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Sample records for primary efficacy measures

  1. Using Self-Efficacy to Measure Primary School Teachers' Perception of ICT: Results from Two Studies

    Science.gov (United States)

    Fanni, F.; Rega, I.; Cantoni, L.

    2013-01-01

    The aim of this article is twofold. First, the final results of two research projects, which investigated the impact of Information and Communication Technology (ICT) on primary schools teachers in disadvantaged areas in Brazil (BET k-12) and South Africa (MELISSA), are presented and discussed. Second, the Self-Efficacy construct is proposed as a…

  2. Clinical trial on the efficacy of exhaled carbon monoxide measurement in smoking cessation in primary health care.

    Science.gov (United States)

    Ripoll, Joana; Girauta, Helena; Ramos, Maria; Medina-Bombardó, David; Pastor, Agnès; Alvarez-Ossorio, Cristina; Gorreto, Lucía; Esteva, Maria; García, Elena; Uréndez, Ana; Buades, Ana; Torres, Elena

    2012-07-04

    Smoking cessation is beneficial for our health at any point in life, both in healthy people and in people already suffering from a smoking-related disease. Any help to quit smoking can produce considerable benefits for Public Health. The purpose of the present study is to evaluate the efficacy of the CO-oximetry technique together with brief advice in smoking cessation, in terms of reduction of the number of cigarettes or in the variation of the motivation to quit smoking at month 12 compared with brief advice alone. Randomised, parallel, single-blind clinical trial in a primary health care setting in Majorca (Spain). Smokers in contemplation or pre-contemplation phase will be included in the study. Smokers in preparation phase, subjects with a terminal illness or whose health status does not allow them to understand the study or complete the informed consent, and pregnant or breastfeeding women. The subjects will be randomly assigned to the control group (CG) or the intervention group (IG). The CG will receive brief advice, and the IG will receive brief advice together with a measurement of exhaled CO. There will be follow-up evaluations at 6 and 12 months after inclusion. 471 subjects will be needed per group in order to detect a difference between groups ≥ 5%. sustained smoking cessation (at 6 and 12 months) confirmed by urine cotinine test. point smoking cessation at 6 and 12 months both confirmed by urine cotinine analysis and self-reported, reduction in cigarette consumption, and variation in phase of smoking cessation. CO-oximetry is an inexpensive, non-invasive, fast technique that requires little technical training; making it a technique for risk assessment in smokers that can be easily applied in primary care and, if proven effective, could serve as a reinforcement aid in smoking cessation intervention activities. Current Controlled Trials ISRCTN67499921.

  3. Clinical trial on the efficacy of exhaled carbon monoxide measurement in smoking cessation in primary health care

    Directory of Open Access Journals (Sweden)

    Ripoll Joana

    2012-07-01

    Full Text Available Abstract Background Smoking cessation is beneficial for our health at any point in life, both in healthy people and in people already suffering from a smoking-related disease. Any help to quit smoking can produce considerable benefits for Public Health. The purpose of the present study is to evaluate the efficacy of the CO-oximetry technique together with brief advice in smoking cessation, in terms of reduction of the number of cigarettes or in the variation of the motivation to quit smoking at month 12 compared with brief advice alone. Methods/Design Randomised, parallel, single-blind clinical trial in a primary health care setting in Majorca (Spain. Smokers in contemplation or pre-contemplation phase will be included in the study. Exclusion criteria: Smokers in preparation phase, subjects with a terminal illness or whose health status does not allow them to understand the study or complete the informed consent, and pregnant or breastfeeding women. The subjects will be randomly assigned to the control group (CG or the intervention group (IG. The CG will receive brief advice, and the IG will receive brief advice together with a measurement of exhaled CO. There will be follow-up evaluations at 6 and 12 months after inclusion. 471 subjects will be needed per group in order to detect a difference between groups ≥ 5%. Primary outcome: sustained smoking cessation (at 6 and 12 months confirmed by urine cotinine test. Secondary outcomes: point smoking cessation at 6 and 12 months both confirmed by urine cotinine analysis and self-reported, reduction in cigarette consumption, and variation in phase of smoking cessation. Discussion CO-oximetry is an inexpensive, non-invasive, fast technique that requires little technical training; making it a technique for risk assessment in smokers that can be easily applied in primary care and, if proven effective, could serve as a reinforcement aid in smoking cessation intervention activities. Trial

  4. mGlu2 Receptor Agonism, but Not Positive Allosteric Modulation, Elicits Rapid Tolerance towards Their Primary Efficacy on Sleep Measures in Rats.

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    Abdallah Ahnaou

    Full Text Available G-protein-coupled receptor (GPCR agonists are known to induce both cellular adaptations resulting in tolerance to therapeutic effects and withdrawal symptoms upon treatment discontinuation. Glutamate neurotransmission is an integral part of sleep-wake mechanisms, which processes have translational relevance for central activity and target engagement. Here, we investigated the efficacy and tolerance potential of the metabotropic glutamate receptors (mGluR2/3 agonist LY354740 versus mGluR2 positive allosteric modulator (PAM JNJ-42153605 on sleep-wake organisation in rats. In vitro, the selectivity and potency of JNJ-42153605 were characterized. In vivo, effects on sleep measures were investigated in rats after once daily oral repeated treatment for 7 days, withdrawal and consecutive re-administration of LY354740 (1-10 mg/kg and JNJ-42153605 (3-30 mg/kg. JNJ-42153605 showed high affinity, potency and selectivity at mGluR2. Binding site analyses and knowledge-based docking confirmed the specificity of JNJ-42153605 at the mGluR2 allosteric binding site. Acute LY354740 and JNJ-42153605 dose-dependently decreased rapid eye movement (REM sleep time and prolonged its onset latency. Sub chronic effects of LY354740 on REM sleep measures disappeared from day 3 onwards, whereas those of JNJ-42153605 were maintained after repeated exposure. LY354740 attenuated REM sleep homeostatic recovery, while this was preserved after JNJ-42153605 administration. JNJ-42153605 enhanced sleep continuity and efficiency, suggesting its potential as an add-on medication for impaired sleep quality during early stages of treatment. Abrupt cessation of JNJ-42153605 did not induce withdrawal phenomena and sleep disturbances, while the initial drug effect was fully reinstated after re-administration. Collectively, long-term treatment with JNJ-42153605 did not induce tolerance phenomena to its primary functional effects on sleep measures, nor adverse effects at withdrawal, while it

  5. Measuring School Psychology Trainee Self-Efficacy

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

    2017-01-01

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

  6. Measuring of luminous efficacy of light sources

    OpenAIRE

    Pungert, David

    2016-01-01

    In the theoretical part of my thesis, I present light spectra, luminous efficacy, as well as light sources and sensors used in my experimental work. In the experimental part of the thesis, I compare three sensors: a spectrometer measuring the light spectrum, a luxmeter measuring the light intensity, as perceived by the human eye, and a light meter measuring the light intensity in watts per square meter. To compare the sensors, I find the relation between the quantities they measure. With cali...

  7. Assessment of the efficacy of desmopressin in treatment of Primary ...

    African Journals Online (AJOL)

    Farida ElBaz

    2015-03-31

    Mar 31, 2015 ... ORIGINAL ARTICLE. Assessment of the efficacy of desmopressin in treatment of Primary Monosymptomatic. Nocturnal Enuresis in Egyptian children. Farida ElBaz, Sally Zahra *, Marian Khairy. Child Psychiatry Clinic, Pediatrics Department, Ain Shams University, Cairo, Egypt. Received 21 December 2014; ...

  8. Assessment of the efficacy of desmopressin in treatment of Primary ...

    African Journals Online (AJOL)

    Background: Enuresis is defined as a normal void occurring at an inappropriate social time or place. The treatment approach for enuresis is controversial due to a lack of consensus as to the exact causes of nocturnal enuresis. Aim: Aim was to assess the efficacy of desmopressin therapy in the treatment of Primary

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

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    André Luís PORPORATTI

    2015-04-01

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

  10. The NIST Primary Radon-222 Measurement System.

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    Collé, R; Hutchinson, J M R; Unterweger, M P

    1990-01-01

    Within the United States, the national standard for radon measurements is embodied in a primary radon measurement system that has been maintained for over 50 years to accurately measure radon ((222)Rn) against international and national radium ((226)Ra) standards. In turn, all of the radon measurements made at the National Institute of Standards and Technology (NIST) and the radon transfer calibration standards and calibration services provided by NIST are directly related to this national radon standard. This primary radon measurement system consists of pulse ionization chambers and ancillary gas handling and gas purification equipment. The system is currently undergoing a significant upgrading and expansion which will replace the extant outdated system.

  11. 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

  12. Clinical efficacy of cyclophosphamide in treatment of primary sclerosing cholangitis

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    CHENG Peng

    2013-12-01

    Full Text Available ObjectiveTo investigate the clinical efficacy of cyclophosphamide in the treatment of primary sclerosing cholangitis (PSC. MethodsTwenty-four patients with PSC who received treatment in the department of gastroenterology in our hospital from January 2004 to December 2012 were selected as subjects and divided into observation group (n=13 and control group (n=11. The control group was treated with ursodesoxycholic acid, while the observation group with ursodesoxycholic acid plus cyclophosphamide. After four weeks of treatment, clinical outcome, changes in serum bilirubin levels, and adverse reactions were compared between the two groups. Categorical data were analyzed by Fisher exact probability test, and continuous data by independent-samples t test and paired-samples t test. ResultsCompared with the control group, the observation group had a significantly higher response rate (84.62% vs 45.45%, P=0.0489, significantly more improvements in serum total and direct bilirubin levels (t=12.45, P<0.001; t=5.60, P<0.001, and a nonsignificantly higher incidence of adverse reactions (23.08% vs 18.18%, P=0.741. ConclusionCyclophosphamide has significant clinical efficacy and tolerable incidence of adverse events in the treatment of PSC, so it is worthy of application in clinical treatment.

  13. The NIST Primary Radon-222 Measurement System

    OpenAIRE

    Coll, R.; Hutchinson, J. M. R.; Unterweger, M. P.

    1990-01-01

    Within the United States, the national standard for radon measurements is embodied in a primary radon measurement system that has been maintained for over 50 years to accurately measure radon (222Rn) against international and national radium (226Ra) standards. In turn, all of the radon measurements made at the National Institute of Standards and Technology (NIST) and the radon transfer calibration standards and calibration services provided by NIST are directly related to this national radon ...

  14. Measuring Teachers' Interpersonal Self-Efficacy: Relationship with Realized Interpersonal Aspirations, Classroom Management Efficacy and Age

    Science.gov (United States)

    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 self-efficacy in classroom management cover…

  15. De-qi, not psychological factors, determines the therapeutic efficacy of acupuncture treatment for primary dysmenorrhea.

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    Xiong, Jin; Liu, Fang; Zhang, Ming-Min; Wang, Wei; Huang, Guang-Ying

    2012-01-01

    To study the impact of De-qi (, obtaining qi) and psychological factors on the efficacy of acupuncture treatment for primary dysmenorrhea, with an attempt to explore the relationship among De-qi, psychological factors, and clinical efficacy. The patients with primary dysmenorrhea were randomly assigned to a group of acupuncture with manual manipulation (manipulation group, n=67) and an acupuncture group without manipulation (non-manipulation group, n=64). Pain intensity and pain duration were used as measures for evaluating the therapeutic efficacy of the acupuncture treatment. De-qi, the sensations a patient experienced during the acupuncture treatment, was scored on a 4-point scale by the subjects. In addition, the psychological factors, including belief in acupuncture, the level of nervousness, anxiety, and depression, were quantitatively assessed. The personality of the subject was assessed using the Eysenck personality questionnaire (EPQ) and 16 personality factor questionnaire (16PF). Complete data were obtained from 120 patients, 60 patients in each group. There were statistically significant differences in pain intensity (W=2410.0, P<0.01) and pain duration (W=3181.0, P<0.01) between the two groups. The number of De-qi acupoints (W=1150.5, P<0.01) and the average intensity of De-qi (W=1141.0, P<0.01) were significantly higher in the manipulation group as compared with their non-manipulation counterparts. The correlation coefficients between De-qi and therapeutic efficacy of acupuncture were greater than those between psychological factors and therapeutic efficacy. Compared with the psychological factors, De-qi contributed more to the pain-relieving effect of acupuncture in subjects with primary dysmenorrhea. Moreover, manual manipulation is a prerequisite for eliciting and enhancing the De-qi sensations, and De-qi is critical for achieving therapeutic effects.

  16. Improving Clinician Self-Efficacy Does Not Increase Asthma Guideline Use by Primary Care Clinicians

    Science.gov (United States)

    Cloutier, Michelle M.; Tennen, Howard; Wakefield, Dorothy B.; Brazil, Kevin; Hall, Charles B.

    2012-01-01

    Objectives The association between changes in clinician self-efficacy and readiness to change and implementation of an asthma management program (Easy Breathing©) was examined. Methods A 36 month randomized, controlled trial was conducted involving 24 pediatric practices (88 clinicians). Randomized clinicians received interventions designed to enhance clinician self-efficacy and readiness to change which were measured at baseline and 3 years. Interventions consisted of an educational toolbox, seminars, teleconferences, mini-fellowships, opinion leader visits, clinician-specific feedback, and pay for performance. The primary outcome was program utilization (number of children enrolled in Easy Breathing/year); secondary outcomes included development of a written treatment plan and severity-appropriate therapy. Results At baseline, clinicians enrolled 149 ± 147 (mean ± SD) children/clinician/year; 84% of children had a written treatment plan and 77% of plans used severity-appropriate therapy. At baseline, higher self-efficacy scores were associated with greater program utilization (Relative Rate (RR) 1.34 (95% Confidence Interval 1.04, 1.72), p=0.04) but not treatment plan development (RR 0.63 (0.29, 1.35), p=.23) or anti-inflammatory use (RR 1.76 (0.92, 3.35), p=.09). Intervention clinicians participated in 17 interventions over 36 months. At study end, self-efficacy scores increased in intervention clinicians compared to control clinicians (p=0.01) and more clinicians were in an action stage of change (p=0.001) but these changes were not associated with changes in primary or secondary outcomes. Conclusions Self-efficacy scores correlated with program use at baseline and increased in the intervention arm but these increases were not associated with greater program-related activities. Self-efficacy may be necessary but not sufficient for behavior change. PMID:22634077

  17. Comparative efficacy of eptifibatide and abciximab in primary angioplasty study

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    Rohan Jayasinghe

    2011-02-01

    Full Text Available Rohan Jayasinghe1 Matias Yudi1 Sanjay Jayasinghe21Cardiology Department, Gold Coast Hospital, Griffith University, Queensland, Australia; 2Centre for Immunisation Research, Sydney, AustraliaBackground: Primary percutaneous intervention is the safest and most effective treatment modality for acute ST-segment elevation myocardial infarction (MI in centers where catheterization facilities exist. Intravenous glycoprotein IIb/IIIa inhibitor therapy during the procedures has been proven to provide added benefits. For the two agents, abciximab and eptifibatide, commonly used in this context, there is only limited comparative data available for the clinicians. Hitherto, there is no data published from the Asia–Pacific region on this topic.Method: A retrospective comprehensive analysis was carried out, comparing patients who were treated with abciximab (n = 125 and eptifibatide (n = 125 during primary angioplasty over a 3-year period. The primary outcome measure was in-hospital mortality. The other outcome measures studied include MI, stroke, blood transfusion, contrast nephropathy, significant bleeding, and vascular complications. A comparative cost analysis was carried out to ascertain the average overall differential cost.Results: In-hospital mortality, MI, stroke, blood transfusion, contrast nephropathy, significant bleeding, and vascular complication were observed at a higher rate in the patients who were treated with abciximab. However, these differences did not reach statistical significance. Due to the higher cost per unit and longer hospital stay, therapy with abciximab costs more than that with eptifibatide.Conclusions: Both abciximab and eptifibatide are safe and effective adjunct therapeutic agents in the setting of primary angioplasty. However, there is a trend toward higher adverse event with the former agent that was not statistically significant. Therapy with abciximab costs more per patient.Keywords: abciximab, eptifibatide, PCI, STEMI

  18. The theory and measurement of the self-efficacy construct.

    Science.gov (United States)

    van der Bijl, J J; Shortridge-Baggett, L M

    2001-01-01

    Self-efficacy is the major concept of Bandura's social cognitive theory. Self-efficacy is influenced by four important sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological information. Other determinants of self-efficacy are internal personal factors and external environmental factors. The degree of change in self-efficacy is partly a function of the variability and the controllability of its determinants. Level of self-efficacy predicts how people are functioning in terms of choice of behavior, effort expenditure and persistence, thought patterns and emotional reactions. Measurement of self-efficacy is related to three dimensions: magnitude, strength and generality. Self-efficacy should be measured in terms of particularized judgments of capability that may vary across realms of activity, different levels of task demands within a given activity domain, and different situational circumstances.

  19. 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…

  20. Primary hyperparathyroidism: intraoperative PTH-measurements

    DEFF Research Database (Denmark)

    Rolighed, L; Heickendorff, L; Hessov, I

    2004-01-01

    BACKGROUND: With the development of rapid assays and intraoperative measurement of intact parathyroid hormone (PTH), new strategies in the handling of patients with primary hyperparathyroidism (pHPT) have evolved. AIM: The aim of our study was to illustrate the performance of the intraoperative PTH...... positive and cured, 11 patients (8%) were test negative but cured, and 10 patients (7%) were test negative and not cured by the primary operation. Consequently, the sensitivity of the test was 0.92 and the specificity 1.00. CONCLUSIONS: The rapid PTH test used is a reliable predictor of a successful...

  1. Blood pressure lowering efficacy of renin inhibitors for primary hypertension.

    Science.gov (United States)

    Musini, Vijaya M; Lawrence, Kendra Ak; Fortin, Patricia M; Bassett, Ken; Wright, James M

    2017-04-05

    Hypertension is a chronic condition associated with an increased risk of mortality and morbidity. Renin is the enzyme responsible for converting angiotensinogen to angiotensin I, which is then converted to angiotensin II. Renin inhibitors are a new class of drugs that decrease blood pressure (BP) by preventing the formation of both angiotensin I and angiotensin II. To quantify the dose-related BP lowering efficacy of renin inhibitors compared to placebo in the treatment of primary hypertension.To determine the change in BP variability, pulse pressure, and heart rate and to evaluate adverse events (mortality, non-fatal serious adverse events, total adverse events, withdrawal due to adverse effects and specific adverse events such as dry cough, diarrhoea and angioedema). The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials (RCTs) up to February 2017: the Cochrane Hypertension Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2017, Issue 2), MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. There was no restriction by language or publication status. We also searched the European Medicines Agency (EMA) for clinical study reports, the Novartis Clinical Study Results Database, bibliographic citations from retrieved references, and contacted authors of relevant papers regarding further published and unpublished work. We included randomized, double-blinded, placebo-controlled studies evaluating BP lowering efficacy of fixed-dose monotherapy with renin inhibitor compared with placebo for a minimum duration of three to 12 weeks in adult patients with primary hypertension. This systematic review is a comprehensive update which includes four additional studies and extensive detail from nine clinical study reports (CSRs) of previously included studies obtained from EMA. The remaining three

  2. 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

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

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    Batool Teimoori

    2016-03-01

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

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

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    Kyoung-Nam Kim

    2014-01-01

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

  5. [Efficacy impacts of psychological factors on primary dysmenorrhea treated with acupuncture].

    Science.gov (United States)

    Xiong, Jin; Liu, Fang; Wang, Wei; Huang, Guang-ying

    2011-06-01

    To explore the relationship between psychological factors and efficacy of acupuncture on primary dysmenorrhea. Sixty cases of primary dysmenorrhea were observed. Before acupuncture treatment, the self-designed confidence questionnaire was used to assess patients' confidence in acupuncture efficacy. Visual Analogue Scale (VAS) was adopted to assess patients' tension level during acupuncture. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were applied to assess the situations of patients' anxiety and depression. Eysenck's personality questionnaire (EPQ) and Cattell sixteen personality factors questionnaire (16PF) were provided to assess the personal characters of patients. Pain intensity, pain duration and accompanied symptoms were recorded before and after acupuncture treatment so as to assess the efficacy. Canonical correlation analysis was used to analyze the relationship between the psychological factors and acupuncture efficacy on primary dysmenorrhea. There were significant differences in grading of dysmenorrhea, pain intensity score and pain duration after treatment as compared statistically with those before treatment (all Panxiety (r=-0.5906) in personality factors and the reduction of pain duration (r=0.9042) among efficacy indices were the highest. The overall correlation coefficients were all lower between the indices of psychological factors and canonical variables of dysmenorrhea efficacy. Acupuncture efficacy on primary dysmenorrhea has a certain correlation with dominance and anxiety of patients' personality factors. But, the psychological factors do not play a leading role in acupuncture treatment.

  6. The Efficacy of Autologous Femoropopliteal Vein Reconstruction for Primary Aortic and Aortic Graft Infection

    NARCIS (Netherlands)

    Dirven, M.; Jagt, M.F.P. van der; Barendregt, W.B.; Vliet, D. van der

    2015-01-01

    BACKGROUND: The objective of our study was to analyze the efficacy of autologous superficial femoropopliteal vein reconstruction for primary aortic or aortic graft infection. METHODS: We performed a retrospective analysis of 14 patients treated for an infected aortic prosthesis or primary infected

  7. 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.…

  8. Measuring contraceptive efficacy and side effects.

    Science.gov (United States)

    Sivin, I

    To assess effectiveness of contraceptives, one reports all pregnancies during use. Multiple and single decrement life-table pregnancy rates computed from these reports constitute the fundamental measures of effectiveness in clinical trials. Minimally biased evaluation of a new method requires a randomized, double-blind (or its nearest semblance), multicentered study of sexually active women. New contraceptives are studied in special, volunteer populations. Evaluation of marketed contraceptives implies broader-gauged representation, larger numbers and longer time frames. Prospective studies, like clinical trials, should include several methods, and may use subsamples for case-control analysis of risk. Well-designed and executed multicentered, prospective studies, nevertheless, may represent specially selected populations. Risk-benefit analyses based on findings from selected populations require careful scrutiny. Although the most persuasive estimates of effectiveness derive from national, representative samples, moderately large samples in the USA have not been able to distinguish among products within a class. Formidable problems of recall are present in household surveys. In the United Kingdom, Europe and North America, analysis of risks and benefits may be enriched by better utilization of the data collection and record linkage resources of national health statistics systems.

  9. An exploratory study of specialist and generalist teachers: predicting self efficacy in delivering primary physical education

    OpenAIRE

    Breslin, Gavin; Hanna, Donncha; Lowry, Ruth G; McKee, David; Haughey, Tandy; Moore, Nicole

    2012-01-01

    We aimed to determine whether primary school teachers’ motivational regulations to exercise and self efficacy in delivering a physical education (PE) lesson are different based on prior PE training. Two groups of qualified primary school teachers were recruited; PE specialists and a group of generalist primary school teachers who also teach PE. All teachers completed the Behavioural Regulation in Exercise Questionnaire-2, International Physical Activity Questionnaire and the Teachers’ Sense o...

  10. 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…

  11. Science teaching self-efficacy in a primary school: A case study

    Science.gov (United States)

    de Laat, Jenny; Watters, James J.

    1995-12-01

    Bandura's theory of self-efficacy predicts that teachers with high, self-efficacy should persist longer, provide a greater academic focus in child-centred classrooms and exhibit different types of feedback than teachers who have lower self-efficacy. This paper reports on the science teaching self-efficacy in a group of teachers at a state primary school. The research was conducted in two stages using firstly the Science Teaching Efficacy Beliefs Instrument (STEBI-A) to identify cases, and secondly, a semistructured interview coupled with classroom observations. Thirty seven teaching staff were surveyed with the STEBI-A instrument. The five highest and five lowest scoring teachers on the personal science teaching self-efficacy subscale of the STEBI-A were interviewed. The analysis of interviews and observations indicated that teachers with high personal science teaching self-efficacy have had a long interest in science and a relatively strong background of formal science studies with opportunities for exploring out of school activities. Although they may have experienced negative science experiences in their own schooling other ameliorating factors existed which maintained their interest. Their instructional strategies in science lessons were more child-centred than those reported by teachers with lower personal science teaching self-efficacy. The implications of the results for the inservice training of teachers are discussed.

  12. Teachers' Sickness Absence in Primary Schools, School Climate and Teachers' Sense of Efficacy.

    Science.gov (United States)

    Imants, Jeroen; van Zoelen, Ad

    1995-01-01

    In the period from 1978 to 1988, teacher absenteeism increased considerably in the Netherlands, especially in primary education. This study questions whether teacher absenteeism is related to school climate and teachers' sense of efficacy. When climates of low- and high-absenteeism schools are compared, several school climate characteristics…

  13. Investigating the Relationships among Primary Teachers' Math Profile, Math Teaching Efficacy, and Math Content Pedagogical Knowledge

    Science.gov (United States)

    Roettinger, Theresa Marie

    2014-01-01

    Kindergarten, first and second grade teachers play an important role in the development of a student's understanding of mathematics. Consequently, in order to improve student achievement in mathematics, it is important to investigate the relationships that may exist among primary teachers' math profile, math teaching efficacy, and math pedagogy…

  14. Efficacy of family-based weight control program for pre-school children in primary care

    Science.gov (United States)

    OBJECTIVE: To test the efficacy of an innovative family-based intervention for overweight pre-school children and overweight parents conducted in the primary care setting. METHODS: 96 children with BMI >85th percentile and an overweight parent were randomized to Intervention or Information Control...

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

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    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

  16. 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…

  17. Measuring and Supporting Pre-Service Teachers’ Self-Efficacy Towards Computers, Teaching, and Technology Integration

    OpenAIRE

    Kiili, 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 completed the self-efficacy questionnaire. Confirmatory factor analyses resulted in a modified measurement model consisting of the three hypothesized sel...

  18. Safety and efficacy of simultaneous bilateral primary combined trabeculotomy-trabeculectomy for developmental glaucoma

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    Mandal Anil

    2002-01-01

    Full Text Available Purpose: To establish the safety and efficacy of simultaneous bilateral primary combined trabeculotomy-trabeculectomy for developmental glaucoma. Methods: We studied 109 consecutive patients who underwent planned simultaneous bilateral primary combined trabeculotomy-trabeculectomy for developmental glaucoma by a single surgeon from January 1990 through December 1999. The main outcome measures were postoperative intraocular pressure (IOP, corneal clarity and diameter, visual acuity, bleb characteristics, time of surgical failure and complications. Postoperative complications including endophthalmitis and anaesthetic morbidity and mortality were also analysed. Results: The series consisted of 218 primary combined trabeculotomy-trabeculectomy surgeries during 109 anaesthesias. The mean follow-up period was 16.33 ± 16.22 months. The IOP reduced from 26.4 ± 5.9 mmHg to 13.5 ± 4.5 mmHg, with a mean percentage reduction of 46.2 ± 23.7 (P < 0.0001. The success (IOP < 16 mmHg probabilities were 90.9%, 88.0% and 69.3% at first, second and third year respectively (Kaplan-Meier analysis. The success probability of 69.3% obtained at third year was maintained till 6 years of follow-up. One hundred and sixty six (76.1% eyes had significant corneal oedema. Postoperatively, the cornea cleared in 93 (57.8 % eyes. Clinically, well functioning blebs were present in 114 of 171 eyes (66.6%. Postoperatively, 18 (8.3% eyes developed shallow anterior chamber and 6 (33.3% of them required surgical reformation. There was no incidence of endophthalmitis or any other sight-threatening complication. Of the anesthetic complications, apnea occurred in 17 (15.6% patients and all were successfully resuscitated. The most serious post-anaesthetic complication was cardio-pulmonary arrest that occurred 5 hours postoperatively following aspiration during feeding in one child; this child could not be resuscitated. Two children had delayed recovery (2 and 4 hours respectively. The

  19. Role expansion on interprofessional primary care teams: Barriers of role self-efficacy among clinical associates.

    Science.gov (United States)

    Giannitrapani, Karleen F; Soban, Lynn; Hamilton, Alison B; Rodriguez, Hector; Huynh, Alexis; Stockdale, Susan; Yano, Elizabeth M; Rubenstein, Lisa V

    2016-12-01

    Interprofessional team-based models of primary care that expand the role of clinical associates (CAs) are increasingly adopted in primary care practices. In this study we query team members of a newly implemented patient centered medical home (PCMH) to identify facilitators and barriers of occupational role self-efficacy, a belief of possessing the capacity to execute their new team based role effectively. 79 key informants, members of primary care teams at six Veterans Health Administration (VA) clinics, were interviewed to assess their experiences with implementing expanded roles for CAs. All sites had implemented Patient Aligned Care Teams, the VA's version of PCMH. Three themes that produced the self-efficacy necessary for successful role expansion of CAs were identified: (1) role training (2) time and resources for roles and (3) cross-disciplinary role agreement. Sub-themes emerged around role challenges. Training sub themes included incomplete or limited training, inconsistencies in trainings within a site, and not receiving training with team members. Insufficient resources sub-themes included limited time for expanded tasks, inadequate space, low staffing, and poor task mix. Cross-disciplinary agreement failed to occur specifically when there was insufficient coordination between medicine and nursing leadership about staff roles, poor primary care provider (PCPs) knowledge of the boundaries of staff roles, and lack of synchronicity between staff roles and what PCPs would like staff roles to include. These identified themes have implications for healthcare professionals working in interprofessional teams in a variety of settings and indicate the need for interdisciplinary leadership based solutions. Clarifying the factors that impact self-efficacy for the role expansion of PACT staff can inform strategies for role transformation for enhanced primary care delivery. Published by Elsevier Inc.

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

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    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

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

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    Khodadad Moradian

    2013-01-01

    Full Text Available Purpose: To evaluate the safety and efficacy of viscocanalostomy in the management of medically uncontrollable primary open-angle glaucoma (POAG in a developing country. Materials and Methods: This is a prospective, non-randomized case series of 14 consecutive eyes with medically uncontrollable POAG, all subjected to viscocanalostomy. The main outcome measure was success rate based on the intraocular pressure (IOP level achieved post-operatively. The procedure was considered a complete success if IOP was less than 21 mmHg without any anti-glaucoma medication. Qualified success was defined as IOP of less than 21 mmHg with anti-glaucoma medication. All patients had a regular follow-up of at least 12 months. Results: IOP was reduced from a mean baseline value of 27.9 ± 7.3 mmHg (range: 21-40 mmHg to a mean final value of 16.0 ± 2.7 mmHg (range: 13-22 mmHg, which was statistically highly significant (P < 0.005. The mean number of pre-operative anti-glaucoma medications was 3.0 ± 0.4 (range: 2-4, which was reduced significantly (P < 0.0001 to 0.3 ± 0.6 (range: 0-2 at the last follow-up visit. One year post-operatively, complete success was achieved in 71% and qualified success was observed in 21.4% of patients, summing up to an overall success rate of 92.4%. There were no major complications in any of the patients. Conclusion: Viscocanalostomy could be performed effectively and safely for control of POAG in developing countries.

  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. Psychometric properties of a hurricane coping self-efficacy measure.

    Science.gov (United States)

    Benight, C C; Ironson, G; Durham, R L

    1999-04-01

    This brief report describes the psychometric properties of an instrument designed to measure Hurricane Coping Self-Efficacy (HCSE). Survivors of Hurricane Andrew (n = 165) and Hurricane Opal (n = 63) completed the HCSE and assessments of optimism, social support, distress, and resource loss. Principal components factor analyses revealed a unidimensional structure for the HCSE. Internal consistency of the HCSE was strong. In both samples, HCSE was positively associated with optimism and social support, but negatively associated with general psychological distress, trauma related distress, and resource loss. Finally, hierarchical regression analyses demonstrated that the HCSE explained a significant amount of experimental variance for intrusive thoughts and avoidance after controlling for social support, lost resources, and optimism.

  4. Antibacterial Efficacy of Pastes Against E Faecalis in Primary Root Dentin: A Confocal Microscope Study.

    Science.gov (United States)

    Verma, R; Sharma, D S; Pathak, A K

    2015-01-01

    Management of abscessed primary teeth often present endodontic failure owing to questioned efficiency of dressings or obturating pastes to eliminate Enterococcus faecalis, a resistant bacterium, residing in depth of dentinal tubules. The present study evaluates the antimicrobial efficacy of two antibacterial and two obturating pastes in dentinal tubules of primary teeth infected with Enterococcus faecalis using viability stain and confocal laser scanning microscope (CLSM). Total 28 samples were prepared.Four groups with 6 samples each were made according to antibacterial pastes i.e. 1% or 2%Chlorhexidine (CHX) + calcium hydroxide (CH), CH + iodoform (Metapex) and Zinc Oxide Eugenol (ZOE). Dentinal tubules from the root canal side were infected with E. faecalis by centrifugation of the bacterial suspension. Two specimens from each group were subjected to 1, 7 and 15 days antibacterial pastes exposure. Viability staining followed by CLSM were used to quantitatively analyze the dead cell count directly inside dentin. Univariate analysis showed that all medicaments were significantly effective (p ZOE(15)> Metapex(15)> 2%CHX+CH(15)> 2%CHX+CH(7)> 2%CHX+CH(1)> 1%CHX+CH(7)> 2%CHX+CH(15)> Metapex(1)> ZOE(1)> ZOE(7). All medicaments were effective against E. faecalis in dentine of primary teeth and their efficacy increased with longer contact with 1%CHX+CH being most effective at day 15. Inclusion of 1% CHX in dressings or obturating pastes might minimize the endodontic relapse and maximize the tooth retention in functional state in pediatric dentistry.

  5. 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.)

  6. Stopwatch-assessed duration of erection: a new measure of the efficacy of erectile dysfunction treatments.

    Science.gov (United States)

    Rosenberg, M T; Miner, M M; Barnes, A L; Janning, S W

    2011-01-01

    Results are reported from the first two adequate trials of the PDE-5 inhibitor vardenafil using a stopwatch to precisely measure erection duration in men with ED. Two randomized, multicenter, double-blind, placebo-controlled trials were conducted: a crossover 4-week treatment in men with ED (ENDURANCE) and a parallel group, 12-week treatment in men with ED and dyslipidemia (the dyslipidemia study). Stopwatch-assessed duration of erection leading to successful intercourse measured by Sexual Encounter Profile question-3 (SEP-3) was the primary end point in ENDURANCE and one of the secondary end points in the dyslipidemia study. Other efficacy end points included responses to SEP-2, SEP-3 and International Index of Erectile Function-Erectile Function (IIEF-EF) domain scores. Adverse events were recorded. Duration of erection (least squares mean ± s.e.) leading to successful intercourse was statistically superior in men receiving vardenafil versus placebo (12.8 ± 1.0 versus 5.5 ± 1.0 min; p<0.001 in ENDURANCE and 10.0 ± 0.8 versus 3.4 ± 0.8; p<0.001 in the dyslipidemia study), with a difference of 7.4 and 6.6 min, respectively, between treatment groups. Results for SEP-2, SEP-3 and IIEF-EF domain scores were consistent across studies and with stopwatch-assessed measures for duration of erection. Vardenafil was well tolerated. Duration of erection leading to successful intercourse is an important indicator of the efficacy of ED treatment. The stopwatch approach offers an alternative, precise and reproducible measure of efficacy. We propose this approach as a potential new paradigm for assessing the efficacy of ED treatments.

  7. 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

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

    OpenAIRE

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

    2015-01-01

    Introduction: 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. Methods and Materials: This experimental study was conducted on 100 extracted primary maxillary and ...

  9. Pre-service and In-service English Teachers’ Efficacy Beliefs about Teaching English at Primary Schools

    OpenAIRE

    Uztosun, Mehmet Sercan

    2016-01-01

    This study investigated pre-service and in-service English teachers’ efficacy beliefs about teaching English at primary schools in Turkey by revealing the teaching aspects that they felt most and least efficacious. The study also attempted to understand pre-service teachers’ views about the effectiveness of pre-service teacher education and explore which major problems in-service teachers encountered while teaching English at primary schools. The quantitative and qualitative data were collect...

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

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    Davood Ghasemi Tudeshchoie

    2013-01-01

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

  11. Quality measures for primary care of complex pediatric patients.

    Science.gov (United States)

    Chen, Alex Y; Schrager, Sheree M; Mangione-Smith, Rita

    2012-03-01

    A well-recognized gap exists in assessing and improving the quality of care for medically complex patients. Our objective was to examine evidence for primary care based on the patient-centered medical home model and to identify valid and meaningful quality measures for use in complex pediatric patients. We conducted literature searches on Medline and the National Quality Measures Clearinghouse for existing measures, as well as evidence to inform the development of new quality measures. We used a 3-step process to select relevant sources from published literature: (1) the titles were screened by 2 independent reviewers; (2) the abstracts were reviewed for quality-of-care contents or constructs; and (3) full-text articles were obtained and reviewed for measure specification. All materials were reviewed for the Oxford Centre For Evidence-Based Medicine level of evidence and for relevance to primary care of complex pediatric patients. A national expert panel was convened to evaluate and rate the measures by using the Rand/University of California Los Angeles Appropriateness Method. We presented 74 quality measures to the expert panel for review and discussion. The panel rated and accepted 35 measures as valid and feasible for assessing primary care quality in complex pediatric patients. The final set of quality measures was grouped in the following domains: primary care-general (14), patient/family-centered care (8), chronic care (2), coordination of care (9), and transition of care (2). By using the patient-centered medical home framework of accessible, continuous, family-centered, coordinated, and culturally effective care, a national expert panel selected 35 primary care quality measures for complex pediatric patients.

  12. 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 (P<0.001). Instrumentation with Flex Master rotary files was significantly less time consuming (P<0.001). CONCLUSION: Although there was no difference in cleanliness efficacy at the apical and middle thirds, the coronal third was more effectively cleaned with hand files. Predictably, time efficiency was a significant advantage with rotary technique. PMID:23940486

  13. 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…

  14. Examination of the Self-Efficacy of Primary School Teacher Candidates towards First Reading-Writing Education

    Science.gov (United States)

    Bayraktar, Hatice Vatansever

    2016-01-01

    The aim of this study is to examine the levels of the self-efficacy of primary school teacher candidates towards first reading-writing education and whether they differentiate by various variables. The study is prepared in accordance with the screening model. The universe of this study consists of the primary school teacher candidates who receive…

  15. Self-Efficacy, School Resources, Job Stressors and Burnout among Spanish Primary and Secondary School Teachers: A Structural Equation Approach

    Science.gov (United States)

    Betoret, Fernando Domenech

    2009-01-01

    This study examines the relationship between school resources, teacher self-efficacy, potential multi-level stressors and teacher burnout using structural equation modelling. The causal structure for primary and secondary school teachers was also examined. The sample was composed of 724 primary and secondary Spanish school teachers. The changes…

  16. Content Area Literacy in the Primary Grades: Teachers' Sense of Efficacy in Teaching Narrative and Informational Text

    Science.gov (United States)

    Selman, Christine Cherry

    2011-01-01

    Research has documented the scarcity of informational text and the overabundance of narrative text in the primary grades (Duke, 2000; Yopp & Yopp, 2006). The purpose of this quantitative study was to determine primary teachers' beliefs, or efficacy, in teaching narrative and informational text as well as assess their use of both text types in…

  17. 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.

  18. 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…

  19. 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…

  20. Primary or secondary antifungal prophylaxis in patients with hematological maligancies: efficacy and damage

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    Gedik H

    2014-04-01

    Full Text Available Habip Gedik,1 Funda Şimşek,1 Taner Yildirmak,1 Arzu Kantürk,1 Deniz Arica,2 Demet Aydin,2 Naciye Demirel,2 Osman Yokuş21Department of Infectious Diseases and Clinical Microbiology, 2Department of Hematology, Ministry of Health Okmeydani Training and Research Hospital, İstanbul, TurkeyBackground: Patients with hematological malignancies often develop febrile neutropenia (FN as a complication of cancer chemotherapy. Primary or secondary antifungal prophylaxis is recommended for patients with hematological malignancies to reduce the risk of invasive fungal infection (IFI. This study retrospectively evaluated the efficacy and potential harm of administration of primary and secondary antifungal prophylaxis to patients with hematological malignancies at one hospital.Methods: All patients with hematological malignancies older than 14 years of age who had experienced at least one FN attack during chemotherapy while being treated at one hospital between November 2010 and November 2012 were retrospectively evaluated.Results: A total of 282 FN episodes in 126 consecutive patients were examined during a 2-year study period. The mean patient age was 51.73±14.4 years (range: 17–82 years, and 66 patients were male. Primary prophylaxis with posaconazole was administered to 13 patients and systemic antifungal treatment under induction or consolidation chemotherapy to seven patients. Of 26 patients who received secondary antifungal prophylaxis with either oral voriconazole (n=17 or posaconazole (n=6 during 46 FN episodes, systemic antifungal therapy was administered in 16 of 38 episodes and three of eight episodes, respectively. Secondary antifungal prophylaxis with caspofungin was found effective in treating six FN episodes in three patients who had experienced at least two persistent candidemia attacks. The mortality rates associated with IFI were 9% in the first year, 2% in the second year, and 6% overall. The mortality rates associated with candidemia

  1. Efficacy of preformed metal crowns vs. amalgam restorations in primary molars: a systematic review.

    Science.gov (United States)

    Randall, R C; Vrijhoef, M M; Wilson, N H

    2000-03-01

    The authors evaluated the treatment efficacy of preformed metal crowns, or PMCs, vs. amalgam restorations in primary molars by means of a literature review and meta-analysis. From a literature search, the authors selected clinical studies that evaluated treatment with PMCs vs. amalgam control restorations in primary molars and provided data against which treatment outcomes could be compared. Ten studies with durations ranging from 1.6 to 10 years fulfilled the selection criteria. Their failure rates, based on need for subsequent treatment or retention of the restoration at final evaluation, ranged from 1.9 to 30.3 percent for PMCs and 11.6 to 88.7 percent for amalgam restorations. Overall, PMCs demonstrated greater longevity and reduced retreatment need compared with amalgam control restorations. The odds ratio for all studies fell within the boundary favoring treatment with PMCs. Analysis of the literature, though mainly retrospective studies, demonstrated evidence of a more favorable outcome for PMCs than for amalgam restorations in primary molars requiring multisurface restorations.

  2. Efficacy and safety of levodropropizine and dihydrocodeine on nonproductive cough in primary and metastatic lung cancer.

    Science.gov (United States)

    Luporini, G; Barni, S; Marchi, E; Daffonchio, L

    1998-07-01

    Nonproductive cough is a frequent and distressing symptom in patients with lung cancer, and it is not even relieved by palliative chemotherapy. A double-blind, randomized clinical trial regarding the treatment of nonproductive cough was performed in 140 adults with primary lung cancer or metastatic cancer of the lungs. The therapeutic efficacy and the tolerability of a 7-day treatment with levodropropizine drops (75 mg t.i.d.) were evaluated in comparison with dihydrocodeine drops (10 mg t.i.d.; 7 days). Efficacy was assessed on the basis of cough severity scores, number of night awakenings due to cough, and overall estimate of antitussive efficacy. Tolerability was evaluated by laboratory results, vital signs and any adverse event occurring during the clinical trial, including presence or absence of somnolence. Subjective cough severity was significantly reduced during treatment with either levodropropizine and dihydrocodeine, the antitussive effect and its time-profile being similar for both drugs. Also, according to the investigator's evaluation, both levodropropizine and dihydrocodeine produced a significant decrease in cough severity. Concurrently with the relief of cough, the number of night awakenings was decreased significantly by both drugs, with no difference between the two treatments. No change in laboratory test values was considered clinically relevant, and vital signs were not clinically affected. The number of patients reporting adverse events was similar in the levodropropizine (n=6) and dihydrocodeine (n=4) group. However, the percentage of patients experiencing somnolence in the group receiving levodropropizine (8%) was significantly lower as compared with that of the dihydrocodeine group (22%). These results confirm the antitussive effectiveness of levodropropizine and suggest a more favourable benefit/risk profile when compared to dihydrocodeine.

  3. Antimicrobial Efficacy of Contemporary Obturating Materials used in Primary Teeth- An In-vitro Study.

    Science.gov (United States)

    Navit, Saumya; Jaiswal, Neha; Khan, Suleman Abbas; Malhotra, Seema; Sharma, Anshul; Mukesh; Jabeen, Seema; Agarwal, Gaurav

    2016-09-01

    Preservation of primary tooth with non-vital pulp has been a major problem for pediatric dentist. In such cases, the preferred treatment modality is pulpectomy. The objective of pulpectomy is complete removal of necrotic and irreversibly infected pulp of an affected tooth but, in spite of chemomechanical preparation and copious irrigation of canal, there are chances of failure of pulp therapy due to the entrapped micro organisms in the canal space owing to the tortuous and complex nature of the root canal system and change in their morphology with root resorption. Thus, for optimal success of endodontic treatment, obturating material with antimicrobial properties is advocated in deciduous teeth. The aim of the study was to assess the antimicrobial efficacy of different obturating materials used in pediatric dentistry. In the present study, antimicrobial efficacy of endoflas, Zinc Oxide Eugenol (ZOE), calcium hydroxide with chlorhexidine, calcium hydroxide with iodoform and distilled water, metapex and saline as control were assessed and compared with each other. The antimicrobial efficacy of obturating materials was evaluated against E. faecalis (ATCC 29212) by agar diffusion method. The statistical analysis was done using SPSS Version 15.0. The Analysis of Variance (ANOVA) and Post-Hoc Tests (Tukey-HSD) were performed to reveal the statistical significance. Intergroup comparison at 24 hours (Tukey's test) revealed significant difference amongst all the groups. Endoflas had significantly higher zone of inhibition as compared to all the other groups except group treated with ZOE (p-value ZOE >Calcium hydroxide + Chlorhexidine > Calcium hydroxide + Iodoform +Distilled water ~ Metapex > Saline.

