and made hunger/satiety ratings before and after ingesting an ad libitum snack of known composition and quantity. Results indicated that children felt hungrier before than after the snack and that pre-snack hunger/satiety, and changes in hunger/satiety, were associated with snack intake. Overall, the studies indicate that the scale has potential for use with primary school children. Implications of the findings are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Prevention of microbial species introductions to the Arctic: The efficacy of footwear disinfection measures on cruise ships

    Directory of Open Access Journals (Sweden)

    Sabine B. Rumpf

    2018-03-01

    Full Text Available Biosecurity measures are commonly used to prevent the introduction of non-native species to natural environments globally, yet the efficacy of practices is rarely tested under operational conditions. A voluntary biosecurity measure was trialled in the Norwegian high Arctic following concern that non-native species might be transferred to the region on the footwear of travellers. Passengers aboard an expedition cruise ship disinfected their footwear with the broad spectrum disinfectant Virkon S prior to and in-between landing at sites around the remote Svalbard archipelago. The authors evaluated the efficacy of simply stepping through a disinfectant foot bath, which is the most common practice of footwear disinfection aboard expedition cruise ships in the Arctic. This was compared to a more time consuming and little-used method involving drying disinfected footwear, as proposed by other studies. The two practices were evaluated by measuring microbial growth on paired footwear samples before and after disinfection under both conditions. Step-through disinfection did not substantially reduce microbial growth on the footwear. Allowing disinfected footwear to dry, however, reduced the microbial burden significantly to lower levels. Thus, the currently adopted procedures used aboard ships are ineffective at removing microbial burden and are only effective when footwear is given more time to dry than currently granted under operational conditions. These findings underscore results from empirical research performed elsewhere and suggest the need to better relay this information to practitioners. It is suggested that footwear should minimally be wiped dry after step-through disinfection as a reasonable compromise between biosecurity and practicability.

  19. Feasibility, safety, acceptability, and preliminary efficacy of measurement-based care depression treatment for HIV patients in Bamenda, Cameroon.

    Science.gov (United States)

    Pence, Brian W; Gaynes, Bradley N; Atashili, Julius; O'Donnell, Julie K; Kats, Dmitry; Whetten, Kathryn; Njamnshi, Alfred K; Mbu, Tabenyang; Kefie, Charles; Asanji, Shantal; Ndumbe, Peter

    2014-06-01

    Depression affects 18-30 % of HIV-infected patients in Africa and is associated with greater stigma, lower antiretroviral adherence, and faster disease progression. However, the region's health system capacity to effectively identify and treat depression is limited. Task-shifting models may help address this large mental health treatment gap. Measurement-Based Care (MBC) is a task-shifting model in which a Depression Care Manager guides a non-psychiatric (e.g., HIV) provider in prescribing and managing antidepressant treatment. We adapted MBC for depressed HIV-infected patients in Cameroon and completed a pilot study to assess feasibility, safety, acceptability, and preliminary efficacy. We enrolled 55 participants; all started amitriptyline 25-50 mg daily at baseline. By 12 weeks, most remained at 50 mg daily (range 25-125 mg). Median (interquartile range) PHQ-9 depressive severity scores declined from 13 (12-16) (baseline) to 2 (0-3) (week 12); 87 % achieved depression remission (PHQ-9 feasibility, safety, acceptability, and preliminary efficacy in this uncontrolled pilot study. Further research should assess whether MBC could improve adherence and HIV outcomes in this setting.

  20. 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

  1. Measurements of Primary Biogenic Aerosol Particles with an Ultraviolet Aerodynamic Particle Sizer (UVAPS) During AMAZE-08

    Science.gov (United States)

    Wollny, A. G.; Garland, R.; Pöschl, U.

    2008-12-01

    Biogenic aerosols are ubiquitous in the Earth's atmosphere and they influence atmospheric chemistry and physics, the biosphere, climate, and public health. They play an important role in the spread of biological organisms and reproductive materials, and they can cause or enhance human, animal, and plant diseases. Moreover, they influence the Earth's energy budget by scattering and absorbing radiation, and they can initiate the formation of clouds and precipitation as cloud condensation and ice nuclei. The composition, abundance, and origin of biogenic aerosol particles and components are, however, still not well understood and poorly quantified. Prominent examples of primary biogenic aerosol particles, which are directly emitted from the biosphere to the atmosphere, are pollen, bacteria, fungal spores, viruses, and fragments of animals and plants. During the AMazonian Aerosol CharacteriZation Experiment (AMAZE-08) a large number of aerosol and gas-phase measurements were taken on a remote site close to Manaus, Brazil, during a period of five weeks in February and March 2008. The presented study is focused on data from an ultraviolet aerodynamic particle sizer (UVAPS, TSI inc.) that has been deployed for the first time in Amazonia. In this instrument, particle counting and aerodynamic sizing over the range of 0.5-20 μm are complemented by the measurement of UV fluorescence at 355 nm (excitation) and 420-575 nm (emission), respectively. Fluorescence at these wavelengths is characteristic for reduced pyridine nucleotides (e.g., NAD(P)H) and for riboflavin, which are specific for living cells. Thus particles exhibiting fluorescence signals can be regarded as 'viable aerosols' or 'fluorescent bioparticles' (FBAP), and their concentration can be considered as lower limit for the actual abundance of primary biogenic aerosol particles. First data analyses show a pronounced peak of FBAP at diameters around 2-3 μm. In this size range the biogenic particle fraction was

  2. The Efficacy of Self-Report Measures in Predicting Social Phobia in African American Adults.

    Science.gov (United States)

    Chapman, L Kevin; Petrie, Jenny M; Richards, Allyn

    2015-03-01

    Empirical literature pertaining to anxiety in African Americans has been relatively sparse. More recent studies indicate that the construct of social fear is different in African Americans than in non-Hispanic Whites. Although some of these studies have examined factor structure utilizing self-report measures of anxiety in African American samples, none to date have examined the clinical utility of these measures in predicting anxiety diagnoses, particularly social phobia. A total of sixty-five African American adults from the community completed the Fear Survey Schedule-Second Edition (FSS-II), Social Anxiety Interaction Scale (SIAS), Social Phobia Scale (SPS), and Albany Panic and Phobia Questionnaire (APPQ). The Anxiety Disorder Interview Schedule-Fourth Edition (ADIS-IV) was administered to all participants to specify differential diagnoses of anxiety and related disorders. Twenty-three African American adults were diagnosed with social phobia leaving 42 diagnostic controls. Results suggest that the social anxiety factors were highly predictive of a social phobia diagnosis (AUC=.84 to .90; CI .73-.98, p<.01) and sensitivity and specificity rates revealed optimal cutoff scores for each measure. The optimal cutoff scores reveal the clinical utility of the social fear factor from these measures in screening for social phobia in African Americans. Future direction and implications are discussed. Psychinfo, PubMed, Medline. © 2015 National Medical Association. Published by Elsevier Inc. All rights reserved.

  3. HLM in Cluster-Randomised Trials--Measuring Efficacy across Diverse Populations of Learners

    Science.gov (United States)

    Hegedus, Stephen; Tapper, John; Dalton, Sara; Sloane, Finbarr

    2013-01-01

    We describe the application of Hierarchical Linear Modelling (HLM) in a cluster-randomised study to examine learning algebraic concepts and procedures in an innovative, technology-rich environment in the US. HLM is applied to measure the impact of such treatment on learning and on contextual variables. We provide a detailed description of such…

  4. Characterization of a new candidate isotopic reference material for natural Pb using primary measurement method.

    Science.gov (United States)

    Nonose, Naoko; Suzuki, Toshihiro; Shin, Ki-Cheol; Miura, Tsutomu; Hioki, Akiharu

    2017-06-29

    A lead isotopic standard solution with natural abundance has been developed by applying a mixture of a solution of enriched 208 Pb and a solution of enriched 204 Pb ( 208 Pb- 204 Pb double spike solution) as bracketing method. The amount-of-substance ratio of 208 Pb: 204 Pb in this solution is accurately measured by applying EDTA titrimetry, which is one of the primary measurement methods, to each enriched Pb isotope solution. Also metal impurities affecting EDTA titration and minor lead isotopes contained in each enriched Pb isotope solution are quantified by ICP-SF-MS. The amount-of-substance ratio of 208 Pb: 204 Pb in the 208 Pb- 204 Pb double spike solution is 0.961959 ± 0.000056 (combined standard uncertainty; k = 1). Both the measurement of lead isotope ratios in a candidate isotopic standard solution and the correction of mass discrimination in MC-ICP-MS are carried out by coupling of a bracketing method with the 208 Pb- 204 Pb double spike solution and a thallium internal addition method, where thallium solution is added to the standard and the sample. The measured lead isotope ratios and their expanded uncertainties (k = 2) in the candidate isotopic standard solution are 18.0900 ± 0.0046 for 206 Pb: 204 Pb, 15.6278 ± 0.0036 for 207 Pb: 204 Pb, 38.0626 ± 0.0089 for 208 Pb: 204 Pb, 2.104406 ± 0.00013 for 208 Pb: 206 Pb, and 0.863888 ± 0.000036 for 207 Pb: 206 Pb. The expanded uncertainties are about one half of the stated uncertainty for NIST SRM 981, for 208 Pb: 204 Pb, 207 Pb: 204 Pb and 206 Pb: 204 Pb, or one eighth, for 208 Pb: 206 Pb and 207 Pb: 206 Pb, The combined uncertainty consists of the uncertainties due to lead isotope ratio measurements and the remaining time-drift effect of mass discrimination in MC-ICP-MS, which is not removed by the coupled correction method. In the measurement of 208 Pb: 204 Pb, 207 Pb: 204 Pb and 206 Pb: 204 Pb, the latter contribution is two or three times larger than the former. When the coupling of

  5. Efficacy of New Measures Saving Time in Acute Stroke Management: A Quantified Analysis.

    Science.gov (United States)

    Iglesias Mohedano, Ana María; García Pastor, Andrés; Díaz Otero, Fernando; Vázquez Alen, Pilar; Vales Montero, Marta; Luque Buzo, Elisa; Redondo Ráfales, Nuria; Chavarria Cano, Beatriz; Fernández Bullido, Yolanda; Villanueva Osorio, Jose Antonio; Gil Núñez, Antonio

    2017-08-01

    Time to treatment remains the most important factor in acute ischemic stroke prognosis. We quantified the effect of new interventions reducing in-hospital delays in acute stroke management and assessed its repercussion on door-to-imaging (DTI), imaging-to-needle (ITN), and door-to-needle (DTN) times. Prospective registry of consecutive stroke patients who were candidates for reperfusion therapy attended in a tertiary care hospital from February 1 to December 31, 2014. A series of measures aimed at reducing in-hospital delays were implemented. We compared DTI, ITN, and DTN times between patients who underwent the interventions and those who did not. 231 patients. DTI time was lower when personal history was reviewed and tests were ordered before patient arrival (2.5 minutes saved, P = .016) and when electrocardiogram was not made (5.4 minutes saved, P time significantly (14 and 12 minutes saved, respectively, P time. Completing all steps resulted in the lowest DTI and ITN times (13 and 19 minutes, respectively). Every measure is an important part of a chain focused on saving time in acute stroke: the lowest DTI and ITN times were obtained when all steps were completed. Measures shortening ITN time produced a greater impact on DTN time reduction; therefore, ITN interventions should be considered a critical part of new protocols and guidelines. Copyright © 2017. Published by Elsevier Inc.

  6. Assessing internal exposures and the efficacy of countermeasures from whole body measurements

    International Nuclear Information System (INIS)

    Likhtarev, I.; Kovgan, L.; Gluvchinsky, R.; Perevoznikov, O.; Morrey, M.; Prosser, S.L.; Jacob, P.; Prohl, G.; Kenigsberg, Y.; Skryabin, A.M.; Colgen, P.A.

    1996-01-01

    Traditional procedures for modelling the ingestion dose pathway combine environmental transfer models with human metabolic models in order to assess the doses received. In general, these models have been developed for specific ecological and socio-economic circumstances, rather than for globally-averaged conditions. Experiences which occurred following the Chernobyl accident have demonstrated that in the event of a large scale radiation accident it will be virtually impossible to monitor adequately all the radiologically significant components of human diet which may have become contaminated with radionuclides. This paper describes an internal dosimetry model based on the most widely available measurements following an accident: radiocesium measurements in soil and milk, and whole body measurements in humans. One application of the model to estimate ingestion doses received by inhabitants of the northern region of the Rovno Region in Ukraine is also described. In addition, this model enables the effectiveness of food Countermeasures to be estimated. This study formed part of Joint Study Programme 5 (JSP5) on pathway analysis and dose distributions and was jointly funded by the European Commission (EC) and Commonwealth of Independent States (CIS)

  7. Measurement of asbestos bodies in lung tissue of autopsy cases diagnosed with primary lung cancer

    International Nuclear Information System (INIS)

    Idei, Yuka; Kamada, Satoe; Matsumoto, Shoji; Ohnishi, Kazuo; Kitazawa, Riko; Kitazawa, Sohei

    2007-01-01

    To investigate the relation between asbestos-related lung cancer and the concentration of asbestos bodies in lung tissue, we analyzed the concentration in 24 autopsy cases diagnosed with primary lung cancer, with regard to the gender, age, histological type of lung cancer and occupation of each case. The asbestos bodies were measured according to Kohyama's method. Positive cases (more than 5,000 bodies per 1 g of dry lung tissue) were further analyzed for asbestosis and pleural plaques by chest X-ray and chest CT. Two cases exhibited more than 5,000 bodies, five cases between 1,000 and 5,000, and seventeen cases less than 1,000. The occupation of the two positive cases was not informative: one demonstrated neither asbestosis nor pleural plaques, and the other showed only pleural plaques. Although the number of cases of asbestos-related lung cancer is minimal among all lung cancer cases, the number of the former may exceed that of mesothelioma patients. Not only physicians but also radiologists, surgeons and pathologists need to collaborate in the diagnosis of asbestos-related lung cancer. (author)

  8. Choice of primary transducers of beam parameters for measuring and control systems of charged particle accelerators

    International Nuclear Information System (INIS)

    Rybin, V.M.

    1981-01-01

    Investigations on classification of primary transducers (pT) of the main parameters of charged particle beams are conducted for development of the common series on the base of program- controlled module systems for measuring the parameters of charged particle beams. The PT classification is exercised by: the physical principle of single transformation, the degree of effect on the beam, principle of operation, design, performance, location. It is shown that the optimal choice of PT and their parameters should be necessarily executed in several stages: estimation of the limiting possibilities of PT; choice of PT by time and metrological characteristics as well as sensitivity for the determined operation conditions; choice of the PT by the degree of effect on the beam: choice of the PT type with account of its design performance and location, determination of PT parameters with account of possibility of information, energy and design compatibility of the used standard. The classification results of magnetoinduction and acoustic transducers have shown that the number of their modifications does not exceed 100 [ru

  9. Measurements and simulation of forest leaf area index and net primary productivity in Northern China.

    Science.gov (United States)

    Wang, P; Sun, R; Hu, J; Zhu, Q; Zhou, Y; Li, L; Chen, J M

    2007-11-01

    Large scale process-based modeling is a useful approach to estimate distributions of global net primary productivity (NPP). In this paper, in order to validate an existing NPP model with observed data at site level, field experiments were conducted at three sites in northern China. One site is located in Qilian Mountain in Gansu Province, and the other two sites are in Changbaishan Natural Reserve and Dunhua County in Jilin Province. Detailed field experiments are discussed and field data are used to validate the simulated NPP. Remotely sensed images including Landsat Enhanced Thematic Mapper plus (ETM+, 30 m spatial resolution in visible and near infrared bands) and Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER, 15m spatial resolution in visible and near infrared bands) are used to derive maps of land cover, leaf area index, and biomass. Based on these maps, field measured data, soil texture and daily meteorological data, NPP of these sites are simulated for year 2001 with the boreal ecosystem productivity simulator (BEPS). The NPP in these sites ranges from 80 to 800 gCm(-2)a(-1). The observed NPP agrees well with the modeled NPP. This study suggests that BEPS can be used to estimate NPP in northern China if remotely sensed images of high spatial resolution are available.

  10. Some Comparisons of Measured and Predicted Primary Radiation Levels in the Aagesta Power Plant

    Energy Technology Data Exchange (ETDEWEB)

    Aalto, E; Sandlin, R; Krell, Aa

    1968-05-15

    Neutron fluxes and gamma exposure rates in the primary shields of the Aagesta nuclear plant have been measured and the results compared with values predicted during shield design, and with values obtained later by the NRN bulk shielding code. The input data for the problems are given. The radial predictions are conservative by a factor of not more than 2 close to the reactor and by an unknown, higher factor further out. The conservatism is explainable by the differences between the true local conditions and core power distributions and those assumed in the predictions. The axial flux levels based on streaming calculations are found to agree quite well with the estimated values. The conservatism here is not so large and it seems to be necessary to be very careful when handling streaming problems. The experience gained shows that a power plant is less suitable for studying the accuracy of the shield design codes as such, but the practical results from the combined application of massive shield codes and void streaming predictions to complicated problems give information about the true degree of conservatism present.

  11. Application of liquid chromatography techniques to the measurement of soluble transition metals in PWR primary coolant

    International Nuclear Information System (INIS)

    Amey, M.D.H.; Brown, G.R.

    1987-01-01

    Two chromatographic techniques have been developed, and evaluated for the on-line analysis of soluble transition metals, particularly cobalt, in PWR primary coolant. Automatic operation and control, together with data processing and storage has been achieved by interfacing a Dionex ion chromatograph to a microprocessor control system. An absolute detection limit of 0.1 ng cobalt has been obtained which, with on-line sample preconcentration (100 ml), has enabled measurements to be made down to part-per-trillion levels (0.001 ppb). Application of the techniques to PWR coolant analysis was demonstrated by a programme of work on the Half Megawatt Loop at Winfrith. During this work some aspects of the behaviour of soluble metal species have been studied in both de-oxygenated and hydrogenated conditions. The effects of changes in coolant chemistry, operating temperature, and sample line flowrates on circulating impurity levels are reported, together with the dramatic effects observed when part of the circuit pipework was replaced with new stainless steel tubing. (author)

  12. Test-retest reproducibility of accommodative facility measures in primary school children.

    Science.gov (United States)

    Adler, Paul; Scally, Andrew J; Barrett, Brendan T

    2018-05-08

    To determine the test-retest reproducibility of accommodative facility (AF) measures in an unselected sample of UK primary school children. Using ±2.00 DS flippers and a viewing distance of 40 cm, AF was measured in 136 children (range 4-12 years, average 8.1 ± 2.1) by five testers on three occasions (average interval between successive tests: eight days, range 1-21 days). On each occasion, AF was measured monocularly and binocularly, for two minutes. Full datasets were obtained in 111 children (81.6 per cent). Intra-individual variation in AF was large (standard deviation [SD] = 3.8 cycles per minute [cpm]) and there was variation due to the identity of the tester (SD = 1.6 cpm). On average, AF was greater: (i) in monocular compared to binocular testing (by 1.4 cpm, p cpm, p cpm lower than in children ≥ 10 years old, p = 0.009); and (iv) on subsequent testing occasions (for example, visit-2 AF was 2.0 cpm higher than visit-1 AF, p cpm monocularly and ≥ 8 cpm binocularly), but this rose to 83.8 per cent after the third test. Using less stringent pass criteria (≥ 6 cpm monocularly and ≥ 3 cpm binocularly), the equivalent figures were 82.9 and 96.4 per cent, respectively. Reduced AF did not co-exist with abnormal near point of accommodation or reduced visual acuity. The results reveal considerable intra-individual variability in raw AF measures in children. When the results are considered as pass/fail, children who initially exhibit normal AF continued to do so on repeat testing. Conversely, the vast majority of children with initially reduced AF exhibit normal performance on repeat testing. Using established pass/fail criteria, the prevalence of persistently reduced AF in this sample is 3.6 per cent. © 2018 Optometry Australia.

  13. Constraining Ecosystem Gross Primary Production and Transpiration with Measurements of Photosynthetic 13CO2 Discrimination

    Science.gov (United States)

    Blonquist, J. M.; Wingate, L.; Ogeé, J.; Bowling, D. R.

    2011-12-01

    The stable carbon isotope composition of atmospheric CO2 (δ13Ca) can provide useful information on water use efficiency (WUE) dynamics of terrestrial ecosystems and potentially constrain models of CO2 and water fluxes at the land surface. This is due to the leaf-level relationship between photosynthetic 13CO2 discrimination (Δ), which influences δ13Ca, and the ratio of leaf intercellular to atmospheric CO2 mole fractions (Ci / Ca), which is related to WUE and is determined by the balance between C assimilation (CO2 demand) and stomatal conductance (CO2 supply). We used branch-scale Δ derived from tunable diode laser absorption spectroscopy measurements collected in a Maritime pine forest to estimate Ci / Ca variations over an entire growing season. We combined Ci / Ca estimates with rates of gross primary production (GPP) derived from eddy covariance (EC) to estimate canopy-scale stomatal conductance (Gs) and transpiration (T). Estimates of T were highly correlated to T estimates derived from sapflow data (y = 1.22x + 0.08; r2 = 0.61; slope P MuSICA) (y = 0.88x - 0.05; r2 = 0.64; slope P MuSICA (y = 1.10 + 0.42; r2 = 0.50; slope P < 0.001). Results demonstrate that the leaf-level relationship between Δ and Ci / Ca can be extended to the canopy-scale and that Δ measurements have utility for partitioning ecosystem-scale CO2 and water fluxes.

  14. The Measurement of Performance skills of Primary Maternal Child Health Workers - An Indian Experiment

    Directory of Open Access Journals (Sweden)

    Mohanty N

    1994-01-01

    Full Text Available Research Questions: 1. What are the cognitive and psychomotor levels of Anganwadi Workers (AWW regarding important aspects of maternal and child health? 2. Can these skills be improved by training with a self learning communication module? Objectives: (i Identify and evaluate the level of intellectual and practical skills acquired by the AWWs on some areas of primary. health care like : detection of low birth weight (LBW babies, weight of the baby, measurement of body temperature by thermometer, identification of diarrhoea and preparation of ORS, detection of high risk cases and referral. (ii Develop and test a self learning communication module capable of improving the psychomotor domains involved in provision of care. (iii Measure the improvement in the knowledge and specific skill components of the AWWs with the self learning communication module. Design : Intervention study. Setting : Integrated Child Development Scheme Blocks of Varanasi District. Participants : Anganwadi workers belonging to two ICDS Blocks, one was the intervention group and the control group. Study Variable : Self learning communication module. Outcome Variable : Improvement in the cognitive and psychomotor skills of those workers who were administered the module in comparison with the control group. Statistical Analysis : Students ‘t’ test and paired ‘t’ test. Results: There was a significant improvement (p less than 0.001 in the performance skills between the intervention and the control groups. Conclusion: The training modules was effective in improving the overall performance of the workers. However, repeated inservice training is essential to maintain the levels of improvement.

  15. Real-World Massage Therapy Produces Meaningful Effectiveness Signal for Primary Care Patients with Chronic Low Back Pain: Results of a Repeated Measures Cohort Study.

    Science.gov (United States)

    Elder, William G; Munk, Niki; Love, Margaret M; Bruckner, Geza G; Stewart, Kathryn E; Pearce, Kevin

    2017-07-01

    While efficacy of massage and other nonpharmacological treatments for chronic low back pain is established, stakeholders have called for pragmatic studies of effectiveness in "real-world" primary health care. The Kentucky Pain Research and Outcomes Study evaluated massage impact on pain, disability, and health-related quality of life for primary care patients with chronic low back pain. We report effectiveness and feasibility results, and make comparisons with established minimal clinically important differences. Primary care providers referred eligible patients for 10 massage sessions with community practicing licensed massage therapists. Oswestry Disability Index and SF-36v2 measures obtained at baseline and postintervention at 12 and 24 weeks were analyzed with mixed linear models and Tukey's tests. Additional analyses examined clinically significant improvement and predictive patient characteristics. Of 104 enrolled patients, 85 and 76 completed 12 and 24 weeks of data collection, respectively. Group means improved at 12 weeks for all outcomes and at 24 weeks for SF-36v2's Physical Component Summary and Bodily Pain Domain. Of those with clinically improved disability at 12 weeks, 75% were still clinically improved at 24 weeks ( P  < 0.01). For SF-36v2 Physical and Mental Component Summaries, 55.4% and 43.4%, respectively, showed clinically meaningful improvement at 12 weeks, 46.1% and 30.3% at 24 weeks. For Bodily Pain Domain, 49.4% were clinically improved at 12 weeks, 40% at 24 weeks. Adults older than age 49 years had better pain and disability outcomes than younger adults. Results provide a meaningful signal of massage effect for primary care patients with chronic low back pain and call for further research in practice settings using pragmatic designs with control groups. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  16. 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.

  17. Efficacy and toxicity in brain tumor treatment - quantitative Measurements using advanced MRI

    DEFF Research Database (Denmark)

    Ravn, Søren

    2016-01-01

    From the clinical introduction in the 1980s, MRI has grown to become an indispensable brain imaging modality, mainly due to its excellent ability to visualize soft tissues. Morphologically, T1- and T2-weighted brain tumor MRI have been part of routine diagnostic radiology for more than two decades...... with the introduction of magnets with higher field strength. Ongoing technical development has enabled a change from semiquantitative measurements to a true quantitative approach. This step is expected to have a great impact on the treatment of brain tumor patients in the future. The aim of this Ph.D. dissertation...... was to explore how different advanced MRI techniques could contribute to a higher degree of individualized treatment of brain tumor patients. The thesis is based on three studies in which advanced MRI is used to evaluate the possible role of fMRI in presurgical planning, Diffusion Tensor Imaging (DTI...

  18. Measurement of the efficacy of calcium silicate for the protection and repair of dental enamel.

    Science.gov (United States)

    Parker, Alexander S; Patel, Anisha N; Al Botros, Rehab; Snowden, Michael E; McKelvey, Kim; Unwin, Patrick R; Ashcroft, Alexander T; Carvell, Mel; Joiner, Andrew; Peruffo, Massimo

    2014-06-01

    To investigate the formation of hydroxyapatite (HAP) from calcium silicate and the deposition of calcium silicate onto sound and acid eroded enamel surfaces in order to investigate its repair and protective properties. Calcium silicate was mixed with phosphate buffer for seven days and the resulting solids analysed for crystalline phases by Raman spectroscopy. Deposition studies were conducted on bovine enamel surfaces. Acid etched regions were produced on the enamel surfaces using scanning electrochemical cell microscopy (SECCM) with acid filled pipettes and varying contact times. Following treatment with calcium silicate, the deposition was visualised with FE-SEM and etch pit volumes were measured by AFM. A second set of bovine enamel specimens were pre-treated with calcium silicate and fluoride, before acid exposure with the SECCM. The volumes of the resultant acid etched pits were measured using AFM and the intrinsic rate constant for calcium loss was calculated. Raman spectroscopy confirmed that HAP was formed from calcium silicate. Deposition studies demonstrated greater delivery of calcium silicate to acid eroded than sound enamel and that the volume of acid etched enamel pits was significantly reduced following one treatment (penamel was 0.092 ± 0.008 cm/s. This was significantly reduced, 0.056 ± 0.005 cm/s, for the calcium silicate treatments (penamel surfaces. Calcium silicate can provide significant protection of sound enamel from acid challenges. Calcium silicate is a material that has potential for a new approach to the repair of demineralised enamel and the protection of enamel from acid attacks, leading to significant dental hard tissue benefits. © 2014 Elsevier Ltd. All rights reserved.

