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Sample records for shown positive outcomes

  1. Predicting Positive Education Outcomes for Emerging Adults in Mental Health Systems of Care.

    Science.gov (United States)

    Brennan, Eileen M; Nygren, Peggy; Stephens, Robert L; Croskey, Adrienne

    2016-10-01

    Emerging adults who receive services based on positive youth development models have shown an ability to shape their own life course to achieve positive goals. This paper reports secondary data analysis from the Longitudinal Child and Family Outcome Study including 248 culturally diverse youth ages 17 through 22 receiving mental health services in systems of care. After 12 months of services, school performance was positively related to youth ratings of school functioning and service participation and satisfaction. Regression analysis revealed ratings of young peoples' perceptions of school functioning, and their experience in services added to the significant prediction of satisfactory school performance, even controlling for sex and attendance. Finally, in addition to expected predictors, participation in planning their own services significantly predicted enrollment in higher education for those who finished high school. Findings suggest that programs and practices based on positive youth development approaches can improve educational outcomes for emerging adults.

  2. Value co-creation in healthcare through positive deviance.

    Science.gov (United States)

    Zanetti, Cole Anthony; Taylor, Natalie

    2016-12-01

    To explore how converging fields of co-creation and positive deviance may increase value in healthcare. Informed by research in positive deviance, patient engagement, value co-creation, and quality improvement, we propose a positive deviance approach to co-creation of health. Co-creation has shown to improve health outcomes with regard to multiple health conditions. Positive deviance has also shown to improve outcomes in multiple healthcare and patient community environments. A positive deviance co-creation framework may aid in achieving improved outcomes for patients, care teams and their respective healthcare organizations. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Pregnancy, Obstetric and Neonatal Outcomes in HIV Positive ...

    African Journals Online (AJOL)

    While the effect of HIV infection on some maternal outcomes is well established, for some others there is conflicting information on possible association with HIV. In this study we investigated pregnancy and neonatal outcome of HIV positive women in large HIV treatment centre over a period of 84 months. They were ...

  4. The fading affect bias shows positive outcomes at the general but not the individual level of analysis in the context of social media.

    Science.gov (United States)

    Gibbons, Jeffrey A; Horowitz, Kyle A; Dunlap, Spencer M

    2017-08-01

    Unpleasant affect fades faster than pleasant affect (e.g., Walker, Vogl, & Thompson, 1997); this effect is referred to as the Fading Affect Bias (FAB; Walker, Skowronski, Gibbons, Vogl, & Thompson, 2003a). Research shows that the FAB is consistently related to positive/healthy outcomes at a general but not at a specific level of analysis based on event types and individual differences (e.g., Gibbons et al., 2013). Based on the positive outcomes for FAB and negative outcomes for social media (Bolton et al., 2013; Huang, 2010), the current study examined FAB in the context of social media events along with related individual differences. General positive outcomes were shown in the form of robust FAB effects across social media and non-social media events, a larger FAB for non-social media events than for social media events, negative correlations of FAB with depression, anxiety, and stress as well as a positive correlation of FAB with self-esteem. However, the lack of a negative correlation between FAB and anxiety for social media events in a 3-way interaction did not show positive outcomes at a specific level of analysis. Rehearsal ratings mediated the 3-way interaction. Implications are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. High risk pregnancy in the workplace. Influencing positive outcomes.

    Science.gov (United States)

    Cannon, R B; Schmidt, J V; Cambardella, B; Browne, S E

    2000-09-01

    Childbearing employees are well served by the occupational health nurse who promotes optimal preconceptual and pregnancy health practices, uses community resources, and maintains current knowledge about high risk pregnancy prevention and care. These broad goals of care can lead to decreased absenteeism, healthier and happier employees, and more positive outcomes of pregnancy. For employees with high risk pregnancies, the role of the occupational health nurse includes, but is not limited to, facilitating awareness with the employer, making suggestions for adjusting working conditions, making frequent assessments of the employee's needs, and communicating with prenatal health care providers. Occupational health nurses should never underestimate their role and potential influence on the mother, and on her significant other, for a positive outcome of her pregnancy.

  6. Multigenerational Challenges: Team-Building for Positive Clinical Workforce Outcomes

    Science.gov (United States)

    Moore, Jill M; Everly, Marcee; Bauer, Renee

    2016-05-31

    Patient acuity in hospital settings continues to increase, and there is greater emphasis on patient outcomes. The current nursing workforce is comprised of four distinct generational cohorts that include veterans, baby boomers, millennials, and generation Xers. Each group has unique characteristics that add complexity to the workforce and this can add challenges to providing optimal patient care. Team building is one strategy to increase mutual understanding, communication, and respect, and thus potentially improve patient outcomes. In this article, we first briefly define generational cohorts by characteristics, and discuss differing expectations for work/life balance and potential negative outcomes. Our discussion offers team building strategies for positive outcomes, a case scenario, and concludes with resources for team building and organizational opportunities.

  7. Excursions out-of-lane versus standard deviation of lateral position as outcome measure of the on-the-road driving test.