  4. Antimicrobial Efficacy of Contemporary Obturating Materials used in Primary Teeth- An In-vitro Study

    Science.gov (United States)

    Jaiswal, Neha; Khan, Suleman Abbas; Malhotra, Seema; Sharma, Anshul; Mukesh; Jabeen, Seema; Agarwal, Gaurav

    2016-01-01

    Introduction Preservation of primary tooth with non-vital pulp has been a major problem for pediatric dentist. In such cases, the preferred treatment modality is pulpectomy. The objective of pulpectomy is complete removal of necrotic and irreversibly infected pulp of an affected tooth but, in spite of chemomechanical preparation and copious irrigation of canal, there are chances of failure of pulp therapy due to the entrapped micro organisms in the canal space owing to the tortuous and complex nature of the root canal system and change in their morphology with root resorption. Thus, for optimal success of endodontic treatment, obturating material with antimicrobial properties is advocated in deciduous teeth. Aim The aim of the study was to assess the antimicrobial efficacy of different obturating materials used in pediatric dentistry. Materials and Methods In the present study, antimicrobial efficacy of endoflas, Zinc Oxide Eugenol (ZOE), calcium hydroxide with chlorhexidine, calcium hydroxide with iodoform and distilled water, metapex and saline as control were assessed and compared with each other. The antimicrobial efficacy of obturating materials was evaluated against E. faecalis (ATCC 29212) by agar diffusion method. The statistical analysis was done using SPSS Version 15.0. The Analysis of Variance (ANOVA) and Post-Hoc Tests (Tukey-HSD) were performed to reveal the statistical significance. Results Intergroup comparison at 24 hours (Tukey’s test) revealed significant difference amongst all the groups. Endoflas had significantly higher zone of inhibition as compared to all the other groups except group treated with ZOE (p-value ZOE >Calcium hydroxide + Chlorhexidine > Calcium hydroxide + Iodoform +Distilled water ~ Metapex > Saline. PMID:27790570

  5. 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.

  6. Comparing efficacy of BCG/lactoferrin primary vaccination versus booster regimen

    Science.gov (United States)

    Hwang, Shen-An; Welsh, Kerry J.; Boyd, Sydney; Kruzel, Marian L.; Actor, Jeffrey K.

    2011-01-01

    Summary Lactoferrin is an iron binding glycoprotein possessing multiple immune modulatory activities, including ability to affect macrophage cytokine production, mature T- and B- lymphocytes and immature dendritic cells, and enhance the ability of macrophages and dendritic cells to stimulate antigen-specific T-cells, and. These characteristics of lactoferrin suggested that it could function as an effective adjuvant enhance efficacy of the BCG, the current vaccine for tuberculosis disease. Admix of lactoferrin to the BCG vaccine promoted host protective responses that surpasses activity of the BCG vaccine alone as determined by decreasing pulmonary pathology upon challenge with virulent Mycobacterium tuberculosis (MTB). This study builds on previous reports by examining the effectiveness of the lactoferrin adjuvant comparing primary vaccination versus an immunization schedule with a booster administered at 8 weeks. BCG/lactoferrin vaccinating, given once or twice, demonstrated an improvement in pulmonary disease compared to both the BCG vaccinated and non-immunized groups. The splenic recall profiles showed a difference in cytokine production induced by mycobacterial antigen from splenocytes isolated from mice immunized with BCG/lactoferrin once or twice. Production of IL-17 is increased in the BCG/lactoferrin 2x group compared to the primary vaccinated group. Both BCG/lactoferrin vaccinated group exhibited increase production of IFN-γ compared to the non-immunized group and decreased production of IL-10 compared to the group vaccinated with only BCG. This study illustrates that the adjuvant activity of lactoferrin to enhance BCG efficacy occurs whether the vaccination regimen is a single delivery or combined with a booster, leading to enhanced host protection and decreased disease manifestation. PMID:22088320

  7. Primary and Secondary Appraisals in Measuring Resilience to Stress

    Directory of Open Access Journals (Sweden)

    Boris B. Velichkovsky

    2009-01-01

    Full Text Available Measuring resilience to stress (or stress resistance validly and reliably is an important theoretical and practical problem. Process-oriented stress theories assume that primary and secondary appraisals play an important role in determining the level of resilience. In the present study, a model of resilience based on the analysis of the interplay between primary and secondary appraisal processes is developed. Resilience is high if benign primary appraisals of taxing situations are accompanied by secondary appraisals of coping resources as being sufficient for controlling stressors. In an implementation of the model, the quality of primary appraisals is assessed through the assessment of anxiety, anger and depression, which characterize the most typical cognitive-emotional reactions to demanding situations. The assessment of secondary appraisals is restricted to the analysis of psychophysiological (functional resources, which are involved in all forms of coping activities. The implementation of the model gives rise to a measure of resilience, which is shown to successfully predict the outcome of the stress process in a sample of Russian police officers.

  8. Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: A randomized placebo-controlled pilot study

    Directory of Open Access Journals (Sweden)

    Sen Ananda

    2011-09-01

    Full Text Available Abstract Background Despite being the most commonly used herbal for sleep disorders, chamomile's (Matricaria recutita efficacy and safety for treating chronic primary insomnia is unknown. We examined the preliminary efficacy and safety of chamomile for improving subjective sleep and daytime symptoms in patients with chronic insomnia. Methods We performed a randomized, double-blind, placebo-controlled pilot trial in 34 patients aged 18-65 years with DSM-IV primary insomnia for ≥ 6-months. Patients were randomized to 270 mg of chamomile twice daily or placebo for 28-days. The primary outcomes were sleep diary measures. Secondary outcomes included daytime symptoms, safety assessments, and effect size of these measures. Results There were no significant differences between groups in changes in sleep diary measures, including total sleep time (TST, sleep efficiency, sleep latency, wake after sleep onset (WASO, sleep quality, and number of awakenings. Chamomile did show modest advantage on daytime functioning, although these did not reach statistical significance. Effect sizes were generally small to moderate (Cohen's d ≤ 0.20 to Conclusion Chamomile could provide modest benefits of daytime functioning and mixed benefits on sleep diary measures relative to placebo in adults with chronic primary insomnia. However, further studies in select insomnia patients would be needed to investigate these conclusions. Trial Registration ClinicalTrials.gov Identifier NCT01286324

  9. Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: a randomized placebo-controlled pilot study.

    Science.gov (United States)

    Zick, Suzanna M; Wright, Benjamin D; Sen, Ananda; Arnedt, J Todd

    2011-09-22

    Despite being the most commonly used herbal for sleep disorders, chamomile's (Matricaria recutita) efficacy and safety for treating chronic primary insomnia is unknown. We examined the preliminary efficacy and safety of chamomile for improving subjective sleep and daytime symptoms in patients with chronic insomnia. We performed a randomized, double-blind, placebo-controlled pilot trial in 34 patients aged 18-65 years with DSM-IV primary insomnia for ≥ 6-months. Patients were randomized to 270 mg of chamomile twice daily or placebo for 28-days. The primary outcomes were sleep diary measures. Secondary outcomes included daytime symptoms, safety assessments, and effect size of these measures. There were no significant differences between groups in changes in sleep diary measures, including total sleep time (TST), sleep efficiency, sleep latency, wake after sleep onset (WASO), sleep quality, and number of awakenings. Chamomile did show modest advantage on daytime functioning, although these did not reach statistical significance. Effect sizes were generally small to moderate (Cohen's d ≤ 0.20 to chamomile. However, TST demonstrated a moderate effect size in favor of placebo. There were no differences in adverse events reported by the chamomile group compared to placebo. Chamomile could provide modest benefits of daytime functioning and mixed benefits on sleep diary measures relative to placebo in adults with chronic primary insomnia. However, further studies in select insomnia patients would be needed to investigate these conclusions.

  10. 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.

  11. 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.

  12. Efficacy of anti-CD47 antibody-mediated phagocytosis with macrophages against primary effusion lymphoma.

    Science.gov (United States)

    Goto, Hiroki; Kojima, Yuki; Matsuda, Kouki; Kariya, Ryusho; Taura, Manabu; Kuwahara, Kazuhiko; Nagai, Hirokazu; Katano, Harutaka; Okada, Seiji

    2014-07-01

    Recently, the critical role of CD47 on the surface of resistant cancer cells has been proposed in their evasion of immunosurveillance. Primary effusion lymphoma (PEL) is a subtype of aggressive non-Hodgkin lymphoma that shows serous lymphomatous effusion in body cavities, especially in advanced acquired immunodeficiency syndrome (AIDS). PEL is resistant to conventional chemotherapy and has a poor prognosis. In this study, we evaluated the effect of anti-CD47 antibody (Ab) on PEL in vitro and in vivo. Surface CD47 of PEL cell lines was examined by flow cytometry. Efficacy of knocking down CD47 or anti-CD47 Ab-mediated phagocytosis against PEL was evaluated using mouse peritoneal macrophages and human macrophages in vitro. Primary PEL cells were injected intraperitoneally into NOD/Rag-2/Jak3 double-deficient (NRJ) mice to establish a direct xenograft mouse model. Surface CD47 of PEL cell lines was highly expressed. Knocking down CD47 and anti-CD47 Ab promoted phagocytic activities of macrophages in a CD47 expression-dependent manner in vitro. Treatment with anti-CD47 Ab inhibited ascite formation and organ invasion completely in vivo compared with control IgG-treated mice. CD47 plays the pivotal role in the immune evasion of PEL cells in body cavities. Therapeutic antibody targeting of CD47 could be an effective therapy for PEL. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Sealing distal proximal caries lesions in first primary molars: efficacy after 2.5 years.

    Science.gov (United States)

    Martignon, S; Tellez, M; Santamaría, R M; Gomez, J; Ekstrand, K R

    2010-01-01

    The prevalence of proximal caries in primary molar teeth is high in many countries. (1) To study by means of a split-mouth design the 1- and 2.5-year efficacy of sealing proximal lesions vs. flossing instructions (control) on primary molar teeth. (2) To assess children's behaviour and pain perception during the procedure. Ninety-one 4- to 6-year-old children from Bogotá, Colombia participated. Participants had to have at least two proximal lesions scored according to the following radiographic classification system: radiolucency (1) in enamel outer half, (2) restricted to enamel-dentine junction, or (3) restricted to dentine outer third. Baseline, 1- and 2.5-year follow-up bitewing radiographs were taken. Test and control lesions were randomly selected. After temporary separation test lesions were sealed (adhesive). Parents/caregivers received a flossing leaflet for their children. Progression of the lesions was assessed by means of independent reading of conventional bitewing radiographs. One-year (n = 73) test vs. control lesion progression was 27.4 vs. 50.7%, respectively (p caries baseline data. More than 88% of the participants presented positive to definitively positive behaviour and very low or low pain intensity at both first and second appointments. The sealing technique was superior to flossing instructions both after 1 and 2.5 years of follow-up and the majority of the participants had no anxiety or pain during the treatment. Copyright © 2010 S. Karger AG, Basel.

  14. 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…

  15. Psychometric properties of the Exercise Self-efficacy Scale in Dutch Primary care patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    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; ...-item ESS had sound psychometric properties in a large sample of primary care type 2 diabetes patients. The 13-item ESS could be useful in (intervention) research on physical activity in type 2 diabetes patients....

  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. Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial.

    Science.gov (United States)

    Yin, Xuan; Gou, Minghui; Xu, Jian; Dong, Bo; Yin, Ping; Masquelin, Fernand; Wu, Junyi; Lao, Lixing; Xu, Shifen

    2017-09-01

    The objective of this study was to evaluate the efficacy and safety of acupuncture treatment for primary insomnia. We conducted a single-center, single-blinded, and randomized controlled clinical trial. Seventy-two patients with primary insomnia were randomly assigned into two groups - the acupuncture group, who received acupuncture treatment, and the control group, who received sham acupuncture treatment. The treatment was given three times a week for four weeks. Patients were asked to wear sleep monitors and complete questionnaires every two weeks for a total of eight weeks. The primary outcome was the Insomnia Severity Index (ISI). The secondary outcomes were sleep parameters including sleep efficiency (SE), sleep awakenings (SA) and total sleep time (TST) recorded by the Actigraphy, as well as scores of the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). Compared with pretreatment baseline, patients in both groups had varying degrees of improvements in their sleep conditions. Paired t-test showed that there was a significant difference in all indicators in the acupuncture group before and after acupuncture treatment. One-way analysis of covariance adjusted for baseline scores indicated that the ISI improved dramatically in the acupuncture group at two weeks post-treatment (F = 11.3, p = 0.001), four weeks post-treatment (F = 33.6, p acupuncture treatment group after the two-week and four-week follow-ups. Acupuncture treatment is more effective than sham acupuncture treatment in increasing insomnia patients' sleep quality and improving their psychological health. Chinese Clinical Trial Registry: Chi CTR-TRC-14004859. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  18. 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.

  19. 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.

  20. Clinical efficacy of perampanel for partial-onset and primary generalized tonic-clonic seizures.

    Science.gov (United States)

    Besag, Frank Mc; Patsalos, Philip N

    2016-01-01

    Perampanel, a selective noncompetitive antagonist at the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor, is highly effective in a wide range of experimental models. Although initially licensed as adjunctive therapy for partial seizures with or without secondary generalization in patients aged 12 years or older, the US Food and Drug Administration has recently approved its use in the treatment of primary generalized tonic-clonic seizures (PGTCS). This paper reviews the pharmacokinetics, efficacy, and tolerability of perampanel as an antiepileptic drug. After oral ingestion, perampanel is rapidly absorbed (T max, 0.5-2.5 hours), has a bioavailability of ~100%, and is highly protein bound (~95%) in plasma. It undergoes extensive (>90%) hepatic metabolism, primarily via cytochrome P450 3A4 (CYP3A4), with a half-life of 48 hours. Carbamazepine and other antiepileptic drugs can enhance its metabolism via induction of CYP3A4. Efficacy of perampanel in focal seizures has been extensively evaluated in Phase II and randomized, placebo-controlled Phase III trials. The efficacy in PGTCS has been reported in one class I study. In the treatment of focal seizures, perampanel showed significant dose-dependent median seizure reductions: 4 mg/d, 23%; 8 mg/d, 26%-31%; 12 mg/d, 18%-35%; and placebo, 10%-21%. The 50% responder rates were 15%-26%, 29%, 33%-38%, and 34%-36% for placebo, 4 mg/d, 8 mg/d, and 12 mg/d perampanel, respectively. Freedom from seizures was recorded in 0%-1.7% of the placebo group, 1.9% of the 2 mg group, 2.6%-4.4% of the 8 mg group, and 2.6%-6.5% of the 12 mg group. For PGTCS, the median seizure reduction was 76.5% for perampanel and 38.4% for placebo. The 50% responder rate was 64.2% for perampanel and 39.5% for placebo. Seizure freedom during maintenance phase was 30.9% for perampanel and 12.3% for placebo. Adverse effects included dose-dependent increases in the frequency of dizziness, somnolence, fatigue, irritability, falls, and

  1. Measuring technology self efficacy: reliability and construct validity of a modified computer self efficacy scale in a clinical rehabilitation setting.

    Science.gov (United States)

    Laver, Kate; George, Stacey; Ratcliffe, Julie; Crotty, Maria

    2012-01-01

    To describe a modification of the computer self efficacy scale for use in clinical settings and to report on the modified scale's reliability and construct validity. The computer self efficacy scale was modified to make it applicable for clinical settings (for use with older people or people with disabilities using everyday technologies). The modified scale was piloted, then tested with patients in an Australian inpatient rehabilitation setting (n = 88) to determine the internal consistency using Cronbach's alpha coefficient. Construct validity was assessed by correlation of the scale with age and technology use. Factor analysis using principal components analysis was undertaken to identify important constructs within the scale. The modified computer self efficacy scale demonstrated high internal consistency with a standardised alpha coefficient of 0.94. Two constructs within the scale were apparent; using the technology alone, and using the technology with the support of others. Scores on the scale were correlated with age and frequency of use of some technologies thereby supporting construct validity. The modified computer self efficacy scale has demonstrated reliability and construct validity for measuring the self efficacy of older people or people with disabilities when using everyday technologies. This tool has the potential to assist clinicians in identifying older patients who may be more open to using new technologies to maintain independence.

  2. Transoral robotic surgery for management of cervical unknown primary squamous cell carcinoma: Updates on efficacy, surgical technique and margin status.

    Science.gov (United States)

    Geltzeiler, Mathew; Doerfler, Sean; Turner, Meghan; Albergotti, William Greer; Kubik, Mark; Kim, Seungwon; Ferris, Robert; Duvvuri, Umamaheswar

    2017-03-01

    Management of cervical unknown primary squamous cell carcinoma (CUP) has evolved with the introduction of transoral robotic surgery (TORS). 1. To describe the efficacy of TORS lingual and palatine tonsillectomy in identifying the primary site of malignancy. 2. To explore how the extent of surgery affects diagnostic yield. 3. To report margin status of TORS resections. A retrospective, single-center cohort study utilizing a prospectively collected database of CUP patients in a high-volume tertiary referral center. Patient underwent operative laryngoscopy plus TORS as clinically indicated. Primary end point was successful identification of the primary. The extent of surgery and margin status were also examined. From 2010-2016, 64 patients with CUP were treated. The primary tumor was found in 51 patients (80%). Fourteen patients (22%) were identified with operative laryngoscopy alone. Fifty patients underwent TORS lingual tonsillectomy ± palatine tonsillectomy with 37 primary tumors identified (74%). The primary was located in the lingual tonsil in 32 patients (86%) and palatine tonsil in 5 patients (10%, p<0.001). Negative margins were achieved in 19 patients (51%). The deep margin was the most commonly positive margin (47%, p=0.049). Operative laryngoscopy with TORS is efficacious, localizing the primary in 80% of patients. If a margin was positive, it was most commonly the deep margin. This study provides valuable information that can help standardize surgical technique, further increasing the diagnostic yield and decreasing the negative margin rate of TORS for CUP. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Safety and efficacy of leflunomide in primary Sjögren's syndrome: A phase II pilot study

    NARCIS (Netherlands)

    Van Woerkom, J.M.; Kruize, A.A.; Geenen, R.; Van Roon, E.N.; Goldschmeding, R.; Verstappen, S.M.M.; Van Roon, J.A.G.; Bijlsma, J.W.J.

    2007-01-01

    Background: For invalidating symptoms in primary Sjögren's syndrome (pSS), there is still a need for easy-to-administer, cost-effective and well-tolerated systemic treatment. Leflunomide (LEF) is structurally unrelated to other immunomodulatory drugs and might be efficacious in pSS, given its

  4. Efficacy and acceptability of pharmacological treatments for depressive disorders in primary care: systematic review and network meta-analysis.

    Science.gov (United States)

    Linde, Klaus; Kriston, Levente; Rücker, Gerta; Jamil, Susanne; Schumann, Isabelle; Meissner, Karin; Sigterman, Kirsten; Schneider, Antonius

    2015-01-01

    The purpose of this study was to investigate whether antidepressants are more effective than placebo in the primary care setting, and whether there are differences between substance classes regarding efficacy and acceptability. We conducted literature searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO up to December 2013. Randomized trials in depressed adults treated by primary care physicians were included in the review. We performed both conventional pairwise meta-analysis and network meta-analysis combining direct and indirect evidence. Main outcome measures were response and study discontinuation due to adverse effects. A total of 66 studies with 15,161 patients met the inclusion criteria. In network meta-analysis, tricyclic and tetracyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), a serotonin-noradrenaline reuptake inhibitor (SNRI; venlafaxine), a low-dose serotonin antagonist and reuptake inhibitor (SARI; trazodone) and hypericum extracts were found to be significantly superior to placebo, with estimated odds ratios between 1.69 and 2.03. There were no statistically significant differences between these drug classes. Reversible inhibitors of monoaminoxidase A (rMAO-As) and hypericum extracts were associated with significantly fewer dropouts because of adverse effects compared with TCAs, SSRIs, the SNRI, a noradrenaline reuptake inhibitor (NRI), and noradrenergic and specific serotonergic antidepressant agents (NaSSAs). Compared with other drugs, TCAs and SSRIs have the most solid evidence base for being effective in the primary care setting, but the effect size compared with placebo is relatively small. Further agents (hypericum, rMAO-As, SNRI, NRI, NaSSAs, SARI) showed some positive results, but limitations of the currently available evidence makes a clear recommendation on their place in clinical practice difficult. © 2015 Annals of Family Medicine, Inc.

  5. 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.

  6. Efficacy of three different pulpotomy agents in primary molars: a randomized control trial.

    Science.gov (United States)

    Rajasekharan, S; Martens, L C; Vandenbulcke, J; Jacquet, W; Bottenberg, P; Cauwels, R G E C

    2017-03-01

    To compare the clinical and radiographic efficacy of Biodentine™ , ProRoot® White Mineral Trioxide Aggregate (WMTA) and Tempophore™ as pulpotomy medicaments in the treatment of carious primary molars. A parallel-design, randomized controlled trial was developed. Patients above 3 years of age with carious primary teeth with vital pulps without spontaneous pain or history of swelling were included. Fifty-eight patients (82 teeth) with a mean age of 4.79 ± 1.23 years were included. The teeth were randomized, blinded and allocated to one of the three groups (Biodentine™ , ProRoot® WMTA or Tempophore™ ) for pulpotomy treatment. All teeth were followed up clinically and radiographically (after 6, 12 and 18 months) by two blinded calibrated investigators. A generalized estimating equation (GEE), Wald chi-square test and an intention-to-treat analysis (ITT) with 'last carried forward' approach were performed using Statistical Package for Social Sciences v 21.0 (IBM Corp., Armonk, NK, USA). Forty-six patients and 69 teeth were available for follow-up after 18 months. Clinical success (radiographic success in parenthesis) was 95.24% (94.4%), 100% (90.9%) and 95.65% (82.4%) in the Biodentine™ , ProRoot® WMTA and Tempophore™ groups, respectively, but the difference was not significant. Pulp canal obliteration was significantly different amongst the experimental groups as the Biodentine™ group exhibited significantly more pulp canal obliteration when compared to the ProRoot® WMTA group at 6 months (P = 0.008) and 18 months (P = 0.003). After 18-month follow-up, there was no significant difference between Biodentine™ in comparison with ProRoot® WMTA or Tempophore™ . © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  7. Exploring Primary Teachers' Self-Efficacy Beliefs for Teaching Dance Education

    Science.gov (United States)

    Renner, Suzanne; Pratt, Keryn

    2017-01-01

    The self-efficacy beliefs of 140 generalist teachers for teaching dance in the New Zealand curriculum were surveyed using an adapted version of the Teachers' Sense of Self-efficacy scale (TSES) developed by Tschannen-Moran and Woolfolk Hoy (2001). Four hypotheses were created to test relationships between the participants' self-efficacy beliefs…

  8. Efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis: a Meta-analysis

    Directory of Open Access Journals (Sweden)

    YU Yuan

    2015-10-01

    Full Text Available ObjectiveTo assess the efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis (PBC. MethodsCNKI, Wanfang Data, China Biology Medicine, PubMed, Embase, and Cochrane library were searched for the pertinent literature of randomized controlled trials (RCTs of adjuvant therapy with fenofibrate for PBC published up to December 31, 2014. Data extraction and quality assessment were carried out, and the data were statistically analyzed by Stata10.1 software. Respectively, for heterogeneity test. The fixed effect model is chosen for homogeneity, and the random effect model is chosen for heterogeneity. ResultsSix RCTs met the inclusion criteria. Treatment with fenofibrate was associated with significantly reduced levels of gamma-glutamyl transpeptidase, alanine aminotransferase, and alkaline phosphatase in PBC patients (SMD=-1.595, -0.447, and -2.125, respectively, all P<0.05. There were no significant changes in the levels of aspartate aminotransferase and total bilirubin after adjuvant therapy with fenofibrate (both P>0.05. Also, fenofibrate led to no significant improvement in immunoglobulin M (P>0.05. ConclusionFenofibrate, which improves the indicators of liver function but leads to no changes in immunological indicators, appears to be an effective adjuvant therapy in PBC patients. There is a critical need for more large-scale, multi-center, high-quality RCTs to determine its effect on liver disease-related morbidity and mortality.

  9. Antiplatelet and antithrombotic treatment after primary percutaneous coronary intervention: balancing safety and efficacy.

    Science.gov (United States)

    Valgimigli, Marco; Minarelli, Monica

    2010-12-01

    Antiplatelet therapy has been shown to significantly reduce the risk of serious vascular events in high-risk patients, including those with a prior acute ischemic event. The long-term use of antiplatelet agents is a key component of secondary prevention measures following acute coronary syndromes, including ST-segment elevation myocardial infarction. While minimizing ischemic recurrences, an intensified antiplatelet regimen also invariably leads to an increased risk for bleeding, which can in turn lead to treatment discontinuation and worse overall cardiovascular outcomes. Thus, a critical balance between efficacy and safety must be pursued in clinical practice. Selection of agents and their combination, dose optimization, and a customized approach based on genotype or assessment of on-treatment phenotype are discussed in the context of available evidence. Copyright © 2010 Mosby, Inc. All rights reserved.

  10. The Efficacy of Telehealth-Delivered Speech and Language Intervention for Primary School-Age Children: A Systematic Review.

    Science.gov (United States)

    Wales, Danielle; Skinner, Leisa; Hayman, Melanie

    2017-01-01

    The purpose of this article is to determine if telehealth-delivered speech-language pathology interventions are as effective as traditional in-person delivery for primary school-age children with speech and/or language difficulties. A systematic review was conducted (in accordance with PRISMA guidelines) using five databases, two journals and reference lists. Titles and abstracts were screened for inclusion, with relevant studies reviewed in full-text. Initial searches identified 132 articles. Following exclusion of non-relevant studies, seven articles remained for inclusion. Results revealed both telehealth and in-person participants made significant and similar improvements when treatment effects were measured through five of the six outcome measures. Findings showed there is limited but promising evidence to support telehealth for delivering speech-language pathology intervention services to school-age children. Whilst this is encouraging, particularly for rural children where in-person services are limited, more rigorous study designs are required to support the efficacy of telehealth for this population.

  11. 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…

  12. 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…

  13. Capture-recapture method for estimating misclassification errors: application to the measurement of vaccine efficacy in randomized controlled trials.

    Science.gov (United States)

    Simondon, F; Khodja, H

    1999-02-01

    The measure of efficacy is optimally performed by randomized controlled trials. However, low specificity of the judgement criteria is known to bias toward lower estimation, while low sensitivity increases the required sample size. A common technique for ensuring good specificity without a drop in sensitivity is to use several diagnostic tests in parallel, with each of them being specific. This approach is similar to the more general situation of case-counting from multiple data sources, and this paper explores the application of the capture-recapture method for the analysis of the estimates of efficacy. An illustration of this application is derived from a study on the efficacy of pertussis vaccines where the outcome was based on > or =21 days of cough confirmed by at least one of three criteria performed independently for each subject: bacteriology, serology, or epidemiological link. Log-linear methods were applied to these data considered as three sources of information. The best model considered the three simple effects and an interaction term between bacteriology and epidemiological linkage. Among the 801 children experiencing > or =21 days of cough, it was estimated that 93 cases were missed, leading to a corrected total of 413 confirmed cases. The relative vaccine efficacy estimated from the same model was 1.50 (95% confidence interval: 1.24-1.82), similar to the crude estimate of 1.59 and confirming better protection afforded by one of the two vaccines. This method allows supporting analysis to interpret primary estimates of vaccine efficacy.

  14. 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.

  15. 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

    2011-05-22

    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.

  16. 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.

  17. Neutron activation analysis: A primary method of measurement

    Science.gov (United States)

    Greenberg, Robert R.; Bode, Peter; De Nadai Fernandes, Elisabete A.

    2011-03-01

    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 Comité Consultatif pour la Quantité de Matière — Métrologie 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.

  18. MULTIFACTOR PRIMARY PREVENTION OF ISCHEMIC HEART DISEASE IN MIDDLE-AGED MEN AND ITS EFFICACY (10-YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    A. M. Kalinina

    2015-09-01

    Full Text Available Aim. To evaluate in a prospective 10-year follow-up study cardiovascular mortality rate in a population of middle-aged men with different levels of total cardiovascular risk, and correlation between combinations of risk factors (RF and the extent of coronary atherosclerosis according to autopsy reports of subjects who have died of ischemic heart disease (IHD undiagnosed during life-time. To estimate the efficacy of multifactor primary prevention.Material and methods. The analysis was based on the results of the “Multifactor ischemic heart disease prevention” prospective controlled study of two 40-59-year-old men populations (1preventive measures, 2 – a group of comparison. Standardized epidemiological examination using unified protocol was performed in the total of 6656 people. The article presents results of prospective follow-up of the two groups, participants of which did not initially have  IHD clinical signs: the group 1 – n=2975, the group 2 – n=2705. Active correction of IHD RF (high blood pressure, hypercholesterolemia, overweight, smoking, low physical activity in the group 1 lasted for 5 years; the whole period of follow-up was 15 years. At that, end points (all-cause mortality, myocardial infarction and stroke were estimated and verified in each case. This article evaluates the 10-year follow-up period.Results. Prevention in middle-aged men population allowed significantly to reduce levels of the major RF and total cardiovascular risk by 38.1%. In the absence of preventive measures cardiovascular risk, predicted by the SCORE chart, already realizes during the first 5 years. In fact cardiovascular mortality rates during 10-year follow-up exceed the risk predicted by the SCORE chart. Active primary IHD prevention allows to reduce the risk of cardiovascular death in men with initially high risk – by 36.9% and with initially very high risk – by 43.4%. Men, who have died of IHD undiagnosed during life-time, with combination

  19. MULTIFACTOR PRIMARY PREVENTION OF ISCHEMIC HEART DISEASE IN MIDDLE-AGED MEN AND ITS EFFICACY (10-YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    A. M. Kalinina

    2014-01-01

    Full Text Available Aim. To evaluate in a prospective 10-year follow-up study cardiovascular mortality rate in a population of middle-aged men with different levels of total cardiovascular risk, and correlation between combinations of risk factors (RF and the extent of coronary atherosclerosis according to autopsy reports of subjects who have died of ischemic heart disease (IHD undiagnosed during life-time. To estimate the efficacy of multifactor primary prevention.Material and methods. The analysis was based on the results of the “Multifactor ischemic heart disease prevention” prospective controlled study of two 40-59-year-old men populations (1preventive measures, 2 – a group of comparison. Standardized epidemiological examination using unified protocol was performed in the total of 6656 people. The article presents results of prospective follow-up of the two groups, participants of which did not initially have  IHD clinical signs: the group 1 – n=2975, the group 2 – n=2705. Active correction of IHD RF (high blood pressure, hypercholesterolemia, overweight, smoking, low physical activity in the group 1 lasted for 5 years; the whole period of follow-up was 15 years. At that, end points (all-cause mortality, myocardial infarction and stroke were estimated and verified in each case. This article evaluates the 10-year follow-up period.Results. Prevention in middle-aged men population allowed significantly to reduce levels of the major RF and total cardiovascular risk by 38.1%. In the absence of preventive measures cardiovascular risk, predicted by the SCORE chart, already realizes during the first 5 years. In fact cardiovascular mortality rates during 10-year follow-up exceed the risk predicted by the SCORE chart. Active primary IHD prevention allows to reduce the risk of cardiovascular death in men with initially high risk – by 36.9% and with initially very high risk – by 43.4%. Men, who have died of IHD undiagnosed during life-time, with combination

  20. A 50-week extension study on the safety and efficacy of colesevelam in adults with primary hypercholesterolemia.

    Science.gov (United States)

    Davidson, Michael H; Donovan, Joanne M; Misir, Soamnauth; Jones, Michael R

    2010-01-01

    Colesevelam is a bile acid sequestrant that differs structurally from traditional bile acid sequestrants, allowing it to bind bile acids with greater affinity. Studies have shown that colesevelam significantly reduces low-density lipoprotein cholesterol (LDL-C) levels and, in some cases, significantly increases high-density lipoprotein cholesterol (HDL-C) levels in adults with primary hypercholesterolemia. To investigate the safety and efficacy of colesevelam in adults with primary hypercholesterolemia. This multicenter, open-label, titration-based extension study enrolled subjects who completed one of three multicenter, randomized, double-blind, placebo-controlled phase II studies with colesevelam. This study consisted of a 4-week washout/dietary stabilization period, a 50-week open-label treatment period, and a 2-week follow-up period. Ten clinical centers within the US. Males and females 18 years of age or older who had completed a previous short-term (4- or 6-week) phase II clinical study with colesevelam. At week 0 (following a 4-week washout of all lipid-lowering medication), subjects initiated treatment with colesevelam at a dosage of 1.5 g/day. Colesevelam was uptitrated to a maximum dosage of 3.75 g/day as necessary to achieve a 15-30% reduction from baseline in LDL-C level. At week 12, an HMG-CoA reductase inhibitor (statin) or niacin (nicotinic acid) could be added if colesevelam 3.75 g/day was not sufficient to result in a 15-30% reduction from baseline in LDL-C level. The primary efficacy measure was the change in LDL-C level from baseline to week 50 across all treatment regimens. Secondary efficacy parameters included the change and percent change in total cholesterol, HDL-C, and triglyceride levels from baseline to week 50. There were three cohorts analyzed: (i) colesevelam monotherapy (included all subjects who received colesevelam monotherapy, regardless of dose); (ii) all treatment regimens (included all subjects who received colesevelam

  1. Efficacy and Safety of Tacrolimus Versus Cyclophosphamide for Primary Membranous Nephropathy: A Meta-Analysis.

    Science.gov (United States)

    Zhu, Lin-Bo; Liu, Lin-Lin; Yao, Li; Wang, Li-Ning

    2017-02-01

    The objective of this systematic review was to compare the efficacy and safety of tacrolimus with cyclophosphamide in primary membranous nephropathy (PMN) patients. We conducted a literature search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CCRCT). Any study that compared the efficacy or safety between tacrolimus and cyclophosphamide in the adult PMN patients was included. We included four randomized controlled trials and two prospective cohort studies with 389 PMN patients. The pooled results using the Dersimonian and Laird method showed that renal remission rates at the longest follow-up periods were not significantly different between the tacrolimus and cyclophosphamide groups (overall remission, six trials, n = 389, relative risk [RR] 0.994 [95% confidence interval [CI] 0.768-1.286); complete remission, six trials, n = 389, RR 1.256 [95% CI 0.733-2.150]). Further analyses found that tacrolimus was comparable with cyclophosphamide for inducing renal remission within 1 year but inferior to cyclophosphamide after 1-year follow-up. It should be noted that only two studies reported the outcomes after 1-year follow-up, which might be considered as weak evidence. The rates of relapse and the drop-outs due to adverse effects were not significantly different (relapse, six trials, n = 389, RR 2.244 [95% CI 0.892-5.644]; drop-outs, six trials, n = 389, RR 1.330 [95% CI 0.412-4.291]). However, the cyclophosphamide group had a significantly higher risk of leukopenia than the tacrolimus group (four trials, n = 216, RR 0.203 [95% CI 0.045-0.916]), whereas the rates of tremor were significantly higher in the tacrolimus group than in the cyclophosphamide group (three trials, n = 202, RR 8.939 [95% CI 1.694-47.173]). The quality and short follow-up durations of the studies limited the reliability of our conclusions. Tacrolimus was comparable with cyclophosphamide for inducing renal remission of PMN patients within 1 year, but the

  2. The importance of measuring self-efficacy in patients with diabetes.

    Science.gov (United States)

    Mishali, M; Omer, H; Heymann, A D

    2011-02-01

    Self-efficacy is an important factor influencing diabetes self-management behaviours. Previous studies have examined self-efficacy as a general measure in diabetes care for all self-care treatment recommendations together. This current study was designed to examine if low self-efficacy in each of the measured self-care treatment recommendations is related to decreased adherence for each specific recommendation. The self-efficacy was measured in 119 patients for four different treatment recommendations: blood glucose self-monitoring, exercise, diet and oral medication intake and correlated with The Resistance to Treatment Questionnaire. Significant and positive Pearson's correlations were found between the frequency of adherence to treatment recommendations and the self-efficacy regarding different recommendations. The correlation between self-efficacy and diet and physical activity was 0.5 and 0.67, respectively. The higher the resistance to treatment score, the less confident the patient is in his or her ability to adhere with treatment recommendations. This pattern was not present in adherence to medication intake. Self-efficacy impacts adherence to treatment and therefore plays a role in the clinical outcome. The practical implication is that assessment of self-efficacy in people with diabetes may be a first step in the development of individually tailored interventions.

  3. A Systematic Review and Meta-Analysis of the Efficacy of Manipulative Therapy in Women with Primary Dysmenorrhea.

    Science.gov (United States)

    Abaraogu, Ukachukwu Okoroafor; Igwe, Sylvester Emeka; Tabansi-Ochiogu, Chidinma Samantha; Duru, Deborah Onyinyechukwu

    2017-08-30

    To assess the robustness of evidence for the efficacy of manipulative therapy in women with primary dysmenorrhea. Seven electronic databases were searched for studies reporting data on manipulative therapy for women with primary dysmenorrhea. The primary and secondary outcomes were pain relief and quality of life, respectively. Quality of eligible studies was assessed using the Physiotherapy Evidence Database (PEDro) guideline. The search yielded 19 citations of which four were systematically reviewed and three eligible for meta-analysis. The systematic review showed above moderate methodological quality with a mean of 6.7 out of 10 on the PEDro quality scale. Manipulative therapy showed evidence of pain reduction in primary dysmenorrhea. Manipulative therapy could be considered as adjunct therapy in the relief of pain in primary dysmenorrhea. More high-quality research is needed before the evidence for their utilization can be ascertained. Particularly, items related to assessor blinding should be considered in future studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. 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 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 rotary files (Groups II 8.9, III 5.6, and IV 8.1 min) (p 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.

  5. The Development of a Leadership Self-Efficacy Measure

    Science.gov (United States)

    2010-03-01

    essence of humanness” ( Bandura , 2001: 1). The ways in which we are able to exercise such controls is at the heart of Albert Bandura’s Social...transforming organizations. Nahwab,  NJ: Erlbaum, 2002.  Bandura ,  Albert . Self‐Efficacy, The Exercise of Control. New York: W.H. Freeman and Company,  1997... Bandura ,  Albert . "Social Cognitive Theory: An angentic Perspective." Annual Review of  Psychology (2001): 52: 1‐26.  Bandura ,  Albert . Social

  6. 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.

  7. Efficacy and safety of Suanzaoren decoction for primary insomnia: a systematic review of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Xie Cheng-long

    2013-01-01

    Full Text Available Abstract Background Insomnia is a widespread human health problem, but there currently are the limitations of conventional therapies available. Suanzaoren decoction (SZRD is a well known classic Chinese herbal prescription for insomnia and has been treating people’s insomnia for more than thousand years. The objective of this study was to evaluate the efficacy and safety of SZRD for insomnia. Methods A systematic literature search was performed for 6 databases up to July of 2012 to identify randomized control trials (RCTs involving SZRD for insomniac patients. The methodological quality of RCTs was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions. Results Twelve RCTs with total of 1376 adult participants were identified. The methodological quality of all included trials are no more than 3/8 score. Majority of the RCTs concluded that SZRD was more significantly effective than benzodiazepines for treating insomnia. Despite these positive outcomes, there were many methodological shortcomings in the studies reviewed, including insufficient information about randomization generation and absence of allocation concealment, lack of blinding and no placebo control, absence of intention-to-treat analysis and lack of follow-ups, selective publishing and reporting, and small number of sample sizes. A number of clinical heterogeneity such as diagnosis, intervention, control, and outcome measures were also reviewed. Only 3 trials reported adverse events, whereas the other 9 trials did not provide the safety information. Conclusions Despite the apparent reported positive findings, there is insufficient evidence to support efficacy of SZRD for insomnia due to the poor methodological quality and the small number of trials of the included studies. SZRD seems generally safe, but is insufficient evidence to make conclusions on the safety because fewer studies reported the adverse events. Further large sample-size and well

  8. 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.

  9. Blood pressure lowering efficacy of renin inhibitors for primary hypertension: a Cochrane systematic review.

    Science.gov (United States)

    Musini, V M; Fortin, P M; Bassett, K; Wright, J M

    2009-08-01

    We conducted a systematic review and meta-analysis of double-blind randomized controlled trials to quantify the dose-related systolic (SBP) and diastolic blood pressure (DBP) lowering efficacy of renin inhibitors vs placebo in the treatment of adults with primary hypertension. Databases searched were Medline (1966-March 2008), EMBASE (1988-March 2008) and Cochrane Central Register of Controlled Trials (CENTRAL). Six trials in 3694 patients met the inclusion criteria. All examined aliskiren, the only renin inhibitor licensed for marketing in Canada and the United States. Aliskiren caused a dose-related SBP/DBP lowering effect compared to placebo: weighted mean difference with 95% CI: aliskiren 75 mg, -2.9 (-4.6, -1.3)/-2.3 (-3.3, -1.3) mm Hg; aliskiren 150 mg, -5.5 (-6.5, -4.4)/-3.0 (-3.7, -2.3) mm Hg; aliskiren 300 mg, -8.7 (-9.7,-7.6)/-5.0 (-5.6, -4.3) and aliskiren 600 mg, -11.4 (-13.5, -9.2)/-6.6 (-7.9, -5.2) mm Hg. Aliskiren 300 mg significantly lowered both SBP -3.0 (-4.0, -2.0) and DBP -1.7 (-2.3, -1.0) as compared to aliskiren 150 mg. Aliskiren has no effect on blood pressure variability. No data were available to assess the effect of aliskiren on heart rate or pulse pressure. This review found weak evidence that during 4- to 8-week use, aliskiren did not increase withdrawals due to adverse effects as compared to placebo. We concluded that aliskiren has a dose-related blood pressure lowering effect better than placebo and magnitude of effect is similar to that determined for angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.

  10. Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT.

    Science.gov (United States)

    Parretti, Helen M; Aveyard, Paul; Blannin, Andrew; Clifford, Susan J; Coleman, Sarah J; Roalfe, Andrea; Daley, Amanda J

    2015-09-01

    To investigate the efficacy of water preloading before meals as a weight loss strategy for adults with obesity. A two-group randomized controlled trial was conducted in Birmingham, England. Eighty-four adults with obesity were recruited from general practices. All participants were given a face-to-face weight management consultation at baseline (30 min) and a follow-up telephone consultation at 2 weeks (10 min). At baseline, participants were randomized to either drinking 500 ml of water 30 min before their main meals or an attention control group where participants were asked to imagine their stomach was full before meals. The primary outcome was weight change at 12-week follow-up. Several measures of adherence were also used, including 24 h total urine collections. 41 participants were randomized to the intervention group and 43 to the comparator group. The water preloading group lost -1.3 kg (95% CI -2.4 to -0.1, P = 0.028) more than comparators at follow up. Adjusting for ethnicity, deprivation, age, and gender resulted in the intervention group losing -1.2 kg (95% CI -2.4 to 0.07, P = 0.063) more than the comparator. There is preliminary evidence that water preloading before main meals leads to a moderate weight loss at follow up. ISRCTN33238158. © 2015 The Obesity Society.

  11. The efficacy of adalimumab in psoriatic arthritis concomitant to overlapping primary biliary cholangitis and primary sclerosing cholangitis: a case report.

    Science.gov (United States)

    Del Ross, Teresa; Ruffatti, Amelia; Floreani, Annarosa; Hoxha, Ariela; Punzi, Leonardo

    2016-11-22

    The overlap syndrome of primary biliary cholangitis (formerly called primary biliary cirrhosis) and primary sclerosing cholangitis is an extremely rare condition that has never been described in association with other immune-mediated diseases, including psoriatic arthritis. While treatment with anti-Tumour Necrosis Factor-alpha (TNF-α) agents has proved to be effective in inflammatory arthropathies such as psoriatic arthritis, they have been employed in only a limited number of patients with autoimmune hepatitis, and their effectiveness is unclear. We report the case of a 51-year-old female affected with psoriatic arthritis concomitant to overlapping primary biliary cholangitis and primary sclerosing cholangitis in whom 28 months of adalimumab treatment improved the symptoms of the inflammatory arthropathy as well as those of both cholangiopathies. Our results suggest that further studies examining the therapeutic role of this particular TNF-α blocker are warranted in cholestatic autoimmune hepatitis patients, and in particular in those individuals in whom the disease is associated with inflammatory arthropathies.

  12. Self-Efficacy in Written Composition among Deaf and Hearing Students in Primary and Secondary Education

    Science.gov (United States)

    Gutierrez-Caceres, Rafaela

    2011-01-01

    Introduction: This article presents some of the more important results from a study focused on the analysis of self-efficacy in written composition among deaf and hearing students. This type of self-efficacy is essential to adequate development of the complex process of writing and the quality of written texts. Method: A total of 116 students…

  13. Deconstructing the measure of vaccine efficacy against disease irrespective of HPV in HPV vaccine clinical trials.

    Science.gov (United States)

    Bautista, Oliver M; Luxembourg, Alain

    2016-03-01

    Human papillomavirus (HPV) vaccines were licensed by demonstrating prevention of anogenital disease caused by specific HPV types in clinical studies. Measuring the impact of HPV vaccination on the overall burden of anogenital disease (irrespective of HPV) is an important public health question which is ideally addressed in post-licensure epidemiological studies. Attempts were made to use clinical trial data for that purpose. However, the interpretation of vaccine efficacy on the endpoint of disease irrespective of HPV is not widely understood. We used the 9-valent HPV vaccine clinical program as a case study to determine the value of measuring vaccine efficacy in such endpoint. This assessment was rigorously performed by heuristic reasoning and through probability calculations. The measure of vaccine efficacy in the irrespective of HPV endpoint is driven simultaneously in opposite directions by the high estimate of prophylactic efficacy and a numerically negative estimate of risk reduction that is also a reflection of high prophylactic efficacy and no cross-protection. The vaccine efficacy estimate in the irrespective of HPV endpoint is ambiguous and difficult to interpret. Comparing this estimate across different HPV vaccine studies requires an understanding of the contributions of vaccine HPV type efficacy and the incidence of disease not related to vaccine HPV types for each study. Without such understanding, comparing studies and drawing conclusions from such comparison are highly misleading. Approaches are proposed to divide this endpoint in components that are easier to interpret. Copyright © 2016. Published by Elsevier Inc.