  19. Measuring Quality of Healthcare Outcomes in Type 2 Diabetes from Routine Data: a Seven-nation Survey Conducted by the IMIA Primary Health Care Working Group.

    Science.gov (United States)

    Hinton, W; Liyanage, H; McGovern, A; Liaw, S-T; Kuziemsky, C; Munro, N; de Lusignan, S

    2017-08-01

    Background: The Institute of Medicine framework defines six dimensions of quality for healthcare systems: (1) safety, (2) effectiveness, (3) patient centeredness, (4) timeliness of care, (5) efficiency, and (6) equity. Large health datasets provide an opportunity to assess quality in these areas. Objective: To perform an international comparison of the measurability of the delivery of these aims, in people with type 2 diabetes mellitus (T2DM) from large datasets. Method: We conducted a survey to assess healthcare outcomes data quality of existing databases and disseminated this through professional networks. We examined the data sources used to collect the data, frequency of data uploads, and data types used for identifying people with T2DM. We compared data completeness across the six areas of healthcare quality, using selected measures pertinent to T2DM management. Results: We received 14 responses from seven countries (Australia, Canada, Italy, the Netherlands, Norway, Portugal, Turkey and the UK). Most databases reported frequent data uploads and would be capable of near real time analysis of healthcare quality.The majority of recorded data related to safety (particularly medication adverse events) and treatment efficacy (glycaemic control and microvascular disease). Data potentially measuring equity was less well recorded. Recording levels were lowest for patient-centred care, timeliness of care, and system efficiency, with the majority of databases containing no data in these areas. Databases using primary care sources had higher data quality across all areas measured. Conclusion: Data quality could be improved particularly in the areas of patient-centred care, timeliness, and efficiency. Primary care derived datasets may be most suited to healthcare quality assessment. Georg Thieme Verlag KG Stuttgart.

  20. Energy Expenditure in Playground Games in Primary School Children Measured by Accelerometer and Heart Rate Monitors.

    Science.gov (United States)

    García-Prieto, Jorge Cañete; Martinez-Vizcaino, Vicente; García-Hermoso, Antonio; Sánchez-López, Mairena; Arias-Palencia, Natalia; Fonseca, Juan Fernando Ortega; Mora-Rodriguez, Ricardo

    2017-10-01

    The aim of this study was to examine the energy expenditure (EE) measured using indirect calorimetry (IC) during playground games and to assess the validity of heart rate (HR) and accelerometry counts as indirect indicators of EE in children´s physical activity games. 32 primary school children (9.9 ± 0.6 years old, 19.8 ± 4.9 kg · m -2 BMI and 37.6 ± 7.2 ml · kg -1 · min -1 VO 2max ). Indirect calorimetry (IC), accelerometry and HR data were simultaneously collected for each child during a 90 min session of 30 playground games. Thirty-eight sessions were recorded in 32 different children. Each game was recorded at least in three occasions in other three children. The intersubject coefficient of variation within a game was 27% for IC, 37% for accelerometry and 13% for HR. The overall mean EE in the games was 4.2 ± 1.4 kcals · min -1 per game, totaling to 375 ± 122 kcals/per 90 min/session. The correlation coefficient between indirect calorimetry and accelerometer counts was 0.48 (p = .026) for endurance games and 0.21 (p = .574) for strength games. The correlation coefficient between indirect calorimetry and HR was 0.71 (p = .032) for endurance games and 0.48 (p = .026) for strength games. Our data indicate that both accelerometer and HR monitors are useful devices for estimating EE during endurance games, but only HR monitors estimates are accurate for endurance games.

  1. Measuring pain self-efficacy and health related quality of life among hemodialysis patients in Greece: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Paraskevi Theofilou

    2013-09-01

    Full Text Available Patients suffering from end-stage kidney disease often complain about pain. It is also known that the presence of chronic pain greatly impacts upon patients’ quality of life (QOL and can play a crucial role in the co-morbidity of mental health symptoms such as depression and anxiety. The main aim of this study protocol is the investigation of pain self-efficacy, QOL as well as their relation in patients undergoing hemodialysis treatment. The final sample size will be around 70-80 patients. Each subject’s QOL and pain self-efficacy will be measured using the following instruments: i the Missoula-ITAS Quality of Life Index-15 and ii the Pain Self-Efficacy Questionnaire. QOL is expected to be related to pain self-efficacy scores. This probable association will be indicated performing regression as well as correlation analysis after controlling for gender, age, education and marital status.

  2. Liver stiffness measurement in cirrhotic patient — Implications of disease activity and treatment efficacy

    Directory of Open Access Journals (Sweden)

    Huang-Wei Xu

    2012-12-01

    Full Text Available Liver stiffness measurement (LSM is a noninvasive method for the diagnosis of hepatic fibrosis. The aim of this study was to evaluate the effects of hepatitis activity and antiviral therapy on LSM in cirrhotic patients. Consecutive patients with compensated hepatic cirrhosis were enrolled for LSM. The medical records of hepatitis activity and antiviral therapy before enrollment were reviewed. Patients were stratified into inactive, fluctuating, and active groups by serial change of alanine transaminase level. For chronic hepatitis C, patients were stratified into sustained virological response (SVR and non-SVR (NSVR by effect of antiviral treatment. LSM results were compared among different groups. A total of 163 patients (mean age = 57.2 ± 11.0 years were enrolled. The median (range LSM values were 9.6 (4.2–20.6, 10.25 (3.9–49.6, and 15.75 (4.8–61.5 kPa in the inactive, fluctuating, and active groups, respectively. Patients in the active group had significantly higher LSM values. For chronic hepatitis C, median (range LSM values were 16.6 (8.1–61.5, 22.9 (11.1–37.4, and 11.2 (3.9–27.0 kPa in patients without antiviral therapy, in NSVR, and in SVR groups, respectively. Patients with SVR had significantly lower LSM values. For chronic hepatitis B, median (range LSM values were 11.8 (5.1–46.6, 16.85 (4.2–48, and 10.6 (4.3–46.4 kPa kPa in patients without oral nucleos(tide analogue (NA therapy, with NA < 12, and ≧12 months, respectively. There was a significantly lower LSM value in patients with NA therapy≧12 months. There were low LSM values in cirrhotic patients without hepatitis activity, as well as with SVR in chronic hepatitis C and long-term NA therapy in chronic hepatitis B.

  3. Improving multiple health risk behaviors in primary care: lessons from the Prescription for Health Common Measures, Better Outcomes (COMBO) study.

    Science.gov (United States)

    Fernald, Douglas H; Dickinson, L Miriam; Froshaug, Desireé B; Balasubramanian, Bijal A; Holtrop, Jodi Summers; Krist, Alex H; Glasgow, Russell E; Green, Larry A

    2012-01-01

    Four health behaviors--smoking, risky drinking, physical inactivity, and unhealthy diets--contribute substantially to health care burden and are common among primary care patients. However, there is insufficient evidence to recommend broadly brief interventions to address all 4 of these in frontline primary care. This study took advantage of a multinetwork initiative to reflect on health behavior outcomes and the challenges of using a common set of measures to assess health behavior-change strategies for multiple health behaviors in routine primary care practice. Standardized, brief practical health behavior and quality of life measures used across 7 practice-based research networks (PBRNs) with independent primary care interventions in 54 primary care practices between August 2005 and December 2007 were analyzed. Mixed-effects longitudinal models assessed whether intervention patients improved diet, physical activity, smoking, alcohol consumption, and unhealthy days over time. Separate analyses were conducted for each intervention. Of 4463 adults, 2199 had follow-up data, and all available data were used in longitudinal analyses. Adjusting for age, race/ethnicity, education, and baseline body mass index where available, diet scores improved significantly in 5 of 7 networks (P practically in PBRNs testing diverse strategies to improve behaviors; however, variations in implementation, instrumentation performance, and some features of study design overwhelmed potential cross-PBRN comparisons. For common measures to be useful for comparisons across practices or PBRNs, greater standardization of study designs and careful attention to practicable implementation strategies are necessary.

  4. 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...

  5. Self-construing in children with primary mono-symptomatic nocturnal enuresis--an investigation of three measures.

    Science.gov (United States)

    Robinson, Joanne C; Butler, Richard J; Holland, Philip; Doherty-Williams, Dianne

    2003-01-01

    This study aims to measure different aspects of self-construing in children with primary mono-symptomatic nocturnal enuresis. 25 children aged 7-14 years, with nocturnal enuresis were recruited from a paediatric outpatient's unit specialising in enuresis [mean age 10.6 [males], 9.39 [females

  6. Association between self-reported and objectively measured physical fitness level in a middle-aged population in primary care

    Directory of Open Access Journals (Sweden)

    Kirstine H. Obling

    2015-01-01

    Conclusion: A single-item question is a cost-effective way of measuring physical fitness level, but the method has low association and fair agreement when compared to the Aastrand test. Men tend to overestimate physical fitness more than women, which should be accounted for if using the question in primary care settings.

  7. Teachers' Checklist on Reading-Related Behavioral Characteristics of Chinese Primary Students: A Rasch Measurement Model Analysis

    Science.gov (United States)

    Chan, David W.; Ho, Connie Suk-han; Chung, Kevin K. H.; Tsang, Suk-man; Lee, Suk-han

    2010-01-01

    Data of item responses to the Hong Kong Specific Learning Difficulties Behaviour Checklist from 673 Chinese primary grade students were analyzed using the dichotomous Rasch measurement model. Rasch scaling suggested that the data fit the model adequately with a latent dimension of global dyslexic dysfunctioning. Estimates of item attributes and…

  8. Point of care platelet activity measurement in primary PCI [PINPOINT-PPCI]: a protocol paper.

    Science.gov (United States)

    Johnson, Thomas W; Marsden, Debbie; Mumford, Andrew; Pike, Katie; Mundell, Stuart; Butler, Mark; Strange, Julian W; Bowles, Ruth; Rogers, Chris; Baumbach, Andreas; Reeves, Barnaby C

    2014-04-04

    Optimal treatment of acute ST-elevation myocardial infarction (STEMI) involves rapid diagnosis, and transfer to a cardiac centre capable of percutaneous coronary intervention (PCI) for immediate mechanical revascularisation. Successful treatment requires rapid return of perfusion to the myocardium achieved by thromboaspiration, passivation of the culprit lesion with stent scaffolding and systemic inhibition of thrombosis and platelet activation. A delicate balance exists between thrombosis and bleeding and consequently anti-thrombotic and antiplatelet treatment regimens continue to evolve. The desire to achieve reperfusion as soon as possible, in the setting of high platelet reactivity, requires potent and fast-acting anti-thrombotic/anti-platelet therapies. The associated bleeding risk may be minimised by use of short-acting anti-thrombotic intravenous agents. However, effective oral platelet inhibition is required to prevent recurrent thrombosis. The interaction between baseline platelet reactivity, timing of revascularisation and effective inhibition of thrombosis is yet to be formally investigated. We present a protocol for a prospective observational study in patients presenting with acute STEMI treated with primary PCI (PPCI) and receiving bolus/infusion bivalirudin and prasugrel therapy. The objective of this study is to describe variation in platelet reactivity, as measured by the multiplate platelet function analyser, at presentation, the end of the PPCI procedure and 1, 2, & 24 hours post-procedure. We intend to assess the prevalence of high residual platelet reactivity within 24 hours of PPCI in acute STEMI patients receiving prasugrel and bivalirudin. Additionally, we will investigate the association between high platelet reactivity before and after PPCI and the door-to-procedure completion time.This is a single centre study with a target sample size of 108 participants. The baseline platelet reactivity on presentation with a STEMI may impact on the

  9. Determining the primary cosmic ray energy from the total flux of Cherenkov light measured at the Yakutsk EAS array

    International Nuclear Information System (INIS)

    Ivanov, A. A.; Knurenko, S. P.; Sleptsov, I. E.

    2007-01-01

    We present a method for determining the energy of the primary particle that generates an extensive air shower (EAS) of comic rays based on measuring the total flux of Cherenkov light from the shower. Applying this method to Cherenkov light measurements at the Yakutsk EAS array has allowed us to construct the cosmic ray energy spectrum in the range 10 15 - 3 x 10 19 eV

  10. Improving the power of an efficacy study of a social and emotional learning program: application of generalizability theory to the measurement of classroom-level outcomes.

    Science.gov (United States)

    Mashburn, Andrew J; Downer, Jason T; Rivers, Susan E; Brackett, Marc A; Martinez, Andres

    2014-04-01

    Social and emotional learning programs are designed to improve the quality of social interactions in schools and classrooms in order to positively affect students' social, emotional, and academic development. The statistical power of group randomized trials to detect effects of social and emotional learning programs and other preventive interventions on setting-level outcomes is influenced by the reliability of the outcome measure. In this paper, we apply generalizability theory to an observational measure of the quality of classroom interactions that is an outcome in a study of the efficacy of a social and emotional learning program called The Recognizing, Understanding, Labeling, Expressing, and Regulating emotions Approach. We estimate multiple sources of error variance in the setting-level outcome and identify observation procedures to use in the efficacy study that most efficiently reduce these sources of error. We then discuss the implications of using different observation procedures on both the statistical power and the monetary costs of conducting the efficacy study.

  11. La primaquina tiene alta eficacia en la quimioprofilaxis primaria simple antipalúdica. Metanálisis High efficacy of primary chemoprophylaxis with primaquine. metanalysis

    Directory of Open Access Journals (Sweden)

    Jaime Carmona Fonseca

    2006-01-01

    Full Text Available Problema: existen informes sobre la capacidad quimioprofiláctica primaria (QP1 antipalúdica de la primaquina (PQ en humanos, pero no conocemos ningún metanálisis sobre el tema. Preguntas: ¿Es eficaz la primaquina para prevenir el paludismo en seres humanos? ¿Depende esa eficacia del lugar, la edad de las personas y de la especie de Plasmodium? Metodología: se aplicaron procedimientos recomendados para metanálisis. Resultados: se incluyeron 4 estudios experimentales de laboratorio (EEL y 7 estudios clínicos controlados (ECC. Según los EEL, para adultos, la dosis de primaquina apropiada en QP1 es 30 mg/d, tomados desde el día previo a la exposición. Los ECC mostraron protección de 93% entre quienes recibieron primaquina y de 45% entre quienes no la recibieron (p = 0,0000000. CONCLUSIONES: la QP1 con primaquina es altamente eficaz en adultos y niños, es igual frente a Plasmodium falciparum y P. vivax y debe adoptarse como alternativa válida. Faltan evaluaciones sobre la seguridad y la toxicidad en niños. Background: There are many reportss about primaquine as primary chemoprophylactic (1-CP in humans, but we do not know of any metaanalysis about this subject. Specific Questions: Is primaquine effective to prevent malaria in humans? Does primaquine efficacy to prevent malaria depend on the place, the age of patients, or the Plasmodium species? Methodology: Procedures recommended for metanalysis were applied. Results: Four laboratory experimental studies (LES in humans and seven clinical controlled studies (CCS were included. According to LES the adequate primaquine dose as 1-CP for adults is 30 mg/day from the day before exposition and during the time of exposition. According to CCS protection was 93% in people that received primaquine and 45% in those who did not receive it (p = 0.0000000.

  12. Measuring primary school teachers' pedagogical content knowledge in technology education with a multiple choice test

    NARCIS (Netherlands)

    Rohaan, E.J.; Taconis, R.; Jochems, W.M.G.; Fatih Tasar, M.; Cakankci, G.; Akgul, E.

    2009-01-01

    Pedagogical content knowledge (PCK) is a crucial part of a teacher’s knowledge base for teaching. Studies in the field of technology education for primary schools showed that this domain of teacher knowledge is related to pupils’ increased learning, motivation, and interest. The common methods to

  13. Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa

    NARCIS (Netherlands)

    Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

    2013-01-01

    Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB

  14. 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...

  15. Psychological and somatic predictors of perceived and measured ocular dryness of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Vriezekolk, JE; Geenen, R; Hartkamp, A; Godaert, GLR; Bootsma, H; Kruize, AA; Bijlsma, JWJ; Derksen, RHWM

    2005-01-01

    Objective. To test if age, disease activity, pain, fatigue, and depression are associated with subjective and objective ocular dryness of patients with primary Sjogren's syndrome (pSS). Methods. Sixty female patients with pSS and 60 age matched healthy controls filled out visual analog scale (VAS)

  16. A review of the primary measures for tar elimination in biomass gasification processes

    International Nuclear Information System (INIS)

    Devi, Lopamudra; Ptasinski, K.J.; Janssen, F.J.J.G.

    2003-01-01

    Tar formation is one of the major problems to deal with during biomass gasification. Tar condenses at reduced temperature, thus blocking and fouling process equipments such as engines and turbines. Considerable efforts have been directed on tar removal from fuel gas. Tar removal technologies can broadly be divided into two approaches; hot gas cleaning after the gasifier (secondary methods), and treatments inside the gasifier (primary methods). Although secondary methods are proven to be effective, treatments inside the gasifier are gaining much attention as these may eliminate the need for downstream cleanup. In primary treatment, the gasifier is optimized to produce a fuel gas with minimum tar concentration. The different approaches of primary treatment are (a) proper selection of operating parameters, (b) use of bed additive/catalyst, and (c) gasifier modifications. The operating parameters such as temperature, gasifying agent, equivalence ratio, residence time, etc. play an important role in formation and decomposition of tar. There is a potential of using some active bed additives such as dolomite, olivine, char, etc. inside the gasifier. Ni-based catalyst are reported to be very effective not only for tar reduction, but also for decreasing the amount of nitrogenous compounds such as ammonia. Also, reactor modification can improve the quality of the product gas. The concepts of two-stage gasification and secondary air injection in the gasifier are of prime importance. Some aspects of primary methods and the research and development in this area are reviewed and cited in the present paper

  17. Measurements of refractive index and size of a spherical drop from Gaussian beam scattering in the primary rainbow region

    Science.gov (United States)

    Yu, Haitao; Sun, Hui; Shen, Jianqi; Tropea, Cameron

    2018-03-01

    The primary rainbow observed when light is scattered by a spherical drop has been exploited in the past to measure drop size and relative refractive index. However, if higher spatial resolution is required in denser drop ensembles/sprays, and to avoid then multiple drops simultaneously appearing in the measurement volume, a highly focused beam is desirable, inevitably with a Gaussian intensity profile. The present study examines the primary rainbow pattern resulting when a Gaussian beam is scattered by a spherical drop and estimates the attainable accuracy when extracting size and refractive index. The scattering is computed using generalized Lorenz-Mie theory (GLMT) and Debye series decomposition of the Gaussian beam scattering. The results of these simulations show that the measurement accuracy is dependent on both the beam waist radius and the position of the drop in the beam waist.

  18. School and University Partnerships: The Role of Teacher Education Institutions and Primary Schools in the Development of Preservice Teachers' Science Teaching Efficacy

    Science.gov (United States)

    Petersen, Jacinta E.; Treagust, David F.

    2014-01-01

    Science in the Australian primary school context is in a state of renewal with the recent implementation of the Australian Curriculum: Science. Despite this curriculum renewal, the results of primary students in science have remained static. Science in Australia has been identified as one of the least taught subjects in the primary school…

  19. 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

  20. Accounting for graduate medical education production of primary care physicians and general surgeons: timing of measurement matters.

    Science.gov (United States)

    Petterson, Stephen; Burke, Matthew; Phillips, Robert; Teevan, Bridget

    2011-05-01

    Legislation proposed in 2009 to expand GME set institutional primary care and general surgery production eligibility thresholds at 25% at entry into training. The authors measured institutions' production of primary care physicians and general surgeons on completion of first residency versus two to four years after graduation to inform debate and explore residency expansion and physician workforce implications. Production of primary care physicians and general surgeons was assessed by retrospective analysis of the 2009 American Medical Association Masterfile, which includes physicians' training institution, residency specialty, and year of completion for up to six training experiences. The authors measured production rates for each institution based on physicians completing their first residency during 2005-2007 in family or internal medicine, pediatrics, or general surgery. They then reassessed rates to account for those who completed additional training. They compared these rates with proposed expansion eligibility thresholds and current workforce needs. Of 116,004 physicians completing their first residency, 54,245 (46.8%) were in primary care and general surgery. Of 683 training institutions, 586 met the 25% threshold for expansion eligibility. At two to four years out, only 29,963 physicians (25.8%) remained in primary care or general surgery, and 135 institutions lost eligibility. A 35% threshold eliminated 314 institutions collectively training 93,774 residents (80.8%). Residency expansion thresholds that do not account for production at least two to four years after completion of first residency overestimate eligibility. The overall primary care production rate from GME will not sustain the current physician workforce composition. Copyright © by the Association of American medical Colleges.

  1. Lifestyle measures for primary prevention of T2 Diabetes Mellitus (T2DM

    Directory of Open Access Journals (Sweden)

    M S A Mansur Ahmed

    2014-12-01

    Full Text Available Worldwide, the number of adults with diabetes was 285 million in 2010 and it will be 439 million in the year 2030. Although the genes we inherit may influence the development of type 2 diabetes, they take a back seat to behavioral and lifestyle factors. Data from the Nurses’ Health Study suggest that 90 percent of type 2 diabetes in women can be attributed to five such factors: excess weight, lack of exercise, a less-than-healthy diet, smoking, and abstaining from alcohol. From this data it can be said that up to 90 percent of diabetes prevention is possible with behavioral and lifestyle factors intervention. This intervention should be given to the people through primary prevention. The purpose of primary prevention is to limit the number of people who develop a disease by controlling causes and risk factors for the disease.

  2. 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.

  3. Relationship between self-reported and objectively measured physical activity and subjective memory impairment in breast cancer survivors: role of self-efficacy, fatigue and distress.

    Science.gov (United States)

    Phillips, Siobhan M; Lloyd, Gillian R; Awick, Elizabeth A; McAuley, Edward

    2017-09-01

    Many breast cancer survivors report cancer and cancer treatment-associated cognitive change. However, very little is known about the relationship between physical activity and subjective memory impairment (SMI) in this population. The purpose of this study is to examine the relationship between physical activity and SMI and longitudinally test a model examining the role of self-efficacy, fatigue and distress as potential mediators. Post-treatment breast cancer survivors (N = 1477) completed measures of physical activity, self-efficacy, distress (depression, concerns about recurrence, perceived stress, anxiety), fatigue and SMI at baseline and 6-month follow-up. A subsample (n = 362) was randomly selected to wear an accelerometer. It was hypothesized that physical activity indirectly influences SMI via exercise self-efficacy, distress and fatigue. Relationships were examined using panel analysis within a covariance modeling framework. The hypothesized model provided a good fit in the full sample (χ 2  = 1462.5, df = 469, p = exercise self-efficacy and reduced distress and fatigue. Higher levels of physical activity, lower levels of fatigue and distress and higher exercise self-efficacy may play an important role in understanding SMI in breast cancer survivors across time. Future research is warranted to replicate and explore these relationships further. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. The Efficacy of Acupuncture on Anthropometric Measures and the Biochemical Markers for Metabolic Syndrome: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Mingjuan Han

    2017-01-01

    Full Text Available Background. Many previous studies have shown the potential therapeutic effect of acupuncture for metabolic syndrome (MetS. However, most of these studies were limited by short durations of observation and a lack of sham acupuncture as control. We designed a randomized controlled trial, used sham acupuncture as the control, and evaluated the efficacy over 12 weeks of treatment and 12 weeks of follow-up. Methods/Design. The study was designed as a multicentre, parallel-group, randomized, double-blinded trial. 40 patients were randomly assigned to two groups: treatment group (treated with acupuncture and control group (treated with sham acupuncture. Outcomes were measured at 4, 8, and 12 weeks and 3 months after treatment. Results. 33 participants (17 in acupuncture group and 16 in control group completed the treatment and the follow-up. Decreases from baseline in mean waist circumference (WC and weight at the end of treatment were 4.85 cm (95% CI [2.405,5.595] and 4.00 kg (95% CI [1.6208,4.4498] in acupuncture group and 1.62 cm and 1.64 kg in control group (P<0.01. The changes in mean glycosylated haemoglobin (HbA1c, triglycerides (TG, total cholesterol (TC, and blood pressure in acupuncture group were greater than the changes in control group (P<0.05, P<0.01. Conclusion. Acupuncture decreases WC, HC, HbA1c, TG, and TC values and blood pressure in MetS.

  5. Measurement of Cue-Induced Craving in Human Methamphetamine- Dependent Subjects New Methodological Hopes for Reliable Assessment of Treatment Efficacy

    Directory of Open Access Journals (Sweden)

    Zahra Alam Mehrjerdi

    2011-09-01

    Full Text Available Methamphetamine (MA is a highly addictive psychostimulant drug with crucial impacts on individuals on various levels. Exposure to methamphetamine-associated cues in laboratory can elicit measureable craving and autonomic reactivity in most individuals with methamphetamine dependence and the cue reactivity can model how craving would result in continued drug seeking behaviors and relapse in real environments but study on this notion is still limited. In this brief article, the authors review studies on cue-induced craving in human methamphetamine- dependent subjects in a laboratory-based approach. Craving for methamphetamine is elicited by a variety of methods in laboratory such as paraphernalia, verbal and visual cues and imaginary scripts. In this article, we review the studies applying different cues as main methods of craving incubation in laboratory settings. The brief reviewed literature provides strong evidence that craving for methamphetamine in laboratory conditions is significantly evoked by different cues. Cue-induced craving has important treatment and clinical implications for psychotherapists and clinicians when we consider the role of induced craving in evoking intense desire or urge to use methamphetamine after or during a period of successful craving prevention program. Elicited craving for methamphetamine in laboratory conditions is significantly influenced by methamphetamine-associated cues and results in rapid craving response toward methamphetamine use. This notion can be used as a main core for laboratory-based assessment of treatment efficacy for methamphetamine-dependent patients. In addition, the laboratory settings for studying craving can bridge the gap between somehow-non-reliable preclinical animal model studies and budget demanding randomized clinical trials.

  6. A measurement of the carbon isotopic composition in primary cosmic radiation

    International Nuclear Information System (INIS)

    Bjarle, C.; Herrstroem, N.Y.; Jacobsson, L.; Joensson, G.; Kristiansson, K.

    1975-01-01

    The isotopic composition is measured in a stack of nuclear emulsions exposed in a balloon flight from Fort Churchill. The masses of the carbon nuclei have been determined from photometric track width measurements in the residual range interval 1 13 C/( 12 C + 13 C) = 0.10 +- 0.04 at the measuring point. The result indicates that 13 C will only be present in the cosmic ray source matter in small amounts. (orig./BJ) [de

  7. Teacher self-efficacy in instruction and in parent involvement

    Directory of Open Access Journals (Sweden)

    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.

  8. Efficacy and safety of combination therapy with latanoprost after a change in therapeutic regimen from timolol to brinzolamide in Japanese adult patients with primary open-angle glaucoma and ocular hypertension: open, non-randomized 12-week study

    Directory of Open Access Journals (Sweden)

    Shusaku Ishikawa

    2008-09-01

    Full Text Available Shusaku Ishikawa1, Yoshimi Nakamura1, Yuko Nakamura1, Hiroshi Sakai1, Shoichi Sawaguchi1, Kazuo Terashima2, Makoto Kanno2, Hidetoshi Yamashita21Department of Ophthalmology, University of the Ryukyus Faculty of Medicine, Okinawa, Japan; 2Department of Ophthalmology and Visual Science, Yamagata University Faculty of Medicine, Yamagata, JapanPurpose: To compare the efficacy of brinzolamide in Japanese patients with primary open-angle glaucoma (POAG or ocular hypertension (OH after a change from timolol in combination therapy with latanoprost.Methods: A 12-week, prospective, open-label, comparative study was performed in 20 patients [11 males and 9 females, mean age of 64.5 ± 11.0 (SDy] with POAG or OH treated with both latanoprost once daily and timolol 0.5% twice daily. During the study brinzolamide was substituted for timolol. Intraocular pressure (IOP was measured at baseline, 4, 8, and 12 weeks. Blood pressure (BP, pulse rate (PR, and adverse events were also recorded.Results: IOPs at baseline, 4, 8, and 12 weeks were 18.6 ± 2.1 mmHg, 17.8 ± 2.6 mmHg, 17.4 ± 2.5 mmHg, and 17.3 ± 3.5 mmHg, respectively. IOP reduction at 4 and 8 weeks was statistically significant (p < 0.05. The PR was significantly increased at 12 weeks (p < 0.01, but BP was not significantly affected. Four ocular adverse events were noted, but all were mild and transient.Conclusions: Substituting brinzolamide 1% for timolol 0.5% in combination therapy with latanoprost 0.005% demonstrated significant IOP reduction with improvement in PR with POAG or OH. Combination therapy using latanoprost and brinzolamide may be recommended for better IOP control with fewer systemic adverse events.Keywords: open-angle glaucoma, brinzolamide/latanprost combination therapy, timolol/latanoprost combination therapy, intraocular pressure

  9. Absolute measurement of the DT primary neutron yield on the National Ignition Facility

    Directory of Open Access Journals (Sweden)

    Leeper R.J.

    2013-11-01

    Full Text Available The measurement of the absolute neutron yield produced in inertial confinement fusion target experiments conducted on the National Ignition Facility (NIF is essential in benchmarking progress towards the goal of achieving ignition on this facility. This paper describes three independent diagnostic techniques that have been developed to make accurate and precise DT neutron yield measurements on the NIF.

  10. Assessing Measurement Invariance of the Children's Depression Inventory in Chinese and Italian Primary School Student Samples

    Science.gov (United States)

    Wu, Wenfeng; Lu, Yongbiao; Tan, Furong; Yao, Shuqiao; Steca, Patrizia; Abela, John R. Z.; Hankin, Benjamin L.

    2012-01-01

    This study tested the measurement invariance of Children's Depression Inventory (CDI) and compared its factorial variance/covariance and latent means among Chinese and Italian children. Multigroup confirmatory factor analysis of the original five factors identified by Kovacs revealed that full measurement invariance did not hold. Further analysis…

  11. Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia -a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Jernelöv Susanna

    2012-01-01

    Full Text Available Abstract Background Cognitive behavioral therapy is treatment of choice for insomnia, but availability is scarce. Self-help can increase availability at low cost, but evidence for its efficacy is limited, especially for the typical insomnia patient with co-morbid problems. We hypothesized that a cognitive behaviorally based self-help book is effective to treat insomnia in individuals, also with co-morbid problems, and that the effect is enhanced by adding brief therapist telephone support. Methods Volunteer sample; 133 media-recruited adults with insomnia. History of sleep difficulties (mean [SD] 11.8 [12.0] years. 92.5% had co-morbid problems (e.g. allergy, pain, and depression. Parallel randomized (block-randomization, n ≥ 21 controlled "open label" trial; three groups-bibliotherapy with (n = 44 and without (n = 45 therapist support, and waiting list control (n = 44. Assessments before and after treatment, and at three-month follow-up. Intervention was six weeks of bibliotherapeutic self-help, with established cognitive behavioral methods including sleep restriction, stimulus control, and cognitive restructuring. Therapist support was a 15-minute structured telephone call scheduled weekly. Main outcome measures were sleep diary data, and the Insomnia Severity Index. Results Intention-to-treat analyses of 133 participants showed significant improvements in both self-help groups from pre to post treatment compared to waiting list. For example, treatment with and without support gave shorter sleep onset latency (improvement minutes [95% Confidence Interval], 35.4 [24.2 to 46.6], and 20.6 [10.6 to 30.6] respectively, and support gave a higher remission rate (defined as ISI score below 8; 61.4%, than bibliotherapy alone (24.4%, p's Conclusions Participants receiving self-help for insomnia benefited markedly. Self-help, especially if therapist-supported, has considerable potential to be as effective as individual treatment at lower cost, also for

  12. Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia--a randomized controlled trial.

    Science.gov (United States)

    Jernelöv, Susanna; Lekander, Mats; Blom, Kerstin; Rydh, Sara; Ljótsson, Brjánn; Axelsson, John; Kaldo, Viktor

    2012-01-22

    Cognitive behavioral therapy is treatment of choice for insomnia, but availability is scarce. Self-help can increase availability at low cost, but evidence for its efficacy is limited, especially for the typical insomnia patient with co-morbid problems. We hypothesized that a cognitive behaviorally based self-help book is effective to treat insomnia in individuals, also with co-morbid problems, and that the effect is enhanced by adding brief therapist telephone support. Volunteer sample; 133 media-recruited adults with insomnia. History of sleep difficulties (mean [SD]) 11.8 [12.0] years. 92.5% had co-morbid problems (e.g. allergy, pain, and depression). Parallel randomized (block-randomization, n ≥ 21) controlled "open label" trial; three groups-bibliotherapy with (n = 44) and without (n = 45) therapist support, and waiting list control (n = 44). Assessments before and after treatment, and at three-month follow-up. Intervention was six weeks of bibliotherapeutic self-help, with established cognitive behavioral methods including sleep restriction, stimulus control, and cognitive restructuring. Therapist support was a 15-minute structured telephone call scheduled weekly. Main outcome measures were sleep diary data, and the Insomnia Severity Index. Intention-to-treat analyses of 133 participants showed significant improvements in both self-help groups from pre to post treatment compared to waiting list. For example, treatment with and without support gave shorter sleep onset latency (improvement minutes [95% Confidence Interval], 35.4 [24.2 to 46.6], and 20.6 [10.6 to 30.6] respectively), and support gave a higher remission rate (defined as ISI score below 8; 61.4%), than bibliotherapy alone (24.4%, p's < .001). Improvements were not seen in the control group (sleep onset latency 4.6 minutes shorter [-1.5 to 10.7], and remission rate 2.3%). Self-help groups maintained gains at three-month follow-up. Participants receiving self-help for insomnia benefited markedly

  13. Atomoxetine and Methylphenidate Treatment in Children with ADHD: The Efficacy, Tolerability and Effects on Executive Functions

    Science.gov (United States)

    Yildiz, Ozlem; Sismanlar, Sahika G.; Memik, Nursu Cakin; Karakaya, Isik; Agaoglu, Belma

    2011-01-01

    The aim of this study was to compare the safety, efficacy, tolerability, and the effects of atomoxetine and OROS-MPH on executive functions in children with ADHD. This study was an open-label study that only included two medication groups. Children were randomized to open-label atomoxetine or OROS-MPH for 12 weeks. Primary efficacy measures were…

  14. Efficacy of dexamethasone suppression test during the diagnosis of primary pigmented nodular adrenocortical disease in Chinese adrenocorticotropic hormone-independent Cushing syndrome.

    Science.gov (United States)

    Chen, Shi; Li, Ran; Lu, Lin; Duan, Lian; Zhang, Xuebin; Tong, Anli; Pan, Hui; Zhu, Huijuan; Lu, Zhaolin

    2018-01-01

    To evaluate the cut-off value of the ratio of 24 h urinary free cortisol (24 h UFC) levels post-dexamethasone to prior-dexamethasone in dexamethasone suppression test (DST) during the diagnosis of primary pigmented nodular adrenocortical disease in Chinese adrenocorticotropic hormone-independent Cushing syndrome. Retrospective study. The patients diagnosed with primary pigmented nodular adrenocortical disease (PPNAD, n = 25), bilateral macronodular adrenal hyperplasia (BMAH, n = 27), and adrenocortical adenoma (ADA, n = 84) were admitted to the Peking Union Medical College Hospital from 2001 to 2016. Serum cortisol, adrenocorticotropic hormone (ACTH), and 24 h UFC were measured before and after low-dose dexamethasone suppression test (LDDST) and high-dose dexamethasone suppression test (HDDST). After LDDST and HDDST, 24 h UFC elevated in patients with PPNAD (paired t-test, P = 0.007 and P = 0.001), while it remained unchanged in the BMAH group (paired t-test, P = 0.471 and P = 0.414) and decreased in the ADA group (paired t-test, P = 0.002 and P = 0.004). The 24 h UFC level after LDDST was higher in PPNAD and BMAH as compared to ADA (P < 0.017), while no significant difference was observed between PPNAD and BMAH. After HDDST, 24 h UFC was higher in patients with PPNAD as compared to that of ADA and BMAH (P < 0.017). The cut-off value of 24 h UFC (Post-L-Dex)/(Pre-L-Dex) was 1.16 with 64.0% sensitivity and 77.9% specificity, and the cut-off value of 24 h UFC (Post-H-Dex)/(Pre-H-Dex) was 1.08 with 84.0% sensitivity and 75.6% specificity. The ratio of post-dexamethasone to prior-dexamethasone had a unique advantage in distinguishing PPNAD from BMAH and ADA.

  15. Clinical assessment and patient-reported outcome measures in low-back pain - a survey among primary health care physiotherapists.

    Science.gov (United States)

    Östhols, Sara; Boström, Carina; Rasmussen-Barr, Eva

    2018-05-09

    We aimed to map the physiotherapy practice in Sweden of clinical tests and patient-reported outcome measures in low-back pain (LBP), and to study advantages and barriers in using patient-reported outcome measures. An online survey was mailed to 4934 physiotherapists in primary health care in Sweden. Multiple choice questions investigated the use of clinical tests and patient-reported outcome measures in assessing patients with LBP. Open questions investigating the advantages and barriers to the use of patient-reported outcome measures were analyzed with content analysis. The response rate was 25% (n = 1217). Clinical tests were used "always/often" by >60% of the participants, while most patient-reported outcome measures were used by measures were: the clinical reasoning process, to increase the quality of assessment, to get the patient's voice, education and motivation of patients, and communication with health professionals. Barriers were lack of time and knowledge, administrative aspects, the interaction between physiotherapist and patient and, the applicability and validity of the patient-reported outcome measures. Our findings show that physiotherapists working in primary health care use clinical testing in LBP to a great extent, while various patient-reported outcome measures are used to a low-to-very-low extent. Several barriers to the use of patient-reported outcome measures were reported such as time, knowledge, and administrative issues, while important findings on advantages were to enhance the clinical reasoning process and to educate and motivate the patient. Barriers might be changed through education or organizational change-work. To enhance the use of patient-reported outcome measures and thus person-centered care in low-back pain, recommendation, and education on various patient-reported outcome measures need to be advocated. Implications for rehabilitation To increase the effects of rehabilitation in low-back pain, yellow flags, and other

  16. Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study.

    Science.gov (United States)

    Surr, C A; Smith, S J; Crossland, J; Robins, J

    2016-01-01

    People with dementia occupy up to one quarter of acute hospital beds. However, the quality of care delivered to this patient group is of national concern. Staff working in acute hospitals report lack of knowledge, skills and confidence in caring for people with dementia. There is limited evidence about the most effective approaches to supporting acute hospital staff to deliver more person-centred care. This study aimed to evaluate the efficacy of a specialist training programme for acute hospital staff regarding improving attitudes, satisfaction and feelings of caring efficacy, in provision of care to people with dementia. A repeated measures design, with measures completed immediately prior to commencing training (T1), after completion of Foundation level training (T2: 4-6 weeks post-baseline), and following Intermediate level training (T3: 3-4 months post-baseline). One NHS Trust in the North of England, UK. 40 acute hospital staff working in clinical roles, the majority of whom (90%) were nurses. All participants received the 3.5 day Person-centred Care Training for Acute Hospitals (PCTAH) programme, comprised of two levels, Foundation (0.5 day) and Intermediate (3 days), delivered over a 3-4 months period. Staff demographics and previous exposure to dementia training were collected via a questionnaire. Staff attitudes were measured using the Approaches to Dementia Questionnaire (ADQ), satisfaction in caring for people with dementia was captured using the Staff Experiences of Working with Demented Residents questionnaire (SEWDR) and perceived caring efficacy was measured using the Caring Efficacy Scale (CES). The training programme was effective in producing a significant positive change on all three outcome measures following intermediate training compared to baseline. A significant positive effect was found on the ADQ between baseline and after completion of Foundation level training, but not for either of the other measures. Training acute hospital staff in

  17. Pooled Analysis Comparing the Efficacy of Intracoronary Versus Intravenous Abciximab in Smokers Versus Nonsmokers Undergoing Primary Percutaneous Coronary Revascularization for Acute ST-Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Piccolo, Raffaele; Galasso, Gennaro; Eitel, Ingo

    2016-01-01

    Cigarette smokers with ST-segment elevation myocardial infarction (STEMI) may present different response to potent antithrombotic therapy compared to nonsmokers. We assessed the impact of smoking status and intracoronary abciximab in patients with STEMI undergoing primary percutaneous coronary...... intervention (PCI). We pooled data from 5 randomized trials comparing intracoronary versus intravenous abciximab bolus in patients undergoing primary PCI. The primary end point was the composite of death or reinfarction at a mean follow-up of 292 ± 138 days. Of 3,158 participants, 1,369 (43.3%) were smokers......, and they had a lower risk of the primary end point in crude, but not in adjusted analyses (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.63 to 1.21, p = 0.405). Intracoronary versus intravenous abciximab was associated with a significant reduction in the risk of primary end point among smokers (3...

  18. Design and construction of a cryogenic facility providing absolute measurements of radon 222 activity for developing a primary standard

    International Nuclear Information System (INIS)

    Picolo, Jean-Louis

    1995-06-01

    Radon 222 metrology is required to obtain higher accuracy in assessing human health risks from exposure to natural radiation. This paper describes the development of a cryogenic facility that allows absolute measurements of radon 222 in order to obtain a primary standard. The method selected is the condensation of a radon 222 sample on a geometrically defined cold surface with a constant, well known and adjustable temperature and facing an alpha particles detector. Counting of the alpha particles reaching the detector and the precisely known detection geometry provide an absolute measurement of the source activity. After describing the cryogenic facility, the measurement accuracy and precision are discussed and a comparison made with other measurement systems. The relative uncertainty is below 1 pc (1 σ). The facility can also be used to improve our knowledge of the nuclear properties of radon 222 and to produce secondary standards. (author) [fr

  19. Evaluation of Low-Cost Mitigation Measures Implemented to Improve Air Quality in Nursery and Primary Schools

    Directory of Open Access Journals (Sweden)

    Juliana P. Sá

    2017-05-01

    Full Text Available Indoor air pollution mitigation measures are highly important due to the associated health impacts, especially on children, a risk group that spends significant time indoors. Thus, the main goal of the work here reported was the evaluation of mitigation measures implemented in nursery and primary schools to improve air quality. Continuous measurements of CO2, CO, NO2, O3, CH2O, total volatile organic compounds (VOC, PM1, PM2.5, PM10, Total Suspended Particles (TSP and radon, as well as temperature and relative humidity were performed in two campaigns, before and after the implementation of low-cost mitigation measures. Evaluation of those mitigation measures was performed through the comparison of the concentrations measured in both campaigns. Exceedances to the values set by the national legislation and World Health Organization (WHO were found for PM2.5, PM10, CO2 and CH2O during both indoor air quality campaigns. Temperature and relative humidity values were also above the ranges recommended by American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE. In general, pollutant concentrations measured after the implementation of low-cost mitigation measures were significantly lower, mainly for CO2. However, mitigation measures were not always sufficient to decrease the pollutants’ concentrations till values considered safe to protect human health.

  20. Evaluation of Low-Cost Mitigation Measures Implemented to Improve Air Quality in Nursery and Primary Schools.

    Science.gov (United States)

    Sá, Juliana P; Branco, Pedro T B S; Alvim-Ferraz, Maria C M; Martins, Fernando G; Sousa, Sofia I V

    2017-05-31

    Indoor air pollution mitigation measures are highly important due to the associated health impacts, especially on children, a risk group that spends significant time indoors. Thus, the main goal of the work here reported was the evaluation of mitigation measures implemented in nursery and primary schools to improve air quality. Continuous measurements of CO₂, CO, NO₂, O₃, CH₂O, total volatile organic compounds (VOC), PM₁, PM 2.5 , PM 10 , Total Suspended Particles (TSP) and radon, as well as temperature and relative humidity were performed in two campaigns, before and after the implementation of low-cost mitigation measures. Evaluation of those mitigation measures was performed through the comparison of the concentrations measured in both campaigns. Exceedances to the values set by the national legislation and World Health Organization (WHO) were found for PM 2.5 , PM 10 , CO₂ and CH₂O during both indoor air quality campaigns. Temperature and relative humidity values were also above the ranges recommended by American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). In general, pollutant concentrations measured after the implementation of low-cost mitigation measures were significantly lower, mainly for CO₂. However, mitigation measures were not always sufficient to decrease the pollutants' concentrations till values considered safe to protect human health.

  1. RESPONSE OF THREE PALEO-PRIMARY PRODUCTION PROXY MEASURES TO DEVELOPMENT OF AN URBAN ESTUARY

    Science.gov (United States)

    In this study we present a novel comparison of three proxy indicators of paleoproductivity, pigments, biogenic silica (BSi), and cysts of autotrophic dinoflagellates measured in cored sediments from New Bedford Harbor, Massachusetts. In addition to detailed historical reports we ...

  2. Measuring Primary Students' Graph Interpretation Skills Via a Performance Assessment: A case study in instrument development

    Science.gov (United States)

    Peterman, Karen; Cranston, Kayla A.; Pryor, Marie; Kermish-Allen, Ruth

    2015-11-01

    This case study was conducted within the context of a place-based education project that was implemented with primary school students in the USA. The authors and participating teachers created a performance assessment of standards-aligned tasks to examine 6-10-year-old students' graph interpretation skills as part of an exploratory research project. Fifty-five students participated in a performance assessment interview at the beginning and end of a place-based investigation. Two forms of the assessment were created and counterbalanced within class at pre and post. In situ scoring was conducted such that responses were scored as correct versus incorrect during the assessment's administration. Criterion validity analysis demonstrated an age-level progression in student scores. Tests of discriminant validity showed that the instrument detected variability in interpretation skills across each of three graph types (line, bar, dot plot). Convergent validity was established by correlating in situ scores with those from the Graph Interpretation Scoring Rubric. Students' proficiency with interpreting different types of graphs matched expectations based on age and the standards-based progression of graphs across primary school grades. The assessment tasks were also effective at detecting pre-post gains in students' interpretation of line graphs and dot plots after the place-based project. The results of the case study are discussed in relation to the common challenges associated with performance assessment. Implications are presented in relation to the need for authentic and performance-based instructional and assessment tasks to respond to the Common Core State Standards and the Next Generation Science Standards.

  3. Radon measurements in air in waterworks and indoor swimming pools - a primary mapping project

    International Nuclear Information System (INIS)

    Marinko, J.; Mjoenes, L.; Soederman, A.-L.

    2004-01-01

    In 2001 the Swedish Work Environment Authority asked five regional offices around the country; Falun, Malmoe, Vaexjoe, Umeaa and Oerebro, to measure radon in air in workplaces where water was likely to enhance radon levels indoors. Track etch detectors were used and placed in workplaces according to the SSI measurement protocol for determining the annual average radon concentration in homes. Rooms that are frequently used by employees were measured. The detectors were exposed between 1 to 3 months. 225 detectors were used in the project and analysed at the same laboratory. The results showed that the radon concentration in waterworks often is high. Measurements were made in 60 waterworks. Levels exceeding 1000 Bq/m 3 were found in 49 of them and levels exceeding 4000 Bq/m 3 were found in 21 waterworks. The variation between waterworks may be a result of the radon concentration in the raw water, the amount of radon gas escaping to the air when water is treated, the air exchange rate in the building and where the detectors were deployed. Measurements were made in 28 indoor swimming baths. The maximum level was 290 Bq/m 3 , but most concentrations were between 30 to 70 Bq/m 3 . The conclusion is that high radon levels do not seem to be a problem in indoor swimming baths. Maybe this is due to good ventilation or the fact that water often has been treated for radon before it is used in swimming pools. The results from measurement in food industries such as breweries showed no extreme radon levels except for a fish farm where levels over 1000 Bq/m 3 were measured in the farming room and 790 Bq/m 3 in the office. The radon concentrations in laundries were relatively low, between 30 and 170 Bq/m 3

  4. Manufacture of immunoglobulin products for patients with primary antibody deficiencies – the effect of processing conditions on product safety and efficacy

    Directory of Open Access Journals (Sweden)

    Albert eFarrugia

    2014-12-01

    Full Text Available Early preparations of immunoglobulin (IG manufactured from human plasma by ethanol (Cohn fractionation were limited in their usefulness for substitution therapy in patients with primary antibody deficiencies (PAD, as IG aggregates formed during manufacture resulted in severe systemic reactions in patients when given intravenously. Developments in manufacturing technology obviated this problem through the capacity to produce concentrated solutions of intact monomeric IG, revolutionizing PAD treatment and improving patient life expectancy and quality of life. As the need for IG has grown, manufacturers have refined further manufacturing technologies to improve yield from plasma and produce therapies which are easier and less expensive to deliver. This has led to the substitution, partly or wholly, of ethanol precipitation by other techniques such as chromatography, and has also stimulated the production of highly concentrated solutions capable of rapid infusion. IG products have been associated, since their inception, with certain adverse events, including infectious disease transmission, haemolysis and thromboembolism. The introduction of standardized manufacturing processes and dedicated pathogen elimination steps has removed the risk of infectious disease, and the focus of attention has shifted to other problems which appear to have increased over the past five years. These include haemolysis and thromboembolism, both the cause for substantial concern and the subject of recent regulatory scrutiny and actions. We review the development of manufacturing technology and the emerging evidence that changes for the optimization of yield and convenience has contributed to the recent incidents in certain adverse events. Industry measures under development will be discussed in terms of their potential to improve safety and optimize care for patients with PAD.

  5. Primary measuring of equipment factor of 222Rn/220Rn indoor

    International Nuclear Information System (INIS)

    Liu Yanyang; Liu Fudong; Wang Chunhong; Sheng Mingwei

    2010-01-01

    The activity concentration of 222 Rn, 220 Rn and their progenies of certain working places and dwellings in Baotou city were measured simultaneously. Based on these results, the equipment factor of 222 Rn is 0.35 for working places and 0.43 for dwellings, while equipment factor of 220 Rn measured at 20 cm distance from wall is 0.030 for both working places and dwellings. Preliminary results show that the temporal change of 220 Rn equilibrium equivalent concentration is same as 222 Rn which is high in midnight and low in afternoon,and significant difference between instant and accumulated measure result of 222 Rn, 220 Rn activity concentration is found, with the factor of 2.1 and 1.7. (authors)

  6. MR imaging of primary sclerosing cholangitis - Additional value of diffusion-weighted imaging and ADC measurement

    Energy Technology Data Exchange (ETDEWEB)

    Djokicc Kovac, Jelena [Center for Radiology and Magnetic Resonance Imaging, Clinical Center Serbia, Belgrade (Serbia)], e-mail: jelenadjokic2003@yahoo.co.uk; Maksimovic, Ruzica [Center for Radiology and Magnetic Resonance Imaging, Clinical Center Serbia, Belgrade (Serbia); Faculty of Medicine, Univ. of Belgrade, Belgrade (Serbia); Jesic, Rada [Clinic for Gastroenterohepatology, Clinical Center Serbia, Belgrade (Serbia); Faculty of Medicine, Univ. of Belgrade, Belgrade (Serbia); Stanisavljevic, Dejana [Inst. for Statistics, Faculty of Medicine, Univ. of Belgrade, Belgrade (Serbia); Kovac, Bojan [Military Medical Academy, Belgrade (Serbia)

    2013-04-15

    Background: Primary sclerosing cholangitis (PSC) is a cholestatic liver disease with chronic inflammation and progressive destruction of biliary tree. Magnetic resonance (MR) examination with diffusion-weighted imaging (DWI) allows analysis of morphological liver parenchymal changes and non-invasive assessment of liver fibrosis. Moreover, MR cholangiopancreatography (MRCP), as a part of standard MR protocol, provides insight into bile duct irregularities. Purpose: To evaluate MR and MRCP findings in patients with primary sclerosing cholangitis and to determine the value of DWI in the assessment of liver fibrosis. Material and Methods: The following MR findings were reviewed in 38 patients: abnormalities in liver parenchyma signal intensity, changes in liver morphology, lymphadenopathy, signs of portal hypertension, and irregularities of intra- and extrahepatic bile ducts. Apparent diffusion coefficient (ADC) was calculated for six locations in the liver for b = 800 s/mm{sup 2}. Results: T2-weighted hyperintensity was seen as peripheral wedge-shaped areas in 42.1% and as periportal edema in 28.9% of patients. Increased enhancement of liver parenchyma on arterial-phase imaging was observed in six (15.8%) patients. Caudate lobe hypertrophy was present in 10 (26.3%), while spherical liver shape was noted in 7.9% of patients. Liver cirrhosis was seen in 34.2% of patients; the most common pattern was micronodular cirrhosis (61.5%). Other findings included lymphadenopathy (28.9%), signs of portal hypertension (36.7%), and bile duct irregularities (78.9%). The mean ADCs (x10{sup -3} mm{sup 2}/s) were significantly different at stage I vs. stages III and IV, and stage II vs. stage IV. No significant difference was found between stages II and III. For prediction of stage {>=}II and stage {>=}III, areas under receiver-operating characteristic curves were 0.891 and 0.887, respectively. Conclusion: MR with MRCP is a necessary diagnostic procedure for diagnosis of PSC and

  7. Use of primary cell cultures to measure the late effects in the skins of rhesus monkeys irradiated with protons

    Science.gov (United States)

    Cox, A. B.; Wood, D. H.; Lett, J. T.

    Previous pilot investigations of the uses of primary cell cultures to study late damage in stem cells of the skin of the New Zealand white (NZW) rabbit and the rhesus monkey /1-3/, have been extended to individual monkeys exposed to 55 MeV protons. Protons of this energy have a larger range in tissue of (~2.6 cm) than the 32 MeV protons (~0.9 cm) to which the animals in our earlier studies had been exposed. Although the primary emphases in the current studies were improvement and simplification in the techniques and logistics of transportation of biopsies to a central analytical facility, comparison of the quantitative measurements obtained thus far for survival of stem cells in the skins from animals irradiated 21 years ago reveals that the effects of both proton energies are similar.

  8. Concept of the detuned primary coupling and model measurements for the radiofrequency system of the VINCY cyclotron

    International Nuclear Information System (INIS)

    Bojovic, B.; Susini, A.