  14. Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: A randomized placebo-controlled pilot study

    Science.gov (United States)

    2011-01-01

    Background Despite being the most commonly used herbal for sleep disorders, chamomile's (Matricaria recutita) efficacy and safety for treating chronic primary insomnia is unknown. We examined the preliminary efficacy and safety of chamomile for improving subjective sleep and daytime symptoms in patients with chronic insomnia. Methods We performed a randomized, double-blind, placebo-controlled pilot trial in 34 patients aged 18-65 years with DSM-IV primary insomnia for ≥ 6-months. Patients were randomized to 270 mg of chamomile twice daily or placebo for 28-days. The primary outcomes were sleep diary measures. Secondary outcomes included daytime symptoms, safety assessments, and effect size of these measures. Results There were no significant differences between groups in changes in sleep diary measures, including total sleep time (TST), sleep efficiency, sleep latency, wake after sleep onset (WASO), sleep quality, and number of awakenings. Chamomile did show modest advantage on daytime functioning, although these did not reach statistical significance. Effect sizes were generally small to moderate (Cohen's d ≤ 0.20 to < 0.60) with sleep latency, night time awakenings, and Fatigue Severity Scale (FSS), having moderate effect sizes in favor of chamomile. However, TST demonstrated a moderate effect size in favor of placebo. There were no differences in adverse events reported by the chamomile group compared to placebo. Conclusion Chamomile could provide modest benefits of daytime functioning and mixed benefits on sleep diary measures relative to placebo in adults with chronic primary insomnia. However, further studies in select insomnia patients would be needed to investigate these conclusions. Trial Registration ClinicalTrials.gov Identifier NCT01286324 PMID:21939549

  15. 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

  16. Comparison of cleaning Efficacy and Instrumentation Time between Rotary and Manual Instrumentation Techniques in Primary Teeth: An in vitro Study.

    Science.gov (United States)

    Katge, Farhin; Chimata, Vamsi Krishna; Poojari, Manohar; Shetty, Shilpa; Rusawat, Bhavesh

    2016-01-01

    The aim of this study was to compare the cleaning efficacy and instrumentation time between manual Hedstrom files (H-files) and rotary Mtwo files in primary molar root canals. A total of 90 primary root canals were selected using standardized radiographs. The canals were injected with India ink with 30 gauge insulin syringe and divided into three groups. Group I-30 root canals instrumented with H-files, group II-30 root canals instrumented with Mtwo files, and group III-control group in which no canal instrumentation was done. The teeth were cleared in various solutions and then observed under a stereomicroscope. No significant difference was seen in cleaning efficacy between H-files and Mtwo files in coronal, middle, and apical thirds of the root canal. The instrumentation time recorded for H-files (3.41 ± 0.38 minutes) was significantly less than that of Mtwo files (4.81 ± 0.52). Although there was no significant difference in cleaning capacity, further studies should be carried out using the single file systems. How to cite this article: Katge F, Chimata VK, Poojari M, Shetty S, Rusawat B. Comparison of cleaning Efficacy and Instrumentation Time between Rotary and Manual Instrumentation Techniques in Primary Teeth: An in vitro Study. Int J Clin Pediatr Dent 2016;9(2):124-127.

  17. Reliability of upright posture measurements in primary school children

    Directory of Open Access Journals (Sweden)

    Grimmer Karen

    2005-06-01

    Full Text Available Abstract Background Correct upright posture is considered to be a measure of good musculoskeletal health. Little is known about the usual variability of children's upright standing posture. The aim of this study was to assess differences between repeated measures of upright posture in a group of primary school children. Methods Sagittal plane photographs of usual, relaxed upright standing posture of 38 boys and girls aged 5–12 years were taken twice within an hour. Reflective markers were placed over the canthus, tragus, C7 spinous process, greater trochanter and lateral malleolus. Digitising software was used to calculate the x,y plane coordinates, from which five postural angles were calculated (trunk, neck, gaze, head on neck, lower limb. Height, weight, motor control estimates (as measured by the Brace Tests and presence of recent pain were recorded for each child, and the association between the first test measure of posture angles and these factors was assessed using linear regression and ANOVA models. Multiple ANOVA models were applied to analyse the effect of repeated testing, and significant predictors on the angles. Results Four of the five postural angles (trunk, neck, head on neck, lower limb were significantly influenced by age. As age was strongly associated with height (r2 = 0.84 and moderately associated with weight and motor control (r2 = 0.67, 0.56 respectively, these developmental parameters may well explain the age effect on angles. There was no relationship between age and pain reported on either the testing day, or recently, and there was no gender influence on any angle. There was no significant effect of repeated testing on any angle (ICC>0.93. None of the hypothesized predictors were associated with differences in angles from repeated testing. Conclusion This study outlined the variability of relaxed upright standing posture of children aged 5–12 years, when measured twice in an hour. Age influenced the size of the

  18. 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

  19. Efficacy of Cardiac Resynchronization Therapy Performed Concomitantly with Primary Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Keisuke Morimoto, MD

    2005-01-01

    CONCLUSION: In patients with poor left ventricular function and impaired cardiac conduction, CRT performed concomitantly with primary surgery may improve the postoperative course. Further study on indications for implantation of a CRT device during primary surgery is needed.

  20. 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.

  1. 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.

  2. 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.

  3. NOx from cement production - reduction by primary measures

    DEFF Research Database (Denmark)

    Jensen, Lars Skaarup

    1999-01-01

    This thesis comprises an investigation of the mechanisms involved in forming and reducing NOx in kiln systems for cement production. Particularly the mechanisms forming and reducing NOx in calciners are dealt with in detail, as altered calciner design and operation are most applicable to controll......This thesis comprises an investigation of the mechanisms involved in forming and reducing NOx in kiln systems for cement production. Particularly the mechanisms forming and reducing NOx in calciners are dealt with in detail, as altered calciner design and operation are most applicable...... to controlling NOx emission by primary measures. The main focus has been on elucidating NOx formation and reduction mechanisms involving reactions of char, and on determining their relative importance in calciners.The first three chapters give an introduction to cement production, combustion and NOx. In modern...... cement production processes cement is typically produced by thermally treating a mixture of limestone and clay minerals in kiln systems consisting of a rotary kiln and a calciner. Clinker burning at a temperature of about 1450 °C takes place in the internally fired rotary kiln and calcination, which...

  4. Efficacy of dynamic traffic management measures: the influence of complexity and situational awareness

    NARCIS (Netherlands)

    Hoogendoorn, R.; Vreeswijk, Jacob Dirk; Hoogendoorn, S.P.; Brookhuis, K.A.; van Arem, Bart; van Berkum, Eric C.

    2012-01-01

    Behavior of road users (e.g. route choice, driving behavior) is a critical factor in the efficacy of measures applied in the context of Dynamic Traffic Management (DTM). In order for drivers to make well-informed decisions, it is required that information provided by DTM measures is perceived. In

  5. Sun Protection Behaviors Associated with Self-Efficacy, Susceptibility, and Awareness among Uninsured Primary Care Patients Utilizing a Free Clinic

    Directory of Open Access Journals (Sweden)

    Akiko Kamimura

    2015-01-01

    Full Text Available Background. Skin cancer is the most commonly diagnosed form of cancer in the United States (US. However, knowledge, behaviors, and attitudes regarding sun protection vary among the general population. The purpose of this study is to examine sun protection behaviors of low-income primary care patients and assess the association between these health behaviors and the self-efficacy, susceptibility, and skin cancer awareness. Methods. Uninsured primary care patients utilizing a free clinic (N=551 completed a self-administered survey in May and June 2015. Results. Using sunscreen was the least common tactic among the participants of this study. Skin cancer awareness and self-efficacy are important to improve sun protection behaviors. Spanish speakers may have lower levels of skin care awareness compared to US born and non-US born English speakers. Male and female participants use different sun protection methods. Conclusion. It is important to increase skin cancer awareness with self-efficacy interventions as well as education on low-cost sun protection methods. Spanish speaking patients would be a target population for promoting awareness. Male and female patients would need separate gender-specific sun protection education. Future studies should implement educational programs and assess the effectiveness of the programs to further promote skin cancer prevention among underserved populations.

  6. Clinical efficacy of Biejiaruangan compound tablets in treatment of primary biliary cirrhosis

    Directory of Open Access Journals (Sweden)

    HUANG Lingying

    2015-02-01

    Full Text Available ObjectiveTo evaluate the clinical efficacy of Biejiaruangan compound tablets in the treatment of primary biliary cirrhosis (PBC. MethodsIn a randomized, double-blind, placebo-controlled study, 56 patients with PBC were collected and equally divided into treatment group and control group. The treatment group was given Biejiaruangan compound tablets (4 pills per dose, 3 doses per day, oral administration combined with ursodeoxycholic acid (UDCA tablets (50 mg/pill, 10-15 mg per kg per day. The control group was given placebo (4 pills per dose, 3 doses per day, oral administration combined with UDCA tablets (50 mg/pill, 10-15 mg per kg per day. All patients were treated for 12 months. Clinical symptoms, PBC-40 scales, liver function [alanine aminotransferase (ALT, aspartate aminotransferase (AST, alkaline phosphatase (ALP, γ-glutamyl transpeptidase (GGT, and total bilirubin (TBil], and liver stiffness values in the two groups were evaluated before and after treatment. Comparison of continuous data between the two groups was made by t test, and comparison of categorical data was made by chi-square test. ResultsThe levels of ALT, AST, GGT, ALP, and TBil in the treatment group significantly decreased after 12 months of treatment (t=3.2019, P<0.01; t=3.0953, P<0.01; t=3.0279, P<0.01; t=2.4420, P<0.05; t=2.1621, P<0.05. In the control group, only the level of GGT significantly decreased after treatment (t=19981, P<0.01. The levels of GGT and ALP were significantly lower in the treatment group than in the control group (t=2.0061, P<0.05; t=2.3106, P<0.05. The liver stiffness value in the treatment group significantly decreased after treatment (14.37±10.58 vs 1002±5.96 kPa, t=2.1134, P<0.05. The PBC-40 scales of skin itch, fatigue, and social dimension in the treatment group significantly decreased after treatment for 12 months (t=2.5158, P<0.05; t=2.1409, P<0.05; t=3.2441, P<0.05. There were significant differences in

  7. Efficacy of a School-Based Primary Prevention Program for Coping with Exposure to Political Violence

    Science.gov (United States)

    Slone, Michelle; Shoshani, Anat

    2008-01-01

    A paradigm conceptualizing resilience as factors moderating between political violence exposure and psychological distress administered in a 7-year research project yielded a profile of factors promoting Israeli children's coping in conflict conditions. Three factors--social support mobilization, self-efficacy, and meaning attribution--were…

  8. Antimicrobial efficacy of three medicinal plants Glycyrrhiza glabra, Ficus religiosa, and Plantago major on inhibiting primary plaque colonizers and periodontal pathogens: An in vitro study

    Directory of Open Access Journals (Sweden)

    Hunny Sharma

    2016-01-01

    Conclusion:G. glabra and F. religiosa showed antibacterial activity against primary plaque colonizers and periodontal pathogens. However, further studies should be undertaken to affirm the same and test their efficacy in different concentration and clinical utility.

  9. Measuring the 'obesogenic' food environment in New Zealand primary schools.

    Science.gov (United States)

    Carter, Mary-Ann; Swinburn, Boyd

    2004-03-01

    Childhood obesity is an increasing health problem in New Zealand and many other countries. Information is needed to guide interventions that reduce the 'obesogenic' (obesity-promoting) elements of school environments. The aim of this study was to identify and measure the obesogenic elements of the school environment and the canteen sales of energy-dense foods and drinks. A self-completion questionnaire was developed for assessing each school's nutrition environment and mailed to a stratified random sample of New Zealand schools. The responses from primary schools (n = 200, response rate 61%) were analysed. Only 15.5% of schools had purpose-built canteen facilities and over half ran a food service for profit (31% profit to the school, 24.5% profit for the contractors). Only 16.5% of schools had a food policy, although 91% of those rated the policy as effective or very effective. The most commonly available foods for sale were pies (79%), juice (57%) and sausage rolls (54.5%). Filled rolls were the most expensive item (mean dollars 1.79) and fruit the least expensive (mean dollars 0.47). The ratio of 'less healthy' to 'more healthy' main choices was 5.6:1, for snacks it was 9.3:1 and for drinks it was 1.4:1. In contrast, approximately 60% of respondents said that nutrition was a priority for the school. Only 50% felt there was management support for healthy food choices and only 39% agreed that mainly nutritious food was offered by the food service. 'Less healthy' choices dominated food sales by more than 2:1, with pies being the top selling item (>55000 per week). We found that the food environment was not conducive to healthy food choices for the children at New Zealand schools and that this was reflected in the high sales of relatively unhealthy foods from the school food services. Programmes that improve school food through policies, availability, prices and school ethos are urgently needed.

  10. 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

  11. The Measurement of Classroom Management Self-Efficacy: A Review of Measurement Instrument Development and Influences

    Science.gov (United States)

    O'Neill, Sue Catherine; Stephenson, Jennifer

    2011-01-01

    Teachers' self-efficacy (SE) in their classroom management capabilities is thought to be an important factor in teachers' overall judgements of their teaching SE. Low SE in classroom management has been linked to teacher attrition and burnout, and reduced student learning outcomes. This article provides the first comprehensive review of classroom…

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

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    Oguche Innocent Ojonugwa

    2015-07-01

    Full Text Available 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 statements. Student’s self-efficacy was measured by asking students to rate themselves  from 1 (“No confidence” to 4 (“Complete confidence”.The self-efficacy of engineering students in Nigeria polytechnic were examined using mean and standard deviation. The mean score for Self-appraisal, Occupational Information, Goal selection, Planning and Problem solving are as follow (3.32, (2.97, (3.28, (3.082 and (3.012 respectively with self-appraisal scoring higher than the others. These findings enhance our understanding of the importance of self-efficacy in the development of employability skills of polytechnic engineering students in Nigeria, more importantly self-appraisal had the highest mean score. The practical implication is that the teaching style will have to shift from being teacher-centred leaning to student-centred learning in order to address and accommodate the need of student’s self-efficacy. Key words: Self-efficacy; Employability; Employability skills; Nigerian polytechnics; Engineering students

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

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    Szczepura Ala

    2011-06-01

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

  14. Measuring Practicing and Prospective Elementary Teachers' Efficacy for Classroom Management: A Preliminary Development and Validation Study

    Science.gov (United States)

    Putman, S. Michael

    2013-01-01

    Research has shown efficacy exerts a powerful influence on behavior. Classroom management represents one vehicle for demonstrations of these behaviors, yet few instruments focus solely on the measurement of this domain-specific form of efficacy. This research explored the relationship between teacher self-efficacy and classroom management through…

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

    OpenAIRE

    Morral Núria; Kamendulis Lisa M; Surendran Sneha; Park Jae-Seung

    2011-01-01

    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 ...

  16. Measuring the Teaching Self-Efficacy of Science, Technology, Engineering, and Math Graduate Teaching Assistants

    Science.gov (United States)

    DeChenne, Sue Ellen; Enochs, Larry

    2010-01-01

    An instrument to measure the teaching self-efficacy of science, technology, engineering, and mathematics (STEM) GTAs is adapted from a general college teaching instrument (Prieto Navarro, 2005) for the specific teaching environment of the STEM GTAs. The construct and content validity and reliability of the final instrument are indicated. The final…

  17. Measuring Self-Efficacy and Outcome Expectations for Resisting Social Pressures to Smoke

    Science.gov (United States)

    Langlois, Marietta A.; Petosa R. Linyak; Hallam, Jeffrey S.

    2006-01-01

    The purpose of this study was to develop a valid and reliable instrument to measure the Social Cognitive Theory (SCT) constructs of smoking refusal skill-efficacy, positive smoking refusal outcome expectations & importance and negative smoking refusal outcome expectations & importance. This article details the rigorous instrument development…

  18. Measuring teachers' pedagogical content knowledge in primary technology education

    NARCIS (Netherlands)

    Wim Jochems; dr. Ellen J. J Rohaan; Ruurd Taconis

    2009-01-01

    Pedagogical content knowledge is found to be a crucial part of the knowledge base for teaching. Studies in the field of primary technology education showed that this domain of teacher knowledge is related to pupils' increased learning, motivation,and interest. The common methods to investigate

  19. 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 (P<0.001). Although there were no differences regarding the cleaning efficacy of either system, Mtwo rotary files were far more time efficient.

  20. 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

    Introduction: 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. Methods and Materials: 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. Results: 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 (P<0.001). Conclusion: Although there were no differences regarding the cleaning efficacy of either system, Mtwo rotary files were far more time efficient. PMID:26523138

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

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    Carl Llor

    2008-10-01

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

  2. Comparison Efficacy of Interferential Currents and Desmopressin in Primary Enuresis Children of 5-15 Years Old

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    P Yazdanpanah

    2007-10-01

    Full Text Available Introduction & Objective: Nocturnal enuresis as a common disorder in children can create many problems. A variety of modalities has been used for its treatment but applying new and effective modalities can be of much interest. In this study efficacy of interferential currents (IFC, as a new modality, has been compared with nasal spray of desmopressin in treatment of primary nocturnal enuresis in 5-15 year old children. Materials & Methods: This is a prospective, randomized, clinical trial in which 39 patients received desmopressin (20µg/day for 3 weeks and left off gradually in six months, if it was responsive. The other 36 patients received IFC therapy (5 times/week, 20 minutes each session, up to 15 sessions. Efficacy of treatment was evaluated after completion of therapeutic sessions and recurrence rate was calculated one month later. Results: About 66.7% of patients were 5-10 and 33.3% were 11-15 years old. Of all subjects, 58.7% were male and 41.3% were female. In those patients who received IFC, complete response was observed in 25%, partial response in 36.1% and 38.9% had no response while in desmopressin group, complete response was achieved in 61.5%, and partial response in 25.6% of cases and 12.8% had no response to the treatment. The recurrence rate in IFC and desmopressin groups were 16.7 % and 23.1%, respectively. In 11-15 year old children, response rate was better than those for 5-10 years old. Male patients had the most rate of recurrence. Therapeutic side effects were not observed in any of the patients in both groups. Conclusion: Desmopressin and IFC are effective and safe modalities for treatment of primary nocturnal enuresis of children with less recurrence in females. Moreover, desmopressin had better efficacy while IFC had less recurrence rate. In addition, desmopressin showed better efficacy in females. IFC can be recommended as an effective and safe modality for treatment of primary nocturnal enuresis, with less

  3. In Vitro Comparative Evaluation of Cleaning Efficacy and Volumetric Filling in Primary Molars: Cone Beam Computed Tomography Evaluation

    Science.gov (United States)

    Deshpande, Anshula Neeraj; Joshi, Neelam Hasmukhbhai; Naik, Kishan S.

    2017-01-01

    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 (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. PMID:28566848

  4. 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.

  5. Efficacy of myofascial release techniques in the treatment of primary Raynaud's phenomenon.

    Science.gov (United States)

    Walton, Anne

    2008-07-01

    This study investigated whether myofascial release techniques performed on upper body connective tissue could mitigate the frequency, duration or pain intensity associated with primary Raynaud's phenomenon. Five treatments were administered over a 3-week treatment period on a 35-year-old female experiencing primary Raynaud's phenomenon for the past 12 years. A log was kept documenting frequency, duration and severity of pain. The myofascial work targeted the upper back, neck and arms according to hypothetical fascial meridian lines. Symptom duration was the one characteristic that showed improvement. After the first treatment, the duration of the subject's vasospastic episodes was reduced by almost half and continued to decrease throughout the 3 weeks of treatments. Neither the frequency or number of affected digits varied significantly from the pre-treatment weeks. The results suggest that by releasing restricted fascia, myofascial techniques may influence the duration and severity of the vasospastic episodes experienced in primary Raynaud's phenomenon.

  6. EFFICACY AND FINANCIAL VIABILITY OF PRIMARY PREVENTION OF ATOPIC DERMATITIS: PROTEIN-HYDROLYSATE-BASED FORMULAE

    Directory of Open Access Journals (Sweden)

    L. M. Ogorodova

    2013-01-01

    Full Text Available Primary prevention of allergy is an attractive aim due to high social, economic burden and increasing prevalence of allergic diseases. The up-to-date data strongly support the use of partially hydrolyzed whey formula for primary prevention of atopic dermatitis. This approach is effective and cost-saving both from societal and governmental health service perspectives. Pediatricians as well as parents of high risk children should be strictly aware of these data. Because of cost-saving effect of partially hydrolyzed whey formula governmental health service administrations should develop programs for primary prevention of atopic dermatitis with free supply of high risk children with this nutrition for first months of life.

  7. Measuring the condom use self-efficacy of deployed, enlisted male U.S. Naval personnel.

    Science.gov (United States)

    Norris, Anne E; Phillips, Raymond E; Grady, Kelly

    2007-01-01

    This article summarizes the development and psychometric analysis of a condom use self-efficacy measure for deployed, enlisted male U.S. Naval personnel. Sample ethnic subgroups included European American, Latino/Hispanic, African American, Asian American, Native American, Pacific Islander, and Biracial/Multiracial. Excellent reliability statistics were obtained for the full sample (alpha = .93, N = 2,722) and various ethnic subgroups (alpha = .93 to .95, n = 44 to 1,383). Correlations between self-efficacy scores and measures of condom use were similar in magnitude to effect sizes reported in research involving civilian populations (r = .18 to .34). Significant differences in self-efficacy scores for groups of condom users (e.g., consistent and nonconsistent users) for the full sample of men and ethnic subgroups provided further support for construct validity (p < .05). Study findings support the reliability and validity of the condom self-efficacy measure in this population and indicate its usefulness and the need for investigating its psychometric properties in other populations.

  8. Nightly treatment of primary insomnia with prolonged release melatonin for 6 months: a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety

    Directory of Open Access Journals (Sweden)

    Wade Alan G

    2010-08-01

    Full Text Available Abstract Background Melatonin is extensively used in the USA in a non-regulated manner for sleep disorders. Prolonged release melatonin (PRM is licensed in Europe and other countries for the short term treatment of primary insomnia in patients aged 55 years and over. However, a clear definition of the target patient population and well-controlled studies of long-term efficacy and safety are lacking. It is known that melatonin production declines with age. Some young insomnia patients also may have low melatonin levels. The study investigated whether older age or low melatonin excretion is a better predictor of response to PRM, whether the efficacy observed in short-term studies is sustained during continued treatment and the long term safety of such treatment. Methods Adult outpatients (791, aged 18-80 years with primary insomnia, were treated with placebo (2 weeks and then randomized, double-blind to 3 weeks with PRM or placebo nightly. PRM patients continued whereas placebo completers were re-randomized 1:1 to PRM or placebo for 26 weeks with 2 weeks of single-blind placebo run-out. Main outcome measures were sleep latency derived from a sleep diary, Pittsburgh Sleep Quality Index (PSQI, Quality of Life (World Health Organzaton-5 Clinical Global Impression of Improvement (CGI-I and adverse effects and vital signs recorded at each visit. Results On the primary efficacy variable, sleep latency, the effects of PRM (3 weeks in patients with low endogenous melatonin (6-sulphatoxymelatonin [6-SMT] ≤8 μg/night regardless of age did not differ from the placebo, whereas PRM significantly reduced sleep latency compared to the placebo in elderly patients regardless of melatonin levels (-19.1 versus -1.7 min; P = 0.002. The effects on sleep latency and additional sleep and daytime parameters that improved with PRM were maintained or enhanced over the 6-month period with no signs of tolerance. Most adverse events were mild in severity with no clinically

  9. 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…

  10. "It's Important to Put Yourself in Any Lesson That You Teach": Self-Efficacy in Action in the Primary Modern Foreign Languages Classroom

    Science.gov (United States)

    Pattison, Elaine Margaret

    2014-01-01

    This article explores how Bourdieu's notion of "habitus" might be employed to shed light on the self-efficacy of primary teachers as they take on an additional specialism when modern foreign languages becomes statutory in primary schools in the new English National Curriculum in 2014. The article argues that Bandura's four principles of…

  11. Efficacy of self-help manuals for anxiety disorders in primary care: a systematic review

    NARCIS (Netherlands)

    van Boeijen, C.A.; van Balkom, A.J.L.M.; van Oppen, P.C.; Blankenstein, N.; Cherpanath, A.; van Dyck, R.

    2005-01-01

    OBJECTIVE: The purpose of this study was to review effectiveness studies of self-help manuals for anxiety disorders in primary care. METHODS: A systematic review of six identified randomized controlled trials was carried out. In addition to outcome, the articles were coded on quality variables.

  12. Efficacy and safety of Oxalobacter formigenes to reduce urinary oxalate in primary hyperoxaluria

    NARCIS (Netherlands)

    Hoppe, Bernd; Groothoff, Jaap W.; Hulton, Sally-Anne; Cochat, Pierre; Niaudet, Patrick; Kemper, Markus J.; Deschênes, George; Unwin, Robert; Milliner, Dawn

    2011-01-01

    Primary hyperoxaluria (PH) is a rare genetic disease, in which high urinary oxalate (Uox) cause recurrent kidney stones and/or progressive nephrocalcinosis, often followed by early end-stage renal disease, as well as extremely high plasma oxalate, systemic oxalosis and premature death. Oxalobacter

  13. Social desirability effects on measures of adjustment to university, independence from parents, and self-efficacy.

    Science.gov (United States)

    Silverthorn, N A; Gekoski, W L

    1995-03-01

    Results of regression analyses on data from 96 first-year undergraduates indicated that social desirability (Jackson and Marlowe-Crowne Social Desirability Scales), particularly scores on the Jackson scale, is related strongly to scores on measures of adjustment (Student Adaptation to College Questionnaire), self-efficacy (Hale-Fibel Generalized Expectation for Success Scale), and independence (Psychological Separation Inventory) from mother, but not from father. In addition, both the Jackson and Marlowe-Crowne scales were correlated highly. Independence from parents and self-efficacy each continued to show a relationship with adjustment to university after social desirability effects were removed. Failure to remove the effect(s) of social desirability from the present measures is likely to lead to inflated estimates of their relation to each other or to other measures.

  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 Various Intracanal Medicaments in Human Primary Teeth with Necrotic Pulp against Candida Biofilms: An in vivo Study.

    Science.gov (United States)

    Paikkatt, Jophie V; Sreedharan, Sheela; Philomina, Beena; Kannan, V P; Santhakumar, Madhu; Kumar, Tv Anupam

    2017-01-01

    Candida has been associated with cases of secondary and persistent root canal infections. The purpose of this study was to evaluate and compare the effectiveness of commonly used intracanal medicament against Candida biofilms found in root canals of human primary teeth with necrotic pulp. Pulp canals of 45 single-rooted primary maxillary anterior teeth with pulp necrosis in 34 children were included in the study. They were divided into three groups of 15 samples each - group I: Ca(OH)2 (calcium hydroxide); group II: 1% chlorhexidine gel (CHX); and group III: 1% metronidazole gel. Bacterial count was obtained from each tooth at two different stages: (1) after instrumentation, and (2) after placement of the medication. Statistical analysis using the Statistical Package for the Social Sciences version 10.0 software program (Inc., Chicago, IL, USA) with Wilcoxon signed rank test after grouping the samples was performed. Ca(OH)2, 1% CHX gel, and 1% metronidazole gel were ineffective in completely eliminating Candida biofilms from root canal of human primary teeth with necrotic pulp. None of the commonly used intracanal medicaments, i.e., Ca(OH)2, 1% CHX gel, and 1% metronidazole gel, was effective in completely eliminating Candida biofilm from root canal of human primary teeth with necrotic pulp. Ineffectiveness of these medicaments against Candida has opened new door of research regarding the use of suitable intracanal medicaments against single and multispecies biofilms. Paikkatt JV, Sreedharan S, Philomina B, Kannan VP, Santhakumar M, Kumar TVA. Efficacy of Various Intracanal Medicaments in Human Primary Teeth with Necrotic Pulp against Candida Biofilms: An in vivo Study. Int J Clin Pediatr Dent 2017;10(1):45-48.

  16. Efficacy of the device combining high-frequency transcutaneous electrical nerve stimulation and thermotherapy for relieving primary dysmenorrhea: a randomized, single-blind, placebo-controlled trial.

    Science.gov (United States)

    Lee, Banghyun; Hong, Seung Hwa; Kim, Kidong; Kang, Wee Chang; No, Jae Hong; Lee, Jung Ryeol; Jee, Byung Chul; Yang, Eun Joo; Cha, Eun-Jong; Kim, Yong Beom

    2015-11-01

    To investigate the efficacy and safety of the combined therapy with high-frequency transcutaneous electrical nerve stimulation (hf-TENS) and thermotherapy in relieving primary dysmenorrheal pain. In this randomized, single-blind, placebo-controlled study, 115 women with moderate or severe primary dysmenorrhea were assigned to the study or control group at a ratio of 1:1. Subjects in the study group used an integrated hf-TENS/thermotherapy device, whereas control subjects used a sham device. A visual analog scale was used to measure pain intensity. Variables related to pain relief, including reduction rate of dysmenorrheal score, were compared between the groups. The dysmenorrheal score was significantly reduced in the study group compared to the control group following the use of the devices. The duration of pain relief was significantly increased in the study group compared to the control group. There were no differences between the groups in the brief pain inventory scores, numbers of ibuprofen tablets taken orally, and World Health Organization quality of life-BREF scores. No adverse events were observed related to the use of the study device. The combination of hf-TENS and thermotherapy was effective in relieving acute pain in women with moderate or severe primary dysmenorrhea. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    NARCIS (Netherlands)

    Chiarotto, A.; Vanti, C.; Ostelo, R.W.J.G.; Ferrari, S.; Tedesco, G.; Rocca, B.; Pillastrini, P.; Monticone, M.

    2015-01-01

    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

  18. [Patient satisfaction measure of the quality of primary health care].

    Science.gov (United States)

    Plentara, Radosław; Knyszyńska, Anna; Bazydło, Marta; Zabielska, Paulina; Kim, Andrzej; Kotwas, Artur; Rotter, Iwona; Kamola, Jolanta; Karakiewicz, Beata

    2015-01-01

    Primary health care centers are subject to supply and demand, while being the foundation of the health care system in the country. The aim of the study determination of satisfaction level of the patients with basic health care services. 124 persons we studied using a standardized questionnaire EUROPEP, developed by The European Working Party on Quality in Family Practice. Experiences 68% of respondents indicate the kindness and helpfulness of nurses POS, and more than half of the respondents (52%) said the same in the case of receptionists. Most of the respondents had a positive opinion about the behavior of GPs emphasizing their delicacy during the medical examinations (83%), respect for intimacy (82%), as well as a benevolent attitude towards patients (77%). However, despite the positive assessment of behavior, doctors in the opinion of 52% of the respondents did not offer them any preventive examinations, and in many cases (43%) did not pass the information regarding the healthy lifestyle. Every third patient (32%) did not receive information from doctor about the side effects of drugs. The results showed that significantly fewer than half of the GPs was interested in the sphere of psychosocial of their patients. Only 27% of respondents received from the doctor's help in dealing with fears about health. An even smaller percentage of respondents experienced interest in respect of their personal (23%) or material (23%) situation, while questions about family members from doctors heard 35% of patients. 1. The overall level of patient satisfaction with primary care services is high. Positively evaluated is the availability of a doctor, kindness, interest in health issues. 2. Patients experience a deficit of prevention and health promotion and they consider inadequate medical attention psychosocial problems. 3. It is necessary increased involvement of staff in health promotion and health prevention education through training in interpersonal communication. 4

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

    Science.gov (United States)

    Park, Jae-Seung; Surendran, Sneha; Kamendulis, Lisa M; Morral, Núria

    2011-01-18

    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. 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. 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. 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.

  1. 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.

  2. Validity of the visual analogue scale as an instrument to measure self-efficacy in resuscitation skills.

    Science.gov (United States)

    Turner, Nigel M; van de Leemput, Anita J; Draaisma, Jos M T; Oosterveld, Paul; ten Cate, Olle Th J

    2008-05-01

    Self-efficacy is an important factor in many areas of medical education, including self-assessment and self-directed learning, but has been little studied in resuscitation training, possibly because of the lack of a simple measurement instrument. We aimed to assess the validity of a visual analogue scale (VAS) linked to a single question as an instrument to measure self-efficacy with respect to resuscitation skills by comparing the VAS with a questionnaire and using known-groups comparisons. We developed questionnaires to measure self-efficacy for a number of resuscitation tasks and for computer skills. These were compared with VASs linked to a single question per task, using a multi-trait, multi-method matrix. We also used known-groups comparisons of self-efficacy in specific professional groups. There was good correlation between the questionnaires and the VASs for self-efficacy for specific resuscitation tasks. There was a less clear correlation for self-efficacy for paediatric resuscitation overall. There was no correlation between self-efficacy for resuscitation and computer tasks. In specific professional groups, measured self-efficacy accorded with theoretical predictions. A VAS linked to a single question appears to be a valid method of measuring self-efficacy with respect to specific well defined resuscitation tasks, but should be used with caution for multi-faceted tasks.

  3. 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.

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

    OpenAIRE

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

  5. Measuring stages of change, perceived barriers and self efficacy for physical activity in Saudi Arabia.

    Science.gov (United States)

    Al-Otaibi, Hala Hazam

    2013-01-01

    The benefits of physical activity are well established and recognized to prevent adults from many chronic diseases and particularly some forms of cancers. The present study was conducted to investigate the present status of physical activity among Saudi adults in Al-Ahsa, and to examine the association between the stages of change for physical activity and perceived barriers, and self efficacy. A cross- sectional study of 242 subjects (118 males and 124 females) attending health centers aged between 20-56 years, were personally interviewed for demographic data, anthropometric measurement, physical activity level, stages of change for physical activity, self efficacy and perceived barriers. Forty eight percent of the females were overweight and 16.9% of the males were obese with no significant difference between the genders for BMI categories. More than half of the females were inactive and 39% of the males were physically active with a significant difference (P=0.007). Twenty percent of the males were in maintenance stage, while similar percentage of the females were in contemplation stage. However the majority of the subjects were in pre-contemplation stage with a significant difference across the stages. Males had a higher mean score of self efficacy and less external barriers of physical activity. The major barrier among the females was lack of time (7.2±1.4) and in the males, lack of motivation (7.7±1.4). The females had less internal (21.2±3.8) barriers comparable to the males (23.08±4.7). Both genders had a significant relationship between stages of changes of physical activity and perceived barriers (internal and external), but in the females no significant difference across the stages was observed for self efficacy unlike the males who had a significant difference for self efficacy and self efficacy categories. The present study provided useful data on stages of change for physical activity and some psychosocial factors (self efficacy and perceived

  6. 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

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

    Science.gov (United States)

    Wong, Simon Sin-man; Yu, Wong L; Wang, Ki; Ahuja, Anil T

    2016-01-01

    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

  8. Evidence-Based Efficacy of Autologous Grated Cartilage in Primary and Secondary Rhinoplasty.

    Science.gov (United States)

    Manafi, Ali; Kaviani, Ali; Hamedi, Zahra Sadat; Rajabiani, Afsaneh; Manafi, Navid

    2017-05-01

    There are numerous methods to mold and shape cartilage grafts for use in rhinoplasty. Each technique has advantages and disadvantages. We are going to introduce a new method for cartilage shaping with long lasting effects confirmed by follow up examination and pathologic evaluation. Grated cartilage was used in 483 patients. For 89 cases, it was wrapped in fascia and in 394 patients, used as a filler per se or in contiguity with solid structural grafts. In 51 patients, the operation was primary rhinoplasty and 432 cases, underwent secondary rhinoplasty. Postoperatively, there was a mean follow up of 2.8 years. Graft viability, and capability to maintain almost original volume, and general durability were assessed. Out of 483 patients, only 23 cases (4.7%) needed later correction. In 11 cases (2%), it was due to overcorrection and some minor imperfections. In the rest 12 cases (2%), there was a need for more augmentation probably due to some degree of graft resorption. Three cases of these 12 patients, were corrected by outpatient shaved cartilage injection. According to the very low revision rate (less than 5%), we strongly recommend our grated cartilage graft for use in primary and secondary rhinoplasty. Our study showed that patient and surgeon`s satisfaction can be achieved with a high degree of confidence.

  9. Comparison of the pattern, efficacy, and tolerability of self-medicated drugs in primary dysmenorrhea: A questionnaire based survey

    Science.gov (United States)

    Sugumar, Ramya; Krishnaiah, Vasundara; Channaveera, Gokul Shetty; Mruthyunjaya, Shilpa

    2013-01-01

    Objective: To compare the pattern, efficacy, and tolerability of self-medicated drugs and to assess the adequacy of their dose in primary dysmenorrhea (PD). Materials and Methods: A survey using a self-developed, validated, objective, and structured questionnaire as a tool was conducted among subjects with PD. Statistical analysis was carried out using Chi-square test and ANOVA with post-hoc Tuckey's test. Results: Out of 641 respondents, 42% were self-medicated. The pattern of drugs used was: Dicyclomine, an unknown drug, mefenamic acid, mefenamic acid + dicyclomine, and metamizole by 35%, 29%, 26%, 9%, and 1% of respondents, respectively. Mefenamic acid + dicyclomine, the combination was the most efficacious in comparison to other drugs in moderate to severe dysmenorrhea. There was better tolerability with mefenamic acid + dicyclomine group compared to other drugs. Sub-therapeutic doses were used by 86% of self-medicating respondents. Conclusions: The prevailing self-medication practices were inappropriate in a substantial proportion of women with inadequate knowledge regarding appropriate drug choice, therapeutic doses, and their associated side effects. PMID:23716896

  10. Efficacy, pharmacokinetics, safety, and tolerability of Flebogamma 10% DIF, a high-purity human intravenous immunoglobulin, in primary immunodeficiency.

    Science.gov (United States)

    Berger, Melvin; Pinciaro, Paul J; Althaus, Arthur; Ballow, Mark; Chouksey, Akhilesh; Moy, James; Ochs, Hans; Stein, Mark

    2010-03-01

    Flebogamma 10% DIF represents an evolution of intravenous immune globulin from the previous 5% product to be administered at higher rates and with smaller infusion volumes. Pathogen safety is enhanced by the combination of multiple methods with different mechanisms of action. The objective of this study as to evaluate the efficacy, pharmacokinetics, and safety of Flebogamma 10% DIF for immunoglobulin replacement therapy in primary immunodeficiency diseases (PIDD). Flebogamma 10% DIF was administered to 46 subjects with well-defined PIDD at a dose of 300-600 mg/kg every 21-28 days for 12 months. Serious bacterial infection rate was 0.025/subject/year. Half-life in serum of the administered IgG was approximately 35 days. No serious treatment-related adverse event (AE) occurred in any patient. Most of the potentially treatment-related AEs occurred during the infusion, accounting for 20% of the 601 infusions administered. Flebogamma 10% DIF is efficacious and safe, has adequate pharmacokinetic properties, and is well-tolerated for the treatment of PIDD.

  11. 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.

  12. Comparative efficacy of two interventions to discontinue long-term benzodiazepine use: cluster randomised controlled trial in primary care.

    Science.gov (United States)

    Vicens, C; Bejarano, F; Sempere, E; Mateu, C; Fiol, F; Socias, I; Aragonès, E; Palop, V; Beltran, J L; Piñol, J L; Lera, G; Folch, S; Mengual, M; Basora, J; Esteva, M; Llobera, J; Roca, M; Gili, M; Leiva, A

    2014-06-01

    Benzodiazepines are extensively used in primary care, but their long-term use is associated with adverse health outcomes and dependence. To analyse the efficacy of two structured interventions in primary care to enable patients to discontinue long-term benzodiazepine use. A multicentre three-arm cluster randomised controlled trial was conducted, with randomisation at general practitioner level (trial registration ISRCTN13024375). A total of 532 patients taking benzodiazepines for at least 6 months participated. After all patients were included, general practitioners were randomly allocated (1:1:1) to usual care, a structured intervention with follow-up visits (SIF) or a structured intervention with written instructions (SIW). The primary end-point was the last month self-declared benzodiazepine discontinuation confirmed by prescription claims at 12 months. At 12 months, 76 of 168 (45%) patients in the SIW group and 86 of 191 (45%) in the SIF group had discontinued benzodiazepine use compared with 26 of 173 (15%) in the control group. After adjusting by cluster, the relative risks for benzodiazepine discontinuation were 3.01 (95% CI 2.03-4.46, PSIW and 3.00 (95% CI 2.04-4.40, P<0.0001) in the SIF group. The most frequently reported withdrawal symptoms were insomnia, anxiety and irritability. Both interventions led to significant reductions in long-term benzodiazepine use in patients without severe comorbidity. A structured intervention with a written individualised stepped-dose reduction is less time-consuming and as effective in primary care as a more complex intervention involving follow-up visits. Royal College of Psychiatrists.

  13. Psychometric properties of the Exercise Self-efficacy Scale in Dutch Primary care patients with type 2 diabetes mellitus.

    Science.gov (United States)

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

    2014-04-01

    Excercise self-efficacy is believed to influence physical activity bahavior. 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. Type 2 diabetes patients (n = 322; old) filled in the ESS and the short questionnaire to assess health enhancing physical activity (SQUASH). The structural validity of the ESS was assessed by means of principal axis factor analyses and confirmatory factor analysis. In addition, reliability and concurrent validity with the SQUASH outcomes "total" and "leisure time minutes/week of moderate to vigorous intensity physical activity" were evaluated. T tests and ANOVAs were used to examine ESS scores in subgroups. In addition, a 13-item version of the ESS was developed. Analyses were performed on complete cases (n = 255). Exploratory factor analysis suggested one underlying factor (total explained variance 54 %), with good internal consistency (α = 0.95). Confirmatory factor analysis showed a poor fit, as did a three-factor model suggested in an earlier research. Therefore, a 13-item ESS was developed with one underlying factor (total explained variance 59 %) and good internal consistency (α = 0.95). Both the 18-item and 13-item ESS correlated significantly with total and leisure time physical activity. ESS scores differed significantly between categories of education level and physical activity level. The 13-item ESS had sound psychometric properties in a large sample of primary care type 2 diabetes patients. The 13-item ESS could be useful in (intervention) research on physical activity in type 2 diabetes patients.

  14. 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.)

  15. [The efficacy of play-based education in preventing dengue in primary-school children].

    Science.gov (United States)

    Vesga-Gómez, Celmira; Cáceres-Manrique, Flor de María

    2010-08-01

    Evaluating the effectiveness of primary-school children's play-based education for improving knowledge about Dengue prevention, control and practice. This was a before-after type intervention study which was carried out in Bucaramanga between July and November 2009. A group of leading primary-school children received play-based education about Dengue and leadership after they had been surveyed regarding their knowledge about dengue control practices. Then they signed commitments to implement action with family and neighbours; they were followed-up for four months and home visits were made to assess commitment and repeat the survey. Data was compared before and after, by Chi2 test, considering pdengue as a disease (from 73 % to 95.5 %), as being very severe (82 % to 96.6 %), being transmitted by mosquitoes (82 % to 100 %), being caused by virus (1.1 % to 19.1 %), in recognising larvae (54 % to 95.5 %) and breeding sites (43 % to 88 %), recognising symptoms of fever (67.4 % to 97.8 %), pain in the bones (21.3 % to 62.9 %), headache (37.1 % to 64 %) and bleeding (16.8 % to 42.7 %), in the need for opportune consultation (77.5 % to 98.9 %), spraying (22.5 % to 47.2 %) and washing out water tanks (67.5 % to 89.7 %). The children fulfilled their commitment and creatively and inventively engaged in more activities. Play-based education was effective in improving knowledge and practice regarding dengue prevention.

  16. Measuring Self-Efficacy in the Context of Pediatric Diabetes Management: Psychometric Properties of the Self-Efficacy for Diabetes Scale.

    Science.gov (United States)

    Van Allen, Jason; Noser, Amy E; Littlefield, Andrew K; Seegan, Paige L; Clements, Mark; Patton, Susana R

    2017-07-04

    The Self-Efficacy for Diabetes Scale (SED) is a widely used measure of diabetes-specific self-efficacy with three subscales: diabetes-specific self-efficacy (SED-D), medical self-efficacy (SED-M), and general self-efficacy (SED-G). The present study examined the factor structure and construct validity of the SED in 116 youth, aged 10-16 years (13.60 ± 1.87), with type 1 diabetes mellitus. Confirmatory factor analysis (CFA) was used to examine the factor structure of the SED. Correlational and regression analyses examined relations between subscales and select outcomes. CFA of the original three-factor structure provided a poor fit to the data. Factor models using rescaled items were tested. Results provided preliminary evidence for the SED-D as an independent one-factor model, and for a reduced one-factor model. Significant associations were found between the SED subscales, responsibility for diabetes management, and glycated hemoglobin. Results provide limited support for the SED-D as a reliable and valid measure of diabetes-specific self-efficacy.

  17. Prevention of mother-to-child transmission of HIV in Zambia: implementing efficacious ARV regimens in primary health centers.

    Science.gov (United States)

    Mandala, Justin; Torpey, Kwasi; Kasonde, Prisca; Kabaso, Mushota; Dirks, Rebecca; Suzuki, Chiho; Thompson, Catherine; Sangiwa, Gloria; Mukadi, Ya Diul

    2009-08-27

    Safety and effectiveness of efficacious antiretroviral (ARV) regimens beyond single-dose nevirapine (sdNVP) for prevention of mother-to-child transmission (PMTCT) have been demonstrated in well-controlled clinical studies or in secondary- and tertiary-level facilities in developing countries. This paper reports on implementation of and factors associated with efficacious ARV regimens among HIV-positive pregnant women attending antenatal clinics in primary health centers (PHCs) in Zambia. Blood sample taken for CD4 cell count, availability of CD4 count results, type of ARV prophylaxis for mothers, and additional PMTCT service data were collected for HIV-positive pregnant women and newborns who attended 60 PHCs between April 2007 and March 2008. Of 14,815 HIV-positive pregnant women registered in the 60 PHCs, 2,528 (17.1%) had their CD4 cells counted; of those, 1,680 (66.5%) had CD4 count results available at PHCs; of those, 796 (47.4%) had CD4 countEfficacious ARV regimens beyond sdNVP can be implemented in resource-constrained PHCs. The majority (73.0%) of women identified eligible for ART were initiated on cART; however, a

  18. Prevention of mother-to-child transmission of HIV in Zambia: implementing efficacious ARV regimens in primary health centers

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    Mandala Justin

    2009-08-01

    Full Text Available Abstract Background Safety and effectiveness of efficacious antiretroviral (ARV regimens beyond single-dose nevirapine (sdNVP for prevention of mother-to-child transmission (PMTCT have been demonstrated in well-controlled clinical studies or in secondary- and tertiary-level facilities in developing countries. This paper reports on implementation of and factors associated with efficacious ARV regimens among HIV-positive pregnant women attending antenatal clinics in primary health centers (PHCs in Zambia. Methods Blood sample taken for CD4 cell count, availability of CD4 count results, type of ARV prophylaxis for mothers, and additional PMTCT service data were collected for HIV-positive pregnant women and newborns who attended 60 PHCs between April 2007 and March 2008. Results Of 14,815 HIV-positive pregnant women registered in the 60 PHCs, 2,528 (17.1% had their CD4 cells counted; of those, 1,680 (66.5% had CD4 count results available at PHCs; of those, 796 (47.4% had CD4 count ≤ 350 cells/mm3 and thus were eligible for combination antiretroviral treatment (cART; and of those, 581 (73.0% were initiated on cART. The proportion of HIV-positive pregnant women whose blood sample was collected for CD4 cell count was positively associated with (1 blood-draw for CD4 count occurring on the same day as determination of HIV-positive status; (2 CD4 results sent back to the health facilities within seven days; (3 facilities without providers trained to offer ART; and (4 urban location of PHC. Initiation of cART among HIV-positive pregnant women was associated with the PHC's capacity to provide care and antiretroviral treatment services. Overall, of the 14,815 HIV-positive pregnant women registered, 10,015 were initiated on any type of ARV regimen: 581 on cART, 3,041 on short course double ARV regimen, and 6,393 on sdNVP. Conclusion Efficacious ARV regimens beyond sdNVP can be implemented in resource-constrained PHCs. The majority (73.0% of women identified

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

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    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.