    1999-01-01

    A new concept of the impedance matching of a radiofrequency (RF) amplifier (primary) coupled to a cyclotron RF cavity (secondary) is discussed. In this arrangement the necessity of moving the coupling loop in vacuum is avoided, and the impedance matching for different operating frequencies is performed only by a variable capacitor. A design procedure based on the transformer equations is proposed, and the design of the RF system of the VINCY Cyclotron, the main part of the TESLA Accelerator Installation, based on the concept of the detuned primary coupling is presented. The measurements on a 1:1 scale model of the RF system of the VINCY Cyclotron were carried out for the whole range of the operating frequencies. The results obtained confirmed the viability of the coupling concept for the cyclotron RF systems. (authors)

  9. Advancing Accounting Research of Teaching Efficacy: Developing a Scale to Measure Student Attitudes toward Active Learning Experiences

    Science.gov (United States)

    Burney, Laurie; Zascavage, Victoria; Matherly, Michele

    2017-01-01

    Literature consistently documents a positive, direct effect of students' attitudes on learning (Lizzio, Wilson, & Simons, 2002). Hence, accounting studies describing active learning activities often report student attitudes as evidence of efficacy (e.g., Matherly & Burney, 2013), but rely on single-item instead of multi-item scales. This…

  10. Anthropometric measures as fitness indicators in primary school children: The Health Oriented Pedagogical Project (HOPP).

    Science.gov (United States)

    Mamen, Asgeir; Fredriksen, Per Morten

    2018-05-01

    As children's fitness continues to decline, frequent and systematic monitoring of fitness is important. Easy-to-use and low-cost methods with acceptable accuracy are essential in screening situations. This study aimed to investigate how the measurements of body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) relate to selected measurements of fitness in children. A total of 1731 children from grades 1 to 6 were selected who had a complete set of height, body mass, running performance, handgrip strength and muscle mass measurements. A composite fitness score was established from the sum of sex- and age-specific z-scores for the variables running performance, handgrip strength and muscle mass. This fitness z-score was compared to z-scores and quartiles of BMI, WC and WHtR using analysis of variance, linear regression and receiver operator characteristic analysis. The regression analysis showed that z-scores for BMI, WC and WHtR all were linearly related to the composite fitness score, with WHtR having the highest R 2 at 0.80. The correct classification of fit and unfit was relatively high for all three measurements. WHtR had the best prediction of fitness of the three with an area under the curve of 0.92 ( p fit and unfit in this population.

  11. A sandwich ELISA for measurement of the primary glucagon-like peptide-1 metabolite

    DEFF Research Database (Denmark)

    Wewer Albrechtsen, Nicolai J; Asmar, Ali; Jensen, Frederik

    2017-01-01

    developed a sandwich ELISA recognizing both GLP-1 9-36NH2 and nonamidated GLP-1 9-37. The ELISA was validated using analytical assay validation guidelines and by comparing it to a subtraction-based method, hitherto employed for estimation of GLP-1 9-36NH2 Its accuracy was evaluated from measurements...

  12. A Primary Investigation into Performance Measurement Systems in the Maltese Further Education (FE Sector

    Directory of Open Access Journals (Sweden)

    N. Zarb

    2014-12-01

    Full Text Available This work investigates the presence of a performance measurement system in the small island state of Malta using data gathered in 2012. In this way the type of system and KPIs currently in use are delineated. An interpretative methodology was employed to gain a deeper understanding of performance measurement in FE organizations. Data were collected from seven FE vocational and academic organizations via interviews with top senior management team (SMT officials and other internal and external stakehold-ers. Very few organizations have performance measurement systems. The use of KPIs is very narrow, usually focusing on pass rates. There is no external QA or performance measurement regime making it very difficult to compare different FE organizations. By utilizing qualitative data it is possible to un-cover particular nuances in specific sectors in small states. Reliability is further enhanced since the number of organizations in any sector in a small state in usually low. This translates into a higher percentage of organizations in the study.

  13. Measurement of Primary and Secondary Stability of Dental Implants by Resonance Frequency Analysis Method in Mandible

    Science.gov (United States)

    Shokri, Mehran; Daraeighadikolaei, Arash

    2013-01-01

    Background. There is no doubt that the success of the dental implants depends on the stability. The aim of this work was to measure the stability of dental implants prior to loading the implants, using a resonance frequency analysis (RFA) by Osstell mentor device. Methods. Ten healthy and nonsmoker patients over 40 years of age with at least six months of complete or partial edentulous mouth received screw-type dental implants by a 1-stage procedure. RFA measurements were obtained at surgery and 1, 2, 3, 4, 5, 7, and 11 weeks after the implant surgery. Results. Among fifteen implants, the lowest mean stability measurement was for the 4th week after surgery in all bone types. At placement, the mean ISQ obtained with the magnetic device was 77.2 with 95% confidence interval (CI) = 2.49, and then it decreased until the 4th week to 72.13 (95% CI = 2.88), and at the last measurement, the mean implant stability significantly (P value implant placement. These suggestions need to be further assessed through future studies. PMID:23737790

  14. Patient-specific simulations and measurements of the magneto-hemodynamic effect in human primary vessels

    International Nuclear Information System (INIS)

    Kyriakou, Adamos; Neufeld, Esra; Szczerba, Dominik; Kuster, Niels; Kainz, Wolfgang; Luechinger, Roger; Kozerke, Sebastian; McGregor, Robert

    2012-01-01

    This paper investigates the main characteristics of the magneto-hemodynamic (MHD) response for application as a biomarker of vascular blood flow. The induced surface potential changes of a volunteer exposed to a 3 T static B0 field of a magnetic resonance imaging (MRI) magnet were measured over time at multiple locations by an electrocardiogram device and compared to simulation results. The flow simulations were based on boundary conditions derived from MRI flow measurements restricted to the aorta and vena cava. A dedicated and validated low-frequency electromagnetic solver was applied to determine the induced temporal surface potential change from the obtained 4D flow distribution using a detailed whole-body model of the volunteer. The simulated MHD signal agreed with major characteristics of the measured signal (temporal location of main peak, magnitude, variation across chest and along torso) except in the vicinity of the heart. The MHD signal is mostly influenced by the aorta; however, more vessels and better boundary conditions are needed to analyze the finer details of the response. The results show that the MHD signal is strongly position dependent with highly variable but reproducibly measurable distinguished characteristics. Additional investigations are necessary before determining whether the MHD effect is a reliable reference for location-specific information on blood flow. (paper)

  15. Efficacy and safety of human papillomavirus vaccine for primary prevention of cervical cancer: A review of evidence from phase III trials and national programs

    Directory of Open Access Journals (Sweden)

    Partha Basu

    2013-01-01

    Full Text Available The Human Papillomavirus (HPV vaccines have been widely introduced in the national immunization programs in most of the medium and high income countries following endorsement from national and international advisory bodies. HPV vaccine is unique and its introduction is challenging in many ways - it is the first vaccine developed to prevent any cancer, the vaccine is gender specific, it targets adolescent females who are difficult to reach by any health intervention programs. It is not unusual for such a vaccine to face scepticism and reservations not only from lay public but also from professionals in spite of the clinical trial results convincingly and consistently proving their efficacy and safety. Over the last few years millions of doses of the HPV vaccine have been administered round the world and the efficacy and safety data have started coming from the real life programs. A comprehensive cervical cancer control program involving HPV vaccination of the adolescent girls and screening of the adult women has been proved to be the most cost-effective approach to reduce the burden of cervical cancer. The present article discusses the justification of HPV vaccination in the backdrop of natural history of cervical cancer, the mechanism of action of the vaccines, efficacy and safety data from phase III randomized controlled trials as well as from the national immunization programs of various countries.

  16. Integrated Clinical Decision Support Systems Promote Absolute Cardiovascular Risk Assessment: An Important Primary Prevention Measure in Aboriginal and Torres Strait Islander Primary Health Care

    Directory of Open Access Journals (Sweden)

    Veronica Matthews

    2017-09-01

    Full Text Available BackgroundAboriginal and Torres Strait Islander Australians experience a greater burden of disease compared to non-Indigenous Australians. Around one-fifth of the health disparity is caused by cardiovascular disease (CVD. Despite the importance of absolute cardiovascular risk assessment (CVRA as a screening and early intervention tool, few studies have reported its use within the Australian Indigenous primary health care (PHC sector. This study utilizes data from a large-scale quality improvement program to examine variation in documented CVRA as a primary prevention strategy for individuals without prior CVD across four Australian jurisdictions. We also examine the proportion with elevated risk and follow-up actions recorded.MethodsWe undertook cross-sectional analysis of 2,052 client records from 97 PHC centers to assess CVRA in Indigenous adults aged ≥20 years with no recorded chronic disease diagnosis (2012–2014. Multilevel regression was used to quantify the variation in CVRA attributable to health center and client level factors. The main outcome measure was the proportion of eligible adults who had CVRA recorded. Secondary outcomes were the proportion of clients with elevated risk that had follow-up actions recorded.ResultsApproximately 23% (n = 478 of eligible clients had documented CVRA. Almost all assessments (99% were conducted in the Northern Territory. Within this jurisdiction, there was wide variation between centers in the proportion of clients with documented CVRA (median 38%; range 0–86%. Regression analysis showed health center factors accounted for 48% of the variation. Centers with integrated clinical decision support systems were more likely to document CVRA (OR 21.1; 95% CI 5.4–82.4; p < 0.001. Eleven percent (n = 53 of clients were found with moderate/high CVD risk, of whom almost one-third were under 35 years (n = 16. Documentation of follow-up varied with respect to the targeted risk factor

  17. Conditional standard errors of measurement for composite scores on the Wechsler Preschool and Primary Scale of Intelligence-Third Edition.

    Science.gov (United States)

    Price, Larry R; Raju, Nambury; Lurie, Anna; Wilkins, Charles; Zhu, Jianjun

    2006-02-01

    A specific recommendation of the 1999 Standards for Educational and Psychological Testing by the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education is that test publishers report estimates of the conditional standard error of measurement (SEM). Procedures for calculating the conditional (score-level) SEM based on raw scores are well documented; however, few procedures have been developed for estimating the conditional SEM of subtest or composite scale scores resulting from a nonlinear transformation. Item response theory provided the psychometric foundation to derive the conditional standard errors of measurement and confidence intervals for composite scores on the Wechsler Preschool and Primary Scale of Intelligence-Third Edition.

  18. Chances and Limitations of Implementing Measures of Differentiation for Gifted Children in Primary Schools: The Teachers’ Part

    Directory of Open Access Journals (Sweden)

    Martina Endepohls-Ulpe

    2014-06-01

    Full Text Available The presented study analyzes German primary school teachers’ attitudes towards several measures of internal differentiation with re-spect to the anticipated benefit for gifted pupils and the anticipated work load for teachers. Be-sides, correlations of these attitudes with teach-ers’ statements on the frequency of adopting the measures in their own classes were inspected. One-hundred thirty-seven teachers and teacher students were interviewed with a questionnaire on the assessed consequences and the fre-quency of the usage of several methods of dif-ferentiation. Data analysis was done by anal-yses of variance and calculation of Pearson cor-relation coefficients. Results show that teachers, as well as teacher students, mostly assessed the listed measures of internal differentiation to be appropriate for the promotion of gifted pupils, but for teachers there were significant negative correlations between assessed work load and frequency of usage in their own classes.

  19. Validation of English-language versions of three scales measuring attitudes towards smoking, smoking-related self-efficacy and the use of smoking cessation strategies.

    Science.gov (United States)

    Christie, Derek H; Etter, Jean-François

    2005-06-01

    To assess the validity of English translations of three scales initially developed in French, measuring perception of the adverse effects of smoking, self-efficacy and the use of smoking cessation strategies. Between 1999 and 2001, 5667 people from 97 countries (4724 smokers and 943 ex-smokers) answered the scales on the internet, of which 997 (18%) took part in a follow-up 86 days later. The factor structures of the scales were generally maintained after translation. Internal consistency coefficients were 0.5-0.9. Test-retest reliability was >0.7 for the "Adverse effects" and self-efficacy scales, but was low (0.2-0.4) for self-change strategies, which probably reflects active use of these strategies in this sample. The translated scales performed adequately in most tests of construct validity. In particular, higher self-efficacy ratings predicted smoking cessation at follow-up, and a lower self-efficacy predicted relapse in baseline ex-smokers. The validity of the scales was maintained after translation in English.

  20. Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care

    Science.gov (United States)

    Parker, Dianne; Wensing, Michel; Esmail, Aneez; Valderas, Jose M

    2015-01-01

    ABSTRACT Background: There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. Objective: To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance that should be assessed when investigating the relationship between safety culture and performance in primary care. Methods: Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care. Results: The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events. Conclusion: Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care. PMID:26339832

  1. Measuring psychological change during cognitive behaviour therapy in primary care: a Polish study using 'PSYCHLOPS' (Psychological Outcome Profiles.

    Directory of Open Access Journals (Sweden)

    Slawomir Czachowski

    Full Text Available BACKGROUND: Psychological outcome measures are evolving into measures that depict progress over time. Interval measurement during therapy has not previously been reported for a patient-generated measure in primary care. We aimed to determine the sensitivity to change throughout therapy, using 'PSYCHLOPS' (Psychological Outcome Profiles, and to determine if new problems appearing during therapy diminish overall improvement. METHODS: Responses to PSYCHLOPS, pre-, during- and post-therapy were compared. SETTING: patients offered brief cognitive behaviour therapy in primary care in Poland. RESULTS: 238 patients completed the pre-therapy questionnaire, 194 (81.5% the during-therapy questionnaire and 142 the post-therapy questionnaire (59.7%. For those completing all three questionnaires (n = 135, improvement in total scores produced an overall Effect Size of 3.1 (2.7 to 3.4. We estimated change using three methods for dealing with missing values. Single and multiple imputation did not significantly change the Effect Size; 'Last Value Carried Forward', the most conservative method, produced an overall Effect Size of 2.3 (1.9 to 2.6. New problems during therapy were reported by 81 patients (60.0%: new problem and original problem scores were of similar magnitude and change scores were not significantly different when compared to patients who did not report new problems. CONCLUSION: A large proportion of outcome data is lost when outcome measures depend upon completed end of therapy questionnaires. The use of a during-therapy measure increases data capture. Missing data still produce difficulties in interpreting overall effect sizes for change. We found no evidence that new problems appearing during therapy hampered overall recovery.

  2. Measuring Connectivity in the Primary Visual Pathway in Human Albinism Using Diffusion Tensor Imaging and Tractography.

    Science.gov (United States)

    Grigorian, Anahit; McKetton, Larissa; Schneider, Keith A

    2016-08-11

    In albinism, the number of ipsilaterally projecting retinal ganglion cells (RGCs) is significantly reduced. The retina and optic chiasm have been proposed as candidate sites for misrouting. Since a correlation between the number of lateral geniculate nucleus (LGN) relay neurons and LGN size has been shown, and based on previously reported reductions in LGN volumes in human albinism, we suggest that fiber projections from LGN to the primary visual cortex (V1) are also reduced. Studying structural differences in the visual system of albinism can improve the understanding of the mechanism of misrouting and subsequent clinical applications. Diffusion data and tractography are useful for mapping the OR (optic radiation). This manuscript describes two algorithms for OR reconstruction in order to compare brain connectivity in albinism and controls.An MRI scanner with a 32-channel head coil was used to acquire structural scans. A T1-weighted 3D-MPRAGE sequence with 1 mm(3) isotropic voxel size was used to generate high-resolution images for V1 segmentation. Multiple proton density (PD) weighted images were acquired coronally for right and left LGN localization. Diffusion tensor imaging (DTI) scans were acquired with 64 diffusion directions. Both deterministic and probabilistic tracking methods were run and compared, with LGN as the seed mask and V1 as the target mask. Though DTI provides relatively poor spatial resolution, and accurate delineation of OR may be challenging due to its low fiber density, tractography has been shown to be advantageous both in research and clinically. Tract based spatial statistics (TBSS) revealed areas of significantly reduced white matter integrity within the OR in patients with albinism compared to controls. Pairwise comparisons revealed a significant reduction in LGN to V1 connectivity in albinism compared to controls. Comparing both tracking algorithms revealed common findings, strengthening the reliability of the technique.

  3. A composite measure to explore visual disability in primary progressive multiple sclerosis.

    Science.gov (United States)

    Poretto, Valentina; Petracca, Maria; Saiote, Catarina; Mormina, Enricomaria; Howard, Jonathan; Miller, Aaron; Lublin, Fred D; Inglese, Matilde

    2017-01-01

    Optical coherence tomography (OCT) and magnetic resonance imaging (MRI) can provide complementary information on visual system damage in multiple sclerosis (MS). The objective of this paper is to determine whether a composite OCT/MRI score, reflecting cumulative damage along the entire visual pathway, can predict visual deficits in primary progressive multiple sclerosis (PPMS). Twenty-five PPMS patients and 20 age-matched controls underwent neuro-ophthalmologic evaluation, spectral-domain OCT, and 3T brain MRI. Differences between groups were assessed by univariate general linear model and principal component analysis (PCA) grouped instrumental variables into main components. Linear regression analysis was used to assess the relationship between low-contrast visual acuity (LCVA), OCT/MRI-derived metrics and PCA-derived composite scores. PCA identified four main components explaining 80.69% of data variance. Considering each variable independently, LCVA 1.25% was significantly predicted by ganglion cell-inner plexiform layer (GCIPL) thickness, thalamic volume and optic radiation (OR) lesion volume (adjusted R 2 0.328, p  = 0.00004; adjusted R 2 0.187, p  = 0.002 and adjusted R 2 0.180, p  = 0.002). The PCA composite score of global visual pathway damage independently predicted both LCVA 1.25% (adjusted R 2 value 0.361, p  = 0.00001) and LCVA 2.50% (adjusted R 2 value 0.323, p  = 0.00003). A multiparametric score represents a more comprehensive and effective tool to explain visual disability than a single instrumental metric in PPMS.

  4. High-resolution measurements of face-to-face contact patterns in a primary school.

    Directory of Open Access Journals (Sweden)

    Juliette Stehlé

    Full Text Available BACKGROUND: Little quantitative information is available on the mixing patterns of children in school environments. Describing and understanding contacts between children at school would help quantify the transmission opportunities of respiratory infections and identify situations within schools where the risk of transmission is higher. We report on measurements carried out in a French school (6-12 years children, where we collected data on the time-resolved face-to-face proximity of children and teachers using a proximity-sensing infrastructure based on radio frequency identification devices. METHODS AND FINDINGS: Data on face-to-face interactions were collected on Thursday, October 1(st and Friday, October 2(nd 2009. We recorded 77,602 contact events between 242 individuals (232 children and 10 teachers. In this setting, each child has on average 323 contacts per day with 47 other children, leading to an average daily interaction time of 176 minutes. Most contacts are brief, but long contacts are also observed. Contacts occur mostly within each class, and each child spends on average three times more time in contact with classmates than with children of other classes. We describe the temporal evolution of the contact network and the trajectories followed by the children in the school, which constrain the contact patterns. We determine an exposure matrix aimed at informing mathematical models. This matrix exhibits a class and age structure which is very different from the homogeneous mixing hypothesis. CONCLUSIONS: We report on important properties of the contact patterns between school children that are relevant for modeling the propagation of diseases and for evaluating control measures. We discuss public health implications related to the management of schools in case of epidemics and pandemics. Our results can help define a prioritization of control measures based on preventive measures, case isolation, classes and school closures, that

  5. Measuring teamwork in primary care: Triangulation of qualitative and quantitative data.

    Science.gov (United States)

    Brown, Judith Belle; Ryan, Bridget L; Thorpe, Cathy; Markle, Emma K R; Hutchison, Brian; Glazier, Richard H

    2015-09-01

    This article describes the triangulation of qualitative dimensions, reflecting high functioning teams, with the results of standardized teamwork measures. The study used a mixed methods design using qualitative and quantitative approaches to assess teamwork in 19 Family Health Teams in Ontario, Canada. This article describes dimensions from the qualitative phase using grounded theory to explore the issues and challenges to teamwork. Two quantitative measures were used in the study, the Team Climate Inventory (TCI) and the Providing Effective Resources and Knowledge (PERK) scale. For the triangulation analysis, the mean scores of these measures were compared with the qualitatively derived ratings for the dimensions. The final sample for the qualitative component was 107 participants. The qualitative analysis identified 9 dimensions related to high team functioning such as common philosophy, scope of practice, conflict resolution, change management, leadership, and team evolution. From these dimensions, teams were categorized numerically as high, moderate, or low functioning. Three hundred seventeen team members completed the survey measures. Mean site scores for the TCI and PERK were 3.87 and 3.88, respectively (of 5). The TCI was associated will all dimensions except for team location, space allocation, and executive director leadership. The PERK was associated with all dimensions except team location. Data triangulation provided qualitative and quantitative evidence of what constitutes teamwork. Leadership was pivotal in forging a common philosophy and encouraging team collaboration. Teams used conflict resolution strategies and adapted to the changes they encountered. These dimensions advanced the team's evolution toward a high functioning team. (c) 2015 APA, all rights reserved).

  6. Determination of temperature measurements uncertainties of the heat transport primary system of Embalse nuclear power plant

    International Nuclear Information System (INIS)

    Pomerantz, Marcelo E.; Coutsiers, Eduardo E.; Moreno, Carlos A.

    1999-01-01

    In this work, the systematic errors in temperature measurements in inlet and outlet headers of HTPS coolant channels of Embalse nuclear power plant are evaluated. These uncertainties are necessary for a later evaluation of the channel power maps transferred to the coolant. The power maps calculated in this way are used to compare power distributions using neutronic codes. Therefore, a methodology to correct systematic errors of temperature in outlet feeders and inlet headers is developed in this work. (author)

  7. Electrophysiological measurement of binaural beats: effects of primary tone frequency and observer age.

    Science.gov (United States)

    Grose, John H; Mamo, Sara K

    2012-01-01

    The purpose of this study was to determine the reliability of the electrophysiological binaural beat steady state response as a gauge of temporal fine structure coding, particularly as it relates to the aging auditory system. The hypothesis was that the response would be more robust in a lower, than in a higher, frequency region and in younger, than in older, adults. Two experiments were undertaken. The first measured the 40 Hz binaural beat steady state response elicited by tone pairs in two frequency regions: lower (390 and 430 Hz tone pair) and higher (810 and 850 Hz tone pair). Frequency following responses (FFRs) evoked by the tones were also recorded. Ten young adults with normal hearing participated. The second experiment measured the binaural beat and FFRs in older adults but only in the lower frequency region. Fourteen older adults with relatively normal hearing participated. Response metrics in both experiments included response component signal-to-noise ratio (F statistic) and magnitude-squared coherence. Experiment 1 showed that FFRs were elicited in both frequency regions but were more robust in the lower frequency region. Binaural beat responses elicited by the lower frequency pair of tones showed greater amplitude fluctuation within a participant than the respective FFRs. Experiment 2 showed that older adults exhibited similar FFRs to younger adults, but proportionally fewer older participants showed binaural beat responses. Age differences in onset responses were also observed. The lower prevalence of the binaural beat response in older adults, despite the presence of FFRs, provides tentative support for the sensitivity of this measure to age-related deficits in temporal processing. However, the lability of the binaural beat response advocates caution in its use as an objective measure of fine structure coding.

  8. Measuring third year undergraduate nursing students' reflective thinking skills and critical reflection self-efficacy following high fidelity simulation: A pilot study.

    Science.gov (United States)

    Tutticci, Naomi; Lewis, Peter A; Coyer, Fiona

    2016-05-01

    Critical reflection underpins critical thinking, a highly desirable generic nursing graduate capability. To improve the likelihood of critical thinking transferring to clinical practice, reflective thinking needs to be measured within the learning space of simulation. This study was divided into two phases to address the reliability and validity measures of previously untested surveys. Phase One data was collected from individuals (n = 6) using a 'think aloud' approach and an expert panel to review content validity, and verbatim comment analysis was undertaken. The Reflective Thinking Instrument and Critical Reflection Self-Efficacy Visual Analogue Scale items were contextualised to simulation. The expert review confirmed these instruments exhibited content validity. Phase Two data was collected through an online survey (n = 58). Cronbach's alpha measured internal consistency and was demonstrated by all subscales and the Instrument as a whole (.849). There was a small to medium positive correlation between critical reflection self-efficacy and general self-efficacy (r = .324, n = 56, p = .048). Participant responses were positive regarding the simulation experience. The research findings demonstrated that the Reflective Thinking and Simulation Satisfaction survey is reliable. Further development of this survey to establish validity is recommended to make it viable. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Primary Results from the Measurement of Nature Ice Nuclear Particles during 2017 Spring in Beijing, China

    Science.gov (United States)

    Che, Y.; Dang, J.; Fang, W.; Qian, Y.

    2017-12-01

    The ice nuclear particles (INPs) play a critical role in weather modification in mixed-phase clouds (MPCs) because ice can influence the supercooled liquid water content through the Wegener-Bergeron-Findeisen process. The fundamental desire to understand ice nucleation is the same as when such research began in earnest more than 60 years ago while the first cloud seeding activity began and enhanced from the last decade by climate change researches. The primary INPs sources, both from natural and anthropogenic, may be change a lot for decades. The purpose of this paper is to get the new background information of INPs and comparing with historical data. The INPs concentrations were observed twice a day(9:00 am and 14:00 pm) in Beijing from Mar. 20 to Apr. 19, 2017 using the 5 Litters Bigg's mixing cloud chamber. The method, time and sites of the observation are basically the same with the experiment at year 1963, 1995 and 1996. Compared with the previous observations, the observed activation temperature -10° is added, besides the -15°, -20°, -25°, -30°. The results show that the INPs concentrations at the different activation temperatures have good consistency trend as diurnal variation. This is consistent with the observations in 1963, 1995 and 1996. The INPs concentrations in this observation are higher than the result in 1963, but obviously lower than 1995 and 1996. It shows that natural changes and human activities in the past 20 years did not significantly increase the INPs concentration. During the observation period, there were weak precipitations in four days (Mar. 20, Mar. 22, Mar. 23, Mar.24), the INPs concentrations tended to decrease in the intermittent precipitation from Mar. 20 to Mar. 25. This shows that the precipitations have effect on the removal of ice nuclei. The visibility sensor was also synchronized observed in the work. There was clearly an inverse correlation between INPs concentration and visibility with the diurnal variation. The

  10. Western Cape Primary Care Assessment Tool (PCAT) study: Measuring primary care organisation and performance in the Western Cape Province, South Africa (2013)

    Science.gov (United States)

    Sayed, Abdul-Rauf; le Grange, Cynthia; Bhagwan, Susheela; Manga, Nayna; Hellenberg, Derek

    2016-01-01

    Background Major health sector reform and the need for baseline measures of performance to determine impact. Aim Baseline audit of primary healthcare (PHC) performance. Setting Cape Town and Cape Winelands (rural) PHC facilities (PCFs) in Western Cape Province, South Africa. Method The South African cross-culturally validated ZA PCAT to audit PHC performance on 11 subdomains associated with improved health and reduced costs. Adult PCF users systematically sampled. All full-time doctors and nurse practitioners in PCFs sampled and all PCF managers in sub-districts sampled invited into the study. Results Data from 1432 users, 100 clinicians and 64 managers from 13 PCFs in 10 sub-districts analysed (figures show stakeholder percentages scoring subdomain performance ‘acceptable to good’). 11.5% users scored access ‘acceptable to good’; community orientation and comprehensive services provided 20.8% and 39.9%, respectively. Total PHC score for users 50.2%; for managers and practitioners 82.8% and 88.0%, respectively. Among practitioners access was lowest (33.3%); PHC team (98.0%) and comprehensive services available (100.0%) highest. Among managers, access (13.5%) and family centredness (45.6%) are lowest; PHC team (85.9%) and comprehensive services available (90.6%) highest. Managers scored access, family centredness and cultural competence significantly lower than practitioners. Users scored comprehensive services available, comprehensive services provided and community orientation significantly lower than practitioners and managers. Conclusion Gaps between users’ experience and providers’ assessments of PHC performance are identified. Features that need strengthening and alignment with best practice, provincial and national, and health policies are highlighted with implications for practitioner and manager training, health policy, and research. PMID:27247157

  11. Measuring parental and family efficacy beliefs of adolescents' parents: Cross-cultural comparisons in Italy and Portugal.

    Science.gov (United States)

    Costa, Marisa; Faria, Luísa; Alessandri, Guido; Caprara, Gian Vittorio

    2016-12-01

    The goal of this study was to examine the psychometric properties of the Perceived Parental Self-Efficacy (PPSE) and Perceived Family Collective Efficacy (PFCE) revised scales in the Portuguese and Italian contexts. To this aim two studies were conducted: the first reported the exploratory and confirmatory factor analyses with Portuguese samples, whereas the second addressed the cross-cultural invariance of PPSE and PFCE (Portugal and Italy). Results of the first study showed the appropriate fit of the unifactorial model of both scales to Portuguese data. The invariance analyses performed in the second study attested to the PPSE and PFCE's configural, metric and scalar invariance in both countries. The correlations of PPSE and PFCE with communication, management of conflict and children's school achievement further attested to their construct and practical validity. Thus, PPSE and PFCE proved to be suitable to further use in research and psychological assessment fields. © 2015 International Union of Psychological Science.

  12. Defining adolescent common mental disorders using electronic primary care data: a comparison with outcomes measured using the CIS-R.

    Science.gov (United States)

    Cornish, Rosie P; John, Ann; Boyd, Andy; Tilling, Kate; Macleod, John

    2016-12-01

    To compare the prevalence of common mental disorders (CMDs) derived from data held in primary care records with that measured using the revised Clinical Interview Schedule (CIS-R) in order to assess the potential robustness of findings based only on routinely collected data. Comparison study using linkage between the Avon Longitudinal Study of Parents and Children (ALSPAC) and electronic primary care records. We studied 1562 adolescents who had completed the CIS-R in ALSPAC at age 17-18 years and had linkage established to their primary care records. Outcome measures from ALSPAC were whether or not an individual met International Classification of Diseases-10 criteria for a diagnosis of (1) a CMD or, specifically, (2) depression. Lists of Read codes corresponding to diagnoses, symptoms and treatments were used to create 12 definitions of CMD and depression alone using the primary care data. We calculated sensitivities and specificities of these, using CIS-R definitions as the reference standard. Sensitivities ranged from 5.2% to 24.3% for depression and from 3.8% to 19.2% for CMD. The specificities of all definitions were above 98% for depression and above 96% for CMD.For both outcomes, the definition that included current diagnosis, treatment or symptoms identified the highest proportion of CIS-R cases. Most individuals meeting case definitions for CMD based on primary care data also met CIS-R case definitions. Conversely many individuals identified as cases using the CIS-R had no evidence of CMD in their clinical records. This suggests that clinical databases are likely to yield underestimates of the burden of CMD in the population. However, clinical records appear to yield valid diagnoses which may be useful for studying risk factors and consequences of CMD. The greatest epidemiological value may be obtained when information is available from survey and clinical records. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  13. Limited english proficiency, primary language at home, and disparities in children's health care: how language barriers are measured matters.

    Science.gov (United States)

    Flores, Glenn; Abreu, Milagros; Tomany-Korman, Sandra C

    2005-01-01

    Approximately 3.5 million U.S. schoolchildren are limited in English proficiency (LEP). Disparities in children's health and health care are associated with both LEP and speaking a language other than English at home, but prior research has not examined which of these two measures of language barriers is most useful in examining health care disparities. Our objectives were to compare primary language spoken at home vs. parental LEP and their associations with health status, access to care, and use of health services in children. We surveyed parents at urban community sites in Boston, asking 74 questions on children's health status, access to health care, and use of health services. Some 98% of the 1,100 participating children and families were of non-white race/ethnicity, 72% of parents were LEP, and 13 different primary languages were spoken at home. "Dose-response" relationships were observed between parental English proficiency and several child and parental sociodemographic features, including children's insurance coverage, parental educational attainment, citizenship and employment, and family income. Similar "dose-response" relationships were noted between the primary language spoken at home and many but not all of the same sociodemographic features. In multivariate analyses, LEP parents were associated with triple the odds of a child having fair/poor health status, double the odds of the child spending at least one day in bed for illness in the past year, and significantly greater odds of children not being brought in for needed medical care for six of nine access barriers to care. None of these findings were observed in analyses of the primary language spoken at home. Individual parental LEP categories were associated with different risks of adverse health status and outcomes. Parental LEP is superior to the primary language spoken at home as a measure of the impact of language barriers on children's health and health care. Individual parental LEP

  14. Primary study of quantitative measurement in different grades of COPD using low-dose multislice CT

    International Nuclear Information System (INIS)

    Li Yiming; Yin Jianzhong; Yang Wenjie; Tan Zhengshuai

    2012-01-01

    Objective: To study the feasibility of airway measurement at the trunk of apical bronchus of right upper lobe in chronic obstructive pulmonary disease (COPD), and airway dimensions and lung density changes in different COPD stages. Methods: 1) Fifteen randomly selected COPD patients underwent low -dose chest multi -slice CT scan. The wall thickness-to-diameter ratio (TDR) and percentage wall area (WA%) at apical bronchus of right upper lobe section and mean TDR and WA% of small airway (<2 mm) were calculated. 2) Another fifty-five randomly selected COPD patients were divided into 4 groups on the basis of pulmonary function tests. There were sixteen patients with grade 1, sixteen patients with grade 2, fourteen patients with grade 3. and nine patients with grade 4. Fifteen non-COPD patients were selected as controls. The total lung was scanned with low-dose multi-slice CT during inspiration. The mean lung attenuation (MLA) and voxel index (VI) were measured. Inner area of bronchus (A i ), TDR and WA% of the apical bronchus of right upper lobe were measured. Results: 1) The TDR of the apical bronchus of right were smaller than the mean TDR of the small airways; The WA% of the apical bronchus of right were larger than the mean WA% of the small airways; but there were good correlation (r=0.793 and 0.784, respectively). 2) The MLA values were decreased with increase of COPD stage. The VI values were increased with increase of COPD stage. However, the values did not differ between adjacent stages. The luminal areas of stage 3-4 patients were smaller than that of other stages. There was no statistics difference in TDR between adjacent groups, except between stages 3 and 4. For WA%, the higher stage group had higher WA%. Conclusion: There were good correlations for TDR and WA% between the apical bronchus of right upper lobe and small airway. WA% is the most sensitive index for detecting thickened airway. (authors)

  15. Final report for measurement of primary particulate matter emissions from light-duty motor vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Norbeck, J. M.; Durbin, T. D.; Truex, T. J.

    1998-12-31

    This report describes the results of a particulate emissions study conducted at the University of California, Riverside, College of Engineering-Center for Environmental Research and Technology (CE-CERT) from September of 1996 to August of 1997. The goal of this program was to expand the database of particulate emissions measurements from motor vehicles to include larger numbers of representative in-use vehicles. This work was co-sponsored by the Coordinating Research Council (CRC), the South Coast Air Quality Management District (SCAQMD), and the National Renewable Energy Laboratory (NREL) and was part of a larger study of particulate emissions being conducted in several states under sponsorship by CRC. For this work, FTP particulate mass emission rates were determined for gasoline and diesel vehicles, along with the fractions of particulates below 2.5 and 10 microns aerodynamic diameter. A total of 129 gasoline-fueled vehicles and 19 diesel-fueled vehicles were tested as part of the program.

  16. Use of AUDIT-based measures to identify unhealthy alcohol use and alcohol dependence in primary care: a validation study.

    Science.gov (United States)

    Johnson, J Aaron; Lee, Anna; Vinson, Daniel; Seale, J Paul

    2013-01-01

    As programs for screening, brief intervention, and referral to treatment (SBIRT) for unhealthy alcohol use disseminate, evidence-based approaches for identifying patients with unhealthy alcohol use and alcohol dependence (AD) are needed. While the National Institute on Alcohol Abuse and Alcoholism Clinician Guide suggests use of a single alcohol screening question (SASQ) for screening and Diagnostic and Statistical Manual checklists for assessment, many SBIRT programs use alcohol use disorders identification test (AUDIT) "zones" for screening and assessment. Validation data for these zones are limited. This study used primary care data from a bi-ethnic southern U.S. population to examine the ability of the AUDIT zones and other AUDIT-based approaches to identify unhealthy alcohol use and dependence. Existing data were analyzed from interviews with 625 female and male adult drinkers presenting to 5 southeastern primary care practices. Timeline follow-back was used to identify at-risk drinking, and diagnostic interview schedule was used to identify alcohol abuse and dependence. Validity measures compared performance of AUDIT, AUDIT-C, and AUDIT dependence domains scores, with and without a 30-day binge drinking measure, for detecting unhealthy alcohol use and dependence. Optimal AUDIT scores for detecting unhealthy alcohol use were lower than current commonly used cutoffs (5 for men, 3 for women). Improved performance was obtained by combining AUDIT cutoffs of 6 for men and 4 for women with a 30-day binge drinking measure. AUDIT scores of 15 for men and 13 for women detected AD with 100% specificity but low sensitivity (20 and 18%, respectively). AUDIT dependence subscale scores of 2 or more showed similar specificity (99%) and slightly higher sensitivity (31% for men, 24% for women). Combining lower AUDIT cutoff scores and binge drinking measures may increase the detection of unhealthy alcohol use in primary care. Use of lower cutoff scores and dependence subscale

  17. Measurement of tritium activity in the aluminum pipe of JRR-2 heavy water primary cooling system using imaging plate

    International Nuclear Information System (INIS)

    Motoishi, Shoji; Kobayashi, Katsutoshi

    2000-12-01

    JRR-2 is the heavy water cooling type nuclear reactor, which has been operated for 36 years (1960-1976) and in the process of decommissioning at present. For this reason, evaluation of tritium quantity permeated into the pipe and apparatus of the primary coolant heavy water circulating system is important. In the Radioisotope Production Division, activity of tritium in aluminum pipe was measured with imaging plate (IP), liquid scintillation analyzer and high purity germanium detector (HPGe). After acrylic paints was applied for the region except for tritium contamination on the surface of aluminum pipe, only the oxidized contaminated part was dissolved by 1.5%(1.21M) HF for 3 minutes, and measured with IP. As a result, the tritium was found to permeate in the depth of 25 μm. Moreover, 90% of it was found to be distributed within 7 μm. (author)

  18. Physico-mechanical properties determination using microscale homotopic measurements: Application to sound and caries-affected primary tooth dentin

    Science.gov (United States)

    Marangos, Orestes; Misra, Anil; Spencer, Paulette; Bohaty, Brenda; Katz, J. Lawrence

    2009-01-01

    Microscale elastic moduli, composition and density have rarely been determined at the same location for biological materials. In this paper, we have performed homotopic measurements to determine the physico-mechanical properties of a second primary molar specimen exhibiting sound and caries-affected regions. A microscale acoustic impedance map of a section through this sample was acquired using scanning acoustic microscopy (SAM). Scanning electron microscopy was then used to obtain mineral mass fraction of the same section using backscattered images. Careful calibration of each method was performed to reduce system effects and obtain accurate data. Resorption, demineralization and hypermineralization mechanisms were considered in order to derive relationships between measured mineral mass fraction and material mass density. As a result, microscale mass density was determined at the same lateral resolution and location as the SAM data. The mass density and the acoustic impedance were combined to find the microscale elastic modulus and study the relationship between microscale composition and mechanical properties. PMID:19059013

  19. Strain measurement and analysis for the RPV of Qinshan NPP (unit I) at primary system hydrostatic test

    International Nuclear Information System (INIS)

    Qu Jiadi; Wang Peizhu; Xie Shiqiu; Chen Renchang; Sheng Xianke; Dou Yikang; Zhao Weiliang

    1994-01-01

    Hydrostatic test for RPV (Reactor Pressure Vessel) is not only a means to inspect the vessels and the associated systems but also an important way to verify the results of mechanical analysis. The loading obtained by measurement is useful for the establishment of loading spectrum. Some discussions on the shop hydrostatic test planning for the RPV of Qinshan NPP (Nuclear Power Plant) performed in Japan are presented. Comparisons between the results of hydrostatic test provided by vendor and those of primary system hydrostatic test conducted at Qinshan Site are also given. Some data obtained at Qinshan Site such as actual loading and technical data of the stud-bolt, are listed. The results of measurement for the flange rotation, important for the sealing characteristics of RPV, are specifically discussed. The authors point out some of the mistakes in the results of the shop hydrostatic test

  20. Problem-focused coping and self-efficacy as correlates of quality of life and severity of fibromyalgia in primary fibromyalgia patients.

    Science.gov (United States)

    Alok, Ragini; Das, Siddharth Kumar; Agarwal, Girdhar Gopal; Tiwari, Sarvada Chand; Salwahan, Latika; Srivastava, Ragini

    2014-09-01

    Patients with fibromyalgia syndrome (FMS) often experience problems such as poor quality of life (QoL), loss of self-efficacy (SE), inappropriate coping behavior, and chronic widespread pain along with other symptoms. Recent studies have indicated that sense of SE and effective coping strategies (CSs) are the crux on which the management of chronic pain and enrichment of QoL of FMS patients depend. Realizing the importance of this subject for the rehabilitation of the people with FMS, this study aimed at analyzing the correlation between severity of FMS, and QoL, SE, and CSs among the patients of FMS. One hundred patients with fibromyalgia (FM) and 100 control subjects were studied. Fibromyalgia Impact Questionnaire-Revised, Quality of Life Scale, Arthritis Self-efficacy Scale, and COPE Scales for CSs were administered to both the groups. Significantly lower SE, poor QoL, and less use of CSs were reported by FM patients (P Fibromyalgia Impact Questionnaire-Revised, namely, pain, function, and symptoms, were found to be significantly and negatively associated with problem-focused coping (P < 0.05), SE (P < 0.01), and QoL (P < 0.01). This study confirms that problem-focused CSs and SE are important correlates of QoL and severity of FM in Indian as well as other populations.

  1. Comparative evaluation of preventive measures against primary side stress corrosion cracking of mill annealed Inconel 600 steam generator tubes

    International Nuclear Information System (INIS)

    Frederick, G.; Hernalsteen, P.

    1986-01-01

    Significant amounts of primary side cracking have been reported in the mechanically expanded area of the tubes of PWR steam generators in Europe, in Japan and to a lesser extent in the USA. The Belgian utilities are faced with the same problem. At Doel 2, where the tubes are rolled for only a part of the tubesheet, primary side cracking appeared in the roll transition. The Doel 3 and Tihange 2 steam generators, whose tubes are expanded for the full depth of the tube sheet, have experienced cracking after about 10 000 h of operation not only in the roll transition but also at roll overlaps. While some leaks and eddy current indications are associated with tubesheet or rolling anomalies, many of them are found on normal tubes. A programme was launched by the Belgian utilities and was further co-sponsored by the Electric Power Research Institute (EPRI) to develop preventive actions applicable not only to hot steam generators but also to cold steam generators already installed on site. These preventive measures include stress relaxation and metallurgical improvement of the material by an in situ heat treatment of the whole tube sheet (a steam generator model was used to evaluate the feasibility of this treatment), and the introduction of residual compressive stresses on ID by rotopeening or shotpeening without inducing unacceptable tensile stresses on OD. A comparative evaluation of these measures was established on the basis of tests performed on representative mock-ups and specimens. (author)

  2. [Usefullness of intraoperatory parathyroid hormone measurement in surgical management of primary hyperparathyroidism due to a parathyroid adenoma].

    Science.gov (United States)

    Obiols, Gabriel; Catalán, Roberto; Alasà, Cristian; Baena, Juan Antonio; Fort, José Manuel; Gémar, Enrique; Mesa, Jordi

    2003-09-13

    Surgical neck exploration of the 4 parathyroid glands is quite an aggressive procedure for most patients with primary hyperparathyroidism (PHPT) due to a parathyroid adenoma. Intraoperatory measurement of parathyroid hormone (PTH) seems to be a useful tool for the management of these cases, allowing the use of minimally invasive surgical techniques with a lower morbidity. Our aims was to assess the usefulness of PTH intraoperatory measurement for the surgical management of PHPT. We studied 27 consecutive patients, diagnosed with PHPT secondary to parathyroid adenoma. Localization studies included neck ultrasonography and Tc-MIBI scintigraphy. PTH at the stage of anesthesia induction as well as 5 and 10 minutes after the removal of the adenoma was determined. A PTH decrement greater than 50% at 10 minutes was considered as curative. PTH was measured by an immunoluminometric method (Advantage, Nichols). In all cases, calcium levels were normal 24 hours after the operation, and therefore all them were considered as cured. PTH levels decreased more than 50% in all patients. In one case, PTH levels remained high after the exeresis of a preoperatively localized lesion. The pathologic study confirmed that it was a normal parathyroid gland. We then continued the surgical exploration which eventually allowed us to find a contralateral adenoma. A further PTH measurement showed an over 50% decrease. Therefore, PTH was predictive of surgical success in all 28 measurements. Intraoperatory determination of PTH is useful for the surgical management of PHPT and it could allow the use of minimally invasive surgical techniques.

  3. Factors Influencing the Efficacy of Free Primary Education Policy in Relation to the Enrolment of Children with Special Needs Education in West Pokot County, Kenya

    Science.gov (United States)

    Nyeris, Raymond; Koross, Benjamin Towett

    2015-01-01

    The introduction of Free Primary Education (FPE) policy in 2003 was aimed at enhancing the enrolment of all school going-age children in Kenya indiscriminately. However, significant concerns have been raised by scholars and the public over the low enrolment of children with Special Needs Education (SNE). The main objective of this study was to…

  4. Primary tumor site is a useful predictor of cetuximab efficacy in the third-line or salvage treatment of KRAS wild-type (exon 2 non-mutant) metastatic colorectal cancer: a nationwide cohort study

    International Nuclear Information System (INIS)

    Chen, Kuo-Hsing; Shao, Yu-Yun; Chen, Ho-Min; Lin, Yu-Lin; Lin, Zhong-Zhe; Lai, Mei-Shu; Cheng, Ann-Lii; Yeh, Kun-Huei

    2016-01-01

    Previous studies have shown left-sided colorectal cancer (LCRC) and right-sided colorectal cancer (RCRC) exhibit different molecular and clinicopathological features. We explored the association between the primary tumor site and cetuximab efficacy in KRAS wild-type colorectal cancer (CRC). This study enrolled a cohort of patients, who had received cetuximab treatment after two or more lines of chemotherapy for KRAS wild-type (exon 2 nonmutant) metastatic CRC, from the databases of Taiwan Cancer Registry (2004–2010) and National Health Insurance (2004–2011). Survival data were obtained from the National Death Registry. Time to treatment discontinuation (TTD) and overall survival (OS) after the start of cetuximab treatment were compared between patients with LCRC (splenic flexure to rectum) and RCRC (cecum to hepatic flexure). A total of 969 CRC patients were enrolled. Among them, 765 (78.9 %) and 136 (14.0 %) patients had LCRC and RCRC, respectively. Patients with LCRC, compared to patients with RCRC, had longer TTD (median, 4.59 vs. 2.75 months, P = .0005) and OS (median, 12.62 vs. 8.07 months, P < .0001) after the start of cetuximab treatment. Multivariate analysis revealed a right-sided primary tumor site was an independent predictor of shorter TTD (adjusted hazard ratio [HR] = 1.32, using the LCRC group as a reference, 95 % confidence interval: 1.08–1.61, P = .0072) and OS (adjusted HR = 1.45, 95 % CI: 1.18–1.78, P = .0003). Our findings demonstrate that a left-sided primary tumor site is a useful predictor of improved cetuximab efficacy in the third-line or salvage treatment of KRAS wild-type (exon 2 nonmutant) metastatic CRC

  5. The efficacy of modified direct lateral versus posterior approach on gait function and hip muscle strength after primary total hip arthroplasty at 12months follow-up

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Broeng, Leif; Overgaard, Søren

    2016-01-01

    -spatial parameters and range of motion. Isometric maximal hip muscle strength in abduction, flexion and extension was also tested. FINDINGS: Post-operatively, no between-group difference in gait function was observed. However, both hip abductor and flexor muscle strength improved more in the posterior approach group......BACKGROUND: The lateral and the posterior approach are the most commonly used procedures for total hip arthroplasty. Due to the detachment of the hip abductors, lateral approach is claimed to cause reduced hip muscle strength and altered gait pattern. However, this has not been investigated...... in a randomised controlled trial. The aim was to compare the efficacy of total hip arthroplasty performed by lateral or posterior approach on gait function and hip muscle strength up to 12months post-operatively. We hypothesised that posterior approach would be superior to lateral approach. METHODS: Forty...

  6. Long-term efficacy of ultrasound-guided low power microwave ablation for the treatment of primary papillary thyroid microcarcinoma: a 3-year follow-up study.

    Science.gov (United States)

    Teng, Dengke; Sui, Guoqing; Liu, Caimei; Wang, Yu; Xia, Yongxu; Wang, Hui

    2018-04-01

    To evaluate the safety and efficacy of ultrasound-guided low-power microwave ablation (MWA) for the treatment of papillary thyroid microcarcinoma (PTMC) with a 3-year follow-up. A total of 21 nodules diagnosed as PTMC from the 15 patients were performed with MWA at a power of 20 W. The images of the nodules were recorded by ultrasound before MWA and 1, 3, 6, 12 months after MWA, and every 6 months thereafter, respectively. The volumes of the nodules were compared before MWA and at each follow-up point after MWA. The volume reduction rate (VRR) of nodules was also calculated. The mean volume of the nodules was 134.3 ± 129.8 mm 3 initially (the range was 7.4-423.8 mm 3 ), which decreased significantly to 2.3 ± 10.5 mm 3 (the range was 0-48.1 mm 3 ) of the ablation area (P = 0.000) at the follow-up point of 36 months with a mean VRR as 98.78 ± 5.61% (the range was 74.28-100%). During the follow-up period (the range was 36-48 months), 20 of the 21 nodules were completely absorbed and no recurrent nodule was found. After a long-term follow-up of 3 years, the low power MWA showed a good safety and efficacy for the treatment of PTMC. In addition to surgery and active surveillance, MWA might be another alternative for patients with PTMC.

  7. Investigating the Interrelationships among Conceptions of, Approaches to, and Self-Efficacy in Learning Science

    Science.gov (United States)

    Zheng, Lanqin; Dong, Yan; Huang, Ronghuai; Chang, Chun-Yen; Bhagat, Kaushal Kumar

    2018-01-01

    The purpose of this study was to examine the relations between primary school students' conceptions of, approaches to, and self-efficacy in learning science in Mainland China. A total of 1049 primary school students from Mainland China participated in this study. Three instruments were adapted to measure students' conceptions of learning science,…

  8. Efficacy of oral health promotion in primary care practice during early childhood: creating positive changes in parent's oral health beliefs and behaviors.

    Science.gov (United States)

    Mattheus, Deborah J

    2014-06-01

    Nurse practitioners frequently provide care to children suffering from poor oral health. Creative approaches to impacting dental disease are needed due to the current lack of traditional dental providers. This study investigated the effects of oral health promotion provided by primary care providers on parental oral health beliefs and behaviors. Participants receiving standard oral care during two well child visits and two additional enhanced oral health visits (n=44) were compared to participants receiving standard oral care during two well child visits alone (n=40). Results revealed changes in parent's perception of the importance of oral care for their children's primary teeth compared to general healthcare needs (pbrushing their children's teeth (pbrushing their teeth (pbrushing (pimportant study shows that oral health programs in primary care can produce changes that can improve oral health outcomes. Parents and children exposed to oral health programs during their frequent well child care visits in the first years of life may help decrease the rate of early childhood caries and improve their quality of life.

  9. Corrosion inhibition measures in primary cooling water system during refurbishment of Cirus, re-commissioning and subsequent operation

    International Nuclear Information System (INIS)

    Rai, K.K.; Ramesh, N.; Sharma, R.C.

    2008-01-01

    Cirus is a 40 MWth, heavy water moderated, demineralized light water cooled, natural uranium fuelled research reactor. Reactor was commissioned in year 1960 and operated satisfactorily till 1990. After that availability factor started decreasing mainly due to equipment outage exhibiting signs of ageing. Based upon systematic ageing studies and assessment of condition of systems, structures and components, a refurbishment plan including safety upgrades was drawn up. Reactor was shut down in October 1997 for execution of jobs. After completion of refurbishment jobs reactor was started back in October 2002 and power operation was achieved in 2003. Primary cooling water (PCW) system consists of re-circulating pumps, heat exchangers, expansion tank, piping, valves, emergency storage reservoir (Ball Tank) and other components. Normally the fission heat from fuel is removed by re-circulating coolant in closed loop and transferred to seawater via heat exchangers. In case of outage of pumps, shut down cooling is provided by flow of water from Ball Tank under gravity to the underground dump tanks. The dissolved oxygen is maintained below 2 ppm and pH is maintained neutral to minimize corrosion of fuel cladding (Aluminum). This paper highlights the experience gained during segmentation of primary cooling water pipelines for pressure testing, measures taken to corrosion inhibition of primary cooling water lines to permit execution of refurbishment jobs, inspections and actions taken to repair/replace the corroded PCW pipe line segments, observations regarding corrosion related failures, re-commissioning of the system after refurbishment, assessment for safe reactor operation and experience during power operation. (author)

  10. Efficacy and Safety of a Pharmaco-Invasive Strategy With Half-Dose Alteplase Versus Primary Angioplasty in ST-Segment-Elevation Myocardial Infarction: EARLY-MYO Trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction).