  20. Efficacy and tolerability of tropisetron in primary fibromyalgia--a highly selective and competitive 5-HT3 receptor antagonist. German Fibromyalgia Study Group.

    Science.gov (United States)

    Färber, L; Stratz, T; Brückle, W; Späth, M; Pongratz, D; Lautenschläger, J; Kötter, I; Zöller, B; Peter, H H; Neeck, G; Alten, R; Müller, W

    2000-01-01

    Based on a potential role for serotonin receptors in fibromyalgia, we investigated the efficacy and tolerability of treatment with tropisetron, a highly selective, competitive inhibitor of the 5-HT3 receptor. In this prospective, multicenter, double-blind, parallel-group, dose-finding study, 418 patients suffering from primary fibromyalgia (ACR criteria) were randomly assigned to receive either placebo, 5 mg, 10 mg or 15 mg tropisetron once daily, respectively. The duration of treatment was 10 days. The clinical response was measured by changes in pain-score, visual analog scale (VAS), and the number of painful tender-points. Treatment with 5 mg tropisetron resulted in a significantly higher response rate (39.2%) when compared with placebo (26.2%) (p=0.033). The absolute reduction in pain-score was -13.5% for 5 mg tropisetron, -13.0% for 10 mg tropisetron, and -6.3% for placebo (pVAS, while a clear trend in terms of clinical benefit was seen with 10 mg tropisetron. The number of painful tender-points was also reduced significantly (p=0.002) in the 5 mg tropisetron group. Of interest, during the 12-month follow-up period, pain intensity of responders on 5 mg and 10 mg tropisetron was still markedly below baseline. The treatment was well tolerated, with gastro-intestinal complaints being the most frequently reported side effects, in keeping with the known safety profile for 5-HT3 receptor antagonists. This study demonstrates the efficacy of short-term treatment with 5 mg tropisetron once daily in primary fibromyalgia. Treatment was well tolerated and prolonged clinical benefits were seen.

  1. Validation of decisional balance and self-efficacy measures for HPV vaccination in college women.

    Science.gov (United States)

    Lipschitz, Jessica M; Fernandez, Anne C; Larson, H Elsa; Blaney, Cerissa L; Meier, Kathy S; Redding, Colleen A; Prochaska, James O; Paiva, Andrea L

    2013-01-01

    Women younger than 25 years are at greatest risk for human papillomavirus (HPV) infection, including high-risk strains associated with 70% of cervical cancers. Effective model-based measures that can lead to intervention development to increase HPV vaccination rates are necessary. This study validated Transtheoretical Model measures of Decisional Balance and Self-Efficacy for seeking the HPV vaccine in a sample of female college students. Cross-sectional measurement development. Setting. Online survey of undergraduate college students. A total of 340 female students ages 18 to 26 years. Stage of Change, Decisional Balance, and Self-Efficacy. The sample was randomly split into halves for exploratory principal components analyses (PCAs), followed by confirmatory factor analyses (CFAs) to test measurement models. Multivariate analyses examined relationships between constructs. For Decisional Balance, PCA indicated two 4-item factors (Pros -α = .90; and Cons -α = .66). CFA supported a two-factor correlated model, χ(2)(19) = 39.33; p internal and external validity of these measures and their use in Transtheoretical Model-tailored interventions. Stage-construct relationships suggest that reducing the Cons of vaccination may be more important for HPV than for behaviors with a true Maintenance stage.

  2. The efficacy of strabismus surgery in adults: a review for primary care physicians.

    Science.gov (United States)

    Kushner, Burton J

    2011-04-01

    Many adult patients with strabismus are under the misconception that nothing can be done to correct the problem or that treatment is associated with a high degree of risk. Moreover, many optometrists, comprehensive ophthalmologists and primary care physicians are similarly misinformed. In fact, most adult patients with strabismus can be successfully treated, with ∼80% of patients achieving satisfactory alignment with one surgical procedure. In addition, adult strabismus surgery carries a relatively low risk, with serious complications being anecdotal and rare. The majority of adults will experience some improvement in binocular function after strabismus surgery even if the strabismus has been longstanding. Most commonly this takes the form of an expansion of binocular visual fields; however, some patients may also regain stereopsis. Consequently, strabismus surgery in adults is not merely cosmetic in most cases. There are many psychological and interpersonal benefits to adult strabismus surgery. These benefits are highlighted by the finding that the majority of adults with strabismus would trade a portion of their life expectancy to be rid of their ocular misalignment. Although adult strabismus surgery has been shown to be highly cost-effective, many adults with strabismus can be successfully managed by non-surgical means. If an adult with strabismus is under the impression, or was told, they cannot be treated, or that treatment is risky, they should consider a referral to an ophthalmologist specifically specialising in strabismus.

  3. Efficacy of oral vancomycin in recurrent primary sclerosing cholangitis following liver transplantation.

    Science.gov (United States)

    Hey, Penelope; Lokan, Julie; Johnson, Paul; Gow, Paul

    2017-09-25

    Primary sclerosing cholangitis (PSC) is a liver disease that leads to progressive destruction and stricturing of the biliary tree. Unfortunately, apart from orthotopic liver transplantation (OLT), there are no universally accepted therapies to treat this disease. Even following transplantation, recurrence of PSC is seen in approximately one quarter of patients and leads to high rates of graft failure. Oral vancomycin, through possible immunomodulatory and anti-inflammatory mechanisms, has been shown in small-scale studies to be successful in improving liver function tests in patients with pretransplant PSC. We report the first case of an adult patient diagnosed with recurrent PSC 4 years after OLT who was treated with oral vancomycin leading to complete normalisation of his liver biochemistry. This case adds to the growing literature of a potential therapeutic role for this antibiotic in PSC and highlights interesting questions regarding mechanisms of disease. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Academic Self-Efficacy among Junior High School Students in Ghana: Evaluating Factor Structure and Measurement Invariance across Gender

    Science.gov (United States)

    Ansong, David; Eisensmith, Sarah R.; Masa, Rainier D.; Chowa, Gina A.

    2016-01-01

    Self-efficacy is a universal construct, but few validated measures exist for researchers in developing countries to use in assessing youths' perceptions of their ability to achieve academic success. This study examined the cross-cultural suitability and psychometric properties of an academic self-efficacy scale (ASES) adapted for the Ghanaian…

  5. The construct validity and predictive validity of a self-efficacy measure for student teachers in competence-based education

    NARCIS (Netherlands)

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

    2013-01-01

    This study intends to investigate the validity of a self-efficacy measure which is developed for predictive and diagnostic purposes concerning student teachers in competence-based education. CFA results delivered converging evidence for the multidimensionality of the student teacher self-efficacy

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

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    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

  7. 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.

  8. [Study of the intervention measures for the occupational stress to the teachers in the primary and secondary schools].

    Science.gov (United States)

    Wu, Si-ying; Wang, Mian-zhen; Li, Jian; Zhang, Xue-feng

    2006-03-01

    To study the status of the occupational stress and the work ability of the teachers in the primary and secondary schools, then take some integrated intervention measures to reduce the occupational stress and improve their work ability, and evaluate the intervening efficacy. The levels of stressor and strain was measured with the occupation stress inventory revised edition (OSI-R) and the work ability was measured with the work ability index (WAI) for the teachers in nine primary and secondary schools in Sichuan Province, then health educations about occupational stress were taken to the teachers in the study group, the same test was carried out after one year for the teachers in the nine schools to evaluate the effect of intervention measures. (1) After intervening, among the six items of occupational role questionnaire, the scores of role overload, role boundary, responsibility and physical environment of the teachers in the study group significantly decreased, compared with the teachers in the control group, the scores of the role overload, role boundary and physical environment were significantly lower (P stress of teachers, strengthen their coping resource and improve their work ability.

  9. Efficacy of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP) primary version.

    Science.gov (United States)

    DiPerna, James Clyde; Lei, Puiwa; Bellinger, Jillian; Cheng, Weiyi

    2015-03-01

    A multisite cluster randomized trial was conducted to examine the effects of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007) on students' classroom social behavior. The final sample included 432 students across 38 second grade classrooms. Social skills and problem behaviors were measured via the SSIS rating scale for all participants, and direct observations were completed for a subsample of participants within each classroom. Results indicated that the SSIS-CIP demonstrated positive effects on teacher ratings of participants' social skills and internalizing behaviors, with the greatest changes occurring in classrooms with students who exhibited lower skill proficiency prior to implementation. Statistically significant differences were not observed between treatment and control participants on teacher ratings of externalizing problem behaviors or direct observation.

  10. Measuring Learning Quality in Ethiopia, India and Vietnam: From Primary to Secondary School Effectiveness

    Science.gov (United States)

    Iyer, Padmini; Moore, Rhiannon

    2017-01-01

    This paper examines the way in which learning quality has been conceptualised and measured in school effectiveness surveys conducted by Young Lives, a longitudinal study of child poverty. Primary school surveys were conducted in Vietnam in 2010-11 and Ethiopia in 2012-13, and surveys at upper-primary and secondary level were conducted in Ethiopia,…

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

    NARCIS (Netherlands)

    Verbakel, N.J.; Zwart, D.L.M.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.

    2013-01-01

    Background: 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

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

    NARCIS (Netherlands)

    Verbakel, N.J.; Zwart, D.L.M.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.

    2013-01-01

    Background: 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

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

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    Hadjar Siswantoro

    2015-01-01

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

  14. 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.

  15. Efficacy and safety of pemetrexed on recurrent primary central nervous system lymphomas in China: a prospective study

    Directory of Open Access Journals (Sweden)

    Sun Y

    2017-05-01

    Full Text Available Yi Sun,1–3,* Yong Wang,2,* Shaolong Han,3 Bo Xing,3 Hong Li,4 Yufang Zhu,2 Shizhen Zhou,2 Xiuhua Wang,2 Jun Xu,2 Rongjie Tao2 1School of Medicine and Life Sciences, University of Jinan, Shandong Academy of Medical Sciences, 2Department of Neurosurgery, Shandong Cancer Hospital affiliated to Shandong University, 3Department of Neurosurgery, The Sixth People’s Hospital of Jinan, 4Department of Ophthalmology and Otolaryngology, The Sixth People’s Hospital of Jinan, Jinan City, Shandong Province, People’s Republic of China *These authors contributed equally to this work Background: Pemetrexed, a new and novel agent for primary central nervous system lymphomas (PCNSLs, has shown to be efficient as a savage therapy for recurrent PCNSLs. However, more studies are needed. A prospective study was performed on 17 recurrent PCNSL patients with pemetrexed at Shandong Tumor Hospital in China to assess the efficacy and safety of pemetrexed for recurrent PCNSL patients. Materials and methods: The medical records and imaging data on all the cases of recurrent PCNSL patients with pemetrexed in our study were collected during August 2012 and April 2015. Folic acid, B12, and dexamethasone were used to induce toxicities related to pemetrexed. Patients were treated with pemetrexed at a dose of 900 mg/m2 intravenously every 3 weeks, and one cycle consists of 6 weeks. Results: A total of 17 cases of recurrent PCNSL patients were enrolled in our study, including 10 males and 7 females with a median age of 66.2 years (ranging from 35 to 81. After the treatment, five cases had complete remission, with partial remission in five cases, stable disease in four cases, and progressive disease in three cases. Consequently, the overall response rate was 58.8%, and the disease control rate was 82.4%. The median overall survival was 7.8 months (95% confidence interval: 5.9–9.6 months in the study of recurrent PCNSL patients. Conclusion: This study has been the first

  16. Development of the Korean primary care assessment tool--measuring user experience: tests of data quality and measurement performance.

    Science.gov (United States)

    Lee, Jae Ho; Choi, Yong-Jun; Sung, Nak Jin; Kim, Soo Young; Chung, Seol Hee; Kim, Jaiyong; Jeon, Tae-Hee; Park, Hoon Ki

    2009-04-01

    To develop a tool for assessing the performance of primary care services in South Korea from the patient's perspective and to test the validity of the tool under the conceptual framework of the recently developed definition of primary care in Korea. Item development for questionnaire and a cross-sectional survey for tool validation at 16 primary care clinics. All family physicians included in this study were required to have practiced at their current clinic for at least 2 years. A nine expert panel was assembled for tool development and patients (or guardians) who had visited their primary care clinic on six or more occasions over a period of more than 6 months participated in the survey. Scores corresponding to each domain of primary care. A total of 722 effective data sets were used for the analysis. Five items were eliminated from the preliminary 30-item tool after expert discussions at two seminars. Another four items were eliminated by principle component analysis. For each of the four domains (comprehensiveness, coordination function, personalized care, and family/community orientation), tests of scaling assumptions were well satisfied by all Likert-scaled measures. On the other hand, 'first contact' turned out to be a composite domain with five independent single-item scales. The Korean primary care assessment tool (version 1) consists of four multi-item scales and one composite scale. Widespread application of this tool will provide an empirical basis for the measurement, monitoring and continuous improvement of primary care in South Korea.

  17. 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…

  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...

  19. [Measurements of mechanical properties and morphology of root canal in maxillary primary anterior teeth].

    Science.gov (United States)

    Jia, Hu; He, Liu; Qing, Cai; Xuliang, Deng

    2017-08-01

    Objective This study aimed to measure the taper and diameter of root canal, as well as the elastic modulus and hardness in the root dentin of maxillary primary anterior teeth. Methods Patients under general anesthesia who needed root canal therapy in the maxillary primary anterior teeth were selected. Silicone impression material was used to take impressions. The impressions were scanned, and the taper and diameter of root canal were measured. Maxillary primary anterior teeth were collected in vitro. The elastic modulus and hardness of root dentin was tested. Results A total of 74 silicone impressions were obtained. The mean tapers of primary incisor teeth, primary lateral incisor teeth, and primary canine teeth were 0.106, 0.185, and 0.098, respectively. The mean diameters of the root canal 5 mm below the cementum-enamel junction (CEJ) were 1.267, 0.860, and 1.429 mm, respectively. The elastic modulus and hardness of root dentin were measured in 10 primary anterior teeth in vitro. The range of elastic modulus was 19.919-25.017 GPa. The range of hardness was 0.867-1.082 GPa. Conclusion The root canal post used in primary anterior teeth can be produced by the following data: taper of primary incisor teeth and primary canine teeth, 0.1; diameters of their tips, 1.2 mm and 1.4 mm, respectively; taper of primary lateral incisor teeth, 0.2; diameter of their tips, 0.8 mm; range of elastic modulus, 20-25 GPa; and range of hardness, 0.87-1.08 GPa.

  20. A Review of In Vitro and In Vivo Studies on the Efficacy of Herbal Medicines for Primary Dysmenorrhea

    Directory of Open Access Journals (Sweden)

    Kyoung-Sun Park

    2014-01-01

    Full Text Available Purpose. Primary dysmenorrhea (PD is a common gynecological complaint among adolescent girls and women of reproductive age. This study aims to review the findings of published articles on the in vitro and in vivo efficacy of herbal medicines for PD. Methods. In vitro and in vivo studies of herbal compounds, individual herbal extracts, or herbal formula decoctions published from their inception to April 2014 were included in this review. Results. A total of 18 studies involving herbal medicines exhibited their inhibitory effect on PD. The majority of in vitro studies investigated the inhibition of uterine contractions. In vivo studies suggest that herbal medicines exert a peripheral analgesic effect and a possible anti-inflammatory activity via the inhibition of prostaglandin (PG synthesis. The mechanisms of herbal medicines for PD are associated with PG level reduction, suppression of cyclooxygenase-2 expression, superoxide dismutase activation and malondialdehyde reduction, nitric oxide, inducible nitric oxide synthase, and nuclear factor-kappa B reduction, stimulation of somatostatin receptor, intracellular Ca2+ reduction, and recovery of phospholipid metabolism. Conclusions. Herbal medicines are thought to be promising sources for the development of effective therapeutic agents for PD. Further investigations on the appropriate herbal formula and their constituents are recommended.

  1. In vivo comparison of cavity disinfection efficacy with APF gel, Propolis, Diode Laser, and 2% chlorhexidine in primary teeth

    Directory of Open Access Journals (Sweden)

    P.V.M. Uday Mohan

    2016-01-01

    Full Text Available Background: The survival of atraumatic restorative treatment (ART restorations would be enhanced if near total elimination of cariogenic microorganisms could be done in the process of cavity cleaning before placing a restoration. Thus, use of disinfecting agents for achieving this goal could herald a new beginning in the field of contemporary dentistry. Aim: To assess and compare the cavity disinfection efficacy of APF gel, Brazilian Propolis, Diode Laser, and 2% chlorhexidine (CHX. Materials and Methods: The study was a randomized, single blinded, parallel grouped, active controlled trial. Eighty primary molars in 68 children with cavitated dentinal occlusal caries were randomly assigned into four groups (20 teeth each Group I: APF gel; Group II: Propolis; Group III: Diode Laser, and Group IV: 2% CHX (control. After cavity preparation using ART procedure, dentinal samples collected before and after disinfection with respective agent of the group. These samples were subjected to microbiological evaluation, for total viable count (TVC on blood agar, Streptococcus mutans on mutans-sanguis (MS agar, and Lactobacilli (LB on Rogosa agar. Results: Intragroup comparison (Wilcoxon signed rank test showed significant reductions in TVC, MS, and LB counts in all the groups. Pairwise Mann–Whitney test showed APF gel had least bacterial reductions among the agents tested. Conclusion: This study illustrated the need for cavity disinfection. Diode Laser and Brazilian Propolis are equally effective as 2% CHX in cavity disinfection.

  2. Efficacy of an educational material on second primary cancer screening practice for cancer survivors: a randomized controlled trial.

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    Dong Wook Shin

    Full Text Available Cancer surivors have limited knowledge about second primary cancer (SPC screening and suboptimal rates of completion of screening practices for SPC. Our objective was to test the efficacy of an educational material on the knowledge, attitudes, and screening practices for SPC among cancer survivors.Randomized, controlled trial among 326 cancer survivors from 6 oncology care outpatient clinics in Korea. Patients were randomized to an intervention or an attention control group. The intervention was a photo-novel, culturally tailored to increase knowledge about SPC screening. Knowledge and attitudes regarding SPC screening were assessed two weeks after the intervention, and screening practices were assessed after one year.At two weeks post-intervention, the average knowledge score was significantly higher in the intervention compared to the control group (0.81 vs. 0.75, P<0.01, with no significant difference in their attitude scores (2.64 vs. 2.57, P = 0.18. After 1 year of follow-up, the completion rate of all appropriate cancer screening was 47.2% in both intervention and control groups.While the educational material was effective for increasing knowledge of SPC screening, it did not promote cancer screening practice among cancer survivors. More effective interventions are needed to increase SPC screening rates in this population.ClinicalTrial.gov NCT00948337.

  3. Assessing the Efficacy of the Measure of Understanding of Macroevolution as a Valid Tool for Undergraduate Non-Science Majors

    Science.gov (United States)

    Romine, William Lee; Walter, Emily Marie

    2014-01-01

    Efficacy of the Measure of Understanding of Macroevolution (MUM) as a measurement tool has been a point of contention among scholars needing a valid measure for knowledge of macroevolution. We explored the structure and construct validity of the MUM using Rasch methodologies in the context of a general education biology course designed with an…

  4. Clinical efficacy of Zisheng pills in treatment of adverse reactions in patients with primary hepatocellular carcinoma after transcatheter arterial chemoembolization

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    LIU Xiaping

    2015-01-01

    Full Text Available ObjectiveTo investigate the clinical efficacy of Zisheng pills in the treatment of adverse reactions in patients with primary hepatocellular carcinoma (HCC after transcatheter arterial chemoembolization (TACE. MethodsThis study included 72 patients with liver cancer hospitalized in the Department of Liver Diseases and Department of Oncology, Wenzhou Hospital of Traditional Chinese Medicine, from June 2011 to May 2014. These cases were randomly divided into treatment group (n=37 and control group (n=35. All the patients were treated with TACE, as well as conventional symptomatic and supportive treatment. In addition, the treatment group was given Zisheng pills (one bag three times a day for at least three consecutive months. Comparison of categorical data was made by chi-square test, while comparison of continuous data (expressed as mean±SD was made by t test. Survival comparison was made by Kaplan-Meier method and log-rank test. ResultsAfter the first TACE, there were significant differences in poor appetite and abdominal distension between the treatment group and the control group (P<0.05; significant differences were also observed in CD3+ and CD4+ T lymphocytes between the two groups (P<0.05. After the second TACE, there were significant differences in postoperative fatigue, poor appetite, and abdominal distension, as well as postoperative Karnofsky score, between the treatment group and the control group (P<0.05; significant differences were also found in CD3+, CD4+, and CD8+ T lymphocytes and CD4+/CD8+ ratio between the two groups (P<0.05. The median survival time showed no significant differences between the treatment group and the control group (82 vs 74 weeks, P>0.05, but the 2-year overall survival rate was significantly higher in the treatment group than in the control group (43.2% vs 20%, P<0.05. ConclusionZisheng pills have good clinical efficacy in the treatment of adverse reactions in liver cancer patients after TACE

  5. The efficacy of Curcuma Longa L. extract as an adjuvant therapy in primary knee osteoarthritis: a randomized control trial.

    Science.gov (United States)

    Pinsornsak, Piya; Niempoog, Sunyarn

    2012-01-01

    Nonsteroidal anti-inflammatory Drugs (NSAIDs) is one of the most commonly use medication for treatment of knee osteoarthritis which has the analgesic and anti-inflammation by inhibition of prostaglandin synthesis via COX-1 and COX-2 isoenzyme. The problem of prolong using NSAIDs has side effect on kidney, liver and GI system. Curcumin longa extract Curcumin) is the Asian herbal medicine that has the anti-inflammatory effect by down regulate activation of NF-kappaB and proinflammatory cytokines such as Tumor Necrotic Factor-alpha, Interleukin-1, Interleukin-8, and Nitric Oxide Syntase. Many research data had advocate for the combination therapy which can increase safety and efficacy with less side effect compare with monotherapy regimen especially when the medicine has the different mechanism of action. The present study is the double blind prospective randomized control trial to evaluate the efficacy of curcumin as an adjuvant therapy of diclofenac in primary knee osteoarthritis. 44 patients were randomized to take NSAIDs (diclofenac) 75 mg/d with placebo and the other 44 took NSAIDs (diclofenac) 75 mg/d with curcumin 1,000 mg/d for 3 months. The authors evaluated the Visual Analog Scale (VAS) for pain and Knee Injury and Osteoarthritis Outcome Score (KOOS) every month for 3 months. At the end of study 36 patients were completed for the first group and 37 for the study group. There was no difference in VAS [p-value = 0.923 (F = 0.009)]. The KOOS was analyzed in 5 categories symptom, pain, function in daily living, function in sport and recreation and knee related quality of life. The curcumin with diclofenac group had tendency to be better in Pain and Function in daily living, but there were no statistic different in all group [p-value = 0.412 (F = 0.683), p-value = 0.814 (F = 0.056), p-value = 0.446 (F = 0.589), p-value = 0.224 (F = 1.511) and p-value = 0.938 (F = 0.006)]. In conclusion, the adjuvant therapy ofcurcumin with diclofenac has the potential beneficial

  6. 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…

  7. Efficacy and Safety of Doxepin 1 mg and 3 mg in a 12-week Sleep Laboratory and Outpatient Trial of Elderly Subjects with Chronic Primary Insomnia.

    Science.gov (United States)

    Krystal, Andrew D; Durrence, H Heith; Scharf, Martin; Jochelson, Philip; Rogowski, Roberta; Ludington, Elizabeth; Roth, Thomas

    2010-11-01

    to evaluate the efficacy and safety of doxepin 1 mg and 3 mg in elderly subjects with chronic primary insomnia. the study was a randomized, double-blind, parallel-group, placebo-controlled trial. Subjects meeting DSM-IV-TR criteria for primary insomnia were randomized to 12 weeks of nightly treatment with doxepin (DXP) 1 mg (n = 77) or 3 mg (n = 82), or placebo (PBO; n = 81). Efficacy was assessed using polysomnography (PSG), patient reports, and clinician ratings. Objective efficacy data are reported for Nights (N) 1, 29, and 85; subjective efficacy data during Weeks 1, 4, and 12; and Clinical Global Impression (CGI) scale and Patient Global Impression (PGI) scale data after Weeks 2, 4, and 12 of treatment. Safety assessments were conducted throughout the study. DXP 3 mg led to significant improvement versus PBO on N1 in wake time after sleep onset (WASO; P treatment groups. There were no significant next-day residual effects; additionally, there were no reports of memory impairment, complex sleep behaviors, anticholinergic effects, weight gain, or increased appetite. DXP 1 mg and 3 mg administered nightly to elderly chronic insomnia patients for 12 weeks resulted in significant and sustained improvements in most endpoints. These improvements were not accompanied by evidence of next-day residual sedation or other significant adverse effects. DXP also demonstrated improvements in both patient- and physician-based ratings of global insomnia outcome. The efficacy of DXP at the doses used in this study is noteworthy with respect to sleep maintenance and early morning awakenings given that these are the primary sleep complaints of the elderly. This study, the longest placebo-controlled, double-blind, polysomnographic trial of nightly pharmacotherapy for insomnia in the elderly, provides the best evidence to date of the sustained efficacy and safety of an insomnia medication in older adults.

  8. Posturography measures and efficacy of different physical treatments in somatic tinnitus.

    Science.gov (United States)

    Amanda, Bonaconsa; Manuela, Mazzoli; Antonia, Magnano; Claudio, Milanesi; Gregorio, Babighian

    2010-01-01

    Somatic modulation in tinnitus has been demonstrated by several studies although few investigations have been published on the efficacy of physical treatments in tinnitus subjects. In the present study the prevalence of somatic components to tinnitus were evaluated and the efficacy of two different physical treatments were compared: InterX® transcutaneous dynamic electrical stimulation and manual osteopathic therapy. Furthermore, posturographic measurements were analysed to verify the postural control in tinnitus subjects. 40 consecutive tinnitus patients, aged 18-65, were randomly selected for treatment (once a week for 2 months): 20 tinnitus subjects were treated with osteopathic manipulations, 20 with InterX®. They were evaluated pre and post therapy with audiogram up to 16 kHz, tinnitus pitch and loudness match, MML, THI questionnaire, posturography, structured interview with special attention on postural and movement influence on tinnitus, physical evaluation and osteopathic evaluation. 40 controls with no tinnitus, underwent audiological tests, postural and osteopathic evaluation for comparison. In our population, tinnitus sufferers presented more frequently musculoscheletal strains assessed with osteopathic visit and postural problems assessed with posturography measures in comparison with controls. Posturographic test, showed an average oscillating areas significantly greater in tinnitus participants (p ≤ 0.05), compared with control subjects. On the average in the treated groups, the enveloped areas were not significantly affected by either of the treatments. Tinnitus improved subjectively in most patients: loudness decreased, % time of awareness, % time of annoyance and quality of life was overall perceived as improved. This was mostly evident in subjects with muscular strain and tensions. This study indicates the benefit of physical, manipulation therapy for those patients with somatic modulation of their tinnitus, further studies are needed to

  9. Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: A scanning electron microscopy study

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    Hariharan V

    2010-01-01

    Full Text Available Aim: The purpose of this in-vitro study is to determine the efficacy of various irrigants in removing the smear layer in primary teeth root canals after hand instrumentation. Materials and Methods: The present study consisted of 30 human primary incisors which were sectioned at the cementoenamel junction horizontally. The specimens were divided randomly into four experimental and one control group having six teeth each and each group was treated with the specific irrigant. 5.25% NaOCl, 5.25% NaOCl + 10% EDTA, 6% citric acid, 2% chlorhexidine, saline (control were the irrigants evaluated for efficacy in removal of smear layer. The specimens were split along the longitudinal axis using a chisel after placing superficial grooves in cementum not extending to the root canal. The exposed surface was subjected to scanning electron microscopic analysis to reveal the efficacy of irrigants in removal of smear layer. The representative areas were evaluated twice at 15 days interval by a single evaluator. The scale for the smear layer removal by Rome et al was modified and used in the present study. Results: The pictures from the scanning electron microscopy showed that among the tested irrigants, citric acid has the best efficacy to remove the smear layer without altering the normal dentinal structures, which was supported by the lowest mean smear scores. The pictures from the 10%EDTA + 5.25% sodium hypochlorite group showed that even though it removed the smear layer, it adversely affected the dentine structure. SEM pictures of the other groups like sodium hypochlorite, chlorhexidine revealed that these irrigants does not have the capacity to remove the smear layer in primary teeth. Conclusions: The results of the present study clearly indicate the superior efficacy of 6% citric acid than the other tested irrigants on removing the smear layer in primary teeth root canals.

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

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    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

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

    Science.gov (United States)

    Sevá, Anaiá da Paixão; Martcheva, Maia; Tuncer, Necibe; Fontana, Isabella; Carrillo, Eugenia; Moreno, Javier; Keesling, James

    2017-01-01

    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 in this and in

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

    Science.gov (United States)

    Barbaranelli, Claudio; Ghezzi, Valerio; Fida, Roberta; Vecchione, Michele

    2017-01-01

    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. PMID:28676781

  13. 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.

  14. The Effects of Creative Drama-Based Instruction on Primary School Teachers’ Self-Efficacy and Conceptions of Teaching and Learning

    OpenAIRE

    Necdet Aykac

    2017-01-01

    The purpose of this study was to examine the influence of creative drama-based instruction on in-service primary teachers’ self-efficacy and teaching and learning conceptions. In this study, sequential explanatory mixed model was used. Questionnaires determining in-service teachers’ self-efficacy and teaching and learning conceptions were administrated as pre-test and post-test. In addition to this, as qualitative data at the beginning of the program, participants were asked to answer open-en...

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Ronny Scherer

    Full Text Available 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

  17. 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

  18. 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.

  19. An in vivo comparison of antimicrobial efficacy of sodium hypochlorite and Biopure MTAD™ against enterococcus faecalis in primary teeth: A qPCR study.

    Science.gov (United States)

    Tulsani, S G; Chikkanarasaiah, N; Bethur, S

    2014-01-01

    Biopure MTAD™, a new root canal irrigant has shown promising results against the most common resistant microorganism, E. faecalis, in permanent teeth. However, there is lack of studies comparing its antimicrobial effectiveness with NaOCl in primary teeth. The purpose of this study was to compare the in vivo antimicrobial efficacy of NaOCl 2.5% and Biopure MTAD™ against E. faecalis in primary teeth. Forty non vital single rooted primary maxillary anterior teeth of children aged 4-8 years, were irrigated either with NaOCl 2.5% (n=15), Biopure MTAD™ (n=15) and 0.9% Saline (n=10, control group). Paper point samples were collected at baseline (S1) and after chemomechanical preparation (S2) during the pulpectomy procedure. The presence of E. faecalis in S1 & S2 was evaluated using Real time Polymerase Chain Reaction. Statistical significant difference was found in the antimicrobial efficacy of NaOCl 2.5 % and BioPure MTAD™ when compared to saline (p>0.05). However, no statistical significant difference was found between the efficacies of both the irrigants. NaOCl 2.5% and BioPure MTAD™, both irrigants are equally efficient against E. faecalis in necrotic primary anterior teeth. MTAD is a promising irrigant, however clinical studies are required to establish it as ideal root canal irrigant in clinical practice.

  20. [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.

  1. Antiviral efficacy and mechanisms of action of oregano essential oil and its primary component carvacrol against murine norovirus.

    Science.gov (United States)

    Gilling, D H; Kitajima, M; Torrey, J R; Bright, K R

    2014-05-01

    To investigate the antiviral efficacy of oregano oil and its primary active component, carvacrol, against the nonenveloped murine norovirus (MNV), a human norovirus surrogate. Along with an observed loss in cell culture infectivity, the antiviral mechanisms of action were determined in side-by-side experiments including a cell-binding assay, an RNase I protection assay and transmission electron microscopy (TEM). Both antimicrobials produced statistically significant reductions (P ≤ 0·05) in virus infectivity within 15 min of exposure (c. 1·0-log10). Despite this, the MNV infectivity remained stable with increasing time exposure to oregano oil (1·07-log10 after 24 h), while carvacrol was far more effective, producing up to 3·87-log10 reductions within 1 h. Based on the RNase I protection assay, both antimicrobials appeared to act directly upon the virus capsid and subsequently the RNA. Under TEM, the capsids enlarged from ≤35 nm in diameter to up to 75 nm following treatment with oregano oil and up to 800 nm with carvacrol; with greater expansion, capsid disintegration could be observed. Virus adsorption to host cells did not appear to be affected by either antimicrobial. Our results demonstrate that carvacrol is effective in inactivating MNV within 1 h of exposure by acting directly on the viral capsid and subsequently the RNA. This study provides novel findings on the antiviral properties of oregano oil and carvacrol against MNV and demonstrates the potential of carvacrol as a natural food and surface (fomite) sanitizer to control human norovirus. © 2014 The Society for Applied Microbiology.

  2. Efficacy of Primary Collagen Cross-Linking with Photoactivated Chromophore (PACK-CXL) for the Treatment of Staphylococcus aureus-Induced Corneal Ulcers.

    Science.gov (United States)

    Tal, Kfir; Gal-Or, Orly; Pillar, Shani; Zahavi, Alon; Rock, Oded; Bahar, Irit

    2015-10-01

    To evaluate the efficacy of corneal collagen cross-linking (CXL) with photoactivated riboflavin (PACK-CXL) as primary therapy for Staphylococcus aureus-induced corneal ulcers in a rabbit model. The right eye of 40 rabbits was inoculated with S. aureus to induce formation of central corneal ulcers (day 1). The ulcer was examined on day 5, and rabbits were randomly assigned to 4 groups-group A: no treatment (control); group B: topical antibiotic treatment (cefazolin 50 mg/mL, garamycin 14 mg/mL drops, chloramphenicol 5% ointment every 2 hours); group C: PACK-CXL; group D: PACK-CXL + topical antibiotics. Follow-up by biomicroscopy was performed on day 5 and then every week for 1 month. The main outcome measures included infiltrates or the scar diameter, time to healing, time to full epithelialization, and a change in corneal thickness. After 1 month of treatment, group C ulcers had the smallest mean scar diameter (8.8 mm), followed by groups D (11.2 mm), B (13.0 mm), and A (24.5 mm) (P = 0.011). Group C had the shortest mean healing time (15.5 days), followed by groups D (17.2 days), B (19.7 days), and A (21.8 days). Analysis of relative reduction in the infiltrate size from day 5 yielded better results for groups C (P = 0.039) and D (P = 0.034) than those of group B. We demonstrate a beneficial effect of PACK-CXL as primary treatment, either as stand-alone or as an adjuvant to antimicrobial therapy.

  3. Diagnostic efficacy of the leukogram and the chemiluminometric ACTH measurement to diagnose canine hypoadrenocorticism.

    Science.gov (United States)

    Zeugswetter, F K; Schwendenwein, I

    2014-01-01

    The gold standard in the diagnosis of canine hypoadrenocorticism (HA) is the adrenocorticotropin (ACTH) response test. As synthetic ACTH (tetracosactide [Synacthen®]) is currently not available in the European Union, the evaluation of other diagnostic tests seemed warranted. The diagnostic efficacy of electrolytes, the leukogram and endogenous ACTH concentrations to diagnose HA was investigated. The medical records of 145 dogs with clinical signs suspect for spontaneous HA were included in a retrospective study. HA was diagnosed (n = 38) or ruled out (n = 84) by using an ACTH response test. In 23 patients HA was excluded by basal cortisol measurement. The diagnostic performance of various variables was assessed based on receiver operating characteristic (ROC) curves and by calculating differential positive rates. A decision tree (IBM SPSS Decision Trees 20, IBM Corporation) was constructed with the variables neutrophil to lymphocyte ratio (N/LR) and sodium to potassium ratio (Na/KR) to illustrate the diagnostic efficacy of the respective test results. The best single variables to diagnose HA were the endogenous ACTH concentration (area under the ROC curve [ROC AUC] 0.97; cutoff > 50 pmol/l: sensitivity 96%, specificity 100%) and the Na/KR (ROC AUC 0.905; cutoff ≤ 22: sensitivity 92%, specificity 91%). The diagnostic performance of various variables of the leukogram was poor to moderate (ROC AUC 0.625-0.828). 68% of dogs with HA had a Na/KR ≤ 22 and a N/LR ≤ 2.3, a combination not observed in dogs with non-adrenal diseases. As secondary HA is very rare, endogenous ACTH measurement is a very good alternative to the traditional ACTH response test. Data also suggest that the combination of a Na/KR ≤ 22 and a N/LR ≤ 2.3 is highly specific and can be used to rule in HA.

  4. 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'…

  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. Deficient knowledge of multidrug-resistant bacteria and preventive hygiene measures among primary healthcare personnel.

    Science.gov (United States)

    Mamhidir, Anna-Greta; Lindberg, Maria; Larsson, Rigmor; Fläckman, Birgitta; Engström, Maria

    2011-04-01

    This paper is a report of a study conducted to describe primary healthcare personnel's knowledge of multidrug-resistant and preventive hygiene measures. The group of patients at risk for multi-drug resistant bacteria is largely cared for in primary care. Knowledge of multidrug-resistant and hygiene preventive measures among primary healthcare personnel is therefore essential. A descriptive and comparative questionnaire survey among primary healthcare personnel was performed in 2008. In total, five urban and rural primary healthcare centres situated in one county in central Sweden were included. Convenient sampling was used and 10 physicians, 38 district nurses and 10 nursing assistants participated. Knowledge/medical facts concerning multidrug-resistant and hygiene preventive measures were investigated and data were analysed using a quantitative approach. Knowledge/medical facts concerning several aspects of multidrug-resistant bacteria, particularly Extended-Spectrum-Beta-Lactamase producing bacteria, were deficient as was knowledge of different aspects of hygiene preventive measures. Physicians showed significantly better results than district nurses and nursing assistants did. Awareness of proper hand-washing as an effective preventive method and use of aprons in nursing care was high among all participants. Staff who knew they had cared for these patients had significantly better results than the others did. Our findings suggest that evidence-based education of multidrug-resistant and hygiene preventive measures, in primary health with subsequent follow-ups should become a prioritized clinician and management concern. Research is needed that focus implementation of evidence-based educations, staff attitudes and responsibilities related to the work with patients at risk of multidrug-resistant bacteria. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  7. Reducing therapist contact in cognitive behaviour therapy for panic disorder and agoraphobia in primary care: global measures of outcome in a randomised controlled trial.

    Science.gov (United States)

    Sharp, D M; Power, K G; Swanson, V

    2000-01-01

    BACKGROUND: Panic disorder, with and without agoraphobia, is a prevalent condition presenting in general practice. Psychological treatments are effective but are limited by restricted availability. Interest has grown in methods by which the efficiency and thus availability of psychological treatments can be improved, with particular emphasis on reduced therapist contact formats. AIM: To evaluate the relative efficacy in a primary care setting of a cognitive behaviour therapy (CBT) delivered at three levels of therapist contact: standard contact, minimum contact, and bibliotherapy. METHOD: A total of 104 patients were randomly allocated to receive standard therapist contact, minimum therapist contact or bibliotherapy, with 91 patients completing treatment. All patients received an identical treatment manual and were seen by the same psychologist therapist. Outcome was reported in terms of brief global ratings of severity of illness, change in symptoms, and levels of social disruption. These brief measures were chosen to be suitable for use in general practice and were used at treatment entry and endpoint. RESULTS: The standard therapist contact group had the strongest and most comprehensive treatment response, showing significant differences from the bibliotherapy group on all, and the minimum therapist contact group on some, endpoint measures. Some reduction in efficacy was therefore found for the reduced therapist contact groups. CONCLUSION: The standard therapist contact group showed the greatest treatment efficacy in the present study. As it was of notably shorter duration than many other current formulations of CBT, it represents a useful and efficient treatment for panic disorder and agoraphobia in primary care. PMID:11224967

  8. Efficacy of Fascial Distortion Model Treatment for Acute, Nonspecific Low-Back Pain in Primary Care: A Prospective Controlled Trial.

    Science.gov (United States)

    Richter, Detlef; Karst, Matthias; Buhck, Hartmut; Fink, Matthias G

    2017-06-23

    Context • Low-back pain (LBP) is a prevalent and potentially crippling condition for which treatment is often unsatisfactory from the perspectives of physicians, patients, and payers. The application of the fascial distortion model (FDM), an integrated concept for the diagnosis and manipulative treatment of musculoskeletal disorders, is conceptually promising for LBP but has not been investigated systematically. Objective • The study intended to provide proof of concept to establish the noninferiority of the FDM treatment as opposed to the therapy recommended by the German National Disease Management Guideline (NDMG) for acute LBP. Design • The study was a prospective, nonrandomized, controlled, parallel-group trial. Setting • The study took place in a private practice for surgery and orthopedics. Participants • Seventy-seven outpatients with acute LBP with an average age of 42.6 ± 13.5 y, 50.6% of whom were male, took part in the study. Intervention • Participants in the intervention group (FDM group) received osteopathic manipulative treatments according to the FDM, whereas the control group (NDMG group) received an active control treatment following the NDMG. Outcome Measures • Comparing the FDM group (n = 39) and the NDMG group (n = 38), the study measured pain (visual analog scale, patient diary), functional (FFbH-R) and self-reported vocational status, and use of medication (patient diary) at baseline and after 1, 4 and 12 wk of treatment. Results • The study found marked improvements of the symptoms in both groups, with a faster onset of efficacy and significantly less medication under the FDM treatment. Conclusions • FDM appears to be effective with regard to pain relief and functional improvement for LBP.

  9. The Effects of Creative Drama-Based Instruction on Primary School Teachers’ Self-Efficacy and Conceptions of Teaching and Learning

    Directory of Open Access Journals (Sweden)

    Necdet Aykac

    2017-03-01

    Full Text Available The purpose of this study was to examine the influence of creative drama-based instruction on in-service primary teachers’ self-efficacy and teaching and learning conceptions. In this study, sequential explanatory mixed model was used. Questionnaires determining in-service teachers’ self-efficacy and teaching and learning conceptions were administrated as pre-test and post-test. In addition to this, as qualitative data at the beginning of the program, participants were asked to answer open-ended questions to map their readiness for the program, including their expectations. At the end of the program they were asked to what degree their expectations were met, and what they learned from the program. A total of 20 female and 20 male in-service primary teachers participated in creative drama-based instruction that consisted of a total of 48 hours over six days. Results showed that the creative drama-based instruction increased primary teachers’ self-efficacy. Teachers reported that creative drama-based instruction had teachers develop more constructivist approach in teaching and learning. Implications and future research direction were also discussed.

  10. 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...... not change (n = 4). Overall, the proportion of patients assigned to the intermediate-risk category decreased from 56% to 51%. INTERPRETATION: Adding CRP measurement to the diagnostic work-up for suspected pneumonia in primary care improved the discrimination and risk classification of patients. However...

  11. 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…

  12. 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.

  13. Usability of the Primary Measures of Music Audiation (PMMA) with 5-Year-Old Korean Children

    Science.gov (United States)

    Lee, Jooyoung

    2010-01-01

    The purpose of this study was to determine whether a standardized test of music aptitude developed for American children yields results, which may have valid interpretation when used with 5-year-old Korean children. The specific questions regarding the Primary Measures of Music Audiation (PMMA) norms were: (1) Does PMMA when used with 5-year-old…

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

    Science.gov (United States)

    Chen, Hongfei; Xia, Yun; Zhu, Binbin; Hu, Xiawei; Xu, Shihao; Chen, Limei; Papadimos, Thomas J; Wang, Wantie; Wang, Quanguang; Xu, Xuzhong

    2014-01-01

    The reversal efficacy of 2% lipid emulsion in cardiac asystole induced by different concentrations of bupivacaine is poorly defined and needs to be determined. 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. 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 < 0.05). The concentration of bupivacaine and the reversal effects of a 2% lipid emulsion showed a typical transoid S-shaped curve, R(2) = 0.9983, IC50 value was 102.5 μmol/L (95% CI: 92.44 - 113.6). There is a concentration-response relationship between the concentrations of bupivacaine and the reversal effects of 2% lipid emulsion.

  15. 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

    . 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...... Communication skills training Self-efficacy Self-assessment Calgary-Cambridge Guide Questionnaire Validity Reliability......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...

  16. 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.

  17. Remotely Programmed Deep Brain Stimulation of the Bilateral Subthalamic Nucleus for the Treatment of Primary Parkinson Disease: A Randomized Controlled Trial Investigating the Safety and Efficacy of a Novel Deep Brain Stimulation System.