    Science.gov (United States)

    Pu, Jun; Ding, Song; Ge, Heng; Han, Yaling; Guo, Jinchen; Lin, Rong; Su, Xi; Zhang, Heng; Chen, Lianglong; He, Ben

    2017-10-17

    Timely primary percutaneous coronary intervention (PPCI) cannot be offered to all patients with ST-segment-elevation myocardial infarction (STEMI). Pharmaco-invasive (PhI) strategy has been proposed as a valuable alternative for eligible patients with STEMI. We conducted a randomized study to compare the efficacy and safety of a PhI strategy with half-dose fibrinolytic regimen versus PPCI in patients with STEMI. The EARLY-MYO trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction) was an investigator-initiated, prospective, multicenter, randomized, noninferiority trial comparing a PhI strategy with half-dose alteplase versus PPCI in patients with STEMI 18 to 75 years of age presenting ≤6 hours after symptom onset but with an expected PCI-related delay. The primary end point of the study was complete epicardial and myocardial reperfusion after PCI, defined as thrombolysis in myocardial infarction flow grade 3, thrombolysis in myocardial infarction myocardial perfusion grade 3, and ST-segment resolution ≥70%. We also measured infarct size and left ventricular ejection fraction with cardiac magnetic resonance and recorded 30-day clinical and safety outcomes. A total of 344 patients from 7 centers were randomized to PhI (n=171) or PPCI (n=173). PhI was noninferior (and even superior) to PPCI for the primary end point (34.2% versus 22.8%, P noninferiority <0.05, P superiority =0.022), with no significant differences in the frequency of the individual components of the combined end point: thrombolysis in myocardial infarction flow 3 (91.3% versus 89.2%, P =0.580), thrombolysis in myocardial infarction myocardial perfusion grade 3 (65.8% versus 62.9%, P =0.730), and ST-segment resolution ≥70% (50.9% versus 45.5%, P =0.377). Infarct size (23.3%±11.3% versus 25.8%±13.7%, P =0.101) and left ventricular ejection fraction (52.2%±11.0% versus 51.4%±12.0%, P =0.562) were similar in both

  11. Safety and Efficacy of Intracoronary Vasodilators in the Treatment of No-Reflow after Primary Percutaneous Intervention in Patients with Acute ST-Elevation Myocardial Infarction: A Literature Review

    Directory of Open Access Journals (Sweden)

    Mostafa Dastani

    2016-04-01

    Full Text Available Introduction: The investigation of no-reflow phenomenon after Percutaneous Coronary Intervention (PCI in patients with acute ST-segment Elevation Myocardial Infarction (STEMI has therapeutic implications. Several vasodilators were administered through intracoronary injection to treat this phenomenon. We aimed to elucidate the risk factors, predictors, and long-term effects of no-reflow phenomenon, and to compare the effects of various vasodilators on re-opening the obstructed vessels. Materials and Methods: All the reviewed articles were retrieved from MEDLINE and Science Direct (up to October 2014. All no-reflow cases were determined through Thrombolysis in Myocardial Infarction grading (TIMI system. Results: Four articles were included, two of which mainly focused on risk factors, predictors, and long-term prognosis of no-reflow phenomenon, and its association with patient mortality and morbidity. The other two articles evaluated therapeutic interventions and compared their efficacy in treating no-reflow. Conclusion: Development of no-reflow in patients with STEMI after primary PCI is associated with low myocardial salvage by primary PCI, large scintigraphic infarct size, deteriorated left ventricle ejection fraction at six months, and increased risk of first-year mortality. During primary PCI, intracoronary infusion of diltiazem and verapamil can reverse no-reflow more effectively than nitroglycerin.

  12. 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

    Directory of Open Access Journals (Sweden)

    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.

  13. Breastfeeding Self-efficacy: A Critical Review of Available Instruments

    Science.gov (United States)

    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

  14. Is the Scale for Measuring Motivational Interviewing Skills a valid and reliable instrument for measuring the primary care professionals motivational skills?: EVEM study protocol.

    Science.gov (United States)

    Pérula, Luis Á; Campiñez, Manuel; Bosch, Josep M; Barragán Brun, Nieves; Arboniés, Juan C; Bóveda Fontán, Julia; Martín Alvarez, Remedios; Prados, Jose A; Martín-Rioboó, Enrique; Massons, Josep; Criado, Margarita; Fernández, José Á; Parras, Juan M; Ruiz-Moral, Roger; Novo, Jesús M

    2012-11-22

    Lifestyle is one of the main determinants of people's health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors' communication skills, and more specifically the Motivational Interviewing. The hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire) is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. - Thirty-two primary care centers in Spain. -Sampling and Size: a) face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b) Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362). Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a) Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b) Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis), internal consistency (Cronbach alpha), intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology), generalizability, construct validity and sensitivity to change (Pearson product-moment correlation

  15. Is the Scale for Measuring Motivational Interviewing Skills a valid and reliable instrument for measuring the primary care professionals motivational skills?: EVEM study protocol

    Directory of Open Access Journals (Sweden)

    Pérula Luis Á

    2012-11-01

    Full Text Available Abstract Background Lifestyle is one of the main determinants of people’s health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors’ communication skills, and more specifically the Motivational Interviewing. Methods/Design The hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. –Scope: Thirty-two primary care centers in Spain. -Sampling and Size: a face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362. Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis, internal consistency (Cronbach alpha, intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology, generalizability, construct validity and

  16. Electron and Positron Fluxes in Primary Cosmic Rays Measured with the Alpha Magnetic Spectrometer on the International Space Station

    CERN Document Server

    Aguilar, M; Alvino, A; Ambrosi, G; Andeen, K; Arruda, L; Attig, N; Azzarello, P; Bachlechner, A; Barao, F; Barrau, A; Barrin, L; Bartoloni, A; Basara, L; Battarbee, M; Battiston, R; Bazo, J; Becker, U; Behlmann, M; Beischer, B; Berdugo, J; Bertucci, B; Bigongiari, G; Bindi, V; Bizzaglia, S; Bizzarri, M; Boella, G; de Boer, W; Bollweg, K; Bonnivard, V; Borgia, B; Borsini, S; Boschini, M J; Bourquin, M; Burger, J; Cadoux, F; Cai, X D; Capell, M; Caroff, S; Casaus, J; Cascioli, V; Castellini, G; Cernuda, I; Cervelli, F; Chae, M J; Chang, Y H; Chen, A I; Chen, H; Cheng, G M; Chen, H S; Cheng, L; Chikanian, A; Chou, H Y; Choumilov, E; Choutko, V; Chung, C H; Clark, C; Clavero, R; Coignet, G; Consolandi, C; Contin, A; Corti, C; Coste, B; Cui, Z; Dai, M; Delgado, C; Della Torre, S; Demirköz, M B; Derome, L; Di Falco, S; Di Masso, L; Dimiccoli, F; Díaz, C; von Doetinchem, P; Du, W J; Duranti, M; D’Urso, D; Eline, A; Eppling, F J; Eronen, T; Fan, Y Y; Farnesini, L; Feng, J; Fiandrini, E; Fiasson, A; Finch, E; Fisher, P; Galaktionov, Y; Gallucci, G; García, B; García-López, R; Gast, H; Gebauer, I; Gervasi, M; Ghelfi, A; Gillard, W; Giovacchini, F; Goglov, P; Gong, J; Goy, C; Grabski, V; Grandi, D; Graziani, M; Guandalini, C; Guerri, I; Guo, K H; Habiby, M; Haino, S; Han, K C; He, Z H; Heil, M; Hoffman, J; Hsieh, T H; Huang, Z C; Huh, C; Incagli, M; Ionica, M; Jang, W Y; Jinchi, H; Kanishev, K; Kim, G N; Kim, K S; Kirn, Th; Kossakowski, R; Kounina, O; Kounine, A; Koutsenko, V; Krafczyk, M S; Kunz, S; La Vacca, G; Laudi, E; Laurenti, G; Lazzizzera, I; Lebedev, A; Lee, H T; Lee, S C; Leluc, C; Li, H L; Li, J Q; Li, Q; Li, Q; Li, T X; Li, W; Li, Y; Li, Z H; Li, Z Y; Lim, S; Lin, C H; Lipari, P; Lippert, T; Liu, D; Liu, H; Lomtadze, T; Lu, M J; Lu, Y S; Luebelsmeyer, K; Luo, F; Luo, J Z; Lv, S S; Majka, R; Malinin, A; Mañá, C; Marín, J; Martin, T; Martínez, G; Masi, N; Maurin, D; Menchaca-Rocha, A; Meng, Q; Mo, D C; Morescalchi, L; Mott, P; Müller, M; Ni, J Q; Nikonov, N; Nozzoli, F; Nunes, P; Obermeier, A; Oliva, A; Orcinha, M; Palmonari, F; Palomares, C; Paniccia, M; Papi, A; Pedreschi, E; Pensotti, S; Pereira, R; Pilo, F; Piluso, A; Pizzolotto, C; Plyaskin, V; Pohl, M; Poireau, V; Postaci, E; Putze, A; Quadrani, L; Qi, X M; Rancoita, P G; Rapin, D; Ricol, J S; Rodríguez, I; Rosier-Lees, S; Rozhkov, A; Rozza, D; Sagdeev, R; Sandweiss, J; Saouter, P; Sbarra, C; Schael, S; Schmidt, S M; Schuckardt, D; Schulz von Dratzig, A; Schwering, G; Scolieri, G; Seo, E S; Shan, B S; Shan, Y H; Shi, J Y; Shi, X Y; Shi, Y M; Siedenburg, T; Son, D; Spada, F; Spinella, F; Sun, W; Sun, W H; Tacconi, M; Tang, C P; Tang, X W; Tang, Z C; Tao, L; Tescaro, D; Ting, Samuel C C; Ting, S M; Tomassetti, N; Torsti, J; Türkoğlu, C; Urban, T; Vagelli, V; Valente, E; Vannini, C; Valtonen, E; Vaurynovich, S; Vecchi, M; Velasco, M; Vialle, J P; Wang, L Q; Wang, Q L; Wang, R S; Wang, X; Wang, Z X; Weng, Z L; Whitman, K; Wienkenhöver, J; Wu, H; Xia, X; Xie, M; Xie, S; Xiong, R Q; Xin, G M; Xu, N S; Xu, W; Yan, Q; Yang, J; Yang, M; Ye, Q H; Yi, H; Yu, Y J; Yu, Z Q; Zeissler, S; Zhang, J H; Zhang, M T; Zhang, X B; Zhang, Z; Zheng, Z M; Zhuang, H L; Zhukov, V; Zichichi, A; Zimmermann, N; Zuccon, P; Zurbach, C

    2014-01-01

    Precision measurements by the Alpha Magnetic Spectrometer on the International Space Station of the primary cosmic-ray electron flux in the range 0.5 to 700 GeV and the positron flux in the range 0.5 to 500 GeV are presented. The electron flux and the positron flux each require a description beyond a single power-law spectrum. Both the electron flux and the positron flux change their behavior at ∼30  GeV but the fluxes are significantly different in their magnitude and energy dependence. Between 20 and 200 GeV the positron spectral index is significantly harder than the electron spectral index. The determination of the differing behavior of the spectral indices versus energy is a new observation and provides important information on the origins of cosmic-ray electrons and positrons.

  17. Electron and Positron Fluxes in Primary Cosmic Rays Measured with the Alpha Magnetic Spectrometer on the International Space Station

    Science.gov (United States)

    Aguilar, M.; Aisa, D.; Alvino, A.; Ambrosi, G.; Andeen, K.; Arruda, L.; Attig, N.; Azzarello, P.; Bachlechner, A.; Barao, F.; Barrau, A.; Barrin, L.; Bartoloni, A.; Basara, L.; Battarbee, M.; Battiston, R.; Bazo, J.; Becker, U.; Behlmann, M.; Beischer, B.; Berdugo, J.; Bertucci, B.; Bigongiari, G.; Bindi, V.; Bizzaglia, S.; Bizzarri, M.; Boella, G.; de Boer, W.; Bollweg, K.; Bonnivard, V.; Borgia, B.; Borsini, S.; Boschini, M. J.; Bourquin, M.; Burger, J.; Cadoux, F.; Cai, X. D.; Capell, M.; Caroff, S.; Casaus, J.; Cascioli, V.; Castellini, G.; Cernuda, I.; Cervelli, F.; Chae, M. J.; Chang, Y. H.; Chen, A. I.; Chen, H.; Cheng, G. M.; Chen, H. S.; Cheng, L.; Chikanian, A.; Chou, H. Y.; Choumilov, E.; Choutko, V.; Chung, C. H.; Clark, C.; Clavero, R.; Coignet, G.; Consolandi, C.; Contin, A.; Corti, C.; Coste, B.; Cui, Z.; Dai, M.; Delgado, C.; Della Torre, S.; Demirköz, M. B.; Derome, L.; Di Falco, S.; Di Masso, L.; Dimiccoli, F.; Díaz, C.; von Doetinchem, P.; Du, W. J.; Duranti, M.; D'Urso, D.; Eline, A.; Eppling, F. J.; Eronen, T.; Fan, Y. Y.; Farnesini, L.; Feng, J.; Fiandrini, E.; Fiasson, A.; Finch, E.; Fisher, P.; Galaktionov, Y.; Gallucci, G.; García, B.; García-López, R.; Gast, H.; Gebauer, I.; Gervasi, M.; Ghelfi, A.; Gillard, W.; Giovacchini, F.; Goglov, P.; Gong, J.; Goy, C.; Grabski, V.; Grandi, D.; Graziani, M.; Guandalini, C.; Guerri, I.; Guo, K. H.; Habiby, M.; Haino, S.; Han, K. C.; He, Z. H.; Heil, M.; Hoffman, J.; Hsieh, T. H.; Huang, Z. C.; Huh, C.; Incagli, M.; Ionica, M.; Jang, W. Y.; Jinchi, H.; Kanishev, K.; Kim, G. N.; Kim, K. S.; Kirn, Th.; Kossakowski, R.; Kounina, O.; Kounine, A.; Koutsenko, V.; Krafczyk, M. S.; Kunz, S.; La Vacca, G.; Laudi, E.; Laurenti, G.; Lazzizzera, I.; Lebedev, A.; Lee, H. T.; Lee, S. C.; Leluc, C.; Li, H. L.; Li, J. Q.; Li, Q.; Li, Q.; Li, T. X.; Li, W.; Li, Y.; Li, Z. H.; Li, Z. Y.; Lim, S.; Lin, C. H.; Lipari, P.; Lippert, T.; Liu, D.; Liu, H.; Lomtadze, T.; Lu, M. J.; Lu, Y. S.; Luebelsmeyer, K.; Luo, F.; Luo, J. Z.; Lv, S. S.; Majka, R.; Malinin, A.; Mañá, C.; Marín, J.; Martin, T.; Martínez, G.; Masi, N.; Maurin, D.; Menchaca-Rocha, A.; Meng, Q.; Mo, D. C.; Morescalchi, L.; Mott, P.; Müller, M.; Ni, J. Q.; Nikonov, N.; Nozzoli, F.; Nunes, P.; Obermeier, A.; Oliva, A.; Orcinha, M.; Palmonari, F.; Palomares, C.; Paniccia, M.; Papi, A.; Pedreschi, E.; Pensotti, S.; Pereira, R.; Pilo, F.; Piluso, A.; Pizzolotto, C.; Plyaskin, V.; Pohl, M.; Poireau, V.; Postaci, E.; Putze, A.; Quadrani, L.; Qi, X. M.; Rancoita, P. G.; Rapin, D.; Ricol, J. S.; Rodríguez, I.; Rosier-Lees, S.; Rozhkov, A.; Rozza, D.; Sagdeev, R.; Sandweiss, J.; Saouter, P.; Sbarra, C.; Schael, S.; Schmidt, S. M.; Schuckardt, D.; von Dratzig, A. Schulz; Schwering, G.; Scolieri, G.; Seo, E. S.; Shan, B. S.; Shan, Y. H.; Shi, J. Y.; Shi, X. Y.; Shi, Y. M.; Siedenburg, T.; Son, D.; Spada, F.; Spinella, F.; Sun, W.; Sun, W. H.; Tacconi, M.; Tang, C. P.; Tang, X. W.; Tang, Z. C.; Tao, L.; Tescaro, D.; Ting, Samuel C. C.; Ting, S. M.; Tomassetti, N.; Torsti, J.; Türkoǧlu, C.; Urban, T.; Vagelli, V.; Valente, E.; Vannini, C.; Valtonen, E.; Vaurynovich, S.; Vecchi, M.; Velasco, M.; Vialle, J. P.; Wang, L. Q.; Wang, Q. L.; Wang, R. S.; Wang, X.; Wang, Z. X.; Weng, Z. L.; Whitman, K.; Wienkenhöver, J.; Wu, H.; Xia, X.; Xie, M.; Xie, S.; Xiong, R. Q.; Xin, G. M.; Xu, N. S.; Xu, W.; Yan, Q.; Yang, J.; Yang, M.; Ye, Q. H.; Yi, H.; Yu, Y. J.; Yu, Z. Q.; Zeissler, S.; Zhang, J. H.; Zhang, M. T.; Zhang, X. B.; Zhang, Z.; Zheng, Z. M.; Zhuang, H. L.; Zhukov, V.; Zichichi, A.; Zimmermann, N.; Zuccon, P.; Zurbach, C.; AMS Collaboration

    2014-09-01

    Precision measurements by the Alpha Magnetic Spectrometer on the International Space Station of the primary cosmic-ray electron flux in the range 0.5 to 700 GeV and the positron flux in the range 0.5 to 500 GeV are presented. The electron flux and the positron flux each require a description beyond a single power-law spectrum. Both the electron flux and the positron flux change their behavior at ˜30 GeV but the fluxes are significantly different in their magnitude and energy dependence. Between 20 and 200 GeV the positron spectral index is significantly harder than the electron spectral index. The determination of the differing behavior of the spectral indices versus energy is a new observation and provides important information on the origins of cosmic-ray electrons and positrons.

  18. Assertion based verification methodology for HDL designs of primary sodium pump speed and eddy current flow measurement systems of PFBR

    International Nuclear Information System (INIS)

    Misra, M.K.; Menon, Saritha P.; Thirugnana Murthy, D.

    2013-01-01

    With the growing complexity and size of digital designs, functional verification has become a huge challenge. The validation and testing process accounts for a significant percentage of the overall development effort and cost for electronic systems. Many studies have shown that up to 70% of the design development time and resources are spent on functional verification. Functional errors manifest themselves very early in the design flow, and unless they are detected upfront, they can result in severe consequences - both financially and from a safety viewpoint. This paper covers the various types of verification methodologies and focuses on Assertion Based Verification Methodology for HDL designs, taking as case studies, the Primary Sodium Pump Speed and Eddy Current Flow Measurement Systems of PFBR. (author)

  19. A Pb-TLD spectrometer to measure high energy photons in z-pinch experiments on the primary test stand

    International Nuclear Information System (INIS)

    Si, Fenni; Yang, Jianlun; Xu, Rongkun; Yuan, Xi; Huang, Zhanchang; Ye, Fan; Wang, Dong; Zhang, Chuanfei

    2017-01-01

    Highlights: • A Pb-TLD spectrometer has been developed to measure spectra of high energy photons in wire-array z pinches on PTS. • Energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code. • The energy of high energy x-ray on PTS is obtained to be mainly within the region of 100 keV to 1.3 MeV. - Abstract: A Pb-TLD spectrometer has been developed based on attenuation techniques to measure high energy photons in wire-array z-pinch experiments on the primary test stand (PTS). It is composed of a stack of 18 lead filters interspersed with 19 thermoluminescent dosimeters (TLD). A shield is constructed for the spectrometer and scattered radiation is reduced to less than 5% by the shield. Response functions of the spectrometer are calculated by MCNP5 for 0–2 MeV photons. Based on response functions and 19 dose data measured in experiments, energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code using iterative least square fit. Results show that energy peak locates within 200 keV and 300 keV, and the fluence decreases to background level at energy higher than 1.3 MeV.

  20. A Pb-TLD spectrometer to measure high energy photons in z-pinch experiments on the primary test stand

    Energy Technology Data Exchange (ETDEWEB)

    Si, Fenni; Yang, Jianlun; Xu, Rongkun; Yuan, Xi; Huang, Zhanchang; Ye, Fan; Wang, Dong; Zhang, Chuanfei, E-mail: sifenni@163.com

    2017-05-15

    Highlights: • A Pb-TLD spectrometer has been developed to measure spectra of high energy photons in wire-array z pinches on PTS. • Energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code. • The energy of high energy x-ray on PTS is obtained to be mainly within the region of 100 keV to 1.3 MeV. - Abstract: A Pb-TLD spectrometer has been developed based on attenuation techniques to measure high energy photons in wire-array z-pinch experiments on the primary test stand (PTS). It is composed of a stack of 18 lead filters interspersed with 19 thermoluminescent dosimeters (TLD). A shield is constructed for the spectrometer and scattered radiation is reduced to less than 5% by the shield. Response functions of the spectrometer are calculated by MCNP5 for 0–2 MeV photons. Based on response functions and 19 dose data measured in experiments, energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code using iterative least square fit. Results show that energy peak locates within 200 keV and 300 keV, and the fluence decreases to background level at energy higher than 1.3 MeV.

  1. Efficacy and prospects for cryopreserved thyroid gland transplantation as a method for treatment of different forms of primary hypothyroidism including postradiation

    International Nuclear Information System (INIS)

    Karachentsev, Yu.I.; Lyakh, I.A.; Khasiev, V.V.

    1999-01-01

    It was established that auto-and allo transplantation of cryopreserved thyroid is a physiologically well grounded technique of treatment and can be an alternative to substitution hormonotherapy of hypothyroidism and can be a main method of treatment in cases when hormone treatment is not effective or is contraindicated.Talking into account the efficiency of cryopreserved thyroid transplantation in patients with primary hypothyroidism,it is possible to predict its positive effect for c postradiation hypothyroidism treatment,if substitution hormonotherapy is not effective

  2. Association between quantitative measures obtained using fluorescence-based methods and activity status of occlusal caries lesions in primary molars.

    Science.gov (United States)

    Novaes, Tatiane Fernandes; Reyes, Alessandra; Matos, Ronilza; Antunes-Pontes, Laura Regina; Marques, Renata Pereira de Samuel; Braga, Mariana Minatel; Diniz, Michele Baffi; Mendes, Fausto Medeiros

    2017-05-01

    Fluorescence-based methods (FBM) can add objectiveness to diagnosis strategy for caries. Few studies, however, have focused on the evaluation of caries activity. To evaluate the association between quantitative measures obtained with FBM, clinical parameters acquired from the patients, caries detection, and assessment of activity status in occlusal surfaces of primary molars. Six hundred and six teeth from 113 children (4-14 years) were evaluated. The presence of a biofilm, caries experience, and the number of active lesions were recorded. The teeth were assessed using FBM: DIAGNOdent pen (Lfpen) and Quantitative light-induced fluorescence (QLF). As reference standard, all teeth were evaluated using the ICDAS (International Caries Detection and Assessment System) associated with clinical activity assessments. Multilevel regressions compared the FBM values and evaluated the association between the FBM measures and clinical variables related to the caries activity. The measures from the FBM were higher in cavitated lesions. Only, ∆F values distinguished active and inactive lesions. The LFpen measures were higher in active lesions, at the cavitated threshold (56.95 ± 29.60). Following regression analyses, only the presence of visible biofilm on occlusal surfaces (adjusted prevalence ratio = 1.43) and ∆R values of the teeth (adjusted prevalence ratio = 1.02) were associated with caries activity. Some quantitative measures from FBM parameters are associated with caries activity evaluation, which is similar to the clinical evaluation of the presence of visible biofilm. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Measurement of circulating transcripts and gene cluster analysis predicts and defines therapeutic efficacy of peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors

    International Nuclear Information System (INIS)

    Bodei, L.; Kidd, M.; Modlin, I.M.; Severi, S.; Nicolini, S.; Paganelli, G.; Drozdov, I.; Kwekkeboom, D.J.; Krenning, E.P.; Baum, R.P.

    2016-01-01

    Peptide receptor radionuclide therapy (PRRT) is an effective method for treating neuroendocrine tumors (NETs). It is limited, however, in the prediction of individual tumor response and the precise and early identification of changes in tumor size. Currently, response prediction is based on somatostatin receptor expression and efficacy by morphological imaging and/or chromogranin A (CgA) measurement. The aim of this study was to assess the accuracy of circulating NET transcripts as a measure of PRRT efficacy, and moreover to identify prognostic gene clusters in pretreatment blood that could be interpolated with relevant clinical features in order to define a biological index for the tumor and a predictive quotient for PRRT efficacy. NET patients (n = 54), M: F 37:17, median age 66, bronchial: n = 13, GEP-NET: n = 35, CUP: n = 6 were treated with 177 Lu-based-PRRT (cumulative activity: 6.5-27.8 GBq, median 18.5). At baseline: 47/54 low-grade (G1/G2; bronchial typical/atypical), 31/49 18 FDG positive and 39/54 progressive. Disease status was assessed by RECIST1.1. Transcripts were measured by real-time quantitative reverse transcription PCR (qRT-PCR) and multianalyte algorithmic analysis (NETest); CgA by enzyme-linked immunosorbent assay (ELISA). Gene cluster (GC) derivations: regulatory network, protein:protein interactome analyses. Statistical analyses: chi-square, non-parametric measurements, multiple regression, receiver operating characteristic and Kaplan-Meier survival. The disease control rate was 72 %. Median PFS was not achieved (follow-up: 1-33 months, median: 16). Only grading was associated with response (p < 0.01). At baseline, 94 % of patients were NETest-positive, while CgA was elevated in 59 %. NETest accurately (89 %, χ 2 = 27.4; p = 1.2 x 10 -7 ) correlated with treatment response, while CgA was 24 % accurate. Gene cluster expression (growth-factor signalome and metabolome) had an AUC of 0.74 ± 0.08 (z-statistic = 2.92, p < 0.004) for predicting

  4. Measurement of circulating transcripts and gene cluster analysis predicts and defines therapeutic efficacy of peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors

    Energy Technology Data Exchange (ETDEWEB)

    Bodei, L. [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); LuGenIum Consortium, Milan, Rotterdam, Bad Berka, London, Italy, Netherlands, Germany (Country Unknown); Kidd, M. [Wren Laboratories, Branford, CT (United States); Modlin, I.M. [LuGenIum Consortium, Milan, Rotterdam, Bad Berka, London, Italy, Netherlands, Germany (Country Unknown); Yale School of Medicine, New Haven, CT (United States); Severi, S.; Nicolini, S.; Paganelli, G. [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine and Radiometabolic Units, Meldola (Italy); Drozdov, I. [Bering Limited, London (United Kingdom); Kwekkeboom, D.J.; Krenning, E.P. [LuGenIum Consortium, Milan, Rotterdam, Bad Berka, London, Italy, Netherlands, Germany (Country Unknown); Erasmus Medical Center, Nuclear Medicine Department, Rotterdam (Netherlands); Baum, R.P. [LuGenIum Consortium, Milan, Rotterdam, Bad Berka, London, Italy, Netherlands, Germany (Country Unknown); Zentralklinik Bad Berka, Theranostics Center for Molecular Radiotherapy and Imaging, Bad Berka (Germany)

    2016-05-15

    Peptide receptor radionuclide therapy (PRRT) is an effective method for treating neuroendocrine tumors (NETs). It is limited, however, in the prediction of individual tumor response and the precise and early identification of changes in tumor size. Currently, response prediction is based on somatostatin receptor expression and efficacy by morphological imaging and/or chromogranin A (CgA) measurement. The aim of this study was to assess the accuracy of circulating NET transcripts as a measure of PRRT efficacy, and moreover to identify prognostic gene clusters in pretreatment blood that could be interpolated with relevant clinical features in order to define a biological index for the tumor and a predictive quotient for PRRT efficacy. NET patients (n = 54), M: F 37:17, median age 66, bronchial: n = 13, GEP-NET: n = 35, CUP: n = 6 were treated with {sup 177}Lu-based-PRRT (cumulative activity: 6.5-27.8 GBq, median 18.5). At baseline: 47/54 low-grade (G1/G2; bronchial typical/atypical), 31/49 {sup 18}FDG positive and 39/54 progressive. Disease status was assessed by RECIST1.1. Transcripts were measured by real-time quantitative reverse transcription PCR (qRT-PCR) and multianalyte algorithmic analysis (NETest); CgA by enzyme-linked immunosorbent assay (ELISA). Gene cluster (GC) derivations: regulatory network, protein:protein interactome analyses. Statistical analyses: chi-square, non-parametric measurements, multiple regression, receiver operating characteristic and Kaplan-Meier survival. The disease control rate was 72 %. Median PFS was not achieved (follow-up: 1-33 months, median: 16). Only grading was associated with response (p < 0.01). At baseline, 94 % of patients were NETest-positive, while CgA was elevated in 59 %. NETest accurately (89 %, χ{sup 2} = 27.4; p = 1.2 x 10{sup -7}) correlated with treatment response, while CgA was 24 % accurate. Gene cluster expression (growth-factor signalome and metabolome) had an AUC of 0.74 ± 0.08 (z-statistic = 2.92, p < 0

  5. 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

  6. Physical Therapists in Primary Care Are Interested in High Quality Evidence Regarding Efficacy of Therapeutic Ultrasound for Knee Osteoarthritis: A Provincial Survey

    Directory of Open Access Journals (Sweden)

    Norma J. MacIntyre

    2013-01-01

    Full Text Available Recent high-level evidence favours therapeutic ultrasound (US for reducing pain in people with knee osteoarthritis (OA. It is unknown how current practice patterns align with current evidence regarding US efficacy and whether physical therapists perceive a need for further high-level evidence. We conducted a descriptive electronic survey to characterize the beliefs and use of US among physical therapists in Ontario treating people with nonsurgical knee OA. Most of the 123 respondents (81% reported at least some use of US with 45% using it often or sometimes. The main goal for using US was to reduce pain in the surrounding soft tissue (n=66 and/or the knee joint (n=43. Almost half (46% endorsed the belief that US is likely to be beneficial for clients with nonsurgical knee OA. Most respondents (85% expressed interest in the results of a randomized controlled trial evaluating the effectiveness of US on pain and physical function. Patterns of use reflect the respondents’ belief that US is likely to be beneficial for knee OA pain.