    Science.gov (United States)

    Li, Dianyou; Zhang, Chencheng; Gault, Judith; Wang, Wei; Liu, Jianmin; Shao, Ming; Zhao, Yanyan; Zeljic, Kristina; Gao, Guodong; Sun, Bomin

    2017-01-01

    Deep brain stimulation (DBS) is the most commonly performed surgery for the debilitating symptoms of Parkinson disease (PD). However, DBS systems remain largely unaffordable to patients in developing countries, warranting the development of a safe, economically viable, and functionally comparable alternative. To investigate the efficacy and safety of wirelessly programmed DBS of bilateral subthalamic nucleus (STN) in patients with primary PD. Sixty-four patients with primary PD were randomly divided into test and control groups (1:1), where DBS was initiated at either 1 month or 3 months, respectively, after surgery. Safety and efficacy of the treatment were compared between on- and off-medication states 3 months after surgery. Outcome measures included analysis of Unified Parkinson's Disease Rating Scale (UPDRS) scores, duration of "on" periods, and daily equivalent doses of levodopa. All patients were followed up both 6 and 12 months after surgery. Three months after surgery, significant decrease in the UPDRS motor scores were observed for the test group in the off-medication state (25.08 ± 1.00) versus the control group (4.20 ± 1.99). Bilateral wireless programming STN-DBS is safe and effective for patients with primary PD in whom medical management has failed to restore motor function. © 2017 S. Karger AG, Basel.

  18. 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…

  19. 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, structura...

  20. 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…

  1. 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…

  2. The measurement of primary productivity in a high-rate oxidation pond (HROP)

    OpenAIRE

    Berner, T.; Dubinsky, Z.; Schanz, F; Grobbelaar, J.U.; Rai, H; Uehlinger, U.; Falkowski, P.G.

    2017-01-01

    A high-rate oxidation pond is studied as a model system for comparing 14C and oxygen evolution methods as tools for measuring primary productivity in hypertrophic aquatic systems. Our results indicate that at very dense algal populations (up to 5 mg chl. a l−1) and high photosynthetic rates, 14C based results may severely underestimate primary productivity, unless a way is found to keep incubation times very short. Results obtained with our oxygen electrode were almost an order of magnitude h...

  3. [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.

  4. 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.

  5. Measures to Assess the Noncognitive Symptoms of Dementia in the Primary Care Setting.

    Science.gov (United States)

    Forester, Brent P.; Oxman, Thomas E.

    2003-08-01

    Noncognitive symptoms associated with Alzheimer's disease and related dementias include psychosis, mood disturbances, personality changes, agitation, aggression, pacing, wandering, altered sexual behavior, changed sleep patterns, and appetite disturbances. These noncognitive symptoms of dementia are common, disabling to both the patient and the caregiver, and costly. Primary care physicians will often play a major role in diagnosing and treating dementia and related disorders in the community. Accurate recognition and treatment of noncognitive symptoms is vital. A brief, user-friendly assessment tool would aid in the clinical management of noncognitive symptoms of dementia. Accordingly, we reviewed the available measures for their relevance in a primary care setting. Among these instruments, the Neuropsychiatric Inventory-Questionnaire seems most appropriate for use in primary care and worthy of further investigation.

  6. Efficacy and safety of alternating norfloxacin and rifaximin as primary prophylaxis for spontaneous bacterial peritonitis in cirrhotic ascites: a prospective randomized open-label comparative multicenter study.

    Science.gov (United States)

    Assem, M; Elsabaawy, M; Abdelrashed, M; Elemam, S; Khodeer, S; Hamed, W; Abdelaziz, A; El-Azab, G

    2016-03-01

    Primary prevention of spontaneous bacterial peritonitis (SBP) is an important strategy to reduce morbidity and mortality in cirrhotic patients with ascites. Efficacy and safety of alternating rifaximin and norfloxacin as primary prophylaxis is questionable. Three hundred thirty-four cirrhotic patients with high SAAG (≥1.1) ascites, protein level in ascitic fluid less than 1.5 g/dL with advanced liver disease (Child-Pugh score >9 points with serum bilirubin level >3 mg/dL) or renal impairment (serum creatinine level >1.2 mg/dL, blood urea nitrogen level >25 mg/dL, or serum sodium level <130 mEq/L) were included in an open-label, randomized study aimed at comparing alternating use of norfloxacin and rifaximin vs. norfloxacin or rifaximin alone as primary prophylaxis for SBP. Both intention-to-treat and per-protocol efficacy analyses were done after 6 months of treatment by assessment of ascitic fluid neutrophil count. Safety analysis was done for all intention-to-treat populations. Alternating norfloxacin and rifaximin showed superior prophylaxis by intention-to-treat (74.7 vs. 56.4% vs. 68.3%, p < 0.048). Pairwise analysis showed that alternating regimen had lower probability to develop SBP when compared to a norfloxacin-based regimen in intention-to-treat (p = 0.016) and per protocol analysis (p = 0.039). There was no difference among the studied groups regarding the incidence and severity of adverse events reported. Alternating norfloxacin- and rifaximin-based primary prophylaxis for SBP showed higher efficacy with the same safety profile when compared with monotherapy of norfloxacin.

  7. Magnitude of efficacy measurements in grass allergy immunotherapy trials is highly dependent on pollen exposure.

    Science.gov (United States)

    Durham, S R; Nelson, H S; Nolte, H; Bernstein, D I; Creticos, P S; Li, Z; Andersen, J S

    2014-05-01

    The objective was to evaluate the association between grass pollen exposure, allergy symptoms and impact on measured treatment effect after grass sublingual immunotherapy (SLIT)-tablet treatment. The association between grass pollen counts and total combined rhinoconjunctivitis symptom and medication score (TCS) was based on a post hoc analysis of data collected over six trials and seven grass pollen seasons across North America and Europe, including 2363 subjects treated with grass SLIT-tablet or placebo. Daily pollen counts were obtained from centralized pollen databases. The effect of treatment on the relationship between the TCS and pollen counts was investigated, and the relative difference between grass SLIT-tablet and placebo as a function of average grass pollen counts was modelled by linear regression. The magnitude of treatment effect based on TCS was greater with higher pollen exposure (P pollen exposure during the first period of the season, with predicted reduction in TCS = 12% + 0.35% × pollen count (slope significantly different from 0, P = 0.003; R(2)  = 0.66). Corresponding correlations to the entire grass pollen season and to the peak season were equally good, whereas there was a poor correlation between difference in measured efficacy and pollen exposure during the last part of the season. In seasonal allergy trials with grass SLIT-tablet, the observed treatment effect is highly dependent on pollen exposure with the magnitude being greater with higher pollen exposure. This is an important relationship to consider when interpreting individual clinical trial results. © 2014 The Authors. Allergy Published by John Wiley & Sons Ltd.

  8. Validity of the visual analogue scale as an instrument to measure self-efficacy in resuscitation skills

    NARCIS (Netherlands)

    Turner, Nigel M.; de Leemput, Anita J. van; Draaisma, Jos M. T.; Oosterveld, Paul; ten Cate, Olle Th J.

    CONTEXT Self-efficacy is an important factor in many areas of medical education, including self-assessment and self-directed learning, but has been little studied in resuscitation training, possibly because of the lack of a simple measurement instrument. OBJECTIVE We aimed to assess the validity of

  9. 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 ...

  10. The development of an instrument to measure the self-efficacy of students participating in VEX robotics competitions

    Science.gov (United States)

    Robinson, Trevor P.

    The number of robotics competitions has steadily increased over the past 30 years. Schools are implementing robotics competitions to increase student content knowledge and interest in science, technology, engineering, and mathematics (STEM). Companies in STEM-related fields are financially supporting robotics competitions to help increase the number of students pursuing careers in STEM among other reasons. These financial supporters and school administrations are asking what the outcomes of students participating in competitive robotics are. Few studies have been conducted to investigate these outcomes. The studies that have been conducted usually compare students in robotics to students not in robotics. There have not been any studies that compare students to themselves before and after participating in robotics competitions. This may be due to the lack of available instruments to measure student outcomes. This study developed an instrument to measure the self-efficacy of students participating in VEX Robotics Competitions (VRC). The VRC is the world's largest and fastest growing robotics competition available for middle and high school students. Self-efficacy was measured because of its importance to the education community. Students with higher self-efficacy tend to persevere through difficult tasks more frequently than students with low self-efficacy. A person's self-efficacy has major influence over what interests, activities, classes, college majors, and careers he or she will pursue in life. The self-efficacy survey instrument created through this study was developed through an occupational and task analysis (OTA), and initial content and face validity was established through the OTA process. Exploratory and confirmatory factor analyses were also conducted to assist in instrument validation. The reliability was calculated using Cronbach's alpha. Face validity was established through the OTA process. Construct validity was established through the factor

  11. Blood pressure measurements are unreliable to diagnose hypertension in primary care.

    Science.gov (United States)

    Sebo, Paul; Pechère-Bertschi, Antoinette; Herrmann, François R; Haller, Dagmar M; Bovier, Patrick

    2014-03-01

    To evaluate the accuracy of blood pressure (BP) measurements performed by primary care physicians (PCPs), and to assess whether it improves following a short theoretical training. Observational study in 26 primary care practices in Geneva, Switzerland. The PCPs were asked to measure BP on 10 volunteers, within the usual context of their practice. Two trained research assistants repeated the measures immediately after the PCPs. The PCPs were then randomized to receive detailed training documentation on standardized BP measurement (group I: 14 doctors) or information about high BP (group II: 12 doctors). Measures were repeated a few weeks later. We computed accuracy and diagnostic categorization of high BP comparing the PCPs' measurements to the average value of four measurements by the research assistants (gold standard). T-tests were used to compare measurements between the two educational groups, both at baseline and following exposure to the educational material. BP measurements were performed on 257 volunteers at baseline and 251 after training. At baseline, the mean BP difference between PCPs and the gold standard were 23.0 mmHg (21.3-24.6) for systolic and 15.3 mmHg (14.3-16.3) for DBP. Following training, the mean difference remained high [group I: 22.3 mmHg (20.4-24.2) and 14.4 mmHg (12.6-16.2); group II: 25.3 mmHg (22.7-27.9) and 17.0 mmHg (15.3-18.7)]. As a result, 24-32% volunteers were misdiagnosed as having systolic hypertension and 15-21% as having diastolic hypertension. Though widely used in the assessment of hypertension in ambulatory settings, in-office BP measurements are highly inaccurate, even following training.

  12. 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

    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...... 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...... provides superior efficacy and comparable tolerability to pravastatin in elderly patients....

  13. Enhanced treatment for depression in primary care : first year results on compliance, self-efficacy, the use of antidepressants and contacts with the primary care physician

    NARCIS (Netherlands)

    Smit, A; Tiemens, BG; Ormel, J; Kluiter, H; Jenner, JA; van de Meer, K; van Os, TWDP; Conradi, HJ

    2005-01-01

    Objective: We describe the contents and feasibility of the Depression Recurrence Prevention (DRP)-Program, a structured psycho-educational self-management intervention based on an ongoing relationship between patient, prevention specialist and primary care physician. The DRP-Program consisted of

  14. Alternative measure for education variable in an empirical economic growth model: Is primary education less important?

    OpenAIRE

    Tin-Chun Lin

    2006-01-01

    In this paper, an alternative measure of the education variable is proposed in an empirical economic growth model. Taiwan from 1964-2000 is selected as a case study. The main innovation of this paper is the weighting of education inputs by schooling level as an additional input into the application of production. Results reveal that primary education carries the greatest credits in Taiwan's economic development, which suggests that educators and policy makers value the importance of the found...

  15. 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…

  16. Efficacy of resin infiltration of proximal caries in primary molars: 1-year follow-up of a split-mouth randomized controlled clinical trial.

    Science.gov (United States)

    Ammari, Michelle Mikhael; Jorge, R C; Souza, I P R; Soviero, V M

    2017-10-08

    The main purpose of this split month, randomized, controlled clinical trial was evaluate the efficacy of caries infiltration in controlling the progression of non-cavitated proximal lesions in primary molars. Anxiety and time required for the caries infiltration was also evaluated. Fifty healthy children, 5 to 9 years, presenting two primary molars with proximal caries lesions (1/2 of the enamel or outer 1/3 of dentin), were included. Lesions were randomly allocated to the test group (fluoridated toothpaste + flossing + infiltration) or to the control group (fluoridated toothpaste + flossing). Caries risk was based on the Cariogram model. The main outcome after 1-year radiographic follow up was assessed by an independent blinded examiner A facial image scale (FIS) was applied to assess dental anxiety and time required to perform the infiltration was recorded. Of the sample, 92.9% corresponded to high or medium caries risk. In 42 patients (1-year follow up), caries progression was observed in 11.9% (5/42) of the test lesions compared with 33.3% (14/42) of the control lesions (p Caries infiltration of proximal caries lesions in primary molars is significantly more efficacious than standard therapy alone (fluoride toothpaste + flossing). Caries infiltration is an applicable and well-accepted method be used in children, representing a promising micro-invasive approach.

  17. 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.

  18. Exploring the alignment of writing self-efficacy with writing achievement using rasch measurement theory and qualitative methods.

    Science.gov (United States)

    Engelhard, George; Behizadeh, Nadia

    2012-01-01

    Alignment of writing self-efficacy and writing achievement is defined as the congruence between student confidence regarding writing skills (writing self-efficacy) and the actual performance on these writing skills as reflected in teacher grades (achievement). One purpose of this study is to examine the relationship between these two variables. A second purpose is to demonstrate a mixed-methods approach to investigating relationships between affective variables using Rasch measurement and interviews. Participants were eighth grade students (N = 94) from an ethnically and socioeconomically diverse school in the southeastern United States. Our results suggest that students who struggle with the mechanics of writing yet appreciate the expressive capacity of writing, may have higher senses of writing self-efficacy that are not predictive of performance.

  19. 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.

  20. 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.

  1. RBS as a new primary direct reference method for measuring quantity of material

    Science.gov (United States)

    Jeynes, C.

    2017-09-01

    The quantity of material in thin films can be measured reliably, non-destructively, and at an absolute traceable accuracy with a combined standard uncertainty of 1% by Rutherford backscattering spectrometry (RBS). We have demonstrated a measurement protocol for the determination of quantity of material by RBS that has been accredited at this accuracy to the ISO 17025 standard by the United Kingdom Accreditation Service (UKAS). The method is entirely traceable to SI units relying on no artefacts, and thus qualifies as a primary direct reference method as defined by the ISO Guide 35:1985 (paragraph 9.4.1).

  2. 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.

  3. A comparison of the efficacy of organic and mixed-organic polymers with polyaluminium chloride in chemically assisted primary sedimentation (CAPS).

    Science.gov (United States)

    De Feo, G; Galasso, M; Landi, R; Donnarumma, A; De Gisi, S

    2013-01-01

    CAPS is the acronym for chemically assisted primary sedimentation, which consists of adding chemicals to raw urban wastewater to increase the efficacy of coagulation, flocculation and sedimentation. The principal benefits of CAPS are: upgrading of urban wastewater treatment plants; increasing efficacy of primary sedimentation; and the major production of energy from the anaerobic digestion of primary sludge. Metal coagulants are usually used because they are both effective and cheap, but they can cause damage to the biological processes of anaerobic digestion. Generally, biodegradable compounds do not have these drawbacks, but they are comparatively more expensive. Both metal coagulants and biodegradable compounds have preferential and penalizing properties in terms of CAPS application. The problem can be solved by means of a multi-criteria analysis. For this purpose, a series of tests was performed in order to compare the efficacy of several organic and mixed-organic polymers with that of polyaluminium chloride (PACl) under specific conditions. The multi-criteria analysis was carried out coupling the simple additive weighting method with the paired comparison technique as a tool to evaluate the criteria priorities. Five criteria with the following priorities were used: chemical oxygen demand (COD) removal > turbidity, SV60 > coagulant dose, and coagulant cost. The PACl was the best alternative in 70% of the cases. The CAPS process using PACl made it possible to obtain an average COD removal of 68% compared with 38% obtained, on average, with natural sedimentation and 61% obtained, on average, with the best PACl alternatives (cationic polyacrylamide, natural cationic polymer, dicyandiamide resin).

  4. 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.

  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

    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. 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.

  7. Efficacy of Various Intracanal Medicaments in Human Primary Teeth with Necrotic Pulp against Candida Biofilms: An in vivo Study

    OpenAIRE

    Paikkatt, Jophie V; Sreedharan, Sheela; Philomina, Beena; Kannan, VP; Santhakumar, Madhu; Kumar, TV Anupam

    2017-01-01

    Background Candida has been associated with cases of secondary and persistent root canal infections. The purpose of this study was to evaluate and compare the effectiveness of commonly used intracanal medicament against Candida biofilms found in root canals of human primary teeth with necrotic pulp. Materials and methods Pulp canals of 45 single-rooted primary maxillary anterior teeth with pulp necrosis in 34 children were included in the study. They were divided into three groups of 15 sampl...

  8. 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.

  9. Measuring organizational attributes of primary care practices: development of a new instrument.

    Science.gov (United States)

    Ohman-Strickland, Pamela A; John Orzano, A; Nutting, Paul A; Perry Dickinson, W; Scott-Cawiezell, Jill; Hahn, Karissa; Gibel, Michelle; Crabtree, Benjamin F

    2007-06-01

    To develop an instrument to measure organizational attributes relevant for family practices using the perspectives of clinicians, nurses, and staff. Clinicians, nurses, and office staff (n=640) from 51 community family medicine practices. A survey, designed to measure a practices' internal resources for change, for use in family medicine practices was created by a multidisciplinary panel of experts in primary care research and health care organizational performance. This survey was administered in a cross-sectional study to a sample of diverse practices participating in an intervention trial. A factor analysis identified groups of questions relating to latent constructs of practices' internal resources for capacity to change. ANOVA methods were used to confirm that the factors differentiated practices. The survey was administered to all staff from 51 practices. The factor analysis resulted in four stable and internally consistent factors. Three of these factors, "communication,"decision-making," and "stress/chaos," describe resources for change in primary care practices. One factor, labeled "history of change," may be useful in assessing the success of interventions. A 21-item questionnaire can reliably measure four important organizational attributes relevant to family practices. These attributes can be used both as outcome measures as well as important features for targeting system interventions.

  10. 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.

  11. 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.

  12. Development of a questionnaire to measure primary care physicians' scope of practice.

    Science.gov (United States)

    Ie, Kenya; Ichikawa, Shuhei; Takemura, Yousuke C

    2015-11-02

    Despite an increase in research devoted to primary care attributes, the patient benefits and educational aspects of broad scope practice of primary care physicians (PCPs) have not been well studied, due to a lack of validated measurement in each country. The objective of this study was to develop and validate the Scope of Practice Inventory (SPI) to measure physicians' scope of practice within the Japanese primary care setting. The questionnaire was developed in seven phases: 1) item generation, 2) consensus method for necessity of each item, 3) Delphi process for the importance of each item, 4) pilot tests to limit the number of items, 5) preliminary cross-sectional study to examine factor structure and to validate the construct validity, 6) evaluation of internal consistency and intra-class reliability, and 7) evaluation of external validity. To confirm the interpretability of the SPI, the determinants of the SPI using a generalized linear model were evaluated. Among 359 items generated by a focus group, 180 reached a defined consensus on face and content validity after the Delphi process. After deletion of items with Kappa values less than 0.6, 120 items were selected for the preliminary study. The principle component analysis using responses from 451 PCPs eliminated 52 items. The final 68-point SPI had three subdomains: Inpatient care, 25 items; Urgent care and minor procedures, 27 items; and Ambulatory care, 16 items. Internal consistency and test-retest reliability for total SPI and each subdomain revealed acceptable reliability. Male sex, less years since graduation, working in a hospital, sub-urban or rural setting, having remote experience, and having board certification as a PCP were positively associated with higher SPI. We developed a self-administered 68-point scale, the SPI, which had satisfactory validity and reliability. Primary care quality and educational research using SPI are expected to contribute to comprehensive and efficient health care

  13. 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.

  14. 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

  15. 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.

  16. 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

    2008-11-01

    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.

  17. 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…

  18. 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…

  19. Self-Efficacy Beliefs amongst Parents of Young Children: Validation of a Self-Report Measure

    Science.gov (United States)

    Meunier, Jean-Christophe; Roskam, Isabelle

    2009-01-01

    The self-efficacy belief (SEB) concept is discussed in the context of parenting. A questionnaire, the "Echelle Globale du Sentiment de Competence Parentale" (EGSCP), assessing several domain-specific SEBs and three related cognitive constructs, was developed with 705 French-speaking parents of 3- to 7-year-old children. The EGSCP displayed good…

  20. Measurement of foliar deposits of Bt and their relation to efficacy

    Science.gov (United States)

    P. G. Fast; E. G. Kettela; C. Wiesner

    1985-01-01

    Interest in and discussion of the relationship between droplet spectrum emitted and droplet spectrum deposited, spray cloud behaviour, the relationship between droplets deposited and efficacy, and optimum droplet size, has increased in recent years and has resulted in a number of collaborative studies addressing aspects of these questions. The questions are...

  1. 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…

  2. Comparison of instrumentation time and cleaning efficacy of manual instrumentation, rotary systems and reciprocating systems in primary teeth: An in vitro study

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    Farhin Katge

    2014-01-01

    Full Text Available Background: Paediatric Endodontics is an important clinical procedure commonly used to manage pulpally involved or non-vital teeth in children. One of the important steps in root canal preparation in deciduous teeth is the removal of organic debris. Aim: The aim of this study was to compare instrumentation time and cleaning efficacy of manual instrumentation, rotary systems and reciprocating systems in the preparation of primary molar root canals. Materials and Methods: India ink was injected into 120 root canals of maxillary and mandibular primary molars. The teeth were randomly divided into three experimental groups, Group one K-file (n = 30, group two ProTaper (n = 30, group three WaveOne (n = 30 and one control group (n = 30. The root canals were prepared using one of the three file system followed by clearing the teeth with different demineralizing solutions. The results were statistically evaluated using Kruskal-Wallis tests. Results: The file systems were compared at coronal, middle and apical level. In the coronal third, WaveOne showed more ink removal and the difference found was highly significant (P < 0.0001. In the middle third of the root canal, WaveOne performed better than ProTaper and K-file (P < 0.005. At the apical level, there was no statistical difference between the three systems. Conclusion: The reciprocating and the rotary systems showed better cleaning efficacy when compared to manual instrumentation especially, in coronal and middle one third.

  3. 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

  4. Using a single item to measure burnout in primary care staff: a psychometric evaluation.

    Science.gov (United States)

    Dolan, Emily D; Mohr, David; Lempa, Michele; Joos, Sandra; Fihn, Stephan D; Nelson, Karin M; Helfrich, Christian D

    2015-05-01

    Burnout affects nearly half of all U.S. nurses and physicians, and has been linked to poor outcomes such as worse patient safety. The most common measure of burnout is the well-validated Maslach Burnout Inventory (MBI). However, the MBI is proprietary and carries licensing fees, posing challenges to routine or repeated assessment. To compare a non-proprietary, single-item burnout measure to a single item from the MBI Emotional Exhaustion (MBI:EE) subscale that has been validated as a standalone burnout measure. Cross-sectional online survey. A sample of primary care providers (PCPs), registered nurses, clinical associates (e.g., licensed practical nurses (LPNs), medical technicians), and administrative clerks in the Veterans Health Administration surveyed in 2012. We compared a validated one-item version of the MBI:EE and a non-proprietary single-item burnout measure used in the Physician Work Life Study. We calculated kappa statistics, sensitivity and specificity, positive predictive (PPV) and negative predictive values (NPV), and area under the receiver operator curve (AUC). We conducted analyses stratified by occupation to determine the stability of the correlation between the two measures. We analyzed responses from 5,404 participants, including 1,769 providers and 1,380 registered nurses. The prevalence of burnout was 36.7% as measured on the single MBI:EE item and 38.5% as measured on the non-proprietary single-item measure. Relative to the MBI:EE, the non-proprietary single-item measure had a correlation of 0.79, sensitivity of 83.2%, specificity of 87.4%, and AUC of 0.93 (se = 0.004). Results were similar when stratified by respondent occupation. A non-proprietary single-item measure served as a reliable substitute for the MBI:EE across occupations. Because it is non-proprietary and easy to interpret, it has logistical advantages over the one-item MBI.

  5. 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

    2017-09-15

    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

  6. Primary Outcome Measures in Pediatric Septic Shock Trials: A Systematic Review.

    Science.gov (United States)

    Menon, Kusum; McNally, James Dayre; Zimmerman, Jerry J; Agus, Michael S D; O'Hearn, Katie; Watson, R Scott; Wong, Hector R; Duffett, Mark; Wypij, David; Choong, Karen

    2017-03-01

    To evaluate all published pediatric randomized controlled trials of patients with septic shock from any cause to examine the outcome measures used, the strengths and limitations of these measurements and whether the trial outcomes met feasibility criteria. We used a previously published database of pediatric critical care randomized controlled trials (PICUtrials.net) derived from searches of MEDLINE, EMBASE, LILACS, and CENTRAL. We included randomized controlled trials of interventions to children admitted to a PICU with septic or dengue hemorrhagic shock which were published in English. Study characteristics and outcomes were retrieved by two independent reviewers with disagreement being resolved by a third reviewer. We defined feasibility as 1) recruitment of at least 90% of the targeted sample size and agreement of the observed outcome rate in the control group with the rate used for the sample size calculation to within 10% or 2) finding of a statistically significant difference in an interim or final analysis. Nineteen of 321 identified articles were selected for review. Fourteen of 19 studies (74%) provided an a priori definition of their primary outcome measure in their "Methods section." Mortality rate was the most commonly reported primary outcome (8/14; 57%), followed by duration of shock (4/14; 29%) followed by organ failure (1/14; 7%). Only three of 19 included trials met feasibility criteria. Our review found that use of mortality alone as a primary outcome in pediatric septic shock trials was associated with significant limitations and that long-term patient-centered outcomes were not used in this setting. Composite outcomes incorporating mortality and long-term outcomes should be explored for use in future pediatric septic shock trials.

  7. Quality Measures at the Interface of Behavioral Health and Primary Care.

    Science.gov (United States)

    Goldman, Matthew L; Spaeth-Rublee, Brigitta; Nowels, Abraham D; Ramanuj, Parashar Pravin; Pincus, Harold Alan

    2016-04-01

    The development of quality measures has gained increasing attention as health care reimbursements transition from fee-for-service to value-based payment models. As behavioral health care moves towards integration of services with primary care, specific measures and payment incentives will be needed to successfully expand access. This study uses a keyword search to identify 730 quality indicators that are relevant to behavioral health and general medical health. Measures identified have been coded and grouped into domains based on a taxonomy developed by the authors. The analysis reveals that quality measures focusing on general medical conditions exceed those focused on behavioral health diagnoses for evidence-based treatments, patient safety, and outcomes. Furthermore, measures predominantly concentrate on care during or following hospitalizations, which represents a minority of behavioral health care and does not characterize the outpatient settings that are the focus of many models of integrated care. The authors offer recommendations for future steps to identify the quality measures that can best evaluate the evolving behavioral health care system.

  8. Efficacy and Potential MicroRNA Mechanism for Computed Tomography-Guided Percutaneous Radiofrequency Ablation of Primary Lung Cancer and Lung Metastasis from Liver Cancer

    Directory of Open Access Journals (Sweden)

    Xun Hu

    2014-04-01

    Full Text Available Background: The aim of this study was to evaluate comparatively the effectiveness of computed tomography-guided percutaneous radiofrequency ablation (CT-PRFA for primary non-small cell lung cancer (NSCLC and lung metastases from hepatocellular carcinoma (HCC and to explore the potential miRNA mechanisms for the efficacy of CT-PRFA. Methods: 14 patients pathologically diagnosed with NSCLC and 12 patients with lung metastases from HCC were enrolled in the study and underwent CT-PRFA. Clinical outcomes were compiled on the basis of review of medical records, imaging follow-up reports, and any biopsy-proved residual or recurrent disease. Real-time RT-PCR was used to quantify the selected miRNAs known to be play key roles in lung cancer. Results: A total of 21 tumors were treated with umbrella-tip electrodes and spiral-tip electrodes were used for the remaining 8 tumors. The median follow-up was 13.5 months (range, 3-30 months and no patient was lost to follow-up. The rate of technique efficacy for primary tumors was ∼93% (13 of 14. Treatment was successful in 11 out of 12 (91.7% lung metastases patients. Overall survival rate was 80.8% at 2 years, and cancer-specific survival rate was 100% at 2 years. The tumor-free survival was 69.2% at 1 year and 26.9% at 2 years. Before PRFA, tumor suppressor let-7a and miR-34a were downregulated whereas oncomiR miR-21 was upregulated in primary tumors, and let-7a and miR-126 levels were downregulated whereas oncomiRs miR-21, miR-155 and miR-17-5p/miR-20b levels were upregulated in secondary tumors. This abnormal expression was normalized by CT-PRFA. Most notably, CT-PRFA failed to normalize the deregulated miRNAs in the non-survivors. Conclusions: CT-PRFA is a effective treatment for primary NSCLCs and secondary lung tumors from HCC and the efficacy may be related to its ability to normalize deregulated expression of miRNAs: upregulating tumor suppressor miRNAs and downregulating oncomiRs.

  9. Measuring practice capacity for change: a tool for guiding quality improvement in primary care settings.

    Science.gov (United States)

    Bobiak, Sarah N; Zyzanski, Stephen J; Ruhe, Mary C; Carter, Caroline A; Ragan, Brian; Flocke, Susan A; Litaker, David; Stange, Kurt C

    2009-01-01

    Capacity for change, or the ability and willingness to undertake change, is an organizational characteristic with potential to foster quality management in health care. We report on the development and psychometric properties of a quantitative measure of capacity for change for use in primary care settings. Following review of previous conceptual and empirical studies, we generated 117 items that assessed organizational structure, climate, and culture. Using information from direct observation and key informant interviews, a research team member rated these items for 15 primary care practices engaged in a quality improvement intervention. Distributional statistics, pairwise correlation analysis, Rasch modeling, and item content review guided item reduction and instrument finalization. Reliability and convergent validity were assessed. Ninety-two items were removed because of limited response distributions and redundancy or because of poor Rasch model fit. The final instrument comprising 25 items had excellent reliability (alpha = .94). A Rasch model-derived capacity for change score correlated well with an independently determined, qualitatively derived summary assessment of each practice's capacity for change (rhoS = 0.82), suggesting good convergent validity. We describe a new instrument for quantifying organizational capacity for change in primary care settings. The ability to quantify capacity for change may enable better recognition of practices likely to be successful in their change efforts and those first requiring capacity building prior to change interventions.

  10. ATO/ATRA/anthracycline-chemotherapy sequential consolidation achieves long-term efficacy in primary acute promyelocytic leukemia.

    Science.gov (United States)

    Long, Zi-Jie; Hu, Yuan; Li, Xu-Dong; He, Yi; Xiao, Ruo-Zhi; Fang, Zhi-Gang; Wang, Dong-Ning; Liu, Jia-Jun; Yan, Jin-Song; Huang, Ren-Wei; Lin, Dong-Jun; Liu, Quentin

    2014-01-01

    The combination of all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3, ATO) has been effective in obtaining high clinical complete remission (CR) rates in acute promyelocytic leukemia (APL), but the long-term efficacy and safety among newly diagnosed APL patients are unclear. In this retrospective study, total 45 newly diagnosed APL patients received ATRA/chemotherapy combination regimen to induce remission. Among them, 43 patients (95.6%) achieved complete remission (CR) after induction therapy, followed by ATO/ATRA/anthracycline-based chemotherapy sequential consolidation treatment with a median follow-up of 55 months. In these patients, the estimated overall survival (OS) and the relapse-free survival (RFS) were 94.4% ± 3.9% and 94.6 ± 3.7%, respectively. The toxicity profile was mild and reversible. No secondary carcinoma was observed. These results demonstrated the high efficacy and minimal toxicity of ATO/ATRA/anthracycline-based chemotherapy sequential consolidation treatment for newly diagnosed APL in long-term follow-up, suggesting a potential frontline therapy for APL.

  11. Efficacy of two interventions on the discontinuation of benzodiazepines in long-term users: 36-month follow-up of a cluster randomised trial in primary care.

    Science.gov (United States)

    Vicens, Caterina; Sempere, Ermengol; Bejarano, Ferrán; Socias, Isabel; Mateu, Catalina; Fiol, Francisca; Palop, Vicente; Mengual, Marta; Folch, Silvia; Lera, Guillem; Basora, Josep; Leiva, Alfonso

    2016-02-01

    Primary care interventions that promote cessation of benzodiazepine (BZD) use in long-term users are effective at 1 year, but their efficacy at 3 years is uncertain. To assess the 3-year efficacy of two primary care interventions delivered by GPs on cessation of BZD use in long-term users. Multicentre, three-arm, cluster randomised, controlled trial, with random allocation at the GP level. Seventy-five GPs and 532 patients were randomly allocated to three groups: usual care (control), structured intervention with stepped-dose reduction and follow-up visits (SIF), or structured intervention with written stepped-dose reduction (SIW). The primary outcome was BZD use at 36 months. At 36 months, 66/168 patients (39.2%) in the SIW group, 79/191 patients (41.3%) in the SIF group, and 45/173 patients (26.0%) in the control group had discontinued BZD use. The relative risks (RR) adjusted by cluster were 1.51 (95% CI = 1.10 to 2.05; P = 0.009) in the SIW group and 1.59 (95% CI = 1.15 to 2.19; P = 0.005) in the SIF group. A total of 131/188 patients (69.7%) who successfully discontinued BZD use at 12 months remained abstinent at 36 months. The groups showed no significant differences in anxiety, depression, or sleep dissatisfaction at 36 months. The interventions were effective on cessation of BZD use; most patients who discontinued at 12 months remained abstinent at 3 years. Discontinuation of BZD use did not have a significant effect on anxiety, depression, or sleep quality. © British Journal of General Practice 2016.

  12. Comparison of the bleaching efficacy of three different agents used for intracoronal bleaching of discolored primary teeth: An in vitro study

    Directory of Open Access Journals (Sweden)

    R Ganesh

    2013-01-01

    Full Text Available Everyone wants whiter teeth to make them feel younger and to provide beautiful smiles with the accompanying increase in self-esteem. Bleaching is an established, simple, cost-effective and conservative method for improving the color of the discolored teeth. Aim: The aim of this in vitro study was to compare the bleaching efficacy of 10% carbamide peroxide, 10% hydrogen peroxide and 2g sodium perborate as bleaching agents on the artificially discolored human primary maxillary central incisors. Materials and Methods: Forty extracted human primary central incisors with intact crowns were selected for the study. Pulpectomy was performed and each tooth was artificially stained with 2 ml of fresh human blood and centrifuged. --The teeth were randomly divided into four experimental groups of 10 teeth each and the baseline color evaluation was performed. 0.04 ml of the bleaching agent is syringed into the access cavity of the tooth and, in the control group, 0.04 ml of distilled water was syringed into the access cavity and it was sealed with IRM and placed at 37°C in an incubator throughout the experiment. The color of the bleached teeth was determined at 0, 7 and 14 days. The data obtained were analyzed using ANOVA and Turkey′s test. Results: There was statistical significance (P = 0.00 among the carbamide peroxide, sodium perborate, hydrogen peroxide and control groups after 7 and 14 days and a significance of P = 0.013 among the carbamide peroxide, sodium perborate and hydrogen peroxide after two bleaching sessions (day 14 was seen. Conclusions: The bleaching efficacy of 10% hydrogen peroxide gel was more effective than 10% carbamide peroxide and sodium perborate in bleaching the artificially discolored primary teeth.

  13. Comparison of the bleaching efficacy of three different agents used for intracoronal bleaching of discolored primary teeth: an in vitro study.

    Science.gov (United States)

    Ganesh, R; Aruna, S; Joyson, M

    2013-01-01

    Everyone wants whiter teeth to make them feel younger and to provide beautiful smiles with the accompanying increase in self-esteem. Bleaching is an established, simple, cost-effective and conservative method for improving the color of the discolored teeth. The aim of this in vitro study was to compare the bleaching efficacy of 10% carbamide peroxide, 10% hydrogen peroxide and 2g sodium perborate as bleaching agents on the artificially discolored human primary maxillary central incisors. Forty extracted human primary central incisors with intact crowns were selected for the study. Pulpectomy was performed and each tooth was artificially stained with 2 ml of fresh human blood and centrifuged. --The teeth were randomly divided into four experimental groups of 10 teeth each and the baseline color evaluation was performed. 0.04 ml of the bleaching agent is syringed into the access cavity of the tooth and, in the control group, 0.04 ml of distilled water was syringed into the access cavity and it was sealed with IRM and placed at 37°C in an incubator throughout the experiment. The color of the bleached teeth was determined at 0, 7 and 14 days. The data obtained were analyzed using ANOVA and Turkey's test. There was statistical significance (P = 0.00) among the carbamide peroxide, sodium perborate, hydrogen peroxide and control groups after 7 and 14 days and a significance of P = 0.013 among the carbamide peroxide, sodium perborate and hydrogen peroxide after two bleaching sessions (day 14) was seen. The bleaching efficacy of 10% hydrogen peroxide gel was more effective than 10% carbamide peroxide and sodium perborate in bleaching the artificially discolored primary teeth.

  14. Adaptation of a scale to measure coping strategies in informal primary caregivers of psychiatric patients.

    Science.gov (United States)

    Rosas-Santiago, F J; Marván, M L; Lagunes-Córdoba, R

    2017-10-01

    WHAT IS KNOWN ON THE SUBJECT?: Informal caregivers of psychiatric patients are vulnerable to many disturbances associated with the stress related to their activity. Caregivers who show a coping style focused on problem-solving report less psychological distress, and this approach positively influences the recovery process of the psychiatric patient. There are some questionnaires to measure coping styles in caregivers of psychiatric patients, but most of them do not have the minimum psychometric properties that a scale must fulfil. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The authors present an adapted and validated scale for measuring both active and passive coping strategies used by informal caregivers to face daily stressful situations with psychiatric patients. The study is an example of how scales can be adapted to small samples (n coping styles of informal caregivers are related to recovery process of psychiatric patients. Background The recovery process of a psychiatric patient is related to his primary informal caregiver's style of coping with stress. There is insufficient literature on validations of instruments that measure coping styles in this population. Objective To adapt and validate a scale to measure coping strategies in primary informal caregivers. Method The adapted scale was based on the Extreme Coping Scale of López-Vázquez and Marván. Items from that scale were adapted for application to informal caregivers. The scale was administered to 122 primary informal caregivers of patients from two psychiatric institutions in Mexico. Psychometric analyses were performed to determine the scale's properties. Results The scale was composed of 20 items (six less than in the original scale) and two factors: (i) active coping (Cronbach's alpha = .837) and (ii) passive coping (Cronbach's alpha = .718). Discussion The findings are discussed in the light of the importance of studying the relationship between coping styles and the well-being of both

  15. 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.

  16. Measurement of the cosmic rays light component (p+He) primary spectrum with ARGO-YBJ

    Energy Technology Data Exchange (ETDEWEB)

    Panico, B., E-mail: beatrice.panico@roma2.infn.it [Dipartimento di Fisica, Universita Roma ' Tor Vergata' , Via della Ricerca Scientifica 1, Roma (Italy); INFN, Sezione Roma Tor Vergata, Via della Ricerca Scientifica 1, Roma (Italy); Di Sciascio, G. [INFN, Sezione Roma Tor Vergata, Via della Ricerca Scientifica 1, Roma (Italy)

    2012-11-11

    The ARGO-YBJ experiment, located at the Yangbajing Cosmic Ray Laboratory (Tibet, 4300 m a.s.l., 606 g/cm{sup 2}) has an high segmentation that allows the detection of air showers with greater detail and lower energy threshold (a few hundred GeV) compared to other EAS arrays. The spectrum of the primary cosmic ray light (p+He) component in the energy range {approx}10-100TeV is measured selecting quasi-vertical showers ({theta}<15 Degree-Sign ) with the reconstructed core position located in a 40 Multiplication-Sign 40 m{sup 2} fiducial area. The results are compared with other measurements carried out with direct methods.

  17. 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

  18. Non-self-sufficiency as a primary outcome measure in ALS trials.

    Science.gov (United States)

    Marin, Benoît; Bianchi, Elisa; Pupillo, Elisabetta; Lunetta, Christian; Tremolizzo, Lucio; Logroscino, Giancarlo; Chiò, Adriano; Preux, Pierre Marie; Beghi, Ettore

    2015-01-01

    Our objective was to assess non-self-sufficiency (NSS) in ALS as an outcome measure in therapeutic trials. Using data from the control arm of two randomized trials and an observational study, associations between NSS (score ≤2 in the ALSFRS-R items for swallowing, cutting food and handling utensils, or walking) and the total ALSFRS-R score, forced vital capacity (FVC), and survival at selected time-points until death or 48 weeks, were assessed. These measures were used as surrogates of relevant functional impairment. Of 82 self-sufficient (SS) patients at baseline, 32 (39.0%) became NSS at four weeks and increased to 72 (87.8%) at the end of follow-up. A significant association was found between NSS, ALSFRS-R score and FVC at 24, 36 and 48 weeks. Thirty-four subjects died (41.5%). Compared to SS patients (median survival, 27.9 months), individuals becoming NSS at four weeks were at increased risk to die (median survival, 23.6 months, p = 0.02). NSS status at four weeks predicted survival even after adjustment for ALSFRS-R total score, age, gender, site of onset, disease duration, BMI, and FVC. 'Walking' was the only predictor of survival when adjusting for all covariates. In conclusion, NSS status is a possible endpoint to investigate short-term efficacy of treatments of ALS.

  19. Influence of agonist efficacy and receptor phosphorylation on antagonist affinity measurements: differences between second messenger and reporter gene responses.

    Science.gov (United States)

    Baker, Jillian G; Hall, Ian P; Hill, Stephen J

    2003-09-01

    The ability of an antagonist to bind to a receptor is an innate property of that ligand-receptor chemical interaction. Provided no change in the antagonist or receptor chemical nature occurs, this affinity should remain constant for a given antagonist-receptor interaction, regardless of the agonists used. This fundamental assumption underpins the classification of receptors. Here, measurements of beta2-adrenoceptor-mediated cAMP accumulation and cAMP response-element (CRE)-mediated reporter-gene transcription revealed differences in antagonist affinity that depended upon agonist incubation time and the efficacy of the competing agonist. In cAMP accumulation studies (10-min agonist incubation), antagonist affinities were the same regardless of the agonist used. The CRE-reporter gene assay (5 h of incubation) antagonist affinities were 10-fold lower in the presence of isoprenaline and adrenaline than when salbutamol or terbutaline were present (e.g., log KD propranolol -8.65 +/- 0.08, n = 22, and -9.68 +/- 0.07, n = 17, for isoprenaline and salbutamol-induced responses, respectively). Isoprenaline and adrenaline were more efficacious in functional studies, and their ability to internalize GFP-tagged human beta2-adrenoceptors. Longer-term cAMP studies also showed significant differences in KD values moving toward that seen with gene transcription. Agonist-dependent differences in antagonist affinity were reduced for reporter-gene responses when a phosphorylation-deficient mutant of the beta2-adrenoceptor was used. This study suggests that high-efficacy agonists induce a chemical modification in beta2-adrenoceptors (via phosphorylation) that reduces antagonist affinities. Because reporter-gene assays are used for high-throughput screening in drug discovery, less efficacious or partial agonists may be more reliable than highly efficacious agonists when reporter-gene techniques are used to estimate antagonist affinity.

  20. 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.

  1. Investigating the efficacy of the use of ICT for slow learners : Case studies in Singapore Primary Schools

    OpenAIRE

    Wettasinghe, Cyraine Marissa; Hasan, Mazlan

    2007-01-01

    This exploratory project investigates the implications and changes effected through the introduction of IBM's KidSmart programme into the Learning Support Programme (LSP) in 6 Singapore primary schools. It focuses on the impact of ICT on teaching and learners methodologies embraced by teachers working with slow learners (or learners at risk). The principal aim of this project is to identify workable teaching models or processes that can maximize learning through the use of ICT with slow learn...

  2. Efficacy of Four Remineralizing Agents on Primary Teeth: In Vitro Evaluation Using Microhardness Testing and Quantitative Light-induced Fluorescence.

    Science.gov (United States)

    Krishnan, Gayathri; George, Sageena; Anandaraj, S; John, Sheen Ann; Mathew, V; Shanavas, Nikil M

    2017-05-15

    This study's purpose was to evaluate the remineralization of primary enamel using GC Tooth Mousse, Clinpro Tooth Crème, SHY-NM, and Pronamel by employing microhardness testing and quantitative light-induced fluorescence (QLF) values. An in vitro study was performed with 100 intact primary anterior teeth. After specimen preparation, they were subjected to baseline microhardness and QLF testing. The specimens were immersed in demineralizing solution, subjected again to microhardness and QLF testing, and divided randomly into five groups of 20 teeth: group one-control group (artificial saliva); group two-GC Tooth Mousse; group three-ClinPro tooth crème; group four-SHY-NM; and group five-Pronamel. The pastes were respectively applied for the specific group specimens for 15 consecutive days. The samples were subjected to microhardness and QLF testing. The results were analyzed using analysis of variance testing. A post-hoc comparison was done using a paired t test. There were mean increases in microhardness and QLF values with all remineralizing agents. Group two showed a statistically significant increase (Pmicrohardness and QLF values. Group four showed a significant increase only in microhardness values. (Pmaterials for remineralizing incipient lesions in primary teeth.

  3. Efficacy of an educational intervention in primary health care in inhalation techniques: study protocol for a pragmatic cluster randomised controlled trial.

    Science.gov (United States)

    Leiva-Fernández, José; Vázquez-Alarcón, Rubén L; Aguiar-Leiva, Virginia; Lobnig-Becerra, Mireya; Leiva-Fernández, Francisca; Barnestein-Fonseca, Pilar

    2016-03-17

    Chronic obstructive pulmonary disease (COPD) accounts for 10-12 % of primary care consultations, 7 % of hospital admissions and 35 % of chronic incapacity related to productivity. The misuse of inhalers is a significant problem in COPD because it is associated with reduced therapeutic drug effects leading to lack of control of both symptoms and disease. Despite all advice, health care professionals' practice management of inhalation treatments is usually deficient. Interventions to improve inhaler technique by health care professionals are limited, especially among primary care professionals, who provide the most care to patients with COPD. The aim of this study is to evaluate the efficacy of an educational intervention to train general practitioners (GPs) in the right inhalation technique for the most commonly used inhalers. We are conducting a pragmatic cluster randomised controlled trial. The sample population is composed of 267 patients diagnosed with COPD using inhalation therapy selected from among those in 20 general practices, divided into two groups (control and intervention) by block randomisation at 8 primary care centres. The sample has two levels. The first level is patients with COPD who agree to participate in the trial and receive the educational intervention from their GPs. The second level is GPs who are primary health care professionals and receive the educational intervention. The intervention is one session of the educational intervention with a monitor given to GPs for training in the right inhalation technique. The primary outcome is correct inhalation technique in patients. Secondary outcomes are functional status (spirometry) and quality of life. The follow-up period will be 1 year. GPs will have two visits (baseline and at the 1-year follow-up visit. Patients will have four visits (at baseline and 3, 6 and 12 months). Analysis will be done on an intention-to-treat basis. We carried out three previous clinical trials in patients with COPD

  4. Empirical versus modelling approaches to the estimation of measurement uncertainty caused by primary sampling.

    Science.gov (United States)

    Lyn, Jennifer A; Ramsey, Michael H; Damant, Andrew P; Wood, Roger

    2007-12-01

    Measurement uncertainty is a vital issue within analytical science. There are strong arguments that primary sampling should be considered the first and perhaps the most influential step in the measurement process. Increasingly, analytical laboratories are required to report measurement results to clients together with estimates of the uncertainty. Furthermore, these estimates can be used when pursuing regulation enforcement to decide whether a measured analyte concentration is above a threshold value. With its recognised importance in analytical measurement, the question arises of 'what is the most appropriate method to estimate the measurement uncertainty?'. Two broad methods for uncertainty estimation are identified, the modelling method and the empirical method. In modelling, the estimation of uncertainty involves the identification, quantification and summation (as variances) of each potential source of uncertainty. This approach has been applied to purely analytical systems, but becomes increasingly problematic in identifying all of such sources when it is applied to primary sampling. Applications of this methodology to sampling often utilise long-established theoretical models of sampling and adopt the assumption that a 'correct' sampling protocol will ensure a representative sample. The empirical approach to uncertainty estimation involves replicated measurements from either inter-organisational trials and/or internal method validation and quality control. A more simple method involves duplicating sampling and analysis, by one organisation, for a small proportion of the total number of samples. This has proven to be a suitable alternative to these often expensive and time-consuming trials, in routine surveillance and one-off surveys, especially where heterogeneity is the main source of uncertainty. A case study of aflatoxins in pistachio nuts is used to broadly demonstrate the strengths and weakness of the two methods of uncertainty estimation. The estimate

  5. Patient reported outcome measures (PROMs) for goalsetting and outcome measurement in primary care physiotherapy, an explorative field study.

    Science.gov (United States)

    van Dulmen, Simone A; van der Wees, Philip J; Bart Staal, J; Braspenning, J C C; Nijhuis-van der Sanden, Maria W G

    2017-03-01

    Routine use of patient reported outcome measures (PROMs) may provide an effective way of monitoring patient valued outcomes. In this study we explored (1) the current use of PROMs; (2) to what extent the goals correspond with the selected PROMs; (3) the health outcomes based on PROMs. Observational clinical cohort study. Dutch primary care physiotherapy practices (n=43). Patients (n=299) with neck pain or low back pain. The number of PROMs used per patient were calculated. The International Classification of Functioning, Disability and Health was used to map the patients' goals and the percentages of PROMS selected that match the domains of the goals were calculated. Health outcomes were assessed using two approaches for estimating the minimal clinically important difference (MCID). Repeated measurements with the Visual Analogue Scale, the Patient Specific Complaints questionnaire, the Quebec Back Pain Disability Scale, or the Neck Disability Index were completed by more than 60% of the patients. The PROMs used matched in 46% of the cases with goals for pain improvement, and in 43% with goals set at activity/participation level. The mean differences between baseline and follow up scores for all PROMs were statistically significant. Improvements of patients based on MCID varied from 57% to 90%. PROMs were used in the majority of the patients, showed improved health outcomes and fitted moderately with goals. The results of this study can be used for future research assessing the routine use of outcome measurements with PROMs. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  6. 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.

  7. Clinical efficacy of the conventional glass ionomer cement and resin modified glass ionomer cement in primary molars.

    Science.gov (United States)

    Mufti, Ayesha Sabeen

    2014-01-01

    Dental caries is the most prevalent communicable disease in the world amongst the population of the children. To compare the outcome of restorations in primary molars using two Glass ionomer cements Ketac-Molar, a Glass ionomer cement (GIC) and Vitremer, a Resin modified glass ionomer cement (RMGIC) in small and medium sized cavities. A randomized controlled trial was conducted on 27 children between ages 4-9 years who had bilateral matched pair of carious lesions in primary posterior teeth. A split mouth design was used in which two materials, Ketac Molar and Vitremer, were placed on contralateral sides of the oral cavity in the same patient. The aim was to compare clinical performance of these restorations after 6 months using United States Public Health Service (USPHS) criteria. Data were collected six months after restoration using USPHS criteria. Statistical analysis was conducted using SPSS-16. Categorical variables were described as frequencies, and percentages. Chi-square test was used to compare the frequencies between groups keeping statistical significance at p<0.05. Based on the USPHS criteria, after six months the results of Ketac Molar and Vitemer were comparable, except for sensitivity where RMGIC performed significantly better (p=0.040). Though not significantly different, GIC performed better in 2/10 variables namely marginal discoloration and surface staining. RMGIC did better in 4/10 variables namely marginal integrity, retention, secondary caries and sensitivity. Both cements performed almost equally well in 4/10 variables, i.e., colour match, anatomic form, surface texture and proximal contact. Overall the clinical performance of Vitremer was better than Ketac molar and is to be considered as a preferable material for restoration of primary molars. More studies are recommended to confirm the results of the present study.

  8. 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.

  9. 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 IOP measurements only for IOPcc vs. GAT (r = 0.830, P IOP obtained by NCT was not significantly different from that of GAT, but ORA measured IOPs were significantly higher than both other devices.

  10. Chaos to complexity: leveling the playing field for measuring value in primary care.

    Science.gov (United States)

    Moran, William P; Zhang, Jingwen; Gebregziabher, Mulugeta; Brownfield, Elisha L; Davis, Kimberly S; Schreiner, Andrew D; Egan, Brent M; Greenberg, Raymond S; Kyle, T Rogers; Marsden, Justin E; Ball, Sarah J; Mauldin, Patrick D

    2017-04-01

    Develop a risk-stratification model that clusters primary care patients with similar co-morbidities and social determinants and ranks 'within-practice' clusters of complex patients based on likelihood of hospital and emergency department (ED) utilization. A retrospective cohort analysis was performed on 10 408 adults who received their primary care at the Medical University of South Carolina University Internal Medicine clinic. A two-part generalized linear regression model was used to fit a predictive model for ED and hospital utilization. Agglomerative hierarchical clustering was used to identify patient subgroups with similar co-morbidities. Factors associated with increased risk of utilization included specific disease clusters {e.g. renal disease cluster [rate ratio, RR = 5.47; 95% confidence interval (CI; 4.54, 6.59) P < 0.0001]}, low clinic visit adherence [RR = 0.33; 95% CI (0.28, 0.39) P < 0.0001] and census measure of high poverty rate [RR = 1.20; 95% CI (1.11, 1.28) P < 0.0001]. In the cluster model, a stable group of four clusters remained regardless of the number of additional clusters forced into the model. Although the largest number of high-utilization patients (top 20%) was in the multiple chronic condition cluster (1110 out of 4728), the largest proportion of high-utilization patients was in the renal disease cluster (67%). Risk stratification enhanced with disease clustering organizes a primary care population into groups of similarly complex patients so that care coordination efforts can be focused and value of care can be maximized. © 2015 John Wiley & Sons, Ltd.

  11. Efficacy, safety, and tolerability of secukinumab in patients with active ankylosing spondylitis: a randomized, double-blind phase 3 study, MEASURE 3.

    Science.gov (United States)

    Pavelka, Karel; Kivitz, Alan; Dokoupilova, Eva; Blanco, Ricardo; Maradiaga, Marco; Tahir, Hasan; Pricop, Luminita; Andersson, Mats; Readie, Aimee; Porter, Brian

    2017-12-22

    Secukinumab, an anti-interleukin-17A monoclonal antibody, improved the signs and symptoms of ankylosing spondylitis (AS) in two phase 3 studies (MEASURE 1 and MEASURE 2). Here, we present 52-week results from the MEASURE 3 study assessing the efficacy and safety of secukinumab 300 and 150 mg subcutaneous maintenance dosing, following an intravenous loading regimen. A total of 226 patients were randomized to intravenous secukinumab 10 mg/kg (baseline, weeks 2 and 4) followed by subcutaneous secukinumab 300 mg (IV-300 mg) or 150 mg (IV-150 mg) every 4 weeks, or matched placebo. Patients in the placebo group were re-randomized to subcutaneous secukinumab at a dose of 300 or 150 mg at week 16. The primary endpoint was the Assessment of SpondyloArthritis international Society criteria for 20% improvement (ASAS20) response rate at week 16 in the IV-300 mg or IV-150 mg versus placebo. Other endpoints assessed through week 52 included improvements in ASAS40, ASAS 5/6, Bath Ankylosing Spondylitis Disease Activity Index, and ASAS partial remission responses, as well as the change from baseline in high-sensitivity C-reactive protein levels. Statistical analyses followed a predefined hierarchical hypothesis testing strategy to adjust for multiplicity of testing, with non-responder imputation used for binary variables and mixed-model repeated measures for continuous variables. The primary efficacy endpoint was met; the ASAS20 response rate was significantly greater at week 16 in the IV-300 mg (60.5%; P < 0.01) and IV-150 mg (58.1%; P < 0.05) groups versus placebo (36.8%). All secondary endpoints were met at week 16, except ASAS partial remission in the IV-150 mg group. Improvements achieved with secukinumab in all clinical endpoints at week 16 were also sustained at week 52. Infections, including candidiasis, were more common with secukinumab than with placebo during the placebo-controlled period. During the entire treatment period, pooled incidence rates of Candida

  12. Improved antiviral efficacy using TALEN-mediated homology directed recombination to introduce artificial primary miRNAs into DNA of hepatitis B virus.

    Science.gov (United States)

    Dreyer, Timothy; Nicholson, Samantha; Ely, Abdullah; Arbuthnot, Patrick; Bloom, Kristie

    2016-09-30

    Chronic infection with hepatitis B virus (HBV) remains an important global health problem. Currently licensed therapies have modest curative efficacy, which is as a result of their transient effects and limited action on the viral replication intermediate comprising covalently closed circular DNA (cccDNA). Gene editing with artificial HBV-specific endonucleases and use of artificial activators of the RNA interference pathway have shown anti-HBV therapeutic promise. Although results from these gene therapies are encouraging, maximizing durable antiviral effects is important. To address this goal, a strategy that entails combining gene editing with homology-directed DNA recombination (HDR), to introduce HBV-silencing artificial primary microRNAs (pri-miRs) into HBV DNA targets, is reported here. Previously described transcription activator-like effector nucleases (TALENs) that target the core and surface sequences of HBV were used to introduce double stranded breaks in the viral DNA. Simultaneous administration of donor sequences encoding artificial promoterless anti-HBV pri-miRs, with flanking arms that were homologous to sequences adjoining the TALENs' targets, augmented antiviral efficacy. Analysis showed targeted integration and the length of the flanking homologous arms of donor DNA had a minimal effect on antiviral efficiency. These results support the notion that gene editing and silencing may be combined to effect improved inhibition of HBV gene expression. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The efficacy of alarm therapy versus desmopressin therapy in the treatment of primary mono-symptomatic nocturnal enuresis: a systematic review.

    Science.gov (United States)

    Perrin, Nina; Sayer, Lynn; While, Alison

    2015-01-01

    To investigate the efficacy of alarm therapy versus desmopressin therapy in treating primary mono-symptomatic nocturnal enuresis (PMNE). PMNE is a common childhood disorder, which if left untreated can have a significant impact on a child's self-esteem and behaviour. Alarm therapy and desmopressin therapy are the two main treatments currently available in UK-based nurse-led enuresis clinics. A systematic review of the literature was undertaken to assess the efficacy of PMNE treatments. Following application of inclusion/exclusion criteria eight randomised controlled/clinical trials were identified involving children aged 5-17 years with PMNE receiving either alarm therapy or desmopressin therapy. Seven studies found no statistical difference in nocturnal continence improvement between the two interventions at the point when treatment was stopped. Four studies had a significantly larger relapse rate of nocturnal enuresis with desmopressin compared with alarm therapy when the treatment was withdrawn. Two papers reported that those participating in the alarm therapy intervention of the trials had a higher attrition rate than the desmopressin intervention. The overall findings from the eight studies showed that long term alarm therapy was more effective in treating nocturnal enuresis than desmopressin therapy. The review found that families and children receiving the alarm therapy intervention require more support from health care professionals to comply with treatment than those receiving the desmopressin therapy. However, if nurse-led clinics can support families to persist with the alarm therapy intervention, they are more likely to experience longer term improvement in continence.

  14. Efficacy and tolerability of pramipexole for the treatment of primary restless leg syndrome: a meta-analysis of randomized placebo-controlled trials

    Directory of Open Access Journals (Sweden)

    Zhang W

    2013-07-01

    Full Text Available Wei Zhang, Ye Wang, Shu Yan Cong, Jian Fei Nao, Juan Feng, Guo Rong Bi Neurology Department, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China Abstract: Primary restless leg syndrome (RLS is a common sensory-motor disorder that is characterized by an irresistible urge to move the limbs and unpleasant sensations in the legs, which affects 1.9%–4.6% adults. Pramipexole, a potent dopamine D2/3 agonist, is recommended as “effective” in the short-term and “possibly effective” in the long-term treatment of primary RLS in the European guidelines on management of RLS. In this meta-analysis, we summarized the efficacy and tolerability of pramipexole in treatment for primary RLS. Results of this meta-analysis showed a favorable effect of pramipexole versus placebo on RLS symptoms (mean change on International RLS Study Group Rating Scale [IRLS] score: mean difference [MD] = -5.96; 95% confidence interval [CI]: -7.79 to -4.41, P < 0.00001 and sleep quality (pooled standard mean difference [SMD] = -0.48, 95% CI: -0.61 to -0.35, P < 0.00001. Nausea (relative risk [RR] = 2.68, 95% CI: 1.82 to 3.95, P < 0.001 and fatigue (RR = 1.82, 95% CI: 1.14 to 2.93, P = 0.013 were the most common adverse events, but, by and large, pramipexole was well-tolerated in patients with primary RLS. Nevertheless, long-term studies and more evidence of head-to-head comparisons of pramipexole with other dopamine agonists, anticonvulsants, and levodopa are needed. Keywords: restless legs syndrome, pramipexole, meta-analysis

  15. 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.

  16. 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.

  17. 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.

  18. Emissions minimization of chlorinated micropollutants in coal solid waste co-combustion by primary measures

    Energy Technology Data Exchange (ETDEWEB)

    Pandelova, M.; Lenoir, D.; Schramm, K.W. [GSF-Forschungszentrum fuer Umwelt und Gesundheit GmbH, Neuherberg (Germany)

    2005-07-01

    This study addresses co-combustion of coal-solid waste mixtures in pilot and laboratory-scale combustors, with emphasis on monitoring of toxic chlorinated hydrocarbon emissions like: polychlorinated dibenzo-p-dioxins (PCDD), polychlorinated dibenzofurans (PCDF), polychlorinated biphenyls (PCB) and polychlorinated benzenes (PCBz). The objectives of the work are stress on the so-called primary measures technique which cause reduction of the toxic emission prior formation the chlorinated micropollutants. Thermally resistant inorganic compounds were added directly to the fuel. The fuel-types used in this study are lignite coal from Puertollano (CIEMAT, Spain), pre-treated municipal solid waste (Rethmann Plano GmbH) and PVC (waste from ground floor). Two low cost and non- toxic nitrogen- and sulfur-compounds were considered as the most effective inhibitors for PCDD/F formation. That makes them applicable for use in a full scale combustion unit. (orig.)

  19. [Measurement of viscoelastic corneal parameters (corneal hysteresis) in patients with primary open angle glaucoma].

    Science.gov (United States)

    Schroeder, B; Hager, A; Kutschan, A; Wiegand, W

    2008-10-01

    The ocular response analyzer (ORA) uses an air-pressure-triggered, dynamic, bi-directional corneal applanation method to measure biomechanical parameters of the cornea. Corneal hysteresis (CH) is defined as the difference in intraocular pressure recorded during inward and outward applanation. CH is therefore an indicator for the viscoelastic properties of the cornea. CH was recorded in non-glaucoma patients (80 eyes) as well as in patients with primary open angle glaucoma (POAG, 82 eyes). The correlation between CH and central corneal thickness (CCT) was analyzed. Mean CH was 10.6+/-2.2 mmHg in the non-glaucoma group and 9.3+/-2.2 mmHg in patients with POAG (pcorneal parameters with a significant decrease in corneal hysteresis. A positive correlation between CH and CCT, which was seen in the non-glaucoma group could not be detected in the POAG group.

  20. Measuring informed decision making about prostate cancer screening in primary care.

    Science.gov (United States)

    Leader, Amy; Daskalakis, Constantine; Braddock, Clarence H; Kunkel, Elisabeth J S; Cocroft, James R; Bereknyei, Sylvia; Riggio, Jeffrey M; Capkin, Mark; Myers, Ronald E

    2012-01-01

    To measure the extent of informed decision making (IDM) about prostate cancer screening in physician-patient encounters, describe the coding process, and assess the reliability of the IDM measure. Audiorecoded encounters of 146 older adult men and their primary care physicians were obtained in a randomized controlled trial of mediated decision support related to prostate cancer screening. Each encounter was dual coded for the presence or absence of 9 elements that reflect several important dimensions of IDM, such as information sharing, patient empowerment, and engaging patients in preference clarification. An IDM-9 score (range = 0-9) was determined for each encounter by summing the number of elements that were coded as present. Estimates of coding reliability and internal consistency were calculated. Male patients tended to be white (59%), married (70%), and between the ages of 50 and 59 (70%). Physicians tended to be white (90%), male (74%), and have more than 10 years of practice experience (74%). IDM-9 scores ranged from 0 to 7.5 (mean [SD], 2.7 [2.1]). Reliability (0.90) and internal consistency (0.81) of the IDM-9 were both high. The IDM dimension observed most frequently was information sharing (74%), whereas the dimension least frequently observed was engagement in preference clarification (3.4%). In physician-patient encounters, the level of IDM concerning prostate cancer screening was low. The use of a dual-coding approach with audiorecorded encounters produced a measure of IDM that was reliable and internally consistent.

  1. [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

  2. [Efficacy of the RIMAG unconventional hip prosthesis in patients with primary bone tumors, metastasis and non-tumor osteoarticular losses].

    Science.gov (United States)

    Rico-Martínez, G; Delgado-Cedillo, E A; Linares-González, L M; Lindoro-Félix, H; León-Hernández, S R

    2013-01-01

    To assess the functional efficacy of the RIMAG unconventional hip prosthesis in cancer and non-cancer patients. Functional analysis of 38 patients with RIMAG arthroplasty, using the Musculoskeletal Tumor Society Scoring System and including the following: functionality versus histologic diagnosis (5 malignancies, 3 metastases, 14 giant cell tumors (GCT), 8 with other benign tumors, and 8 had no tumor), age (40.4 +/- 19.1 years), sex (24 females, 14 males), postoperative follow-up (34.7 +/- 31.3 months). Analysis of intraoperative, immediate and late complications, time to weight bearing, gait and work or social reintegration were also assessed. Global mean of ideal functionality was 65.6 +/- 23.2%. Age was negatively correlated with the functionality rate (r = -0.507, p = 0.001); significant difference with the histologic diagnosis: malignant tumors 54.8, metastasis 58.6, giant cell tumor 25.6, other benign tumors 34.2, non-tumor causes 56.6 (p = 0.001). When functionality means were adjusted for age with a covariance analysis, better percentages were found for benign tumors (79.2 +/- 6.8%) and giant cell tumors (76.4 +/- 6.3%), less functionality for non-tumor causes (45.7 +/- 7.6%), and intermediate percentages for malignant tumors and metastasis (p = 0.03). Intraoperative complications occurred in 4 cases (28.6%), immediate in 3 (7.8%), late in 15 (39.4%); 62.5% of patients started immediate weight bearing, 92.1% resumed their usual activities after surgery. The reconstruction of the proximal femur with RIMAG is a safe and reliable treatment option, with complication rates below the ones reported in the literature. Satisfactory results were obtained, with high functional rates for benign tumors, and low rates in older patients, malignant tumors and metastasis.

  3. A method to measure the impact of primary care programs targeted to reduce racial and ethnic disparities in health outcomes.

    Science.gov (United States)

    Luther, Stephen L; Studnicki, James; Kromrey, Jeffrey; Lomando-Frakes, Kathleen; Grant, Pauline; Finley, Gabrielle C

    2003-01-01

    A retrospective population-based study was designed to test the impact on selected health outcomes of community-based primary care programs targeting racial and ethnic minorities. Zip codes were coded as either "high" or "low" access to targeted primary care programs to create the independent variable of interest. Outcome measures were chosen to represent unique dimensions of primary care. Generalized linear models were developed to compare rates for the outcome measures among blacks in high- and low-access areas. This study provides a useful approach that could be used to evaluate the impact of such programs in other communities.

  4. Which and How Many Patients Should Be Included in Randomised Controlled Trials to Demonstrate the Efficacy of Biologics in Primary Sjögren’s Syndrome?

    Science.gov (United States)

    Devauchelle-Pensec, Valérie; Gottenberg, Jacques-Eric; Jousse-Joulin, Sandrine; Berthelot, Jean-Marie; Perdriger, Aleth; Hachulla, Eric; Hatron, Pierre Yves; Puechal, Xavier; Le Guern, Véronique; Sibilia, Jean; Chiche, Laurent; Goeb, Vincent; Vittecoq, Olivier; Larroche, Claire; Fauchais, Anne Laure; Hayem, Gilles; Morel, Jacques; Zarnitsky, Charles; Dubost, Jean Jacques; Dieudé, Philippe; Pers, Jacques Olivier; Cornec, Divi; Seror, Raphaele; Mariette, Xavier; Nowak, Emmanuel; Saraux, Alain

    2015-01-01

    Objective The goal of this study was to determine how the choice of the primary endpoint influenced sample size estimates in randomised controlled trials (RCTs) of treatments for primary Sjögren’s syndrome (pSS). Methods We reviewed all studies evaluating biotechnological therapies in pSS to identify their inclusion criteria and primary endpoints. Then, in a large cohort (ASSESS), we determined the proportion of patients who would be included in RCTs using various inclusion criteria sets. Finally, we used the population of a large randomised therapeutic trial in pSS (TEARS) to assess the impact of various primary objectives and endpoints on estimated sample sizes. These analyses were performed only for the endpoints indicating greater efficacy of rituximab compared to the placebo. Results We identified 18 studies. The most common inclusion criteria were short disease duration; systemic involvement; high mean visual analogue scale (VAS) scores for dryness, pain, and fatigue; and biological evidence of activity. In the ASSESS cohort, 35 percent of patients had recent-onset disease (lower than 4 years), 68 percent systemic manifestations, 68 percent high scores on two of three VASs, and 52 percent biological evidence of activity. The primary endpoints associated with the smallest sample sizes (nlower than 200) were a VAS dryness score improvement higher to 20 mm by week 24 or variable improvements (10, 20, or 30 mm) in fatigue VAS by week 6 or 16. For patients with systemic manifestations, the ESSDAI change may be the most logical endpoint, as it reflects all domains of disease activity. However, the ESSDAI did not improve significantly with rituximab therapy in the TEARS study. Ultrasound score improvement produced the smallest sample size estimate in the TEARS study. Conclusion This study provides valuable information for designing future RCTs on the basis of previously published studies. Previous RCTs used inclusion criteria that selected a small part of the

  5. Which and How Many Patients Should Be Included in Randomised Controlled Trials to Demonstrate the Efficacy of Biologics in Primary Sjögren's Syndrome?

    Directory of Open Access Journals (Sweden)

    Valérie Devauchelle-Pensec

    Full Text Available The goal of this study was to determine how the choice of the primary endpoint influenced sample size estimates in randomised controlled trials (RCTs of treatments for primary Sjögren's syndrome (pSS.We reviewed all studies evaluating biotechnological therapies in pSS to identify their inclusion criteria and primary endpoints. Then, in a large cohort (ASSESS, we determined the proportion of patients who would be included in RCTs using various inclusion criteria sets. Finally, we used the population of a large randomised therapeutic trial in pSS (TEARS to assess the impact of various primary objectives and endpoints on estimated sample sizes. These analyses were performed only for the endpoints indicating greater efficacy of rituximab compared to the placebo.We identified 18 studies. The most common inclusion criteria were short disease duration; systemic involvement; high mean visual analogue scale (VAS scores for dryness, pain, and fatigue; and biological evidence of activity. In the ASSESS cohort, 35 percent of patients had recent-onset disease (lower than 4 years, 68 percent systemic manifestations, 68 percent high scores on two of three VASs, and 52 percent biological evidence of activity. The primary endpoints associated with the smallest sample sizes (nlower than 200 were a VAS dryness score improvement higher to 20 mm by week 24 or variable improvements (10, 20, or 30 mm in fatigue VAS by week 6 or 16. For patients with systemic manifestations, the ESSDAI change may be the most logical endpoint, as it reflects all domains of disease activity. However, the ESSDAI did not improve significantly with rituximab therapy in the TEARS study. Ultrasound score improvement produced the smallest sample size estimate in the TEARS study.This study provides valuable information for designing future RCTs on the basis of previously published studies. Previous RCTs used inclusion criteria that selected a small part of the entire pSS population. The

  6. Critical Analysis of Primary Literature in a Master's-Level Class: Effects on Self-Efficacy and Science-Process Skills.

    Science.gov (United States)

    Abdullah, Christopher; Parris, Julian; Lie, Richard; Guzdar, Amy; Tour, Ella

    2015-01-01

    The ability to think analytically and creatively is crucial for success in the modern workforce, particularly for graduate students, who often aim to become physicians or researchers. Analysis of the primary literature provides an excellent opportunity to practice these skills. We describe a course that includes a structured analysis of four research papers from diverse fields of biology and group exercises in proposing experiments that would follow up on these papers. To facilitate a critical approach to primary literature, we included a paper with questionable data interpretation and two papers investigating the same biological question yet reaching opposite conclusions. We report a significant increase in students' self-efficacy in analyzing data from research papers, evaluating authors' conclusions, and designing experiments. Using our science-process skills test, we observe a statistically significant increase in students' ability to propose an experiment that matches the goal of investigation. We also detect gains in interpretation of controls and quantitative analysis of data. No statistically significant changes were observed in questions that tested the skills of interpretation, inference, and evaluation. © 2015 C. Abdullah et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  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

    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.

  8. The efficacy of pregabalin for the management of postoperative pain in primary total knee and hip arthroplasty: a meta-analysis.

    Science.gov (United States)

    Li, Fei; Ma, Jianxiong; Kuang, Mingjie; Jiang, Xuan; Wang, Ying; Lu, Bin; Zhao, Xingwen; Sun, Lei; Ma, Xinlong

    2017-03-24

    A systematic review of randomized controlled trials (RCTs) was conducted to evaluate the efficacy of pregabalin for the management of postoperative pain in patients undergoing primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA). The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. RevMan 5.3 software was selected to conduct the meta-analysis. Seven RCTs were included in our meta-analysis. There were significant differences in visual analogue scale (VAS) at 24 and 48 h with rest, knee flexion degree, mean morphine consumption, and postoperative side effects (nausea, vomiting, pruritus, and dizziness) when comparing the pregabalin group to the placebo group after TKA and THA. However, the differences in VAS at 72 h with rest and at 24 h on movement were not significant between the two groups. Pregabalin was found to improve pain control at 24 and 48 h with rest, reduce morphine consumption, improve the knee flexion degree, decrease the incident rate of nausea, vomiting, and pruritus, and increase the incident rate of dizziness after TKA and THA but could not improve the pain control at 72 h with rest. In summary, the use of pregabalin may be a valuable asset in pain management within the first 48 h after TKA and THA. However, future studies regarding doses and pregabalin medication are required.

  9. Antibacterial Efficacy of Calcium Hydroxide and Chlorhexidine Mixture for Treatment of Teeth with Primary Endodontic Lesions: A Randomized Clinical Trial.

    Science.gov (United States)

    Donyavi, Zakiyeh; Ghahari, Parastoo; Esmaeilzadeh, Mohammad; Kharazifard, Mohammadjavad; Yousefi-Mashouf, Rasoul

    2016-01-01

    This study compared the root canal microbial count of necrotic teeth after irrigation with 6% sodium hypochlorite (NaOCl) (single session treatment) and two-session root canal treatment with two-week application of calcium hydroxide (CH) mixed with 0.2% chlorhexidine (CHX) as intracanal medicament. In this randomized clinical trial, single-rooted necrotic teeth were divided into two groups. Root canal was irrigated with 2 mL of 6% NaOCl in one group, and a mixture of 0.2% CHX and CH powder as an intracanal medicament for two weeks, in the other group. Root canal samples were obtained before and after the intervention and number of colony forming units (CFUs) was counted in each phase. The reduction of Enterococcus faecalis CFU was not significantly different between the two groups (P=0.233) but the CFU of aerobic and anaerobic bacteria was significantly lower in CH+CHX group (P<0.001). Two-week application of CH+CHX caused significant reduced the aerobic, anaerobic and E. faecalis colony counts. Thus, it may be beneficial to carry out primary root canal treatment of necrotic teeth with endodontic lesions in two sessions with intracanal medicaments to achieve predictable results.

  10. 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

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

    Science.gov (United States)

    Ballard, Kirrie J; Savage, Sharon; Leyton, Cristian E; Vogel, Adam P; Hornberger, Michael; Hodges, John R

    2014-01-01

    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 repetition task

  12. Adaptation and evaluation of the measurement properties of the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale.

    Science.gov (United States)

    Pedrosa, Rafaela Batista dos Santos; Rodrigues, Roberta Cunha Matheus

    2016-01-01

    to undertake the cultural adaptation of, and to evaluate the measurement properties of, the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale in coronary heart disease (CHD) patients, with outpatient monitoring at a teaching hospital. the process of cultural adaptation was undertaken in accordance with the international literature. The data were obtained from 147 CHD patients, through the application of the sociodemographic/clinical characterization instrument, and of the Brazilian versions of the Morisky Self-Reported Measure of Medication Adherence Scale, the General Perceived Self-Efficacy Scale, and the Self-efficacy for Appropriate Medication Adherence Scale. the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of semantic-idiomatic, conceptual and cultural equivalencies, with high acceptability and practicality. The floor effect was evidenced for the total score and for the domains of the scale studied. The findings evidenced the measure's reliability. The domains of the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented significant inverse correlations of moderate to strong magnitude between the scores of the Morisky scale, indicating convergent validity, although correlations with the measure of general self-efficacy were not evidenced. The validity of known groups was supported, as the scale discriminated between "adherents" and "non-adherents" to the medications, as well as to "sufficient dose" and "insufficient dose". the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of reliability and validity in coronary heart disease outpatients.

  13. Overview of a FPGA-based nuclear instrumentation dedicated to primary activity measurements.

    Science.gov (United States)

    Bobin, C; Bouchard, J; Pierre, S; Thiam, C

    2012-09-01

    In National Metrology Institutes like LNE-LNHB, renewal and improvement of the instrumentation is an important task. Nowadays, the current trend is to adopt digital boards, which present numerous advantages over the standard electronics. The feasibility of an on-line fulfillment of nuclear-instrumentation functionalities using a commercial FPGA-based (Field-Programmable Gate Array) board has been validated in the case of TDCR primary measurements (Triple to Double Coincidence Ratio method based on liquid scintillation). The new applications presented in this paper have been included to allow either an on-line processing of the information or a raw-data acquisition for an off-line treatment. Developed as a complementary tool for TDCR counting, a time-to-digital converter specifically designed for this technique has been added. In addition, the description is given of a spectrometry channel based on the connection between conventional shaping amplifiers and the analog-to-digital converter (ADC) input available on the same digital board. First results are presented in the case of α- and γ-counting related to, respectively, the defined solid angle and well-type NaI(Tl) primary activity techniques. The combination of two different channels (liquid scintillation and γ-spectrometry) implementing the live-time anticoincidence processing is also described for the application of the 4πβ-γ coincidence method. The need for an optimized coupling between the analog chain and the ADC stage is emphasized. The straight processing of the signals delivered by the preamplifier connected to a HPGe detector is also presented along with the first development of digital filtering. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Measuring organizational attributes in primary care: a validation study in Germany.

    Science.gov (United States)

    Ose, Dominik; Freund, Tobias; Kunz, Cornelia U; Szecsenyi, Joachim; Natanzon, Iris; Trieschmann, Johanna; Wensing, Michel; Miksch, Antje

    2010-12-01

    Models for the structured delivery of care rely on organizational attributes of practice teams. The Survey of Organizational Attributes for Primary Care (SOAPC) is known to be a valid instrument to measure this aspect in the primary care setting. The aim of this study was to determine the validity of a translated and culturally adapted German version of the SOAPC. The SOAPC was translated and culturally adapted according to established standards. The external validity of the German SOAPC was assessed using the German version of the Warr-Cook-Wall scale. A total of 200 practices randomly selected from a conference database were asked to participate in the validation study. Practice, clinicians and staff characteristics were determined via short-form questionnaires. We used standardized statistical procedures to reveal the psychometric properties of the SOAPC. A total of 54 practice teams participated by returning 297 completed questionnaires (297/425, response rate 69.8%). All four domains of the SOAPC (communication, decision making, stress/chaos, history of change) could be approved by factor analysis. Internal consistency is underlined by a Cronbach's alpha of 0.70 or higher in all categories. We show strong correlation with the Warr-Cook-Wall scale in all corresponding categories indexing high external validity. The German SOAPC is a reliable and valid instrument for the assessment of organizational attributes of practice teams as the providers of quality of care. Moreover, the tool makes it possible to map the state of implementation of quality management and practice organization. The availability of the German SOAPC encourages further research on this topic in German-speaking countries. © 2010 Blackwell Publishing Ltd.

  15. 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.

  16. 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.

  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. 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.

  19. Changes in Nasal Configuration Following Primary Rhinoplasty: Direct Anthropometric Measurement in Patients With Complete Unilateral Cleft Lip and Palate.

    Science.gov (United States)

    Tang, Paula M Y; Chao, Nicholas S Y; Leung, Michael W Y; Kelvin, K W Liu

    2016-09-01

    With the recent advances of surgical adjuncts including presurgical naso-alveolar molding and postoperative nasal stenting, information on the anthropometric evaluation of cleft lip nasal symmetry after primary rhinoplasty is lacking. Twenty-nine nonsyndromic patients with complete unilateral cleft lip and palate undergoing modified rotation advancement cheiloplasty with synchronous primary rhinoplasty in our center were prospectively recruited in our study. All of them received our center's peri-operative management protocol, including presurgical naso-alveolar molding and postoperative nasal stenting. Direct anthropometric measurements of their nasal configuration were documented when they were anesthetized for primary lip repair at 3 months of age and for the primary palate repair at 12 months of age. Their nasal configurations were analyzed before primary rhinoplasty and at 9 months after rhinoplasty. There is a statistically significant change in nasal symmetry at 9 months after the primary rhinoplasty. There is no significant correlation between the nasal configuration before and at 9 months after the primary rhinoplasty. With significant relapse of nasal deformity at 9 months after the primary rhinoplasty despite the use of presurgical naso-alveolar molding and postoperative nasal stenting, overcorrection of the nasal configuration at primary rhinoplasty should be considered for optimal long-term nasal symmetrical outcome.

  20. Long term measurements of aerosol optical properties at a primary forest site in Amazonia

    Directory of Open Access Journals (Sweden)

    L. V. Rizzo

    2013-03-01

    Full Text Available A long term experiment was conducted in a primary forest area in Amazonia, with continuous in-situ measurements of aerosol optical properties between February 2008 and April 2011, comprising, to our knowledge, the longest database ever in the Amazon Basin. Two major classes of aerosol particles, with significantly different optical properties were identified: coarse mode predominant biogenic aerosols in the wet season (January–June, naturally released by the forest metabolism, and fine mode dominated biomass burning aerosols in the dry season (July–December, transported from regional fires. Dry particle median scattering coefficients at the wavelength of 550 nm increased from 6.3 Mm−1 to 22 Mm−1, whereas absorption at 637 nm increased from 0.5 Mm−1 to 2.8 Mm−1 from wet to dry season. Most of the scattering in the dry season was attributed to the predominance of fine mode (PM2 particles (40–80% of PM10 mass, while the enhanced absorption coefficients are attributed to the presence of light absorbing aerosols from biomass burning. As both scattering and absorption increased in the dry season, the single scattering albedo (SSA did not show a significant seasonal variability, in average 0.86 ± 0.08 at 637 nm for dry aerosols. Measured particle optical properties were used to estimate the aerosol forcing efficiency at the top of the atmosphere. Results indicate that in this primary forest site the radiative balance was dominated by the cloud cover, particularly in the wet season. Due to the high cloud fractions, the aerosol forcing efficiency absolute values were below −3.5 W m−2 in 70% of the wet season days and in 46% of the dry season days. Besides the seasonal variation, the influence of out-of-Basin aerosol sources was observed occasionally. Periods of influence of the Manaus urban plume were detected, characterized by a consistent increase on particle scattering (factor 2.5 and absorption coefficients (factor 5. Episodes of

  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. Efficacy of single-component MTV to measure turbulent wall-flow velocity derivative profiles at high resolution

    Science.gov (United States)

    Elsnab, John R.; Monty, Jason P.; White, Christopher M.; Koochesfahani, Manoochehr M.; Klewicki, Joseph C.

    2017-09-01

    Physical interpretations and especially analytical considerations benefit from the ability to accurately estimate derivatives of experimentally measured statistical profiles. Toward this aim, experiments were conducted to investigate the efficacy of single-component molecular tagging velocimetry (1c-MTV) to measure mean velocity profiles that can be differentiated multiple times. Critical effects here pertain to finite measurement uncertainty in the presence of high spatial resolution. Measurements acquired in fully developed turbulent channel flow over a friction Reynolds number range from 390 to 1800 are used to investigate these issues. Each measured profile contains about 880 equally spaced data points that span from near the edge of the viscous sublayer to the channel centreline. As a result of the high spatial resolution, even very small levels of uncertainty in the data adversely affect the capacity to produce smooth velocity derivative profiles. It is demonstrated that the present 1c-MTV measurements can be differentiated twice, with the resulting profile remaining smooth and accurate. The experimental mean velocity profiles and their wall-normal derivatives up to second order are shown to convincingly agree with existing DNS data, including the apparent variations with Reynolds number.

  3. Sensitivity and Specificity of French Language and Processing Measures for the Identification of Primary Language Impairment at Age 5

    Science.gov (United States)

    Thordardottir, Elin; Kehayia, Eva; Mazer, Barbara; Lessard, Nicole; Majnemer, Annette; Sutton, Ann; Trudeau, Natacha; Chilingaryan, Gevorg

    2011-01-01

    Purpose: Research on the diagnostic accuracy of different language measures has focused primarily on English. This study examined the sensitivity and specificity of a range of measures of language knowledge and language processing for the identification of primary language impairment (PLI) in French-speaking children. Because of the lack of…

  4. Primary Marine Aerosol Emissions: Size Resolved Eddy Covariance Measurements with Estimates of the Sea Salt and Organic Carbon Fractions

    NARCIS (Netherlands)

    Nilsson, E.D.; Martensson, E.M.; Ekeren, J.S. van; Leeuw, G. de; Moerman, M.M.; O'Dowd, C.

    2007-01-01

    Primary marine aerosol fluxes were measured using eddy covariance (EC), a condensation particle counter (CPC) and an optical particle counter (OPC) with a heated inlet. The later was used to discriminate between sea salt and total aerosol. Measurements were made from the 25m tower at the research

  5. Are we making the grade? Practices and reported efficacy measures of primate conservation education programs.

    Science.gov (United States)

    Kling, Katherine J; Hopkins, Mariah E

    2015-04-01

    Conservation education is often employed alongside primate conservation efforts with the aim of changing knowledge, attitudes, and behaviors toward non-human primates. Recommended best-use practices include longevity, use of program incentives, collaboration among educators, and adaptive program assessment, among others. This study surveys primate conservation education programs (PCEPs) to assess the frequency of suggested best-use practices, and to investigate impacts on program efficacy. Online surveys were collected from PCEPs in 2013-2014 (N = 43). The majority of programs reported lengths of 5-10 years, with participant involvement ranging widely from a day to several years. Non-economic and economic incentives were distributed by approximately half of all programs, with programs that provided economic incentives reporting positive participant attitude changes more frequently than those that did not (P = 0.03). While >70% of PCEPs consulted with community leaders, local teachers, and research scientists, only 45.9% collaborated with other conservation educators and only 27% collaborated with cultural experts such as cultural anthropologists. Programs that collaborated with other conservation educators were more likely to report reductions in threats to primates, specifically to bushmeat hunting and capture of primates for the pet trade (P = 0.07). Formal program evaluations were employed by 72.1% of all programs, with the majority of programs using surveys to assess changes to participant attitudes and knowledge. Formal evaluations of participant behavior, community attitudes and behaviors, and threats to primate populations were less common. While results indicate that PCEPs follow many suggested best-use practices, program impacts may be enhanced by greater discussion of economic incentivization, increased collaboration between conservation educators, and improved commitment to adaptive evaluation of changes to behaviors in addition to attitudes and

  6. 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.

  7. Real-time indoor and outdoor measurements of black carbon at primary schools

    Science.gov (United States)

    Reche, C.; Rivas, I.; Pandolfi, M.; Viana, M.; Bouso, L.; Àlvarez-Pedrerol, M.; Alastuey, A.; Sunyer, J.; Querol, X.

    2015-11-01

    Epidemiological and toxicological studies have demonstrated the association between Black Carbon in indoor and outdoor air and the occurrence of health risks. Data on air quality in schools is of special interest, as children are more vulnerable to health hazards. In this context, indoor and outdoor measurements of real-time Equivalent Black Carbon (EBC) were collected at 39 primary schools located in Barcelona (Spain), with classrooms naturally ventilated under warm weather conditions. A main contribution of road traffic emissions to indoor and outdoor EBC levels was evidenced through different approaches. Simultaneous measurements of EBC levels at schools under different traffic conditions revealed concentrations by 30-35% higher at schools exposed to higher vehicles intensities. Moreover, a significant correlation was obtained between average outdoor EBC levels at different districts of the city and the percentage of surface area in each district used for the road network (R2 = 0.61). Higher indoor than outdoor levels were recorded at some instances when the indoor sampling location was relatively closer to road traffic, even under low outdoor temperatures. Indeed, the average indoor/outdoor EBC ratios for each school correlate moderately between campaigns in spite of significant differences in temperature between sampling periods. These two facts highlight the strong dependency of the EBC levels on the distance to traffic. The peaks of exposure inside the classrooms seemed to be determined by outdoor concentrations, as shown by the parallelism between indoor and outdoor mean EBC daily cycles and the similar contribution of traffic rush hours to indoor and outdoor daily mean levels. The airtightness of the classroom was suggested as the responsible for the indoor/outdoor ratios of EBC higher than 1 recorded at nights.

  8. 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.

  9. Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol.

    Science.gov (United States)

    Légaré, France; Stacey, Dawn; Graham, Ian D; Elwyn, Glyn; Pluye, Pierre; Gagnon, Marie-Pierre; Frosch, Dominick; Harrison, Margaret B; Kryworuchko, Jennifer; Pouliot, Sophie; Desroches, Sophie

    2008-01-03

    Shared decision-making (SDM) is defined as a process by which a healthcare choice is made by practitioners together with the patient. Although many diagnostic and therapeutic processes in primary care integrate more than one type of health professional, most SDM conceptual models and theories appear to be limited to the patient-physician dyad. The objectives of this study are to develop a conceptual model and propose a set of measurement tools for enhancing an interprofessional approach to SDM in primary healthcare. An inventory of SDM conceptual models, theories and measurement tools will be created. Models will be critically assessed and compared according to their strengths, limitations, acknowledgement of interprofessional roles in the process of SDM and relevance to primary care. Based on the theory analysis, a conceptual model and a set of measurements tools that could be used to enhance an interprofessional approach to SDM in primary healthcare will be proposed and pilot-tested with key stakeholders and primary healthcare teams. This study protocol is informative for researchers and clinicians interested in designing and/or conducting future studies and educating health professionals to improve how primary healthcare teams foster active participation of patients in making health decisions using a more coordinated approach.

  10. Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol

    Directory of Open Access Journals (Sweden)

    Frosch Dominick

    2008-01-01

    Full Text Available Abstract Background Shared decision-making (SDM is defined as a process by which a healthcare choice is made by practitioners together with the patient. Although many diagnostic and therapeutic processes in primary care integrate more than one type of health professional, most SDM conceptual models and theories appear to be limited to the patient-physician dyad. The objectives of this study are to develop a conceptual model and propose a set of measurement tools for enhancing an interprofessional approach to SDM in primary healthcare. Methods/Design An inventory of SDM conceptual models, theories and measurement tools will be created. Models will be critically assessed and compared according to their strengths, limitations, acknowledgement of interprofessional roles in the process of SDM and relevance to primary care. Based on the theory analysis, a conceptual model and a set of measurements tools that could be used to enhance an interprofessional approach to SDM in primary healthcare will be proposed and pilot-tested with key stakeholders and primary healthcare teams. Discussion This study protocol is informative for researchers and clinicians interested in designing and/or conducting future studies and educating health professionals to improve how primary healthcare teams foster active participation of patients in making health decisions using a more coordinated approach.