  7. Safety and efficacy of a xenogeneic DNA vaccine encoding for human tyrosinase as adjunctive treatment for oral malignant melanoma in dogs following surgical excision of the primary tumor.

    Science.gov (United States)

    Grosenbaugh, Deborah A; Leard, A Timothy; Bergman, Philip J; Klein, Mary K; Meleo, Karri; Susaneck, Steven; Hess, Paul R; Jankowski, Monika K; Jones, Pamela D; Leibman, Nicole F; Johnson, Maribeth H; Kurzman, Ilene D; Wolchok, Jedd D

    2011-12-01

    To evaluate the safety and efficacy of a vaccine containing plasmid DNA with an insert encoding human tyrosinase (ie, huTyr vaccine) as adjunctive treatment for oral malignant melanoma (MM) in dogs. 111 dogs (58 prospectively enrolled in a multicenter clinical trial and 53 historical controls) with stage II or III oral MM (modified World Health Organization staging scale, I to IV) in which locoregional disease control was achieved. 58 dogs received an initial series of 4 injections of huTyr vaccine (102 μg of DNA/injection) administered transdermally by use of a needle-free IM vaccination device. Dogs were monitored for adverse reactions. Surviving dogs received booster injections at 6-month intervals thereafter. Survival time for vaccinates was compared with that of historical control dogs via Kaplan-Meier survival analysis for the outcome of death. Kaplan-Meier analysis of survival time until death attributable to MM was determined to be significantly improved for dogs that received the huTyr vaccine, compared with that of historical controls. However, median survival time could not be determined for vaccinates because dogs as adjunctive treatment for oral MM. Response to DNA vaccination in dogs with oral MM may be useful in development of plasmid DNA vaccination protocols for human patients with similar disease.

  8. Safety measures to prevent workplace violence in emergency primary care centres--a cross-sectional study.

    Science.gov (United States)

    Morken, Tone; Johansen, Ingrid H

    2013-10-03

    Employees in emergency primary care centres (EPCC) have raised personal safety as an issue. Despite a high risk of experiencing workplace violence at EPCCs in Norway, knowledge regarding applied preventive measures is limited. The description of existing safety measures is an important prerequisite to evaluate and make guidelines for the improvement of preventive practices on a national level. The objective of this study was to investigate to which extent general practitioners work alone in EPCCs in Norway, and to estimate the prevalence of other preventive measures against workplace violence. A survey was sent to the managers of all 210 registered EPCCs in Norway. The questionnaire included 22 items on safety measures, including available staff, architecture and outfitting of the reception and consulting rooms, and the availability of electronic safety systems and training or monitoring systems. The data were analysed using descriptive statistics. Differences between EPCCs staffed by one general practitioner alone and EPCCs with more health personnel on duty were explored. Sixty-one (30%) of the 203 participating EPCCs had more than one person on duty round-the-clock. These EPCCs reported the application of a significantly higher number of safety measures compared to the EPCCs with only one general practitioner on duty during some or part of the 24 hours. Examples of safety measures being more common in highly staffed EPCCs were automatic door locks (p < 0.001), arrangement of furniture in the consulting room ensuring that the patient is not seated between the clinician and the exit (p = 0.014), the possibility of bringing an extra person on emergency call-outs or home visits when needed for security reasons (p = 0.014), and having organised training regarding violence (p < 0.001). This study shows considerable differences between Norwegian EPCCs regarding applied preventive measures, and a higher prevalence of such measures in EPCCs staffed with

  9. Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care.

    Science.gov (United States)

    Blackburn, Steven; Higginbottom, Adele; Taylor, Robert; Bird, Jo; Østerås, Nina; Hagen, Kåre Birger; Edwards, John J; Jordan, Kelvin P; Jinks, Clare; Dziedzic, Krysia

    2016-01-01

    People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG

  10. Salivary gland ultrasonography as a primary imaging tool for predicting efficacy of xerostomia treatment in patients with Sjögren's syndrome.

    Science.gov (United States)

    Takagi, Yukinori; Sumi, Misa; Nakamura, Hideki; Sato, Shuntaro; Kawakami, Atsushi; Nakamura, Takashi

    2016-02-01

    To evaluate ultrasonography (US) grading of salivary gland disease as a predictor of treatment efficacy for impaired salivary function in xerostomia patients with or without Sjögren's syndrome (SS). We retrospectively analysed the prognostic importance of salivary US grading in 317 patients (168 with SS and 149 without SS). US images of the parotid and submandibular glands in each patient were individually categorized into grades 0-4 based on the extent of damage to the gland; and the sum total grade of the two gland types on either side was assigned a US score of 0-8 for each patient. The relative importance of US score and demographic and clinical variables was assessed using stepwise multiple regression analysis after various durations of xerostomia treatment. Multiple regression analysis indicated that the baseline US score before treatment was the most important factor [standardized regression coefficient (β) = -0.523, t-statistic (t) = -7.967, P < 0.001] in predicting negative outcomes in SS patients. Treatment duration (β = 0.277, t = 4.225, P < 0.001) was also a significant but less important positive variable. On the other hand, US grading did not effectively predict treatment outcomes in non-SS patients, with treatment duration (β = 0.199, t = 2.486, P = 0.014) and baseline salivary flow rate before treatment (β = -0.172, t = -2.159, P = 0.032) being significant but weak predictors of positive and negative outcome, respectively. Salivary gland US grading may help to predict outcomes of treatment for impaired salivary function in patients with SS. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Evaluation of the Efficacy of Tranexamic Acid on the Surgical Field in Primary Cleft Palate Surgery on Children-A Prospective, Randomized Clinical Study.

    Science.gov (United States)

    Durga, Padmaja; Raavula, Parvathi; Gurajala, Indira; Gunnam, Poojita; Veerabathula, Prardhana; Reddy, Mukund; Upputuri, Omkar; Ramachandran, Gopinath

    2015-09-01

    To assess the effect of tranexamic acid on the quality of the surgical field. Prospective, randomized, double-blind study. Institutional, tertiary referral hospital. American Society of Anesthesiologists physical status class I patients, aged 8 to 60 months with Group II or III (Balakrishnan's classification) clefts scheduled for cleft palate repair. Children were randomized into two groups. The control group received saline, and the tranexamic acid group received tranexamic acid 10 mg/kg as a bolus, 15 minutes before incision. Grade of surgical field on a 10-point scale, surgeon satisfaction, and primary hemorrhage. Significant improvements were noted in surgeon satisfaction and median grade of assessment of the surgical field (4 [interquartile range, 4 to 6] in the control group vs. 3 [interquartile range, 2 to 4] in the test group; P = .003) in the tranexamic acid group compared to the control group. Preincision administration of 10 mg/kg of tranexamic acid significantly improved the surgical field during cleft palate repair.

  12. Measurement of H, He, C and O Cosmic ray primaries preliminary results from the CREAM II experiment

    CERN Document Server

    Mognet, Samuel

    The direct measurement of the energy spectrum and composition of the incoming cosmic-ray flux at multi-TeV energies is of great interest. A feature located somewhere between 1000-10,000 TeV in the all-particle spectrum, referred to as the ‘knee’ characterized by a steepening of the power-law flux, has been observed by ground-based detectors for many years. It is believed to be related to an upper limit or change in efficiency of the Galactic accelerators of cosmic rays and/or properties of the propagation of cosmic rays in the Galaxy. Presented here is a preliminary analysis of the flux of primary H, He, C and O cosmic-ray species measured using the CREAM II instrument. This analysis is conducted using the Penn State-built Timing Charge Detector, distinct from other charge detectors used in alternative published CREAM II results. The second Antarctic flight of the CREAM instrument had a ∼ 28 day flight in the 2005-2006 Antarctic flight season. The instrument was launched on December 16th 2005 from Willi...

  13. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1998-12-01

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy.

  14. Measuring conflict management, emotional self-efficacy, and problem solving confidence in an evaluation of outdoor programs for inner-city youth in Baltimore, Maryland.

    Science.gov (United States)

    Caldas, Stephanie V; Broaddus, Elena T; Winch, Peter J

    2016-08-01

    Substantial evidence supports the value of outdoor education programs for promoting healthy adolescent development, yet measurement of program outcomes often lacks rigor. Accurately assessing the impacts of programs that seek to promote positive youth development is critical for determining whether youth are benefitting as intended, identifying best practices and areas for improvement, and informing decisions about which programs to invest in. We generated brief, customized instruments for measuring three outcomes among youth participants in Baltimore City Outward Bound programs: conflict management, emotional self-efficacy, and problem solving confidence. Measures were validated through exploratory and confirmatory factor analyses of pilot-testing data from two groups of program participants. We describe our process of identifying outcomes for measurement, developing and adapting measurement instruments, and validating these instruments. The finalized measures support evaluations of outdoor education programs serving urban adolescent youth. Such evaluations enhance accountability by determining if youth are benefiting from programs as intended, and strengthen the case for investment in programs with demonstrated success. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Cognitive stimulation therapy in the Italian context: its efficacy in cognitive and non-cognitive measures in older adults with dementia.

    Science.gov (United States)

    Capotosto, Emanuela; Belacchi, Carmen; Gardini, Simona; Faggian, Silvia; Piras, Federica; Mantoan, Vanessa; Salvalaio, Elisa; Pradelli, Samantha; Borella, Erika

    2017-03-01

    Cognitive stimulation therapy (CST) has been shown to have significant benefits in enhancing cognitive functioning and improving the quality of life of people with mild to moderate dementia. The present study examines the efficacy of the Italian version of the therapy (CST-IT). Older adults with mild to moderate dementia (n = 39) were randomly assigned to two programs: one group participated in the CST-IT, consisting of 14 sessions (twice a week for 7 weeks) and the active control group took part in alternative general activities. The outcome measures were cognitive functioning (measured by the Mini-Mental State Examination-MMSE-, the Alzheimer's Disease Assessment scale-cognitive subscale, the backward digit span test, and a narrative language test); quality of life (Quality of life--Alzheimer's Disease scale); mood (Cornell scale for depression in dementia and the social and emotional loneliness scale); functional activities in daily living (Disability Assessment for Dementia); and behavior (neuropsychiatric inventory). After the intervention, only the CST-IT group maintained its MMSE score, while the control group displayed deterioration. The CST-IT group also performed better in some of the cognitive measures (Alzheimer's Disease Assessment Scale-Cognitive subscale and narrative language), mood measures (Cornell scale, social and emotional loneliness scale with a decrease in reported loneliness), and the Quality of life--Alzheimer's Disease scale. No other treatment effect was observed. The findings confirm the efficacy, at least in the short term, of the CST in sustaining cognitive functions and perceived quality of life in older adults with dementia in the Italian care setting as well. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Validation of the German version of the patient activation measure 13 (PAM13-D) in an international multicentre study of primary care patients

    NARCIS (Netherlands)

    Brenk-Franz, K.; Hibbard, J.H.; Herrmann, W.J.; Freund, T.; Szecsenyi, J.; Djalali, S.; Steurer-Stey, C.; Sonnichsen, A.; Tiesler, F.; Storch, M.; Schneider, N.; Gensichen, J.

    2013-01-01

    The patients' active participation in their medical care is important for patients with chronic diseases. Measurements of patient activation are needed for studies and in clinical practice. This study aims to validate the Patient Activation Measure 13 (PAM13-D) in German-speaking primary care

  17. Measuring the apparent diffusion coefficient in primary rectal tumors: is there a benefit in performing histogram analyses?

    Science.gov (United States)

    van Heeswijk, Miriam M; Lambregts, Doenja M J; Maas, Monique; Lahaye, Max J; Ayas, Z; Slenter, Jos M G M; Beets, Geerard L; Bakers, Frans C H; Beets-Tan, Regina G H

    2017-06-01

    The apparent diffusion coefficient (ADC) is a potential prognostic imaging marker in rectal cancer. Typically, mean ADC values are used, derived from precise manual whole-volume tumor delineations by experts. The aim was first to explore whether non-precise circular delineation combined with histogram analysis can be a less cumbersome alternative to acquire similar ADC measurements and second to explore whether histogram analyses provide additional prognostic information. Thirty-seven patients who underwent a primary staging MRI including diffusion-weighted imaging (DWI; b0, 25, 50, 100, 500, 1000; 1.5 T) were included. Volumes-of-interest (VOIs) were drawn on b1000-DWI: (a) precise delineation, manually tracing tumor boundaries (2 expert readers), and (b) non-precise delineation, drawing circular VOIs with a wide margin around the tumor (2 non-experts). Mean ADC and histogram metrics (mean, min, max, median, SD, skewness, kurtosis, 5th-95th percentiles) were derived from the VOIs and delineation time was recorded. Measurements were compared between the two methods and correlated with prognostic outcome parameters. Median delineation time reduced from 47-165 s (precise) to 21-43 s (non-precise). The 45th percentile of the non-precise delineation showed the best correlation with the mean ADC from the precise delineation as the reference standard (ICC 0.71-0.75). None of the mean ADC or histogram parameters showed significant prognostic value; only the total tumor volume (VOI) was significantly larger in patients with positive clinical N stage and mesorectal fascia involvement. When performing non-precise tumor delineation, histogram analysis (in specific 45th ADC percentile) may be used as an alternative to obtain similar ADC values as with precise whole tumor delineation. Histogram analyses are not beneficial to obtain additional prognostic information.

  18. Breast augmentation, antibiotic prophylaxis, and infection: comparative analysis of 1,628 primary augmentation mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration.

    Science.gov (United States)

    Khan, Umar Daraz

    2010-02-01

    Infections after augmentation mammoplasty are not uncommon, and prophylactic antibiotics are routinely administered to minimize infection. However, there is paucity of information on the relationship between the length of prophylaxis cover and its benefits in primary augmentation mammoplasty. A retrospective analysis of different antibiotic cover regimens, their effectiveness in preventing infections, and the management of infection in established cases is reviewed. A retrospective chart analysis of periprosthetic infections in primary augmentation mammoplasties performed over the past 10 years was conducted. Periprosthetic infection was determined by the presence of pain, swelling, redness, and discharge. Each breast was taken as an individual unit in 1,628 patients, and data for 3,256 breasts were analyzed. The patients had their augmentation in the partial submuscular plane (214 breasts in 107 patients), the subglandular plane (1,548 breasts in 774 patients), and the muscle-splitting biplane (1,494 breasts in 747 patients). All the patients had soft round cohesive gel silicone implants. Of the 3,256 implants, 3,218 were textured, and 38 were smooth surfaced. The patients received antibiotics as a single intravenous dose of cephalosporin (474 breasts in 237 patients), a single intravenous dose plus an oral dose for 24 h (344 breasts in 172 patients), or a single intravenous dose plus an oral course for 5 days (2,438 breasts in 1,219 patients). Infection was recorded as superficial (e.g., wound breakdown, stitch extrusion, stitch abscess) or deep (periprosthetic). The patients with established periprosthetic infections, determined clinically by the presence of pain, discharge, swelling, and redness of the breasts, were managed either conservatively using antibiotics, passive wound drainage, and healing of the wound with secondary intention or by explantation and replacement after 3 to 4 months. In selected cases of periprosthetic infection, the implants were

  19. The Exposure Hierarchy as a Measure of Progress and Efficacy in the Treatment of Social Anxiety Disorder

    Science.gov (United States)

    Katerelos, Marina; Hawley, Lance L.; Antony, Martin M.; McCabe, Randi E.

    2008-01-01

    This study explored the psychometric properties and utility of the exposure hierarchy as a measure of treatment outcome for social anxiety disorder (SAD). An exposure hierarchy was created for each of 103 individuals with a diagnosis of SAD who completed a course of cognitive behavioral group therapy. Exposure hierarchy ratings were collected on a…

  20. The Internet Self-Perception Scale: Measuring Elementary Students' Levels of Self-Efficacy regarding Internet Use

    Science.gov (United States)

    Hinson, Janice; DiStefano, Christine; Daniel, Cathy

    2003-01-01

    This study investigated fourth grade students' perceptions of abilities to use the Internet. The 31-item research instrument measuring Internet Self-Perceptions was adapted for use from the Reader Self-Perception Scale (RSPS) developed by Henk and Melnick (1995). The RSPS survey was based upon Bandura's (1977, 1986, 1995) research in the areas of…

  1. 78 FR 24584 - Imposition of Special Measures Against Halawi Exchange Co. as a Financial Institution of Primary...

    Science.gov (United States)

    2013-04-25

    ... financial institution operating outside of the United States that is of primary money laundering concern... international money laundering and the financing of terrorism. Regulations implementing the BSA appear at 31 CFR..., class of transaction, or type of account is of ``primary money laundering concern,'' to require domestic...

  2. Clinical value of combined measurement of serum alpha-fetoprotein, alpha-L-fucosidase and ferritin levels in the diagnosis of primary liver cancer

    International Nuclear Information System (INIS)

    Zhang Aimin; Chai Xiaohong; Jin Ying; Dong Xuemei

    2005-01-01

    Objective: To investigate the clinical value of combined measurement of serum alpha-fetoprotein (AFP), alpha-L-fucosidase (AFU) and ferritin (SF) levels in the diagnosis of primary liver cancer. Methods: Serum AFP, AFU (with RIA) and SF (with biochemical method) were determined in 52 patients with primary liver cancer and 40 controls. Results: The positive rates of AFP, AFU and SF in patient with liver cancer were 82.7%, 86.6% and 76.9%, respectively. Positive rates with combined measurement of AFP plus AFU, AFP plus SF, and AFP plus AFU, SF were 94.2%, 90.4% and 98.1% respectively. Conclusion: Combined measurement of AFP, AFU and SF can significantly increase the positive rate in the diagnosis of primary liver cancer. (authors)

  3. Using personal response systems to assess speech perception within the classroom: an approach to determine the efficacy of sound field amplification in primary school classrooms.

    Science.gov (United States)

    Vickers, Deborah A; Backus, Bradford C; Macdonald, Nora K; Rostamzadeh, Niloofar K; Mason, Nisha K; Pandya, Roshni; Marriage, Josephine E; Mahon, Merle H

    2013-01-01

    The assessment of the combined effect of classroom acoustics and sound field amplification (SFA) on children's speech perception within the "live" classroom poses a challenge to researchers. The goals of this study were to determine: (1) Whether personal response system (PRS) hand-held voting cards, together with a closed-set speech perception test (Chear Auditory Perception Test [CAPT]), provide an appropriate method for evaluating speech perception in the classroom; (2) Whether SFA provides better access to the teacher's speech than without SFA for children, taking into account vocabulary age, middle ear dysfunction or ear-canal wax, and home language. Forty-four children from two school-year groups, year 2 (aged 6 years 11 months to 7 years 10 months) and year 3 (aged 7 years 11 months to 8 years 10 months) were tested in two classrooms, using a shortened version of the four-alternative consonant discrimination section of the CAPT. All children used a PRS to register their chosen response, which they selected from four options displayed on the interactive whiteboard. The classrooms were located in a 19th-century school in central London, United Kingdom. Each child sat at their usual position in the room while target speech stimuli were presented either in quiet or in noise. The target speech was presented from the front of the classroom at 65 dBA (calibrated at 1 m) and the presented noise level was 46 dBA measured at the center of the classroom. The older children had an additional noise condition with a noise level of 52 dBA. All conditions were presented twice, once with SFA and once without SFA and the order of testing was randomized. White noise from the teacher's right-hand side of the classroom and International Speech Test Signal from the teacher's left-hand side were used, and the noises were matched at the center point of the classroom (10sec averaging [A-weighted]). Each child's expressive vocabulary age and middle ear status were measured

  4. Safety measures in hip arthroscopy and their efficacy in minimizing complications: a systematic review of the evidence.

    Science.gov (United States)

    Gupta, Asheesh; Redmond, John M; Hammarstedt, Jon E; Schwindel, Leslie; Domb, Benjamin G

    2014-10-01

    The purpose of this systematic review was to evaluate the literature to determine complications of hip arthroscopy, with a secondary focus on how to minimize complications and risks. Two independent reviewers performed a search of PubMed for articles that contained at least 1 of the following terms: complications and hip arthroscopy, hip impingement, femoral acetabular impingement and complications, or femoroacetabular impingement (FAI) and complications. The search was limited to articles published between 1999 and June 2013. An additional search was performed for articles evaluating techniques on how to minimize complications. We identified 81 studies (5,535 patients; 6,277 hips). The mean age was 35.48 years, and the mean body mass index was 25.20 kg/m(2). Of the participants, 52% were male and 48% were female. The majority of studies were Level IV Evidence (63%). A total of 285 complications were reported, for an overall rate of 4.5%. There were 26 major complications (0.41%) and a 4.1% minor complication rate. The overall reoperation rate was 4.03%. A total of 94 hips underwent revision arthroscopy. Regarding open procedures, 150 patients (93%) underwent either total hip arthroplasty or a hip resurfacing procedure. The conversion rate to total hip arthroplasty or a resurfacing procedure was 2.4%. Overall, primary hip arthroscopy is a successful procedure with low rates of major (0.41%) and minor (4.1%) complications. The reoperation rate was 4.03% in our review. There is admittedly a learning curve to performing hip arthroscopy, and we present a systematic review of the complications and how to minimize these complications with careful technique and planning. Level IV, systematic review of Level II to V studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Defining the endpoints: how to measure the efficacy of drugs that are active against central nervous system metastases

    OpenAIRE

    Fabi, Alessandra; Vidiri, Antonello

    2016-01-01

    Brain metastases (BMs) are the most common cause of malignant central nervous system (CNS) tumors in adults. In the recent past, patients with BMs were excluded from clinical trials, but now, with the advent of new biological and immunological drugs, their inclusion is more common. In the last era response and progression criteria used across clinical trials have defined the importance to consider not only measurement changes of brain lesions but also the modification of parameters related to...

  6. Change in interpersonal functioning during psychological interventions for borderline personality disorder—a systematic review of measures and efficacy.

    Science.gov (United States)

    Sinnaeve, Roland; van den Bosch, Louisa M C; van Steenbergen-Weijenburg, Kirsten M

    2015-08-01

    To provide a systematic review of measures of interpersonal functioning used in treatments for people diagnosed with borderline personality disorder (BPD) and to report the effectiveness of treatments on these measures of interpersonal functioning. Literature was reviewed using the online databases and reference lists of previous systematic reviews. Selected studies were randomized controlled trials (RCTs) that examined psychotherapeutic interventions for people with BPD and contained quantitative outcomes on various aspects of interpersonal functioning and reported their results in peer-reviewed journals. Reliability and validity of the results were evaluated. Nineteen RCTs met our inclusion criteria. We found 16 different (sub)scales that measured some aspect of interpersonal functioning. Only four instruments were used by more than one research team. There is some evidence that psychotherapeutic interventions have beneficial effects on some aspects of interpersonal functioning in people diagnosed with BPD, both after individual and group therapy. Generalizability of these findings is limited. There is preliminary evidence that psychotherapeutic interventions have beneficial effects on various aspects of interpersonal reactivity that characterize people diagnosed with BPD. However, none of these effects have a robust evidence base. There are serious concerns about the lack of agreed-upon concepts and instruments. Copyright © 2015 John Wiley & Sons, Ltd.

  7. The efficacy of two electrodes radiofrequency technique: comparison study using a cadaveric interspinous ligament and temperature measurement using egg white.

    Science.gov (United States)

    Lee, Chang-Hyung; Derby, Richard; Choi, Hyun-Seok; Lee, Sang-Heon; Kim, Se Hoon; Kang, Yoon Kyu

    2010-01-01

    One technique in radiofrequency neurotomies uses 2 electrodes that are simultaneously placed to lie parallel to one another. Comparing lesions on cadaveric interspinous ligament tissue and measuring the temperature change in egg white allows us to accurately measure quantitatively the area of the lesion. Fresh cadaver spinal tissue and egg white tissue were used. A series of samples were prepared with the electrodes placed 1 to 7 mm apart. Using radiofrequency, the needle electrodes were heated in sequential or simultaneous order and the distance of the escaped lesion area and temperature were measured. Samples of cadaver interspinous ligament showed sequential heating of the needles limits the placement of the needle electrodes up to 2 mm apart from each other and up to 4 mm apart when heated simultaneously. The temperature at the escaped lesion area decreased according to the distance for egg white. There was a significant difference in temperature at the escaped lesion area up to 6 mm apart and the temperature was above 50 degrees celsius up to 5 mm in simultaneous lesion and 3 mm in the sequential lesion. The limitations of this study include cadaveric experimentation and use of intraspinous ligament rather than medial branch of the dorsal ramus which is difficult to identify. Heating the 2 electrodes simultaneously appears to coagulate a wider area and potentially produce better results in less time.

  8. Efficacy evaluation of managed population shift in Ukraine from zone of obligate (compulsory) resettlement as a measure of public radiation protection

    International Nuclear Information System (INIS)

    Gun'ko, N.V.