  11. Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol

    Science.gov (United States)

    Légaré, France; Stacey, Dawn; Graham, Ian D; Elwyn, Glyn; Pluye, Pierre; Gagnon, Marie-Pierre; Frosch, Dominick; Harrison, Margaret B; Kryworuchko, Jennifer; Pouliot, Sophie; Desroches, Sophie

    2008-01-01

    Background Shared decision-making (SDM) is defined as a process by which a healthcare choice is made by practitioners together with the patient. Although many diagnostic and therapeutic processes in primary care integrate more than one type of health professional, most SDM conceptual models and theories appear to be limited to the patient-physician dyad. The objectives of this study are to develop a conceptual model and propose a set of measurement tools for enhancing an interprofessional approach to SDM in primary healthcare. Methods/Design An inventory of SDM conceptual models, theories and measurement tools will be created. Models will be critically assessed and compared according to their strengths, limitations, acknowledgement of interprofessional roles in the process of SDM and relevance to primary care. Based on the theory analysis, a conceptual model and a set of measurements tools that could be used to enhance an interprofessional approach to SDM in primary healthcare will be proposed and pilot-tested with key stakeholders and primary healthcare teams. Discussion This study protocol is informative for researchers and clinicians interested in designing and/or conducting future studies and educating health professionals to improve how primary healthcare teams foster active participation of patients in making health decisions using a more coordinated approach. PMID:18173848

  12. Measuring three aspects of motivation among health workers at primary level health facilities in rural Tanzania.

    Directory of Open Access Journals (Sweden)

    Miho Sato

    Full Text Available The threshold of 2.3 skilled health workers per 1,000 population, published in the World Health Report in 2006, has galvanized resources and efforts to attain high coverage of skilled birth attendance. With the inception of the Sustainable Development Goals (SDGs, a new threshold of 4.45 doctors, nurses, and midwives per 1,000 population has been identified. This SDG index threshold indicates the minimum density to respond to the needs of health workers to deliver a much broader range of health services, such as management of non-communicable diseases to meet the targets under Goal 3: Ensure healthy lives and promote well-being for all people of all ages. In the United Republic of Tanzania, the density of skilled health workers in 2012 was 0.5 per 1,000 population, which more than doubled from 0.2 per 1,000 in 2002. However, this showed that Tanzania still faced a critical shortage of skilled health workers. While training, deployment, and retention are important, motivation is also necessary for all health workers, particularly those who serve in rural areas. This study measured the motivation of health workers who were posted at government-run rural primary health facilities.We sought to measure three aspects of motivation-Management, Performance, and Individual Aspects-among health workers deployed in rural primary level government health facilities. In addition, we also sought to identify the job-related attributes associated with each of these three aspects. Two regions in Tanzania were selected for our research. In each region, we further selected two districts in which we carried out our investigation. The two regions were Lindi, where we carried out our study in the Nachingwea District and the Ruangwa District, and Mbeya, within which the Mbarali and Rungwe Districts were selected for research. All four districts are considered rural.This cross-sectional study was conducted by administering a two-part questionnaire in the Kiswahili

  13. Measuring three aspects of motivation among health workers at primary level health facilities in rural Tanzania.

    Science.gov (United States)

    Sato, Miho; Maufi, Deogratias; Mwingira, Upendo John; Leshabari, Melkidezek T; Ohnishi, Mayumi; Honda, Sumihisa

    2017-01-01

    The threshold of 2.3 skilled health workers per 1,000 population, published in the World Health Report in 2006, has galvanized resources and efforts to attain high coverage of skilled birth attendance. With the inception of the Sustainable Development Goals (SDGs), a new threshold of 4.45 doctors, nurses, and midwives per 1,000 population has been identified. This SDG index threshold indicates the minimum density to respond to the needs of health workers to deliver a much broader range of health services, such as management of non-communicable diseases to meet the targets under Goal 3: Ensure healthy lives and promote well-being for all people of all ages. In the United Republic of Tanzania, the density of skilled health workers in 2012 was 0.5 per 1,000 population, which more than doubled from 0.2 per 1,000 in 2002. However, this showed that Tanzania still faced a critical shortage of skilled health workers. While training, deployment, and retention are important, motivation is also necessary for all health workers, particularly those who serve in rural areas. This study measured the motivation of health workers who were posted at government-run rural primary health facilities. We sought to measure three aspects of motivation-Management, Performance, and Individual Aspects-among health workers deployed in rural primary level government health facilities. In addition, we also sought to identify the job-related attributes associated with each of these three aspects. Two regions in Tanzania were selected for our research. In each region, we further selected two districts in which we carried out our investigation. The two regions were Lindi, where we carried out our study in the Nachingwea District and the Ruangwa District, and Mbeya, within which the Mbarali and Rungwe Districts were selected for research. All four districts are considered rural. This cross-sectional study was conducted by administering a two-part questionnaire in the Kiswahili language. The first

  14. Exploring the problem of mold growth and the efficacy of various mold inhibitor methods during moisture sorption isotherm measurements.

    Science.gov (United States)

    Yu, X; Martin, S E; Schmidt, S J

    2008-03-01

    Mold growth is a common problem during the equilibration of food materials at high relative humidity values using the standard saturated salt slurry method. Exposing samples to toluene vapor and mixing samples with mold inhibitor chemicals are suggested methods for preventing mold growth while obtaining isotherms. However, no published research was found that examined the effect of mold growth on isotherm performance or the efficacy of various mold inhibitor methods, including their possible effect on the physicochemical properties of food materials. Therefore, the objectives of this study were to (1) explore the effect of mold growth on isotherm performance in a range of food materials, (2) investigate the effectiveness of 4 mold inhibitor methods, irradiation, 2 chemical inhibitors (potassium sorbate and sodium acetate), and toluene vapor, on mold growth on dent corn starch inoculated with A. niger, and (3) examine the effect of mold inhibitor methods on the physicochemical properties of dent corn starch, including isotherm performance, pasting properties, gelatinization temperature, and enthalpy. Mold growth was found to affect starch isotherm performance by contributing to weight changes during sample equilibration. Among the 4 mold inhibitor methods tested, irradiation and toluene vapor were found to be the most effective for inhibiting growth of A. niger on dent cornstarch. However, both methods exhibited a significant impact on the starches' physiochemical properties, suggesting the need to probe the efficacy of other mold inhibitor methods and explore the use of new rapid isotherm instruments, which hamper mold growth by significantly decreasing measurement time.

  15. 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…

  16. Measuring primary care services performance: issues and opportunities from a home care pilot experience in the Tuscan health system.

    Science.gov (United States)

    Cinquini, Lino; Vainieri, Milena

    2008-08-01

    In recent years in Italy, as in other European countries, profound changes have been introduced in health care both at central and regional levels. Most of them were oriented towards a shift from 'hospital-centred' health care to health care based more on primary care services. This transition pursues two objectives: giving more effective responses to citizens' needs and reducing public health expenditure. Changes that involve organizational structure must also be carried out with the introduction of measurement tools that can help in planning and can control the changes. The paper provides the results obtained through the experience of modelling a measurement system for primary care carried out in 2004 and 2005 by some territorial managers and controllers in the Tuscan Health system, and the main issues in measuring primary care services emerging from this pilot experience focused on integrated home care services.

  17. 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.

  18. A Randomized, Placebo-Controlled Clinical Trial of Efficacy and Safety: Modafinil in the Treatment of Fatigue in Patients With Primary Biliary Cirrhosis.

    Science.gov (United States)

    Silveira, Marina G; Gossard, Andrea A; Stahler, Alisha C; Jorgensen, Roberta A; Petz, Janice L; Ali, Ahmad H; Lindor, Keith D

    Fatigue is a common symptom of primary biliary cirrhosis (PBC), and is associated with an impaired quality of life. No studies have assessed the use of modafinil in fatigue related to PBC in a controlled manner. A randomized, double-blind, placebo-controlled study was conducted to determine the safety and efficacy of modafinil for the treatment of fatigue in PBC. Forty patients were randomized to modafinil (n = 20) or placebo (n = 20) for 12 weeks. A verbal report of fatigue for at least 6 months was required for enrollment. Modafinil was administered at 100 mg by mouth once daily; a change by 50 mg every 2 weeks (maximum: 200 mg once daily) was allowed, depending on the subject's response to treatment. The primary outcome was defined as a ≥50% improvement in fatigue severity [quantified by the Fisk Fatigue Impact Scale (FFIS)] after 12 weeks of treatment, compared with baseline values. Thirty-three PBC patients completed the study. After 12 weeks of therapy, only 5 patients had a ≥50% reduction in FFIS scores: 3 patients (17.6%) in the modafinil arm and 2 (12.5%) in the placebo arm (P = 1.00). Change in median FFIS score was not statistically different between patients in the 2 treatment groups (P = 0.36). Modafinil was associated with minimal adverse events (headaches, diarrhea, and rash). In patients with PBC who have fatigue, treatment with modafinil for 12 weeks was safe and fairly well tolerated; however, it did not result in beneficial effects on fatigue compared with patients treated with placebo (CONSORT Table 1). ClinicalTrials.gov identifier NCT00943176.

  19. Measuring Adolescent Social and Academic Self-Efficacy: Cross-Ethnic Validity of the SEQ-C

    Science.gov (United States)

    Minter, Anthony; Pritzker, Suzanne

    2017-01-01

    Objective: This study examines the psychometric strength, including cross-ethnic validity, of two subscales of Muris' Self-Efficacy Questionnaire for Children: Academic Self-Efficacy (ASE) and Social Self-Efficacy (SSE). Methods: A large ethnically diverse sample of 3,358 early and late adolescents completed surveys including the ASE and SSE.…

  20. Magnitude of efficacy measurements in grass allergy immunotherapy trials is highly dependent on pollen exposure

    OpenAIRE

    Durham, S R; Nelson, H. S.; Nolte, H.; Bernstein, D I; Creticos, P S; Li, Z; Andersen, J. S.

    2014-01-01

    Background The objective was to evaluate the association between grass pollen exposure, allergy symptoms and impact on measured treatment effect after grass sublingual immunotherapy (SLIT)-tablet treatment. Methods The association between grass pollen counts and total combined rhinoconjunctivitis symptom and medication score (TCS) was based on a post hoc analysis of data collected over six trials and seven grass pollen seasons across North America and Europe, including 2363 subjects treated w...

  1. Safety and Efficacy of a Pharmacoinvasive Strategy in ST-Segment Elevation Myocardial Infarction: A Patient Population Study Comparing a Pharmacoinvasive Strategy With a Primary Percutaneous Coronary Intervention Strategy Within a Regional System.

    Science.gov (United States)

    Rashid, Mohammed K; Guron, Nita; Bernick, Jordan; Wells, George A; Blondeau, Melissa; Chong, Aun-Yeong; Dick, Alexander; Froeschl, Michael P V; Glover, Chris A; Hibbert, Benjamin; Labinaz, Marino; Marquis, Jean-François; Osborne, Christina; So, Derek Y; Le May, Michel R

    2016-10-10

    This study investigated the safety and efficacy of a pharmacoinvasive strategy compared with a primary percutaneous coronary intervention (PCI) strategy for ST-segment elevation myocardial infarction (STEMI) in the context of a real-world system. Primary PCI continues to be the optimal reperfusion therapy; however, in areas where PCI centers are not readily available, a pharmacoinvasive strategy has been proposed. The University of Ottawa Heart Institute regional STEMI system provides a primary PCI strategy for patients presenting within a 90-km radius from the PCI center, and a pharmacoinvasive strategy for patients outside this limit. We included all confirmed STEMI patients between April 2009 and May 2011. The primary efficacy outcome was a composite of mortality, reinfarction, or stroke and the primary safety outcome was major bleeding. We identified 236 and 980 consecutive patients enrolled in pharmacoinvasive and primary PCI strategies, respectively. The median door-to-needle time was 31 min in the pharmacoinvasive group and the median door-to-balloon time was 95 min in the primary PCI group. In a multivariable model, there was no significant difference in the primary efficacy outcome (odds ratio: 1.54; p = 0.21); however, the propensity for more bleeding with a pharmacoinvasive strategy approached statistical significance (odds ratio: 2.02; p = 0.08). Within the context of a STEMI system, a pharmacoinvasive strategy was associated with similar rates of the composite of mortality, reinfarction, or stroke as compared with a primary PCI strategy; however, there was a propensity for more bleeding with a pharmacoinvasive strategy. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. What efficacy measures are clinically relevant and should be used in Cochrane Reviews of acute migraine trials?

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer

    2015-01-01

    BACKGROUND: Cochrane Reviews are methodologically of high quality but the clinical relevance of analysed efficacy measures (EMs) should also be assessed. METHODS: The clinical relevance of EMs used in one systematic Cochrane review of oral zolmitriptan for migraine headache was evaluated. RESULTS......: The following EMs were used: pain free at two hours (30%), headache relief at two hours (60%), sustained pain free for 24 hours (19%) and sustained headache relief for 24 hours (39%). These EMs were also used in four other Cochrane reviews of acute migraine treatment. Of these EMs sustained headache relief...... for 24 h is not judged clinically relevant. CONCLUSION: Pain free and sustained pain free are clinically relevant, but the responses are rather low, demonstrating that there is a need for improvement of acute drug treatment in migraine....

  3. Efficacy of local herbal therapy in the management of dermatophytosis among primary school children in Cross River State, South-south Nigeria.

    Science.gov (United States)

    Eja, M E; Arikpo, G E; Enyi-Idoh, K H; Etim, S E; Etta, H E

    2009-06-01

    As a contribution to the on-going search for alternative, available and affordable treatment of common infections in Sub-saharan Africa, the efficacy of local herbs, Senna alata(Linn) and Borreria ocymoides (Burm), in comparison with conventional drugs, griseofulvin and clotrimazole in the treatment of dermatophytosis among primary school children, was examined in the three districts of Cross River State, South-South Nigeria. Out of 840 pupils screened, 68 (8.1%) were infected, with incidence ranging from 11 (1.3%) in the southern to 33 (3.9%) in the northern districts, indicating a widespread of the infection. Specimens taken from the infected pupils and analyzed for the causative agents, showed that Trichophyton tonsurans 29 (20.4%) followed by Microsporum soudanense 24 (16.9%) was most frequent. The greater sensitivity of the isolated dermatophytes to the local plants than the chemotherapeutic drugs (control) offers some hope of treatment and control. The antifungal activity of the plants was associated with their very high levels of chemical components, saponins, anthraquinones and flavonoids. We recommend further studies on the chemical properties and safety of the plants before total dependence on them for treatment.

  4. 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.

  5. 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.

  6. Development and validation of a measure of primary care behavioral health integration.

    Science.gov (United States)

    Kessler, Rodger S; Auxier, Andrea; Hitt, Juvena R; Macchi, C R; Mullin, Daniel; van Eeghen, Constance; Littenberg, Benjamin

    2016-12-01

    We developed the Practice Integration Profile (PIP) to measure the degree of behavioral health integration in clinical practices with a focus on primary care (PC). Its 30 items, completed by providers, managers, and staff, provide an overall score and 6 domain scores derived from the Lexicon of Collaborative Care. We describe its history and psychometric properties. The PIP was tested in a convenience sample of practices. Linear regression compared scores across integration exemplars, PC with behavioral services, PC without behavioral services, and community mental health centers without PC. An additional sample rated 4 scenarios describing practices with varying degrees of integration. One hundred sixty-nine surveys were returned. Mean domain scores ran from 49 to 65. The mean total score was 55 (median 58; range 0-100) with high internal consistency (Cronbach's alpha = .95). The lowest total scores were for PC without behavioral health (27), followed by community mental health centers (44), PC with behavioral health (60), and the exemplars (86; p < .001). Eleven respondents rerated their practices 37 to 194 days later. The mean change was + 1.5 (standard deviation = 11.1). Scenario scores were highly correlated with the degree of integration each scenario was designed to represent (Spearman's ρ = -0.71; P = 0.0005). These data suggest that the PIP is useful, has face, content, and internal validity, and distinguishes among types of practices with known variations in integration. We discuss how the PIP may support practices and policymakers in their integration efforts and researchers assessing the degree to which integration affects patient health outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Enhancing patient-doctor-computer communication in primary care: towards measurement construction.

    Science.gov (United States)

    Assis-Hassid, Shiri; Reychav, Iris; Heart, Tsipi; Pliskin, Joseph S; Reis, Shmuel

    2015-01-01

    The traditional dyadic dynamics of the medical encounter has been altered into a triadic relationship by introducing the computer into the examination room. This study defines Patient-Doctor-Computer Communication (PDCC) as a new construct and provides an initial validation process of an instrument for assessing PDCC in the computerized exam room: the e-SEGUE. Based on the existing literature, a new construct, PDCC, is defined as the physician's ability to provide patient-centered care while using the computer during the medical encounter. This study elucidates 27 PDCC-related behaviors from the relevant literature and state of the art models of PDCC. These were embedded in the SEGUE communication assessment framework to form the e-SEGUE, a communication skills assessment tool that integrates computer-related communication skills. Based on Mackenzie et al.'s methodological approach of measurement construction, we conducted a two-phased content validity analysis by a general and expert panels of the PDCC behaviors represented in the e-SEGUE. This study was carried out in an environment where EMR use is universal and fully integrated in the physicians' workflow. The panels consisted of medical students, residents, primary care physicians, healthcare leaders and faculty of medicine members, who rated and provided input regarding the 27 behaviors. Overall, results show high level of agreement with 23 PDCC-related behaviors. The PDCC instrument developed in this study, the e-SEGUE, fared well in a rigorous, albeit initial, validation process has a unique potential for training and enhancing patient-doctor communication (PDC) in the computerized examination room pending further development.

  8. Safety and efficacy of pulmonary vein isolation using a surround flow catheter with contact force measurement capabilities: A multicenter registry.

    Science.gov (United States)

    Stabile, Giuseppe; Di Donna, Paolo; Schillaci, Vincenzo; Di Monaco, Antonio; Iuliano, Assunta; Caponi, Domenico; Urraro, Francesco; Solimene, Francesco; Grimaldi, Massimo; Scaglione, Marco

    2017-07-01

    Pulmonary vein (PV) isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). Surround flow and contact force (CF) measurement capabilities might enhance procedure efficacy and safety. We report on the safety and midterm efficacy of a novel ablation catheter for PV isolation in patients with AF. Two hundred thirty-three consecutive patients (57 ± 11 years, 76% males, 51% with structural heart disease), referred for paroxysmal (157) or persistent (76) AF, underwent PV isolation by a surround flow catheter with CF measurement capability in four centers. Ablation was guided by electroanatomic mapping allowing radiofrequency (RF) energy delivery in the antral region aiming at PV isolation. Mean overall procedure time was 100 ± 42 minutes with a mean fluoroscopy time of 6 ± 5 minutes. Mean ablation time was 31±15 minutes; 99% of the targeted veins were isolated. The mean CF value during ablation was 13 ± 4 g. Intraprocedural early (30 minutes) PV reconnection occurred in 12% PVs, and all PVs were effectively reisolated. One pericardial effusion and five groin hematomas were reported. During a mean follow-up of 12 ± 6 months, 30 (12.9%) (10% paroxysmal AF vs. 18% persistent AF, P = 0.07) patients had an atrial arrhythmias recurrence. In this multicenter registry, RF ablation using a new surround flow catheter, with CF sensor, resulted as feasible, achieving a high rate of isolated PVs. Procedural and fluoroscopy times and success rates were comparable with other techniques with a low complication rate. © 2017 Wiley Periodicals, Inc.

  9. Efficacy of Pramipexole for the Treatment of Primary Restless Leg Syndrome: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

    Science.gov (United States)

    Liu, Guang Jian; Wu, Lang; Lin Wang, Song; Xu, Li Li; Ying Chang, Li; Fu Wang, Yun

    2016-01-01

    The objective of this meta-analysis was to systematically evaluate the efficacy of pramipexole for the treatment of primary moderate-to-severe restless leg syndrome (RLS). Databases of PubMed, OVID, ScienceDirect, SpringerLink, Thomson Reuters Web of Science, the Cochrane Library, the Wiley Online Library, ArticleFirst, CALIS, Study, CNKI, and WanFang were searched to identify randomized controlled trials (RCTs) investigating pramipexole for the treatment of primary moderate-to-severe RLS. A meta-analysis was then conducted to pool results. Twelve RCTs involving 3286 participants were included in this study. The mean (SD) treatment duration was 11.12 (5.72) weeks/person. The meta-analysis found that the post-treatment change in the International Restless Leg Syndrome Study Group Rating Scale (IRLS) score of the pramipexole group was significantly superior to that of the placebo group (weighted mean difference [WMD] = -4.64; 95% CI, -5.95 to -3.33; n = 8). More patients in the pramipexole group reported at least a 50% reduction in the IRLS score after treatment (risk ratio [RR] = 1.57; 95% CI, 1.43 to 1.73; n = 8). In terms of the scores for the Clinical Global Impression of Improvement scale (RR = 1.48; 95% CI, 1.31 to 1.66; n = 11) and the Patient Global Impression scale (RR = 1.54; 95% CI, 1.31 to 1.81; n = 9), treatment outcomes of the pramipexole group were significantly superior to those of the placebo group. In terms of the change in quality of life (WMD = 5.39; 95% CI, 2.28 to 8.50; n = 4), the change in daytime tiredness (WMD = -0.61; 95% CI, -1.21 to -0.01; n = 4), the change in the number of periodic limb movements per hour of sleep (WMD = -35.95; 95% CI, -56.42 to -15.48; n = 3), and the change in the quality of sleep (WMD = 3.60; 95% CI, 1.69 to 5.50; n = 6), the treatment outcomes of the pramipexole group were significantly superior to those of the placebo group. This meta-analysis study indicated that pramipexole could effectively improve the symptoms

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

    National Research Council Canada - National Science Library

    Ballard, Kirrie J; Savage, Sharon; Leyton, Cristian E; Vogel, Adam P; Hornberger, Michael; Hodges, John R

    2014-01-01

    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...

  11. 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

  12. 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.

  13. Testing the measurement invariance of the University of Washington Self-Efficacy Scale short form across four diagnostic subgroups.

    Science.gov (United States)

    Chung, Hyewon; Kim, Jiseon; Park, Ryoungsun; Bamer, Alyssa M; Bocell, Fraser D; Amtmann, Dagmar

    2016-10-01

    The University of Washington Self-Efficacy Scale (UW-SES) was originally developed for people with multiple sclerosis (MS) and spinal cord injury (SCI). This study evaluates the measurement invariance of the 6-item short form of the UW-SES across four disability subgroups. Evidence of measurement invariance would extend the UW-SES for use in two additional diagnostic groups: muscular dystrophy (MD) and post-polio syndrome (PPS). Multi-group confirmatory factor analysis was used to evaluate successive levels of measurement invariance of the 6-item short form, the UW-SES: (a) configural invariance, i.e., equivalent item-factor structures between groups; (b) metric invariance, i.e., equivalent unstandardized factor loadings between groups; and (c) scalar invariance, i.e., equivalent item intercepts between groups. Responses from the four groups with different diagnostic disorders were compared: MD (n = 172), MS (n = 868), PPS (n = 225), and SCI (n = 242). The results of this study support that the most rigorous form of invariance (i.e., scalar) holds for the 6-item short form of the UW-SES across the four diagnostic subgroups. The current study suggests that the 6-item short form of the UW-SES has the same meaning across the four diagnostic subgroups. Thus, the 6-item short form is validated for people with MD, MS, PPS, and SCI.

  14. Signal-to-Noise Ratio Measures Efficacy of Biological Computing Devices and Circuits

    Science.gov (United States)

    Beal, Jacob

    2015-01-01

    Engineering biological cells to perform computations has a broad range of important potential applications, including precision medical therapies, biosynthesis process control, and environmental sensing. Implementing predictable and effective computation, however, has been extremely difficult to date, due to a combination of poor composability of available parts and of insufficient characterization of parts and their interactions with the complex environment in which they operate. In this paper, the author argues that this situation can be improved by quantitative signal-to-noise analysis of the relationship between computational abstractions and the variation and uncertainty endemic in biological organisms. This analysis takes the form of a ΔSNRdB function for each computational device, which can be computed from measurements of a device’s input/output curve and expression noise. These functions can then be combined to predict how well a circuit will implement an intended computation, as well as evaluating the general suitability of biological devices for engineering computational circuits. Applying signal-to-noise analysis to current repressor libraries shows that no library is currently sufficient for general circuit engineering, but also indicates key targets to remedy this situation and vastly improve the range of computations that can be used effectively in the implementation of biological applications. PMID:26177070

  15. Hemocytometric Measures Predict the Efficacy of Oral Rehydration for Children with Postural Tachycardia Syndrome.

    Science.gov (United States)

    Lu, Wenxin; Yan, Hui; Wu, Shu; Xu, Wenrui; Jin, Hongfang; Du, Junbao

    2017-08-01

    To explore whether hemocytometric measures could be qualified predictors for the effect of oral rehydration salts (ORS) in children with postural tachycardia syndrome (POTS). Thirty-five children with POTS and 29 healthy children were enrolled. General information, hemodynamic status, and baseline hemocytometric variables were collected. Children with POTS received ORS therapy and were followed up for 3 months. The independent risk factors of developing POTS were explored. A receiver-operating characteristic curve was used to evaluate predictive value of hemocytometric variables for therapeutic effectiveness of ORS therapy. Children with POTS had larger mean corpuscular volume (MCV) and lower mean corpuscular hemoglobin concentration (MCHC) values than controls (P < .05). The baseline MCV values positively correlated with heart rate elevation from supine to upright (r = 0.294, P < .05). Both larger MCV and lower MCHC values were independent risk factors of developing POTS (for MCV, P < .05, OR 1.222; for MCHC, P < .05, OR 0.936). In children with POTS, responders to ORS had baseline lower MCV and higher MCHC than nonresponders (P < .05). The receiver-operating characteristic curve for the predictive value of MCHC showed that area under the curve was 0.73. MCHC values could be used to predict the effectiveness of ORS for treating POTS in children. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Utilisation of a Novel Test to Measure Severity and Treatment Efficacy of Posterior Blepharitis

    Directory of Open Access Journals (Sweden)

    Steven T. H. Yun

    2015-01-01

    Full Text Available Background. This study evaluated the effectiveness of managing posterior blepharitis (PB using a novel Posterior Blepharitis Management Protocol (PBMP. Design. Prospective, consecutive case series with 100% followup to one month. Participants. 27 patients (54 eyes with PB from an Ophthalmology practice in Sydney, Australia. Methods. Each patient’s PB was assessed by grading the nature and expressibility of the central lower lid tarsal gland secretions on Compression Of The Eyelid (COTE. Patients were then instructed in detail to undertake daily PB management sessions at home using our modified PBMP. Main Outcome Measures. On a subjective scale, patients compared their symptoms at one month with baseline. COTE scores were reevaluated to assess the objective effectiveness of each individual’s PBMP. COTE scoring was described as grades 1 (clear oil, 2 (pus, liquid, 3 (toothpaste-like secretions, and 4 (complete tarsal gland obstruction. Results. Patients reported a mean 77.8% ± 13.5% subjective improvement in symptoms. There was a trend towards improvement in COTE grading at one month compared with baseline: grades 1 (0 to 7.4%, 2a (22.2 to 16.6%, 2b (7.4 to 3.7%, 3 (18.5 to 27.7%, and 4 (51.8 to 44%. Conclusions. PBMP provided a rapid, inexpensive, simple, effective, and safe method of treating PB.

  17. 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.

  18. 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

    ... Liberty Reserve S.A. as a Financial Institution of Primary Money Laundering Concern AGENCY: Financial...), the Director of FinCEN found that Liberty Reserve S.A. (Liberty Reserve) is a financial institution... notice of proposed rulemaking (NPRM) to propose the imposition of a special measure against Liberty...

  19. Evaluating the species energy relationship with the newest measures of ecosystem energy: NDVI versus MODIS primary production

    Science.gov (United States)

    Linda B. Phillips; Andrew J. Hansen; Curtis H. Flather

    2008-01-01

    Ecosystem energy has been shown to be a strong correlate with biological diversity at continental scales. Early efforts to characterize this association used the normalized difference vegetation index (NDVI) to represent ecosystem energy. While this spectral vegetation index covaries with measures of ecosystem energy such as net primary production, the covariation is...

  20. Evaluation of the Efficacy and Correlation between Blood Glucose Measured Using Glucometers and Enzymatic Laboratory Methods

    Directory of Open Access Journals (Sweden)

    R Rasouli

    2012-05-01

    Full Text Available

    Background and Objectives: Diabetes Mellitus (DM is the most common chronic metabolic disease, with many complications including renal failure, blindness and non-traumatic amputation, so it is important to monitor and regulate blood glucose. Considering how easy home blood glucose monitoring is, we decided to evaluate the performance of two available glucometers for detection of blood glucose compared with standard laboratory methods.

     

    Methods: In this analytical study, we compared the capillary blood glucose levels of 60 volunteers with mean age of 32.8±9.6 years in Tabriz Mehr Laboratory as determined by test strips (two different Glucometers with venous blood glucose levels’ measurements by the enzymatic method (the standard laboratory kit. Data were analyzed using one way-ANOVA test, T-test, Pearson correlation and Bland and Altman plot.

     

    Results: The mean differences of No: 1 and No: 2 Glucometers with enzymatic laboratory method were 20.78±11.61 and 4.5±3.76mg/dl respectively. The one way ANOVA test indicated significant differences between three methods (p<0.05. Further Duncan's test revealed significant differences between two devices (p=0.001 and device No.1 and laboratory method (p=0.001; however, the differences between device No.2 and laboratory method were not statistically significant (p=0.83.

     

    Conclusion: According to the results, calibrating the devices with laboratory instruments in order to make major clinical decisions is recommended.

  1. The efficacy of neuroprosthesis in young hemiplegic patients, measured by three different gait indices: early results.

    Science.gov (United States)

    Danino, Barry; Khamis, Sam; Hemo, Yoram; Batt, Reuven; Snir, Erel; Wientroub, Shlomo; Hayek, Shlomo

    2013-12-01

    To evaluate functional electrical stimulation (FES) neuroprothesis as a method to improve gait in hemiplegic patients, using three different gait scoring methods as measures. Five hemiplegic patients (four with cerebral palsy at GMFCS I, one with diffuse pontine glioma) with a mean age of 16.5 years were given a FES neuroprosthesis (NESS(®) L300™) that was applied and calibrated individually. After an adaptation period during which the participants increased their daily use of the neuroprosthesis, gait was assessed with the stimulation off and with the FES on. Kinematic, kinetic, and temporal spatial data were determined using motion analysis and summarized by three scoring methods: Gait Profile Score (GPS), Gait Deviation Index (GDI), and Gillette Gait Index (GGI). Indices were calculated using the Gaitabase program available online. Patients were followed for a minimum of 1 year. When comparing gait with and without stimulation, all scoring methods showed improvement. GPS and GDI of the affected leg were significantly improved: 12.23-10.23° (p = 0.017) and 72.36-78.08 (p = 0.002), respectively. By applying the movement analysis profile, the decomposed GPS score, we found that only the ankle dorsiflexion and the foot progression angle were significantly changed. GGI of the affected leg showed improvement, but without statistical significance: 168.88-131.64 (p = 0.221). Total GPS of legs and the GPS, GDI, and GGI of the nonaffected leg showed improvement without statistical significance. At the 1-year follow-up, all patients expressed high satisfaction and continued to use the device. Dorsiflexion functional electrical stimulation improves gait in hemiplegic patients, as reflected by GPS, GDI, and GGI.

  2. 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 <5) by 12 weeks. Intervention fidelity was high: HIV providers followed MBC recommendations at 96 % of encounters. Most divergences reflected a failure to increase dose when indicated. No serious and few bothersome side effects were reported. Most suicidality (prevalence 62 % at baseline; 8 % at 12 weeks) was either passive or low-risk. Participant satisfaction was high (100 %), and most participants (89 %) indicated willingness to pay for medications if MBC were implemented in routine care. The adapted MBC intervention demonstrated high 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.

  3. The relative safety and efficacy of abciximab and eptifibatide in patients undergoing primary percutaneous coronary intervention: insights from a large regional registry of contemporary percutaneous coronary intervention.

    Science.gov (United States)

    Gurm, Hitinder S; Smith, Dean E; Collins, J Stewart; Share, David; Riba, Arthur; Carter, Andrew J; LaLonde, Thomas; Kline-Rogers, Eva; O'Donnell, Michael; Changezi, Hameem; Zughaib, Marcel; Safian, Robert; Moscucci, Mauro

    2008-02-05

    This study sought to assess whether the use of eptifibatide instead of abciximab is associated with a difference in outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Pooled data from randomized controlled trials suggest that the use of abciximab may be associated with a survival advantage in patients undergoing primary PCI for acute STEMI. However, a large proportion of patients in the community are treated with eptifibatide, an agent that shares some but not all pharmacological properties with abciximab. We evaluated the outcomes of 3,541 patients who underwent primary PCI for STEMI from October 2002 to July 2006 in a large regional consortium and who were treated with abciximab (n = 729) or with eptifibatide (n = 2,812). There was no difference in the incidence of in-hospital death (4.1% with abciximab vs. 3.5% with eptifibatide, p = 0.39), recurrent myocardial infarction (0.8% vs. 1.2%, p = 0.42), or stroke/transient ischemic attack (0.7% vs. 0.6%, p = 0.80). There was no difference in the need for blood transfusion (12.4% vs. 11.7%, p = 0.61), whereas there was a greater incidence of gastrointestinal bleeding with abciximab (4.8% vs. 2.8%, p = 0.01). In parsimonious risk-adjusted models, no significant difference between abciximab and eptifibatide was observed with respect to any of the outcomes measures. Currently, eptifibatide is used as the adjunct antiplatelet agent in the majority of patients undergoing primary PCI. There is no apparent difference in early outcomes of patients treated with eptifibatide compared with patients treated with abciximab.

  4. Adaptation and evaluation of the measurement properties of the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale

    Directory of Open Access Journals (Sweden)

    Rafaela Batista dos Santos Pedrosa

    2016-01-01

    Full Text Available Objectives: to undertake the cultural adaptation of, and to evaluate the measurement properties of, the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale in coronary heart disease (CHD patients, with outpatient monitoring at a teaching hospital. Method: the process of cultural adaptation was undertaken in accordance with the international literature. The data were obtained from 147 CHD patients, through the application of the sociodemographic/clinical characterization instrument, and of the Brazilian versions of the Morisky Self-Reported Measure of Medication Adherence Scale, the General Perceived Self-Efficacy Scale, and the Self-efficacy for Appropriate Medication Adherence Scale. Results: the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of semantic-idiomatic, conceptual and cultural equivalencies, with high acceptability and practicality. The floor effect was evidenced for the total score and for the domains of the scale studied. The findings evidenced the measure's reliability. The domains of the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented significant inverse correlations of moderate to strong magnitude between the scores of the Morisky scale, indicating convergent validity, although correlations with the measure of general self-efficacy were not evidenced. The validity of known groups was supported, as the scale discriminated between "adherents" and "non-adherents" to the medications, as well as to "sufficient dose" and "insufficient dose". Conclusion: the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of reliability and validity in coronary heart disease outpatients.

  5. Measurements of primary trace gases and NO Y composition in Houston, Texas

    Science.gov (United States)

    Luke, Winston T.; Kelley, Paul; Lefer, Barry L.; Flynn, James; Rappenglück, Bernhard; Leuchner, Michael; Dibb, Jack E.; Ziemba, Luke D.; Anderson, Casey H.; Buhr, Martin

    2010-10-01

    Concentrations of CO, SO 2, NO, NO 2, and NO Y were measured atop the University of Houston's Moody Tower supersite during the 2006 TexAQS-II Radical and Aerosol Measurement Project (TRAMP). The lowest concentrations of all primary and secondary species were observed in clean marine air in southerly flow. SO 2 concentrations were usually low, but increased dramatically in sporadic midday plumes advected from sources in the Houston Ship Channel (HSC), located NE of the site. Concentrations of CO and NO x displayed large diurnal variations in keeping with their co-emission by mobile sources in the Houston Metropolitan Area (HMA). CO/NO x emission ratios of 5.81 ± 0.94 were observed in the morning rush hour. Nighttime concentrations of NO x (NO x = NO + NO 2) and NO Y (NO Y = NO + NO 2 + NO 3 + HNO 3 + HONO + 2∗N 2O 5 + HO 2NO 2 + PANs + RONO 2 + p-NO 3- + …) were highest in winds from the NNW-NE due to emission from mobile sources. Median ratios of NO x/NO Y were approximately 0.9 overnight, reflecting the persistence and/or generation of NO Z (NO Z = NO Y - NO x) species in the nighttime Houston boundary layer, and approached unity in the morning rush hour. Daytime concentrations of NO x and NO Y were highest in winds from the HSC. NO x/NO Y ratios reached their minimum values (median ca 0.63) from 1300 to 1500 CST, near local solar noon, and air masses often retained enough NO x to sustain additional O 3 formation farther downwind. HNO 3 and PANs comprised the dominant NO Z species in the HMA, and on a median basis represented 17-20% and 12-15% of NO Y, respectively, at midday. Concentrations of HNO 3, PANs, and NO Z, and fractional contributions of these species to NO Y, were at a maximum in NE flow, reflecting the source strength and reactivity of precursor emissions in the HSC. As a result, daytime O 3 concentrations were highest in air masses with HSC influence. Overall, our findings confirm the impact of the HSC as a dominant source region within the HMA

  6. Measuring the efficacy of a project for adolescents and young adults with cancer: A study from the Milan Youth Project.

    Science.gov (United States)

    Ferrari, Andrea; Silva, Matteo; Veneroni, Laura; Magni, Chiara; Clerici, Carlo Alfredo; Meazza, Cristina; Terenziani, Monica; Spreafico, Filippo; Chiaravalli, Stefano; Casanova, Michela; Luksch, Roberto; Catania, Serena; Schiavello, Elisabetta; Biassoni, Veronica; Podda, Marta; Bergamaschi, Luca; Puma, Nadia; Indini, Alice; Proserpio, Tullio; Massimino, Maura

    2016-12-01

    Various projects dedicated specifically to adolescents and young adults (AYA) with cancer have been developed in recent years. A critical aspect of such programs is the ability to demonstrate its value, and therefore how to measure desired outcomes. A list of metrics to consider for demonstrating the advantages of an AYA program was identified and used to assess the activity of the Youth Project operating at the Pediatric Oncology Unit of the Istituto Nazionale Tumori in Milan. The number of newly diagnosed AYA patients seen at the Unit has increased since the formal launch of the Youth Project, from 65 to 81.2 cases/year. Concerning the 78 AYA patients presenting with malignant neoplasms in 2015, 82% were included in clinical trials (the other 18% in prospective observational studies). Fertility preservation measures were implemented for 59% of AYA patients considered at risk, and specific psychological support was provided in 70.6% of cases; 72.5% of patients actively participated in support activities. Other parameters considered were a preliminary satisfaction questionnaire administered to patients and the program's scientific recognition and acknowledgment by the community. The study proposed a number of potentially reproducible, practical parameters to consider in assessing the value of a program dedicated to AYA. These metrics were examined in terms of the activities of our Youth Project, and confirmed its efficacy. To be sustainable over time, AYA projects have to be accepted as a standard of care at the community and government levels. © 2016 Wiley Periodicals, Inc.

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

    OpenAIRE

    Claudio Barbaranelli; Valerio Ghezzi; Roberta Fida; Michele Vecchione

    2017-01-01

    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 ga...

  8. Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings.

    Science.gov (United States)

    Lukewich, Julia; Corbin, Renée; VanDenKerkhof, Elizabeth G; Edge, Dana S; Williamson, Tyler; Tranmer, Joan E

    2014-12-01

    Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  9. Agreeing the content of a patient-reported outcome measure for primary care: a Delphi consensus study.

    Science.gov (United States)

    Murphy, Mairead; Hollinghurst, Sandra; Salisbury, Chris

    2017-04-01

    As the first contact for any health-related need, primary care clinicians often address multiple patient problems, with a range of possible outcomes. There is currently no patient-reported outcome measure (PROM) which covers this range of outcomes. Therefore, many research studies into primary care services use PROMs that do not capture the full impact of these services. The study aim was to identify outcomes sought by primary care patients which clinicians can influence, thus providing the basis for a new primary care PROM. We used a Delphi process starting with an outcomes list inductively derived in a prior qualitative study. Thirty-five experts were recruited into patient, clinician and academic panels. Participants rated each outcome on whether it was (i) relevant to health, (ii) influenced by primary care and (iii) detectable by patients. In each round, outcomes which passed/failed preset levels of agreement were accepted/rejected. Remaining outcomes continued to the next round. The process resulted in a set of outcomes occupying the domains of health status, health empowerment (internal and external), and health perceptions. Twenty-six of 36 outcomes were accepted for inclusion in a PROM. Primary care having insufficient influence was the main reason for exclusion. To our knowledge, this is the first time PROM outcomes have been agreed through criteria which explicitly exclude outcomes less relevant to health, uninfluenced by primary care or undetected by patients. The PROM in development covers a unique set of outcomes and offers an opportunity for enhanced research into primary care. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  10. Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings

    Science.gov (United States)

    Lukewich, Julia; Corbin, Renée; VanDenKerkhof, Elizabeth G; Edge, Dana S; Williamson, Tyler; Tranmer, Joan E

    2014-01-01

    Rationale, aims and objectives Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Methods Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. Results A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. Conclusions There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information. PMID:24840066

  11. Efficacy of stereotactic gamma knife surgery and microvascular decompression in the treatment of primary trigeminal neuralgia: a retrospective study of 220 cases from a single center

    Directory of Open Access Journals (Sweden)

    Dai ZF

    2016-07-01

    Full Text Available Zi-Feng Dai, Qi-Lin Huang, Hai-Peng Liu, Wei Zhang Department of Neurosurgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, People’s Republic of China Objectives: A retrospective study was undertaken to compare the efficacy of stereotactic gamma knife surgery (GKS and microvascular decompression (MVD in the treatment of primary trigeminal neuralgia (TN at a single center. The study included the evaluation of clinical outcomes of pain relief and pain recurrence and complications associated with GKS and MVD.Methods: The study included 202 patients with primary TN and was conducted between January 2013 and December 2014; about 115 patients were treated with GKS and 87 patients were treated with MVD. TN pain was evaluated using the Barrow Neurological Institute and the visual analog scale scoring systems. Preoperative magnetic resonance tomographic angiography was performed for all patients. Microscope-assisted MVD used the suboccipital retrosigmoid sinus approach. GKS targeted the trigeminal nerve root entry zone with a margin radiation dose of 59.5 Gy, and brainstem dose <12 Gy. Posttreatment follow-up was for 2 years.Results: Postoperative Barrow Neurological Institute scores for patients treated with GKS and MVD were significantly improved compared with preoperative scores (P<0.01. Reduction in postoperative pain following MVD (95.4% patients was significantly greater than that following GKS (88.7% patients (P<0.01. Postoperative visual analog scale scores of the MVD group were significantly reduced compared with those of patients treated with GKS at the same postoperative time points (P<0.01. Patients treated with GKS had a significantly increased rate of loss of corneal reflex compared with patients treated with MVD (P=0.002.Conclusion: Both GKS and MVD are safe and effective first-line and adjunctive treatment options for patients with TN. The clinical outcomes of pain relief and reduction of pain recurrence were

  12. Antimicrobial efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, and Psidium guajava on primary plaque colonizers: An in vitro comparison between hot and cold extraction process

    National Research Council Canada - National Science Library

    Shekar, Chandra; Nagarajappa, Ramesh; Singh, Rupal; Thakur, Rupesh

    2015-01-01

    .... The objective was to assess and compare antimicrobial efficacy of four plant extracts derived using hot and cold extraction methods against Streptococcus mutans, Streptococcus sanguis, and Streptococcus salivarius...

  13. Evaluation of Binocular Vision Therapy Efficacy by 3D Video-Oculography Measurement of Binocular Alignment and Motility.

    Science.gov (United States)

    Laria, Carlos; Pinero, David P

    2013-01-01

    To evaluate two cases of intermittent exotropia treated by vision therapy the efficacy of the treatment by complementing the clinical examination with a 3D videooculography to register and to evidence the potential applicability of this technology for such purpose. We report the binocular alignment changes occurring after vision therapy in a woman of 36 years with an intermittent exotropia of 25 prism diopters at far and 18 PD at near and a child of 10 years with 8 PD of intermittent exotropia in primary position associated to 6 PD of left eye hypotropia. Both patients presented good visual acuity with correction in both eyes. Instability of ocular deviation was evident by VOG analysis, revealing also the presence of vertical and torsional components. Binocular vision therapy was prescribed and performed including different types of vergence, accommodation, and consciousness of diplopia training. After therapy, excellent ranges of fusional vergence and a to-the-nose near point of convergence were obtained.The 3D VOG examination confirmed the compensation of the deviation with a high level of stability of binocular alignment. Significant improvement could be observed after therapy in the vertical and torsional components that were found to become more stable. Patients were very satisfied with the outcome obtained by vision therapy. 3D-VOG is a useful technique for providing an objective register of the compensation of the ocular deviation and the stability of the binocular alignment achieved after vision therapy in cases of intermittent exotropia, providing a detailed analysis of vertical and torsional improvements.

  14. The relevance of testing the efficacy of anti-angiogenesis treatments on cells derived from primary tumors: a new method for the personalized treatment of renal cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Renaud Grépin

    Full Text Available Despite the numerous available drugs, the most appropriate treatments for patients affected by common or rare renal cell carcinomas (RCC, like those associated with the Xp11.2 translocation/transcription factor for immunoglobulin heavy-chain enhancer 3 (TFE3 gene fusion (TFE3 RCC, are not clearly defined. We aimed to make a parallel between the sensitivity to targeted therapies on living patients and on cells derived from the initial tumor. Three patients diagnosed with a metastatic RCC (one clear cell RCC [ccRCC], two TFE3 RCC were treated with anti-angiogenesis drugs. The concentrations of the different drugs giving 50% inhibition of cell proliferation (IC50 were determined with the Thiazolyl Blue Tetrazolium Bromide (MTT assay on cells from the primary tumors and a reference sensitive RCC cell line (786-O. We considered the cells to be sensitive if the IC50 was lower or equal to that in 786-O cells, and insensitive if the IC50 was higher to that in 786-O cells (IC 50 of 6 ± 1 µM for sunitinib, 10 ± 1 µM for everolimus and 6 ± 1 µM for sorafenib. Based on this standard, the response in patients and in cells was equivalent. The efficacy of anti-angiogenesis therapies was also tested in cells obtained from five patients with non-metastatic ccRCC, and untreated as recommended by clinical practice in order to determine the best treatment in case of progression toward a metastatic grade. In vitro experiments may represent a method for evaluating the best first-line treatment for personalized management of ccRCC during the period following surgery.