    2015-01-01

    Evaluation of efficacy of the managed population transmigration from zone of obligate (compulsory) resettlement as a measure of civil protection after the Chernobyl NPP accident from the perspective of radiation biology. Materials and methods. Legislative and statutory-tutorial documents that regulate the managed population shift from radiologically contaminated territories of Ukraine and data from the Ukrainian State Service of Statistics on time limits and scopes of population transmigration from contaminated settlements were the informational back ground of the study. Data on retrospective and expected/anticipated radiation doses in population of settlements exposed to radiological contamination in Ukraine after the Chernobyl disaster summarized for the 1986-1997 period and up to 2055 were the information source for calculation of averted doses due to population shift. Battery of basic research empirical evidence review methods was applied under the calculation, systemic, and biomedical approach. Population shift from zone of obligate (compulsory) resettlement (hereafter referred to as Zone 2) to stop the radiation exposure as a tool of civil protection from emergency ionizing radiation after the Chernobyl NPP accident was scientifically substantiated and expedient from the perspective of radiation biology. Estimability of a managed population shift from 'dose-effect' perspective and 'benefit/harm' principle is worse because of data absence on individual radiation doses to migrants in the country. Public shift in 1990 and 1991 was most effective from the viewpoint of level of averted lifetime dose. Due to transmigration the averted lifetime dose to the most vulnerable group of the Chernobyl disaster survivors i.e. children aged 0 years varied from 11.2 to 28.8 mSv (calculated for the Perejizdiv village council of Zhytomyr province). Since 2000 there was almost no public shift being not accomplished in the scheduled scope. Delay and incompleteness of

  9. Efficacy evaluation of managed population shift in Ukraine from zone of obligate (compulsory) resettlement as a measure of public radiation protection.

    Science.gov (United States)

    Gunko, N V

    2015-12-01

    Evaluation of efficacy of the managed population transmigration from zone of obligate (compulsory) resettlement as a measure of civil protection after the Chernobyl NPP accident from the perspective of radiation biology. Legislative and statutory tutorial documents that regulate the managed population shift from radiologically contaminated territories of Ukraine and data from the Ukrainian State Service of Statistics on time limits and scopes of population transmigration from contaminated settlements were the informational back ground of the study. Data on retrospective and expected/anticipated radiation doses in population of settlements exposed to radiological contamination in Ukraine after the Chernobyl disaster summarized for the 1986-1997 peri od and up to 2055 were the information source for calculation of averted doses due to population shift. Battery of basic research empirical evidence review methods was applied under the calculation, systemic, and biomedical approach. Population shift from zone of obligate (compulsore) resettlement (hereafter referred to as Zone 2) to stop the radiation exposure as a tool of civil protection from emergency ionizing radiation after the Chernobyl NPP accident was scientifically substantiated and expedient from the perspective of radiation biology. Estimability of a managed population shift from "dose effect" perspective and "benefit/harm" principle is worse because of data absence on individual radiation doses to migrants in the country. Public shift in 1990 and 1991 was most effective from the viewpoint of level of averted lifetime dose. Due to transmigration the averted lifetime dose to the most vulnerable group of the Chernobyl disaster survivors i.e. children aged 0 years varied from 11.2 to 28.8 mSv (calculated for the Perejizdiv village council of Zhytomyr province). Since 2000 there was almost no public shift being not accomplished in the scheduled scope. Delay and incompleteness of transmigration have diminished the

  10. Development and evaluation of an instrument to measure community pharmacists' self-efficacy beliefs about communicating with Spanish-speaking patients.

    Science.gov (United States)

    Young, Henry N; Hwang, Monica J; Dilworth, Thomas J; Mott, David; Cox, Elizabeth D; Moreno, Megan A

    2011-12-01

    Hispanics are the largest growing population in the United States, and their use of prescription medications can be influenced by the education and counseling they receive from pharmacists. However, little is known about pharmacists' communication with patients who speak Spanish or factors that can influence such communication. The objective of the study was to develop and validate an instrument to measure pharmacists' self-efficacy in communicating with Spanish-speaking patients. An initial pool of 15 items developed from previous research and suggestions from communication experts and practicing pharmacists was subjected to cognitive interviewing. Nine retained items were administered to 1022 licensed pharmacists by mail survey. Summary statistics and exploratory factor analysis (EFA) were conducted. Retained factors were determined by the examination of eigenvalues and scree test results. Cronbach's alpha coefficients were calculated to assess internal consistency. A total of 540 community pharmacists completed the survey. Item means ranged from 2.93±1.47 to 1.58±0.88 based on a 5-point scale (1: not at all confident to 5: extremely confident). EFA resulted in a 2-factor solution, accounting for 71% of the variance. The 2 factors consisted of health and drug information (alpha=0.92) and opening the encounter (alpha=0.75). The alpha for the overall scale was 0.88. The results provide evidence to support the reliability and validity of an instrument to measure pharmacists' self-efficacy beliefs about communicating with Spanish-speaking patients in community practice. Practitioners and researchers may use this instrument to inform pharmacy education, pharmacy practice improvement, and research efforts around communicating with Spanish-speaking clients. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Efficacy and safety of once-weekly GLP-1 receptor agonist albiglutide (HARMONY 2): 52 week primary endpoint results from a randomised, placebo-controlled trial in patients with type 2 diabetes mellitus inadequately controlled with diet and exercise.

    Science.gov (United States)

    Nauck, Michael A; Stewart, Murray W; Perkins, Christopher; Jones-Leone, Angela; Yang, Fred; Perry, Caroline; Reinhardt, Rickey R; Rendell, Marc

    2016-02-01

    Additional safe and effective therapies for type 2 diabetes are needed, especially ones that do not cause weight gain and have a low risk of hypoglycaemia. The present study evaluated albiglutide as monotherapy. In this placebo-controlled study, 309 patients (aged ≥ 18 years) with type 2 diabetes inadequately controlled by diet and exercise and who were not using a glucose-lowering agent (HbA1c 7.0-10.0% [53.00-85.79 mmol/mol], body mass index 20-45 kg/m(2), and fasting C-peptide ≥ 0.26 nmol/l) were randomised (1:1:1 on a fixed randomisation schedule using an interactive voice response system) to receive once-weekly albiglutide 30 mg (n = 102) or 50 mg (n = 102) or matching placebo (n = 105). The study treatments were blinded to both patients and study personnel. All study data were collected at individual patient clinic visits. The primary efficacy endpoint was change in HbA1c from baseline to week 52. The primary analysis was applied to the intent-to-treat population. Additional efficacy and safety endpoints were assessed. At week 52, both albiglutide 30 mg and 50 mg were superior to placebo in reducing HbA1c. The least-squares means treatment difference from placebo was -0.84% (95% CI -1.11%, -0.58%; p < 0.0001) with albiglutide 30 mg and -1.04% (-1.31%, -0.77%; p < 0.0001) with albiglutide 50 mg. Injection-site reactions were reported more frequently with albiglutide (30 mg: 17.8%; 50 mg: 22.2%) than with placebo (9.9%). Other commonly reported adverse events included nausea, diarrhoea, vomiting and hypoglycaemia; the incidences of these were generally similar across treatment groups. Albiglutide is safe and effective as monotherapy and significantly lowered HbA1c levels over 52 weeks, did not cause weight gain, and had good gastrointestinal tolerability and a low rate of hypoglycaemia compared with placebo. Trial registration ClinicalTrials.gov NCT00849017 Funding This study was sponsored by GlaxoSmithKline.

  12. Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

    Directory of Open Access Journals (Sweden)

    Lionis Christos D

    2011-12-01

    Full Text Available Abstract Background Research has indicated that general practitioners (GPs have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN within rural general practices in Crete, Greece. Methods The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST. Results The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; p = 0.029. Conclusions The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete.

  13. Quantitative measurement of trace amounts of dissolved oxygen in the primary and secondary systems of PWR nuclear power plants

    International Nuclear Information System (INIS)

    Castaneda, H.B.; Neale, T.A.

    1989-01-01

    Establishing and maintaining the correct water chemistry conditions in the primary and secondary systems of pressurized water reactor (PWR) nuclear power plants is essential in order to maximize the operating life and guarantee the uninterrupted availability of the major components of each PWR unit. The exact specifications for maintaining the correct water chemistry are well established. One of the most important parameters that must be closely monitored in a modern power generation plant is the level of dissolved oxygen (DO) present in the system. Because of the high temperatures and pressures involved, even minute traces of DO---on the order of a few parts per billion (ppb)---can be detrimental to the heat transfer surfaces in steam generators, heaters, etc. The authors argue that the method of determining trace levels of DO presented here is a modification of the original method that has greatly increased the detection level obtainable with Rhodazine-D. Measurements down to less than 1 ppb (μg/Liter), with a resolution of 0.5 ppb (μ/Liter), are now easily obtainable. No calibration procedures are required and no maintenance of critical components is needed. This quantitative method is based on the instantaneous stoichiometric reaction of Rhodazine-D with oxygen. After less than one minute the oxidation reaction is complete and the fully developed color is compared with a set of stable liquid color standards. The color standards are formulated using the oxidized form of Rhodazine-D, thus providing an exact color match for the reacted sample-reagent. Supporting data are presented that confirm the relative accuracy and sensitivity of the new method, as well as results of a comparative evaluation of the method versus in-line dissolved oxygen analyzers

  14. Thermographic skin temperature measurement compared with cold sensation in predicting the efficacy and distribution of epidural anesthesia.

    Science.gov (United States)

    Bruins, Arnoud A; Kistemaker, Kay R J; Boom, Annemieke; Klaessens, John H G M; Verdaasdonk, Rudolf M; Boer, Christa

    2018-04-01

    Due to the high rates of epidural failure (3-32%), novel techniques are required to objectively assess the successfulness of an epidural block. In this study we therefore investigated whether thermographic temperature measurements have a higher predictive value for a successful epidural block when compared to the cold sensation test as gold standard. Epidural anesthesia was induced in 61 patients undergoing elective abdominal, thoracic or orthopedic surgery. A thermographic picture was recorded at 5, 10 and 15 min following epidural anesthesia induction. After 15 min a cold sensation test was performed. Epidural anesthesia is associated with a decrease in skin temperature. Thermography predicts a successful epidural block with a sensitivity of 54% and a PPV of 92% and a specificity of 67% and a NPV of 17%. The cold sensation test shows a higher sensitivity and PPV than thermography (97 and 93%), but a lower specificity and NPV than thermography (25 and 50%). Thermographic temperature measurements can be used as an additional and objective method for the assessment of the effectiveness of an epidural block next to the cold sensation test, but have a low sensitivity and negative predictive value. The local decrease in temperature as observed in our study during epidural anesthesia is mainly attributed to a core-to-peripheral redistribution of body heat and vasodilation.

  15. Identification of light and very heavy cosmic ray primaries at E0 ∼ 1015 eV from surface and deep underground measurements at the Gran Sasso Laboratories

    International Nuclear Information System (INIS)

    Navarra, G.

    1999-01-01

    'Very heavy' (iron-like) and 'light' (proton-like) cosmic ray primaries are identified at primary energies E 0 ∼ 10 15 eV by means of simultaneous measurements of shower size N e , N μ GeV (= N μ (E μ > 1 GeV)) at the surface, and N μ TeV (= N μ (E μ > 1.3 TeV)) and ΔE μ /ΔL (i.e. muon energy losses per unit of track length) at the Gran Sasso Laboratories by EAS-TOP at the surface (2000 m a.s.l.) and LVD deep underground (3400 m w.e. depth). 'Very heavy' primaries are selected using large muon numbers detected by LVD; 'light' primaries using high muon energy losses in the LVD scintillation counters, the two selections operating in two different predefined ranges of N e . Their identification is confirmed from the analysis at the surface in the N e - N μ GeV domain, by their 'location' in regions of 'high' and 'low' muon numbers. The experimental points lay around the average predictions from the CORSIKA-HDPM code. This procedure provides the first interpretation of individual events at such primary energies through the Extensive Air Shower technique, and the verification (at least on average) of the CORSIKA-HDPM code. The presence of iron-like primaries is proved up to primary energies E 0 ∼ 5.10 15 eV

  16. Human immunodeficiency virus type 1 quantitative cell microculture as a measure of antiviral efficacy in a multicenter clinical trial.

    Science.gov (United States)

    Fiscus, S A; DeGruttola, V; Gupta, P; Katzenstein, D A; Meyer, W A; LoFaro, M L; Katzman, M; Ragni, M V; Reichelderfer, P S; Coombs, R W

    1995-02-01

    A quantitative cell microculture assay (QMC) was used to measure the human immunodeficiency virus type 1 (HIV-1) peripheral blood mononuclear cell (PBMC)-associated titer in 109 subjects rolled in an open-label phase I/II study of didanosine monotherapy or combination therapy with zidovudine. The titer was inversely correlated with CD4+ cell count at baseline (r = .37, P = .001). After 12 weeks of therapy, subjects showed a significant decreases in virus titer and those with the highest baseline virus titers had the greatest increase in CD4+ cell number (r = .430, P = .002). The QMC assay was more sensitive (98%) for assessing the antiretroviral effect of therapy than was immune complex-dissociated HIV p24 antigen (32%) or plasma culture (3.4%). Estimated sample sizes for phase I/II clinical trials were derived using the within-subject QMC SD of .72 log10 infectious units per 10(6) PMBC.

  17. The Effect of Volunteering at a Student-Run Free Healthcare Clinic on Medical Students' Self-Efficacy, Comfortableness, Attitude, and Interest in Working with the Underserved Population and Interest in Primary Care.

    Science.gov (United States)

    Tran, Kelvin; Kovalskiy, Aleksandr; Desai, Anand; Imran, Amna; Ismail, Rahim; Hernandez, Caridad

    2017-02-23

    The number of primary care physicians in the United States continues to lag behind the number of uninsured people. There has been a growing demand for medical students to improve their self-efficacy, comfortableness, attitude, and interest in working with the underserved and in primary care. This study aims to discern whether volunteering at a student-run, free healthcare clinic has a positive impact on these five variables of interest or not. A 95-item survey was distributed through Qualtrics Survey Software (Qualtrics, Provo, UT, USA) to medical students from the Class of 2018 and Class of 2019 at the University of Central Florida College of Medicine. They were recruited via emails, Facebook, and in-classroom announcements. Mean responses on a Likert-like scale to different survey items were collected and compared between two study cohorts: Keeping Neighbors In Good Health Through Service (KNIGHTS) Clinic volunteers and non-volunteers. Results from 128 students showed no significant differences in the means between the two cohorts (p-values were not significant). When volunteers were asked the survey item, "KNIGHTS Clinic positively influenced my attitude towards working with underserved patients," 62% strongly agreed, 26% agreed, 10% were neutral, and 2% disagreed. Based on the results, volunteering at KNIGHTS Clinic may not have a positive impact on the five variables of interest. However, the lack of significance may also be due to certain limitations of this study addressed elsewhere in this paper. With the majority of KNIGHTS Clinic volunteers agreeing that "KNIGHTS Clinic positively influenced […their] attitude towards working with underserved patients," there may be a positive impact of volunteering on volunteers' attitude towards working with the underserved.

  18. A systematic review of the literature examining the diagnostic efficacy of measurement of fractionated plasma free metanephrines in the biochemical diagnosis of pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Thabane Lehana

    2004-06-01

    Full Text Available Abstract Background Fractionated plasma metanephrine measurements are commonly used in biochemical testing in search of pheochromocytoma. Methods We aimed to critically appraise the diagnostic efficacy of fractionated plasma free metanephrine measurements in detecting pheochromocytoma. Nine electronic databases, meeting abstracts, and the Science Citation Index were searched and supplemented with previously unpublished data. Methodologic and reporting quality was independently assessed by two endocrinologists using a checklist developed by the Standards for Reporting of Diagnostic Studies Accuracy Group and data were independently abstracted. Results Limitations in methodologic quality were noted in all studies. In all subjects (including those with genetic predisposition: the sensitivities for detection of pheochromocytoma were 96%–100% (95% CI ranged from 82% to 100%, whereas the specificities were 85%–100% (95% CI ranged from 78% to 100%. Statistical heterogeneity was noted upon pooling positive likelihood ratios when those with predisposition to disease were included (p Conclusion Negative plasma fractionated free metanephrine measurements are effective in ruling out pheochromocytoma. However, a positive test result only moderately increases suspicion of disease, particularly when screening for sporadic pheochromocytoma.

  19. Collective Efficacy

    DEFF Research Database (Denmark)

    Chen, Ying; Zhou, Xiaohu; Klyver, Kim

    2018-01-01

    at manufacturing companies show that benevolent leadership and moral leadership, both components of paternalistic leadership, are positively related to organizational commitment and further that collective efficacy mediates the moral leadership–organizational commitment relationship. We did not find a relationship...... between authoritarian leadership and organizational commitment. Besides, it was found that team cohesion negatively moderates the relationship between moral leadership and collective efficacy and positively moderates the relationship between collective efficacy and organizational commitment. Explanations......Based on social cognitive theory, we theorize that collective efficacy plays a mediating role in the relationship between paternalistic leadership and organizational commitment and that this mediating role depends on team cohesion. The empirical results from a study of 238 employees from 52 teams...

  20. Measurement of endotoxin levels in blood of hemodialysis Patients by 'Lal' test and comparision of its efficacy with blood culture

    Directory of Open Access Journals (Sweden)

    Gh Vazirzadeh

    2006-01-01

    Full Text Available Introduction: Presently, bacteremia is the principal cause of morbidity in patients undergoing hemodialysis. Gram-negative bacteria account for approximately 50 percent of documented infections. Endotoxins released during lysis of gram negative bacteremia result in inflammatory and defense response by the body and if not treated promptly result in septic shock and ultimately death of the patient. This study describes the detection of endotoxins in blood of patients with bacteremia due to gram - negative bacteria by LAL test. Method: Blood samples of 278 hemodialysis patients were analyzed in this study and pathogens were isolated from blood culture samples. Then, their antibiotic sensitivity was determined. In patients with positive blood culture, endotoxin levels were measured by LAL-test. Results: Frequency of bacteremia in patients was 13.6% . The prevalence of gram – negative bacteremia was 44.7%. E coli were the major pathogens, while staphylococcus aureus was the most common gram positive bacterium. Endotoxin was detected in 15 patients (3.8 ± 1.08 EU/ml . The sensitivity and specificity of endotoxins for gram – negative bacteremia were 88% and 95%, respectively. Conclusion: The results indicate that the LAL method is a fast, sensitive and simple method. There was no significant difference between the results of blood culture and LAL – test ( P > 0.05 .

  1. Measurement data of cesium 137 yields in primary coolant of an in-pile water loop in fission products release experiment

    International Nuclear Information System (INIS)

    Ishiwatari, Nasumi; Nagai, Hitoshi; Takeda, Tsuneo

    1979-03-01

    Series of fuel rods (UO 2 pellets sheathed with stainless steel) having an artificial pinhole were irradiated in the in-pile test section of water loop JMTR OWL-1. Presented are the results of measurements of cesium 137 yields in primary coolant of OWL-1 from 1975 to 1978. (author)

  2. Associations of self-reported and objectively measured sleep disturbances with depression among primary caregivers of children with disabilities

    Directory of Open Access Journals (Sweden)

    Orta OR

    2016-06-01

    Full Text Available Olivia R Orta,1 Clarita Barbosa,1 Juan Carlos Velez,2 Bizu Gelaye,1 Xiaoli Chen,1 Lee Stoner,3 Michelle A Williams,1 1Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; 2Worker's Hospital, The Chilean Safety Association, Santiago, Chile; 3School of Sport and Exercise, Massey University, Wellington, New Zealand Objective: The objective of this study was to determine the association between sleep and depression using both self-reported (subjective and actigraphic (objective sleep traits. Methods: A cross-sectional study was conducted among 175 female primary caregivers of children with disabilities receiving care at a rehabilitation center in Punta Arenas, Chile. The eight-item Patient Health Questionnaire was used to ascertain participants' depression status. The Pittsburgh Sleep Quality Index was used to define subjective, or perceived, sleep quality. Wrist-worn actigraph monitors, worn for seven consecutive nights, were used to characterize objective sleep quality and disturbances. Interviewer-administered questionnaires were used to collect information on sociodemographic and lifestyle factors. Linear regression models were fit using continuous sleep parameters as the dependent variables and depression status as the independent variable. Multivariable models were adjusted for body mass index, marital status, smoking status, education level, and children's disabilities. Results: Using an eight-item Patient Health Questionnaire score ≥10, 26.3% of participants presented with depression. Depressed women were more likely to self-report overall poorer (subjective sleep compared to non-depressed women; however, differences in sleep were not consistently noted using actigraphic (objective sleep traits. Among the depressed, both sleep duration and total time in bed were significantly underestimated. In multivariable models, depression was negatively associated with sleep duration using both subjective (β=–0

  3. Efficacy of levetiracetam in primary hemifacial spasm.

    Science.gov (United States)

    Kuroda, Takeshi; Saito, Yu; Fujita, Kazuhisa; Yano, Satoshi; Ishigaki, Seiichiro; Kato, Hirotaka; Murakami, Hidetomo; Ono, Kenjiro

    2016-12-01

    Hemifacial spasm (HFS) is a peripherally-induced movement disorder characterized by the involuntary, unilateral, intermittent, irregular, tonic or clonic contractions of muscles innervated by the ipsilateral facial nerve. Kindling-like hyperactivity of the facial nucleus induced by constant stimulation of compressing artery is considered as the predominant mechanism underlying the pathogenesis of HFS. As a treatment for HFS, microsurgical decompression and botulinum toxin injection have been shown to be highly successful. Anticonvulsant drugs relieve HFS in some patients; however, the use of such drugs is limited owing to their side effects, predominantly in elderly patients. We experienced two elderly HFS patients who exhibited a marked response to levetiracetam (LEV) without side effects. Although the exact underlying pharmacological mechanism remains unknown, we assume anti-kindling effect as one of the important pharmacological mechanism underlying the effect of LEV against HFS. Moreover, LEV is considered to be suitable for use in elderly patients because of its good tolerability. In addition, the lack of hepatic induction or inhibition makes it an easy and safe drug when used in addition to other anticonvulsants. Although the long-term benefit remains unknown, LEV may represent an alternative treatment for elderly HFS patients who are unable to undergo or decline surgical intervention and/or botulinum toxin injections or are intolerant to other anticonvulsants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Is the General Self-Efficacy Scale a Reliable Measure to be used in Cross-Cultural Studies? Results from Brazil, Germany and Colombia.

    Science.gov (United States)

    Damásio, Bruno F; Valentini, Felipe; Núñes-Rodriguez, Susana I; Kliem, Soeren; Koller, Sílvia H; Hinz, Andreas; Brähler, Elmar; Finck, Carolyn; Zenger, Markus

    2016-05-26

    This study evaluated cross-cultural measurement invariance for the General Self-efficacy Scale (GSES) in a large Brazilian (N = 2.394) and representative German (N = 2.046) and Colombian (N = 1.500) samples. Initially, multiple-indicators multiple-causes (MIMIC) analyses showed that sex and age were biasing items responses on the total sample (2 and 10 items, respectively). After controlling for these two covariates, a multigroup confirmatory factor analysis (MGCFA) was employed. Configural invariance was attested. However, metric invariance was not supported for five items, in a total of 10, and scalar invariance was not supported for all items. We also evaluated the differences between the latent scores estimated by two models: MIMIC and MGCFA unconstraining the non-equivalent parameters across countries. The average difference was equal to |.07| on the estimation of the latent scores, and 22.8% of the scores were biased in at least .10 standardized points. Bias effects were above the mean for the German group, which the average difference was equal to |.09|, and 33.7% of the scores were biased in at least .10. In synthesis, the GSES did not provide evidence of measurement invariance to be employed in this cross-cultural study. More than that, our results showed that even when controlling for sex and age effects, the absence of control on items parameters in the MGCFA analyses across countries would implicate in bias of the latent scores estimation, with a higher effect for the German population.

  5. COMPARATIVE ANALYSIS OF ACCESS TO PATENTED HIV/AIDS PHARMACEUTICAL MEDICINES THROUGH THE CANADIAN AND EU TRIPS FLEXIBILITIES MEASURES: ARE THEY EFFICACIOUS OR OVERLY BURDENSOME AND INEFFECTIVE MEASURES?

    Directory of Open Access Journals (Sweden)

    Omphemetse S Sibanda

    2012-08-01

    Full Text Available This paper evaluates the Canadian and the European Union's (EU implementation of the World Trade Organisation (WTO General Council Decision of 2003, which resolved that developed nations could export patented pharmaceutical drugs to member states in order to address public health challenges such as Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS, tuberculosis, malaria and other epidemics, such states including Sub-Saharan Africa (SSA. The author makes a primarily textual appraisal of how and to what extent the Canada Access to Medicine Regime (CAMR and European Union (EU Regulations benefit, for instance, SSA countries in the WTO in their quest to make essential medicine more accessible. The author argues that although there are identifiable complexities inherent in the Canadian and the EU's access to pharmaceutical product regimes, there are far more important incentives and benefits that can be reaped in taking advantage of the respective systems. The author recommends that countries facing public health crises/emergencies, such as SSA countries, and non-governmental organisations (NGOs take advantage of the regulatory flexibilities of Canada and the EU in their efforts to provide their communities with essential HIV/AIDS treatment, and treatment for other diseases such as malaria. The author dismisses the arguments against TRIPS (Trade-Related Aspects of Intellectual Property flexibilities-inspired legislation and similar measures as mostly mere rhetoric and hair-splitting, because they sometimes unwarrantedly dismiss a workable solution to public-health problems.

  6. 77 FR 59747 - Repeal of the Final Rule Imposing Special Measures and Withdrawal of the Findings of Primary...

    Science.gov (United States)

    2012-10-01

    ... Money Laundering Concern of November 25, 2003, issued pursuant to 31 U.S.C. 5318A of the Bank Secrecy... amends the anti-money laundering provisions of the BSA, codified at 12 U.S.C. 1829b, 12 U.S.C. 1951-1959..., or type of account is of ``primary money laundering concern,'' to require domestic financial...

  7. 78 FR 34008 - Imposition of Special Measure Against Liberty Reserve S.A. as a Financial Institution of Primary...

    Science.gov (United States)

    2013-06-06

    ... PATRIOT Act amends the anti- money laundering provisions of the Bank Secrecy Act (BSA), codified at 12 U.S..., detection, and prosecution of international money laundering and the financing of terrorism. Regulations... jurisdiction, institution, class of transaction, or type of account is of ``primary money laundering concern...

  8. Measuring mechanisms for quality assurance in primary care systems in transition: test of a new instrument in Slovenia and Uzbekistan.

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.G.W.; Pellny, M.

    2009-01-01

    Aim: This WHO study, carried out by the authors, aimed to develop and field test an instrument to assess the availability of structures and mechanisms for managing quality in primary care in countries in transition. Methods: The instrument is based on a literature study, consensus meetings with

  9. A radical-local approach to bringing cultural practices into mathematics teaching in Ghanaian primary schools, exemplified in the case of measurement

    DEFF Research Database (Denmark)

    Davis, Ernest Kofi; Chaiklin, Seth

    2015-01-01

    on a study that drew on aspects of the radical-local approach to teaching and learning (Hedegaard & Chaiklin, 2005), to teach the idea of measurement to primary four school children from an average rural school in Cape Coast Metropolis of Ghana. The first four teaching sessions with a primary four class......The main aim of this article is to put forward the idea of the general value of the radical-local approach to teaching and learning for the development of mathematics teaching in Ghana, both in relation to classroom teaching and for teacher training. To illustrate this idea, this article reports...... are described. Each of the teaching sessions drew on the social and cultural practices of the children to help them form an idea of what measurement is and which physical properties could be measured from given objects. Qualitative analysis of the teaching sessions revealed that the teaching approach enabled...

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

    Science.gov (United States)

    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