  15. Measuring the primary cilium length: improved method for unbiased high‑throughput analysis

    NARCIS (Netherlands)

    Dummer, A; Poelma, C.; DeRuiter, MC; Goumans, M-J TH; Hierck, BP

    2016-01-01

    Background
    Primary cilia are cellular protrusions involved in mechanic and chemical sensing on almost all cells of our body. Important signaling pathways, including Hedgehog, TGFβ, and Ca2+, are linked to cilia and/or cilia function. Cilia can vary in length, which has functional implications.

  16. 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...

  17. 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

    2015-01-01

    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…

  18. Parallel Measurement of Circadian Clock Gene Expression and Hormone Secretion in Human Primary Cell Cultures.

    Science.gov (United States)

    Petrenko, Volodymyr; Saini, Camille; Perrin, Laurent; Dibner, Charna

    2016-11-11

    Circadian clocks are functional in all light-sensitive organisms, allowing for an adaptation to the external world by anticipating daily environmental changes. Considerable progress in our understanding of the tight connection between the circadian clock and most aspects of physiology has been made in the field over the last decade. However, unraveling the molecular basis that underlies the function of the circadian oscillator in humans stays of highest technical challenge. Here, we provide a detailed description of an experimental approach for long-term (2-5 days) bioluminescence recording and outflow medium collection in cultured human primary cells. For this purpose, we have transduced primary cells with a lentiviral luciferase reporter that is under control of a core clock gene promoter, which allows for the parallel assessment of hormone secretion and circadian bioluminescence. Furthermore, we describe the conditions for disrupting the circadian clock in primary human cells by transfecting siRNA targeting CLOCK. Our results on the circadian regulation of insulin secretion by human pancreatic islets, and myokine secretion by human skeletal muscle cells, are presented here to illustrate the application of this methodology. These settings can be used to study the molecular makeup of human peripheral clocks and to analyze their functional impact on primary cells under physiological or pathophysiological conditions.

  19. Measuring access to primary health care: use of a GIS-based accessibility analysis (conference paper)

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-10-01

    Full Text Available in a GIS-based accessibility analysis to assist in the spatial planning of health care services. Due to the absence of accurate patient databases and / or registers, GIS tools are used to determine three different scenarios of defining public primary...

  20. Evaluating the long-term efficacy of short-duration 0.1 mg/ml and 0.2 mg/ml MMC in primary trabeculectomy for primary adult glaucoma.

    Science.gov (United States)

    Sihota, Ramanjit; Angmo, Dewang; Chandra, Anuradha; Gupta, Viney; Sharma, Ajay; Pandey, R M

    2015-07-01

    To evaluate safety and efficacy of 0.1 mg/ml versus 0.2 mg/ml mitomycin-C (MMC), applied for 1 min subconjunctivally, during trabeculectomy for primary adult glaucoma in previously un-operated eyes. This is a randomised controlled, non-inferior, clinical trial consisting of 50 consecutive POAG or CPACG patients uncontrolled on maximal hypotensive therapy, meeting all inclusion criteria. Patients were randomized into two groups and underwent a standard limbus-based trabeculectomy with MMC: Group I, 0.1 mg/ml and Group II, 0.2 mg/ml. The pre-operative and post-operative intraocular pressure (IOP), bleb morphology, and visual acuity were recorded every 6 months for 2 years. Complete success (primary outcome) was defined as IOP ≤ 15 mmHg without any additional medications at the end of 2 years. The average age of patients was 62.6 ± 9.8 years and 61.2 ± 8.1 years in Group 1 and 2, respectively; p = 0.57. The mean preoperative IOP was 22.5 ± 1.4 mmHg and 23.3 ± 1.8 mmHg; p = 0.10. The mean IOP at 2 years was 11.1 ± 1.6 mmHg and 10.8 ± 2.8 mmHg, a mean reduction in IOP of 50.6 ± 1.23 %, and 53.7 ± 2.25 % in Group I and II, respectively. The complete success was 92.0 % and 91.7 % in the two groups, respectively (p = 0.99), and there was one failure (Group II, post trauma). A wider bleb extent and larger areas of thin, transparent conjunctiva over the bleb were seen with the 0.2 mg/ml MMC group (p MMC is non-inferior to 0.2 mg/ml and is probably a safer alternative, as thinning of the bleb is significantly less frequent in the long term.

  1. Measuring team factors thought to influence the success of quality improvement in primary care: a systematic review of instruments.

    Science.gov (United States)

    Brennan, Sue E; Bosch, Marije; Buchan, Heather; Green, Sally E

    2013-02-14

    Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instruments. We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments; reference lists of systematic reviews; and citations and references of the main report of instruments. To determine the scope of the review, we developed and used a conceptual framework designed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). We included papers reporting development or use of an instrument measuring factors relevant to teamwork. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarizing and comparing instruments. Instrument content was categorized using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. We identified 192 potentially relevant instruments, 170 of which were analyzed to develop the taxonomy. Eighty-one instruments measured constructs relevant to CQI teams in primary care, with content covering teamwork context (45 instruments measured enabling conditions or attitudes to teamwork), team process (57 instruments measured teamwork behaviors), and team outcomes (59 instruments measured perceptions of the team or its effectiveness). Forty instruments were included for

  2. First results in the development of an on-line digital counting platform dedicated to primary measurements.

    Science.gov (United States)

    Bobin, C; Bouchard, J; Censier, B

    2010-01-01

    This paper describes the first step in the development of a digital platform dedicated to primary radionuclide measurements. In order to validate the implementation of an on-line processing based on extendable dead-times, a FPGA-based digital system has been programmed for liquid scintillation counting. After a description of the hardware, TDCR (Triple to Double Coincidence Ratio) measurements are presented. Comparisons of activity measurements with the classical system operating at LNHB are used to validate the new system; coincidence counting differences observed when increasing the resolving time in the digital platform are discussed. Copyright 2009 Elsevier Ltd. All rights reserved.

  3. First results in the development of an on-line digital counting platform dedicated to primary measurements

    Energy Technology Data Exchange (ETDEWEB)

    Bobin, C., E-mail: christophe.bobin@cea.f [CEA, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), F-91191 Gif-sur-Yvette Cedex (France); Bouchard, J.; Censier, B. [CEA, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), F-91191 Gif-sur-Yvette Cedex (France)

    2010-07-15

    This paper describes the first step in the development of a digital platform dedicated to primary radionuclide measurements. In order to validate the implementation of an on-line processing based on extendable dead-times, a FPGA-based digital system has been programmed for liquid scintillation counting. After a description of the hardware, TDCR (Triple to Double Coincidence Ratio) measurements are presented. Comparisons of activity measurements with the classical system operating at LNHB are used to validate the new system; coincidence counting differences observed when increasing the resolving time in the digital platform are discussed.

  4. Two-dimensional electron density measurement of pulsed positive primary streamer discharge in atmospheric-pressure air

    Science.gov (United States)

    Inada, Yuki; Aono, Kaiho; Ono, Ryo; Kumada, Akiko; Hidaka, Kunihiko; Maeyama, Mitsuaki

    2017-05-01

    Elucidating the electron density of streamer discharges propagating in atmospheric-pressure air is critical for achieving a systematic understanding of the production mechanisms of reactive species. Using Shack-Hartmann-type laser wavefront sensors with a temporal resolution of 2 ns, we carried out single-shot two-dimensional electron density measurements for positive primary streamers generated in a 13 mm air gap between pin-to-plate electrodes. The electron density over the positive primary streamers decayed from 1015 to {{10}14}\\text{c}{{\\text{m}}-3} during the propagation. The decay time constant of the electron density in the primary streamer channels was estimated to be  ˜2 ns. The distribution widths of the electron density were in good agreement with those of the light emission, typically ranging from 0.8 to 1.5 mm.

  5. Measuring the Relationship between Agriculture Teachers' Self-Efficacy, Outcome Expectation, Interest, and Their Use of Interactive Whiteboards

    Science.gov (United States)

    Bunch, J. C.; Robinson, J. Shane; Edwards, M. Craig

    2012-01-01

    The purpose of this descriptive-correlational study was to examine the level of self-efficacy of Oklahoma secondary agricultural education teachers regarding their use of the interactive whiteboard (IWB) in classroom teaching. The study also sought to determine if relationships existed between teachers' IWB self-efficacy scores, outcome…

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

    National Research Council Canada - National Science Library

    Ballard, Kirrie J; Savage, Sharon; Leyton, Cristian E; Vogel, Adam P; Hornberger, Michael; Hodges, John R

    2014-01-01

    .... 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...

  7. 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.

  8. High-impact practices and first-year seminars: A quasi-experimental study measuring change in academic self-efficacy

    Science.gov (United States)

    Barber Applewhite, Stephanie

    First-year seminars, high-impact practices, and academic self-efficacy have been identified as relevant to the successful transition process from high school to college. This study investigated the interconnections between freshman academic self-efficacy, high-impact practices, zone of proximal development and first-year seminars. This research contributed to the understandings of the significance of high-impact practices in the development of academic self-efficacy in freshman students. As colleges strive to improve retention from the freshman to sophomore years, it is useful to identify the relevance of high-impact practices within a first-year seminar on academic self-efficacy. A two-group, quasi-experimental study using a pre/post survey was conducted at a regional comprehensive university in east Texas in which 800 students were given a pre and post survey to measure academic self-efficacy. After matching for fidelity, eleven sections were identified for the control group (104 participants) and eleven sections (91 participants) were selected for the experiment group. The findings revealed that the overall gain in the mean of both groups from the pre to post survey was statistically significant. While the students in the high-impact sections reported a higher post mean on the College Academic Self-Efficacy Scale than those who did not receive high-impact instruction, the gain was not statistically significant.

  9. 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.

  10. 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.

  11. Assessment of Primary Care Physicians' Use of a Pocket Ultrasound Device to Measure Left Ventricular Mass in Patients with Hypertension.

    Science.gov (United States)

    Bornemann, Paul; Johnson, Jeremy; Tiglao, Samuel; Moghul, Amina; Swain, Sheila; Bornemann, Gina; Lustik, Mike

    2015-01-01

    Left ventricular hypertrophy (LVH) is common in primary care and is associated with increased morbidity and mortality. Treatment of underlying hypertension can reverse LVH and eliminate the associated risks. Electrocardiography is widely available and commonly used to screen hypertensive patients for LVH, but it is limited by low sensitivity. Limited echocardiographic measurement of the left ventricle is a method for screening with improved sensitivity; however, it is not currently widely used in the primary care setting. This study attempts to test the accuracy of primary care physicians' (PCPs) measurements of the left ventricle using a pocket-sized ultrasound (pUS) device after a brief training session. This study was performed in an outpatient cardiology clinic by 3 family medicine residents and 1 family medicine faculty member after a 4-hour training session. Measurements of the left ventricle were made by PCPs using a pUS device; these measurements were compared with cardiologists' measurements from images obtained by echocardiography technicians. Left ventricular mass index (LVMI) was calculated based on these measurements and then compared between groups. There was no statistically significant difference between the mean LVMI calculations in the 2 groups. The agreement in measurements between the groups, however, showed high variability. This was manifested by the low sensitivity (70%) and specificity (76%) of PCPs in the detection of LVH. This study showed that limited echocardiography for the detection of LVH performed by PCPs at the point of care was feasible. Future studies are needed to determine the ideal training and experience necessary to yield competency. © Copyright 2015 by the American Board of Family Medicine.

  12. Impact of communicative and critical health literacy on understanding of diabetes care and self-efficacy in diabetes management: a cross-sectional study of primary care in Japan.

    Science.gov (United States)

    Inoue, Machiko; Takahashi, Miyako; Kai, Ichiro

    2013-03-23

    The role of a patient's functional health literacy (HL) has received much attention in the context of diabetes education, but researchers have not fully investigated the roles of communicative and critical HL, especially in primary care. Communicative HL is the skill to extract health information and derive meaning from different forms of communication, and to apply this information to changing circumstances. Critical HL allows the patient to critically analyze information and to use this information to achieve greater control over life events and situations. We examined how HL, particularly communicative and critical HL, is related to the patient's understanding of diabetes care and self-efficacy for diabetes management in primary care settings. We also examined the impact of patient-physician communication factors on these outcomes, taking HL into account. We conducted a cross-sectional observational study of 326 patients with type 2 diabetes who were seen at 17 primary care clinics in Japan. The patients completed a self-administered questionnaire that assessed their HL (functional, communicative, and critical), understanding of diabetes care, and self-efficacy for diabetes management. We also examined the perceived clarity of the physician's explanation to assess patient-physician communication. Multivariate regression analyses were performed to determine whether HL and patient-physician communication were associated with understanding of diabetes care and self-efficacy. A total of 269 questionnaires were analyzed. Communicative and critical HL were positively associated with understanding of diabetes care (β = 0.558, 0.451, p critical HL and clear patient-physician communication were independently associated with the patient's understanding of diabetes care and self-efficacy. The potential impact of communicative and critical HL should be considered in communications with, and the education of, patients with diabetes in primary care settings.

  13. Preparing an E-learning-based Speech Therapy (EST) efficacy study: Identifying suitable outcome measures to detect within-subject changes of speech intelligibility in dysarthric speakers

    NARCIS (Netherlands)

    Beijer, L.J.; Rietveld, A.C.; Ruiter, M.B.; Geurts, A.C.H.

    2014-01-01

    We explored the suitability of perceptual and acoustic outcome measures to prepare E-learning based Speech Therapy (EST) efficacy tests regarding speech intelligibility in dysarthric speakers. Eight speakers with stroke (n=3), Parkinson's disease (n=4) and traumatic brain injury (n=1) participated

  14. Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol

    OpenAIRE

    Légaré, France; Stacey, Dawn; Graham, Ian D; Elwyn, Glyn; Pluye, Pierre; Gagnon, Marie-Pierre; Frosch, Dominick; Harrison, Margaret B; Kryworuchko, Jennifer; Pouliot, Sophie; Desroches, Sophie

    2008-01-01

    Abstract Background Shared decision-making (SDM) is defined as a process by which a healthcare choice is made by practitioners together with the patient. Although many diagnostic and therapeutic processes in primary care integrate more than one type of health professional, most SDM conceptual models and theories appear to be limited to the patient-physician dyad. The objectives of this study are to develop a conceptual model and propose a set of measurement tools for enhancing an interprofess...

  15. 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

    saturation indices (Ik) were as low as 11 mmol quanta m22 s21 in the winter. On an annual timescale, the average areal rate of benthic GPP was 11.5 mol O2 m22 yr21, which is , 1.4 times higher than the integrated gross pelagic primary production of the , 30–50 m deep photic zone of the fjord. These results...... document the importance of benthic photosynthesis on an ecosystem level and indicate that the benthic phototrophic compartment should be accounted for when assessing carbon and nutrient budgets as well as responses of coastal Arctic ecosystems to climate change....

  16. Measuring variation in EMD reduction with location in primary alkaline batteries

    Energy Technology Data Exchange (ETDEWEB)

    Urfer, A.; Lawrance, G.A.; Swinkels, D.A.J. [Newcastle Univ., NSW (Australia). Dept. of Chemistry

    1997-06-01

    Reduction of manganese dioxide is not uniform throughout alkaline cells with thick cathodes. Quantification of the degree of reduction of MnO{sub 2} as a function of location in the cathode by determining the degree of EMD reduction in discharged alkaline cathodes is described, using a new experimental technique which allows collection and analysis of regionally defined electrolytic manganese dioxide (EMD) samples from commercial primary alkaline batteries of different sizes. This method has been developed for 1.5 V D-size and C-size alkaline batteries. The information gained can be used to better explain the behaviour of real cells with thick cathodes. (author)

  17. 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.

  18. 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.

  19. Investigation of tunable diode laser absorption spectroscopy for its application as primary standard for partial pressure measurements

    Energy Technology Data Exchange (ETDEWEB)

    Jousten, K; Bock, T [Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, D-10587 Berlin (Germany); Padilla-VIquez, G [Laboratorio Costarricense de MetrologIa (Lacomet), Ciudad de la Investigacion de la UCR, San Pedro de Montes de Oca (Costa Rica)], E-mail: Karl.jousten@ptb.de

    2008-03-01

    Partial pressures in vacuum systems can be quite accurately measured by tunable diode laser absorption spectroscopy in the infrared. To examine the possibility for its application as primary standard, for CO{sub 2} in the 2-{mu}m-region we made full traceability to the respective SI unit for each input quantity of the model, evaluated the results according to the ISO guide to the expression of uncertainty in measurement, and validated the method successfully by comparison with gravimetrically produced samples of CO{sub 2} in N{sub 2}.

  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, 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.

  1. 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.

  2. 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.

    2017-01-01

    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. PMID:28561795

  3. A manual on methods for measuring primary production in aquatic environments: including a chapter on bacteria

    National Research Council Canada - National Science Library

    Vollenweider, Richard A; Talling, J. F; Westlake, D. F

    1969-01-01

    The present manual starts from methods used to assess standing crops of phytoplankton, periphyton and higher aquatic, and proceeds to techniques of rate measurement currently available for these three...

  4. Measuring access to primary health care: use of a GIS-based accessibility analysis

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-10-01

    Full Text Available planning practice of today? TWO MAIN CHALLENGES (a) What method is the best in determining health service demand in the absence of accurate databases indicating public versus private health care usage? (b) How accurate is a rational choice... Register. o Calculate the probability variance of rational choice vs. actual choice based on a distance measure to further enhance the model’s capabilities. o Availability of spatially linked population employment data so that measures can...

  5. 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.

  6. Seasonality of Ecosystem Respiration and Gross Primary Production as Derived from Fluxnet Measurements

    Science.gov (United States)

    Falge, E.; Baldocchi, D.; Tenhunen, J.

    2001-12-01

    Differences in the seasonal pattern of assimilatory and respiratory processes are responsible for divergences in seasonal net carbon exchange among ecosystems. Using FLUXNET data (http://www-eosdis.ornl.gov/FLUXNET) we have analyzed seasonal patterns of gross primary productivity (GPP), and ecosystem respiration (RE) of boreal and temperate, deciduous and coniferous forests, mediterranean evergreen systems, rainforest, temperate grasslands, and C3 and C4 crops. Based on generalized seasonal patterns classifications of ecosystems into vegetation functional types can be evaluated for use in global productivity and climate change models. The results of this study contribute to our understanding of respiratory costs of assimilated carbon in various ecosystems. Seasonal variability of GPP and RE increased in the order tropical, Mediterranean, temperate coniferous, temperate deciduous, boreal forests. Together with boreal forests, managed grasslands and crops show the largest seasonal variability. In temperate coniferous forests, seasonal patterns of GPP and RE are in phase, in temperate deciduous and boreal coniferous forests RE was delayed compared to GPP, resulting in the greatest imbalance between respiratory and assimilatory fluxes early in the growing season. Gross primary productivity adjusted for the length of the growing season decreased across functional types in the order C4 crops, and temperate and boreal deciduous forests (7.5-8.3 g C m-2 d-1), temperate conifers, C3 grassland and crops (5.7-6.9 g C m-2 d-1), rainforest and boreal conifers (4.6-4.9 g C m-2 d-1). Annual GPP and NEP decreased across climate zones in the order tropical, temperate, boreal. However, the decrease in NEP was greater than the decrease in GPP, indicating a larger contribution of respiratory (especially heterotrophic) processes in boreal systems.

  7. Cross-cultural adaptation and measurement properties of the Arabic version of the Fall Efficacy Scale International.

    Science.gov (United States)

    Alghadir, Ahmad H; Al-Momani, Murad; Marchetti, Gregory F; Whitney, Susan L

    2015-07-01

    To translate the Falls Efficacy Scale International (FES-I) into Arabic according to the World Health Organization`s (WHO) criteria and to evaluate the concurrent validity of the FES-I in persons living with balance and vestibular disorders. This cross-sectional descriptive study included 43 persons with balance and vestibular disorders presenting to an outpatient dizziness center at King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia between June 2012 and May 2013. All participants completed the Arabic version of the FES-I and the Dizziness Handicap Inventory (DHI) during their assessment with the clinical audiologist. In addition, subjects completed the Dynamic Gait Index 4-item (DGI-4) gait test. An additional 55 control participants also completed the Arabic FES-I, the DGI-4, and the Arabic DHI. Forty-three participants with vestibular disorders (36 females, 7 males) with a mean age of 32 years (standard deviation (SD) 10 years, range 18-56 years) and 55 control participants (27 females, 28 males) with a mean age of 33, (SD-12), and age range of 18-78 participated. The correlation between the Arabic FES-I and the Arabic DHI was 0.75 in patients and 0.77 in control participants. The correlation between the Arabic FES-I and the DGI-4 was r=-0.30 (p=0.003). The Arabic FES-I has established concurrent validity and may be helpful for measuring an individual`s concern of falling in people with vestibular and balance disorders.

  8. Comparative efficacy of two primary care interventions to assist withdrawal from long term benzodiazepine use: a protocol for a clustered, randomized clinical trial.

    Science.gov (United States)

    Vicens, Caterina; Socias, Isabel; Mateu, Catalina; Leiva, Alfonso; Bejarano, Ferran; Sempere, Ermengol; Basora, Josep; Palop, Vicente; Mengual, Marta; Beltran, Jose Luis; Aragonès, Enric; Lera, Guillem; Folch, Silvia; Piñol, Josep Lluís; Esteva, Magdalena; Roca, Miguel; Arenas, Arturo; Del Mar Sureda, María; Campoamor, Francisco; Fiol, Francisca

    2011-04-20

    Although benzodiazepines are effective, long-term use is not recommended because of potential adverse effects; the risks of tolerance and dependence; and an increased risk of hip fractures, motor vehicle accidents, and memory impairment. The estimated prevalence of long-term benzodiazepine use in the general population is about 2,2 to 2,6%, is higher in women and increases steadily with age. Interventions performed by General Practitioners may help patients to discontinue long-term benzodiazepine use. We have designed a trial to evaluate the effectiveness and safety of two brief general practitioner-provided interventions, based on gradual dose reduction, and will compare the effectiveness of these interventions with that of routine clinical practice. In a three-arm cluster randomized controlled trial, general practitioners will be randomly allocated to: a) a group in which the first patient visit will feature a structured interview, followed by visits every 2-3 weeks to the end of dose reduction; b) a group in which the first patient visit will feature a structured interview plus delivery of written instructions to self-reduce benzodiazepine dose, or c) routine care. Using a computerized pharmaceutical prescription database, 495 patients, aged 18-80 years, taking benzodiazepine for at least 6 months, will be recruited in primary care health districts of three regions of Spain (the Balearic Islands, Catalonia, and Valencia). The primary outcome will be benzodiazepine use at 12 months. The secondary outcomes will include measurements of anxiety and depression symptoms, benzodiazepine dependence, quality of sleep, and alcohol consumption. Although some interventions have been shown to be effective in reducing benzodiazepine consumption by long-term users, the clinical relevance of such interventions is limited by their complexity. This randomized trial will compare the effectiveness and safety of two complex stepped care interventions with that of routine care in a

  9. Development of a scale to measure parental self-efficacy in the care of pre-school children during periods of health and minor illness: integrating health and social policy methods.

    Science.gov (United States)

    Purssell, Edward; While, Alison

    2011-06-01

    To develop a scale to measure parental self-efficacy in the care of pre-school children during periods of health and minor illness. Children account for many health service consultations at all levels, but particularly in primary care. There are logistical, financial and social reasons for encouraging self-care by parents and other family members during periods of health and minor illness. In the absence of valid parental self-efficacy measurement tool, this paper describes the development of such a tool. A psychometric approach combining elements of social policy and health scale development is outlined. UK health and social policies were searched and from this a systematised concept was developed. This was assessed for international durability by checking the concept against other policies, including those from major international organisations. Statements were developed from this and sent to a panel representing a wide range of stakeholders who were asked to rate the proposed items of the scale and changes were made accordingly. Widespread agreement among panel members supported the systematised concept. Some alterations to the proposed items, particularly increasing the range of health service providers, were made. The study suggests a new method for clinical health policy research, including elements of social policy and health services research. The resulting scale can be contextualised for different circumstances and now needs extensive field testing and refinement. There is increasing diversity in the provision of healthcare; however parents remain the primary carers of young children in both health and illness. This tool can be used to measure the impact of health and social policy upon their confidence and knowledge, and to evaluate new initiatives. The emphasis upon health and social policy ensures that those using the tool have a holistic approach to evaluation. © 2011 Blackwell Publishing Ltd.

  10. Application of a stochastic TDCR model based on Geant4 for Cherenkov primary measurements.

    Science.gov (United States)

    Bobin, C; Thiam, C; Bouchard, J; Jaubert, F

    2010-12-01

    Cherenkov measurements can be advantageously carried out using a counting instrumentation dedicated to liquid scintillation. In the case of radionuclide measurements, the interest of this technique is largely described in the literature. For instance, it is generally quoted that the possibility to measure directly the activity of aqueous solutions makes the sample preparation easier. Based on a three-photomultipliers apparatus, the Triple to Double Coincidence Ratio (TDCR) method is implemented in National Metrology Institutes for liquid scintillation measurements. Knowing the decay scheme associated with the radionuclide to be standardized, a free parameter model of light emission is constructed to determine the counter detection efficiency using the experimental TDCR value. Contrary to liquid scintillation, Cherenkov emission is characterized by a directional behavior. Instead of using an additional free parameter to take this effect into account, a stochastic modeling based on the Monte Carlo code Geant4 is proposed in order to extend the TDCR method to Cherenkov counting. The purpose of this model is to simulate the different optical processes of Cherenkov photons leading to the production of photoelectrons in the three-photomultipliers counter. The validation of this stochastic approach of the TDCR method for Cherenkov counting is carried out in the case of (90)Y activity measurements. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Application of a stochastic TDCR model based on Geant4 for Cherenkov primary measurements

    Energy Technology Data Exchange (ETDEWEB)

    Bobin, C., E-mail: christophe.bobin@cea.f [CEA, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), F-91191 Gif-sur-Yvette Cedex (France); Thiam, C.; Bouchard, J.; Jaubert, F. [CEA, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), F-91191 Gif-sur-Yvette Cedex (France)

    2010-12-15

    Cherenkov measurements can be advantageously carried out using a counting instrumentation dedicated to liquid scintillation. In the case of radionuclide measurements, the interest of this technique is largely described in the literature. For instance, it is generally quoted that the possibility to measure directly the activity of aqueous solutions makes the sample preparation easier. Based on a three-photomultipliers apparatus, the Triple to Double Coincidence Ratio (TDCR) method is implemented in National Metrology Institutes for liquid scintillation measurements. Knowing the decay scheme associated with the radionuclide to be standardized, a free parameter model of light emission is constructed to determine the counter detection efficiency using the experimental TDCR value. Contrary to liquid scintillation, Cherenkov emission is characterized by a directional behavior. Instead of using an additional free parameter to take this effect into account, a stochastic modeling based on the Monte Carlo code Geant4 is proposed in order to extend the TDCR method to Cherenkov counting. The purpose of this model is to simulate the different optical processes of Cherenkov photons leading to the production of photoelectrons in the three-photomultipliers counter. The validation of this stochastic approach of the TDCR method for Cherenkov counting is carried out in the case of {sup 90}Y activity measurements.

  12. Do specific parenting practices and related parental self-efficacy associate with physical activity and screen time among primary schoolchildren? A cross-sectional study in Belgium.

    Science.gov (United States)

    De Lepeleere, Sara; De Bourdeaudhuij, Ilse; Cardon, Greet; Verloigne, Maïté

    2015-09-07

    To assess the association between specific parenting practices and related parental self-efficacy with children's physical activity (PA) and screen time. Parental body mass index (BMI), family socioeconomic status (SES), and child's age and gender were examined as possible influencing factors. Cross-sectional. January 2014, Flanders (Belgium). 207 parents (87.4% mothers) of children aged 6-12 years. Specific parenting practices, related parental self-efficacy, and children's PA and screen time. The majority of investigated parenting practices and related parental self-efficacy were not significantly associated with children's PA or screen time. However, children were more physically active if sports equipment was available at home (pparents did not find it difficult to motivate their child to be physically active (pparents limited their own gaming (pparenting practices and related parental self-efficacy with children's PA or screen time were significant for parents with a normal BMI, for medium-high SES families and for parents of younger children. Furthermore, the association between the parenting relating factors and children's PA and screen time differed for boys and girls. In contrast to what we expected, the findings of the current study show that only a very few specific parenting practices and related parental self-efficacy were associated with children's PA and screen time. It was expected that parental self-efficacy would play a more important role. This can be due to the fact that parental self-efficacy was already high in this group of parents. Therefore, it is possible that parents do not realise how difficult it is to perform certain parenting practices until they are faced with it in an intervention. EC/2012/317. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Trust in medical organizations predicts pandemic (H1N1) 2009 vaccination behavior and perceived efficacy of protection measures in the Swiss public.

    Science.gov (United States)

    Gilles, Ingrid; Bangerter, Adrian; Clémence, Alain; Green, Eva G T; Krings, Franciska; Staerklé, Christian; Wagner-Egger, Pascal

    2011-03-01

    Following the recent avian influenza and pandemic (H1N1) 2009 outbreaks, public trust in medical and political authorities is emerging as a new predictor of compliance with officially recommended protection measures. In a two-wave longitudinal survey of adults in French-speaking Switzerland, trust in medical organizations longitudinally predicted actual vaccination status 6 months later, during the pandemic (H1N1) 2009 vaccination campaign. No other variables explained significant amounts of variance. Trust in medical organizations also predicted perceived efficacy of officially recommended protection measures (getting vaccinated, washing hands, wearing a mask, sneezing into the elbow), as did beliefs about health issues (perceived vulnerability to disease, threat perceptions). These findings show that in the case of emerging infectious diseases, actual behavior and perceived efficacy of protection measures may have different antecedents. Moreover, they suggest that public trust is a crucial determinant of vaccination behavior and underscore the practical importance of managing trust in disease prevention campaigns.

  14. 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.

  15. Developing a primary care patient measure of safety (PC PMOS): a modified Delphi process and face validity testing.

    Science.gov (United States)

    Hernan, Andrea L; Giles, Sally J; O'Hara, Jane K; Fuller, Jeffrey; Johnson, Julie K; Dunbar, James A

    2016-04-01

    Patients are a valuable source of information about ways to prevent harm in primary care and are in a unique position to provide feedback about the factors that contribute to safety incidents. Unlike in the hospital setting, there are currently no tools that allow the systematic capture of this information from patients. The aim of this study was to develop a quantitative primary care patient measure of safety (PC PMOS). A two-stage approach was undertaken to develop questionnaire domains and items. Stage 1 involved a modified Delphi process. An expert panel reached consensus on domains and items based on three sources of information (validated hospital PMOS, previous research conducted by our study team and literature on threats to patient safety). Stage 2 involved testing the face validity of the questionnaire developed during stage 1 with patients and primary care staff using the 'think aloud' method. Following this process, the questionnaire was revised accordingly. The PC PMOS was received positively by both patients and staff during face validity testing. Barriers to completion included the length, relevance and clarity of questions. The final PC PMOS consisted of 50 items across 15 domains. The contributory factors to safety incidents centred on communication, access to care, patient-related factors, organisation and care planning, task performance and information flow. This is the first tool specifically designed for primary care settings, which allows patients to provide feedback about factors contributing to potential safety incidents. The PC PMOS provides a way for primary care organisations to learn about safety from the patient perspective and make service improvements with the aim of reducing harm in this setting. Future research will explore the reliability and construct validity of the PC PMOS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. 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

  17. 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.

  18. Primary production and eddy correlation measurements of CO2 exchange over an intertidal estuary

    NARCIS (Netherlands)

    Zemmelink, H.J.; Slagter, H.A.; Slooten van, C.; Snoek, J.W.; Heusinkveld, B.G.; Elbers, J.A.; Bink, N.J.; Klaassen, W.; Philippart, C.J.M.; Baar, de H.

    2009-01-01

    Field measurements by eddy correlation indicate an average CO2 uptake of 1.9 g C m-2 d-1 by the intertidal Wadden Sea estuary in spring 2008. The flux did not show a dependency on the tide and fluxes during high and low tide were comparable. We hypothesize that biological production in the water

  19. Testing a Comprehensive Model for Measuring Problem Solving and Problem Posing Skills of Primary Pupils

    Science.gov (United States)

    Charalambous, Charalambos; Kyriakides, Leonidas; Philippou, George

    2003-01-01

    The study reported in this paper is an attempt to develop a comprehensive model of measuring problem solving and posing (PSP) skills based on Marshall's schema theory (ST). A battery of tests on PSP skills was administered to 5th and 6th grade Cypriot students (n=2519). The Rasch model was used and a scale was created for the battery of tests and…

  20. Measuring Changes in Cytosolic Calcium Levels in HBV- and HBx-Expressing Cultured Primary Hepatocytes.

    Science.gov (United States)

    Casciano, Jessica C; Bouchard, Michael J

    2017-01-01

    Chronic infection with hepatitis B virus (HBV) remains a major worldwide health concern and is the leading cause of hepatocellular carcinoma (HCC). The HBV X protein (HBx) is the only regulatory protein encoded in the HBV genome; HBx stimulates HBV replication in vivo and in vitro. HBx also regulates cytosolic Ca(2+) signaling, and altered Ca(2+) signaling is associated with the development of many diseases, including HCC. Importantly, many HBx functions, including HBx modulation of cell proliferation, apoptosis, and transcription pathways, have been linked to changes in cytosolic Ca(2+) signaling. Additionally, several stages of HBV replication, including capsid formation and activation of the HBV polymerase, are dependent on intracellular Ca(2+). Consequently, defining the molecular mechanism that underlies HBV and HBx modulation of cytosolic Ca(2+) levels is important for understanding HBV pathogenesis and the role of HBx in HBV replication. Here, we describe a single-cell Ca(2+)-imaging protocol that we use to investigate HBV and HBx effects on the level of cytosolic Ca(2+). We specifically outline two methods that we use to evaluate HBV and HBx regulation of cytosolic Ca(2+) levels in cultured primary hepatocytes. This protocol can also be adapted for use in liver cell lines.

  1. Measuring health literacy among immigrants with a phonetic primary language: a case of Korean American women.

    Science.gov (United States)

    Han, Hae-Ra; Kim, Jiyun; Kim, Miyong T; Kim, Kim B

    2011-04-01

    While the need for understanding the issue of health literacy among ethnic minority groups with limited English skills is rapidly increasing in the US, it is difficult to find valid and useful health literacy tools for certain linguistic minorities. This study was designed to validate the Korean translation of Rapid Estimate of Adult Literacy in Medicine (REALM) and Test of Functional Health Literacy in Adults-Short form (S-TOFHLA). Korean REALM and S-TOFHLA were administered to 98 Korean American women, together with REALM-English. Participants were first-generation immigrants who were educated in Korea. Both Korean REALM and S-TOFHLA resulted in a negatively-skewed distribution. REALM-English yielded well-distributed groups with significant correlations with Korean REALM and S-TOFHLA (Spearman's rho = 0.30, P = 0.003 and 0.22, P = 0.03, respectively). Educational level was significantly correlated with REALM-English and Korean S-TOFHLA (Spearman's rho = 0.39, P = 0.000 and 0.25, P = 0.014), but not with REALM-Korean. The translation of REALM and S-TOFHLA into the Korean language did not lead to a valid assessment of health literacy. A more systematic approach is needed to assess health literacy in immigrants with limited English skills, particularly those with a phonetic primary language. Meanwhile, REALM-English could be used as a crude health literacy test for individuals with some English skills.

  2. Diabetes Outcome and Process Measures Among Patients Who Require Language Interpreter Services in Minnesota Primary Care Practices.

    Science.gov (United States)

    Njeru, Jane W; Boehm, Deborah H; Jacobson, Debra J; Guzman-Corrales, Laura M; Fan, Chun; Shimotsu, Scott; Wieland, Mark L

    2017-08-01

    Immigrants and refugees are less likely to meet diabetes management goals than the general US population. Those with limited English proficiency (LEP) and who need interpreter services (IS) for health care encounters, maybe at higher risk for encountering barriers to optimal diabetes management, and while most receive diabetes care in primary care settings, little is known about the association between IS need and diabetes outcomes. This study aims to determine adherence with diabetes process and outcomes measures among LEP patients in primary care settings, and is a retrospective cohort study of patients with type II diabetes at two large primary care networks in Minnesota from January 1, 2012 through December 31, 2013. Diabetes outcome measure goals were defined as hemoglobin A1C <8%, LDL-C <100 mg/dL, and blood pressure <140/90 mmHg. Process measure goals were defined as hemoglobin A1C measured within the previous 6 months and LDL cholesterol (LDL-C) measured within the previous 12 months. Compared to non-IS patients (N = 11,970), IS patients (N = 1486) were more likely to meet guideline outcome recommendations for blood pressure (Adjusted odds ratio [OR] 2.02; 95% confidence interval [CI] 1.70, 2.40), hemoglobin A1C (OR 1.23; 95% CI 1.08, 1.40), and LDL-C (OR 1.40; 95% CI 1.2, 1.62). Older IS patients and male IS patients were less likely to meet recommendations for hemoglobin A1C (OR 0.70; 95% CI 0.48, 1.02; OR 0.66; CI 0.54, 0.79; respectively) and LDL-C (OR 0.81; 95% CI 0.55, 1.17; OR 0.47; CI 0.39, 0.57; respectively). Healthcare system solutions need to bridge gaps from process to outcomes among LEP patients who require IS in primary care settings.

  3. 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.

  4. 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).

  5. Novel Laser-Based Technique for Measurements of Primary Atomization Characteristics of Liquid Jets

    Science.gov (United States)

    2012-08-22

    air velocity. The swirling air flow component will be generated by introducing the air flow in the upstream pipe through tangential air inlets...Discussion 11 (a) Geometrical Optics calculations 11 (b) Design of experimental facility of liquid jet in a cross stream of swirling air flow 14...unique, because it allows swirling air flow to interact with the injected liquid jet. No measurements are available of the behaviour of liquid jets

  6. Correlation of radiographic and functional measurements in patients who underwent primary scoliosis surgery in adult age.

    Science.gov (United States)

    Sánchez-Mariscal, Felisa; Gomez-Rice, Alejandro; Izquierdo, Enrique; Pizones, Javier; Zúñiga, Lorenzo; Alvarez-González, Patricia

    2012-04-01

    Prospective radiographic and clinical analysis. To evaluate whether radiographic spinopelvic parameters correlate with health-related quality of life (HRQOL) measures, in the long run, in patients operated on scoliosis in adult age. There are papers that correlate sagittal radiographic parameters with HRQOL scores for healthy spine as well as for some spinal disorders. However, there are limited studies evaluating correlations between HRQOL measures, radiographic spinopelvic parameters, and age in patients operated on scoliosis in adult age. Fifty-nine patients, older than 21 years at surgery time (median: 50.2 years), were operated upon at a single center. All of them suffered mainly frontal deformity, idiopathic or degenerative curves, and long fusions, with more than a 2-year follow-up (median:8.5 years). Full-length freestanding radiographs, including the spine and pelvis, and SRS22 and SF36 instruments, were available for every patient at final follow-up. Sagittal and frontal radiographic parameters and age were analyzed for correlation with HRQOL. A multivariate analysis was performed. No significant correlation was found between frontal parameters and HRQOL measures. Spearman rank order test showed correlation (P Scoliosis Research Society (SRS) activity and sagittal vertical axis (SVA) (r = -0.44), pelvic tilt (PT) (r = -0.49), and age (r = -0.5). SRS total was correlated (P scoliosis, frontal radiographic parameters did not correlate with HRQOL measures. In univariate analysis, patient age, SVA, and PT correlated with activity scores, although the correlation coefficients did not reach high values. After multivariate analysis, SVA was not a predictor of function.

  7. Study protocol, rationale and recruitment in a European multi-centre randomized controlled trial to determine the efficacy and safety of azithromycin maintenance therapy for 6 months in primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Kobbernagel, Helene Elgaard; Buchvald, Frederik F; Haarman, Eric G

    2016-01-01

    in PCD. The secondary objectives are to evaluate the efficacy of azithromycin on lung function, ventilation inhomogeneity, hearing impairment, and symptoms (respiratory, sinus, ears and hearing) measured on a PCD-specific health-related quality of life instrument, and to assess the safety of azithromycin...

  8. Measurements with fluorescent probes in primary neural cultures; improved multiwell techniques.

    Science.gov (United States)

    Ring, Avi; Tanso, Rita

    2007-01-01

    Fluorescence imaging techniques are valuable tools for the pharmacological characterization of CNS drugs. Dissected cerebellar granule neurons (CGN) are an important model system in the study of mechanisms of excitotoxicity, glutamate receptors and transporters. Widely applied techniques use fluorescent probes loaded in neural cells cultured on glass supports. CGN, however, require at least 7 days for differentiation and over time cells tend to cluster and loose adherence to the glass substrate. This problem is accentuated in small wells (e.g. 96-well plates). CGN were grown on large coverslips (60 x 24 mm) and measurements made with a designed mountable multiwell in 48 regions on 4 coverslips at a time. The UV ratiometric probe fura-2 was used to measure glutamatergic calcium ([Ca(2+)](i)) responses induced by NMDA. The IC(50) of NMDA receptor antagonists was determined from inhibition curves with 6 doses and 8 parallels per experiment. The method was validated by comparing with published data for the dose response to NMDA and glycine and IC(50) values for ion-channel block by Mg(2+) and MK-801. Resolution is enhanced with the new technique since it allows measurement of multiple doses on cells from the same batch. It has advantages to cuvette techniques because cells have intact dendritic tree and synaptic function and it is a convenient method to obtain reliable dose-response curves for NMDA channel modulators on differentiated neural cells.

  9. 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 R2 0.328, p = 0.00004; adjusted R2 0.187, p = 0.002 and adjusted R2 0.180, p = 0.002). The PCA composite score of global visual pathway damage independently predicted both LCVA 1.25% (adjusted R2 value 0.361, p = 0.00001) and LCVA 2.50% (adjusted R2 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.

  10. 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.

  11. 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

  12. 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. An explorative randomised controlled trial.

    Science.gov (United States)

    Rosenlund, Signe; Broeng, Leif; Overgaard, Søren; Jensen, Carsten; Holsgaard-Larsen, Anders

    2016-11-01

    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. Forty-seven patients with primary hip osteoarthritis were randomised to total hip arthroplasty with either posterior or lateral approach and evaluated pre-operatively, 3 and 12months post-operatively using 3-dimensional gait analyses as objective measures of gait function, including Gait Deviation Index, temporo-spatial parameters and range of motion. Isometric maximal hip muscle strength in abduction, flexion and extension was also tested. 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: -0.20(Nm/kg)[95%CI:-0.4 to 0.0] and -0.20(Nm/kg)[95%CI:-0.4 to 0.0], respectively. Contrary to our first hypothesis, the overall gait function in the posterior approach group did not improve more than in the lateral approach group. However, in agreement with our second hypothesis, patients in the posterior approach group improved more in hip abductor and flexor muscle strength at 12months. Further investigation of the effect of reduced maximal hip muscle strength on functional capacity is needed. ClinicalTrials.gov. No.: NCT01616667. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. 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

  14. 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

  15. 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

    2015-09-01

    There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. 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. 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. 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. 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.

  16. 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.

  17. Comparative efficacy of two primary care interventions to assist withdrawal from long term benzodiazepine use: A protocol for a clustered, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Roca Miguel

    2011-04-01

    Full Text Available Abstract Background Although benzodiazepines are effective, long-term use is not recommended because of potential adverse effects; the risks of tolerance and dependence; and an increased risk of hip fractures, motor vehicle accidents, and memory impairment. The estimated prevalence of long-term benzodiazepine use in the general population is about 2,2 to 2,6%, is higher in women and increases steadily with age. Interventions performed by General Practitioners may help patients to discontinue long-term benzodiazepine use. We have designed a trial to evaluate the effectiveness and safety of two brief general practitioner-provided interventions, based on gradual dose reduction, and will compare the effectiveness of these interventions with that of routine clinical practice. Methods/Design In a three-arm cluster randomized controlled trial, general practitioners will be randomly allocated to: a a group in which the first patient visit will feature a structured interview, followed by visits every 2-3 weeks to the end of dose reduction; b a group in which the first patient visit will feature a structured interview plus delivery of written instructions to self-reduce benzodiazepine dose, or c routine care. Using a computerized pharmaceutical prescription database, 495 patients, aged 18-80 years, taking benzodiazepine for at least 6 months, will be recruited in primary care health districts of three regions of Spain (the Balearic Islands, Catalonia, and Valencia. The primary outcome will be benzodiazepine use at 12 months. The secondary outcomes will include measurements of anxiety and depression symptoms, benzodiazepine dependence, quality of sleep, and alcohol consumption. Discussion Although some interventions have been shown to be effective in reducing benzodiazepine consumption by long-term users, the clinical relevance of such interventions is limited by their complexity. This randomized trial will compare the effectiveness and safety of two

  18. 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

  19. 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)

    2012-01-01

    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 < .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. Conclusions Participants receiving self

  20. 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

  1. 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…

  2. Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year

    DEFF Research Database (Denmark)

    Ekstrand, K R; Bakhshandeh, A; Martignon, S

    2010-01-01

    This split-mouth study aimed to assess the efficacy of resin-infiltrated lesions covered by fluoride varnish (FV) versus FV treatment only of proximal lesions on deciduous molar teeth. The study lasted for 1 year. Children with 2 or more superficial proximal lesions on deciduous molar teeth...... for controlling proximal lesion progression on deciduous molar teeth....

  3. 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.

  4. Western Cape Primary Care Assessment Tool (PCAT study: Measuring primary care organisation and performance in the Western Cape Province, South Africa (2013

    Directory of Open Access Journals (Sweden)

    Graham F. Bresick

    2016-03-01

    Full Text Available 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.

  5. 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)

    Bresick, Graham F; Sayed, Abdul-Rauf; Le Grange, Cy