    Science.gov (United States)

    Verster, Joris C; Roth, Thomas

    2014-07-01

    The traditional outcome measure of the Dutch on-the-road driving test is the standard deviation of lateral position (SDLP), the weaving of the car. This paper explores whether excursions out-of-lane are a suitable additional outcome measure to index driving impairment. A literature search was conducted to search for driving tests that used both SDLP and excursions out-of-lane as outcome measures. The analyses were limited to studies examining hypnotic drugs because several of these drugs have been shown to produce next-morning sedation. Standard deviation of lateral position was more sensitive in demonstrating driving impairment. In fact, solely relying on excursions out-of-lane as outcome measure incorrectly classifies approximately half of impaired drives as unimpaired. The frequency of excursions out-of-lane is determined by the mean lateral position within the right traffic lane. Defining driving impairment as having a ΔSDLP > 2.4 cm, half of the impaired driving tests (51.2%, 43/84) failed to produce excursions out-of-lane. Alternatively, 20.9% of driving tests with ΔSDLP < 2.4 cm (27/129) had at least one excursion out-of-lane. Excursions out-of-lane are neither a suitable measure to demonstrate driving impairment nor is this measure sufficiently sensitive to differentiate adequately between differences in magnitude of driving impairment. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Positive Outcome Expectancy Mediates the Relationship Between Peer Influence and Internet Gaming Addiction Among Adolescents in Taiwan.

    Science.gov (United States)

    Wu, Jo Yung Wei; Ko, Huei-Chen; Wong, Tsui-Yin; Wu, Li-An; Oei, Tian Po

    2016-01-01

    The present study examined the role of positive outcome expectancy in the relationship between peer/parental influence and Internet gaming addiction (IGA) among adolescents in Taiwan. Two thousand, one hundred and four junior high students completed the Chen Internet Addiction Scale for IGA, Parental Influence for IGA, peer influence for IGA, and Positive Outcome Expectancy of Internet Gaming Questionnaire. Results showed that the three types of peer influences (positive attitudes toward Internet gaming, frequency of Internet game use, and invitation to play) and positive outcome expectancy were significantly and positively correlated with IGA. Moreover, peer influence was also positively correlated with positive outcome expectancy. On the other hand, positive outcome expectancy and parental influences had a low correlation. Structural equation modeling analysis revealed that positive outcome expectancy did not mediate the relationship between either type of parental influences and IGA, and only the parent's invitation to play Internet games directly predicted IGA severity. However, peers' positive attitude or the frequency of peers' Internet game use positively predicted IGA and was fully mediated through positive outcome expectancy of Internet gaming. In addition, the frequency of peers' invitation to play Internet games directly and indirectly predicted IGA severity through a partial mediation of positive outcome expectancy of Internet gaming. The overall fit of the model was adequate and was able to explain 25.0 percent of the variance. The findings provide evidence in illuminating the role of peer influences and positive outcome expectancy of Internet gaming in the process of why adolescents may develop IGA.

  9. Promoting positive outcomes through strengths interventions : A literature review

    NARCIS (Netherlands)

    Ghielen, S.T.S.; van Woerkom, M.; Meyers, M.C.

    2018-01-01

    This paper reviews studies of strengths interventions published between 2011 and 2016. Strengths interventions aim to promote well-being or other positive outcomes by facilitating strengths identification, and sometimes also strengths use and/or development. The present review provides an overview

  10. Positive parenting in ethnic minority families : challenges and outcomes

    NARCIS (Netherlands)

    Emmen, Rosalia Antonia Grada (Rosanneke)

    2014-01-01

    The overall goal of the current dissertation is to uncover predictors and outcomes of positive parenting in ethnic minority families. Chapter 2 provides an overview of commonly used observational instruments to measure sensitivity, showing the versatility and scientific importance of the construct.

  11. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review.

    Science.gov (United States)

    Stansfeld, Jacki; Stoner, Charlotte R; Wenborn, Jennifer; Vernooij-Dassen, Myrra; Moniz-Cook, Esme; Orrell, Martin

    2017-08-01

    Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were subject to a quality assessment to appraise psychometric properties. Twelve positive outcome measures and six validation papers of these scales were identified. The emerging constructs of self-efficacy, spirituality, resilience, rewards, gain, and meaning are in line with positive psychology theory. There are some robust positive measures in existence for family caregivers of people living with dementia. However, lack of reporting of the psychometric properties hindered the quality assessment of some outcome measures identified in this review. Future research should aim to include positive outcome measures in interventional research to facilitate a greater understanding of the positive aspects of caregiving and how these contribute to well-being.

  12. Positive uncertainty: The benefit of the doubt in advertising

    NARCIS (Netherlands)

    Ketelaar, P.E.; Riet, J.P. van 't; Thorbjornsen, H.; Buijzen, M.A.

    2018-01-01

    Positive uncertainty refers to uncertainty surrounding an anticipated positive outcome. It provides consumers with the opportunity to imagine and speculate on a product's or experience's potentially positive characteristics. Research has shown that when uncertainty is associated with something

  13. A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China.

    Science.gov (United States)

    Zhang, Hongyu; Huang, Shurong; Guo, Xiaolan; Zhao, Ningning; Lu, Yujing; Chen, Min; Li, Yingxia; Wu, Junqin; Huang, Lihua; Ma, Fenglan; Yang, Yuhong; Zhang, Xiaoli; Zhou, Xiaoyu; Guo, Renfei; Cai, Wenzhi

    2017-07-01

    the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012. In total, 1400 women were recruited and randomly allocated to either the experimental group (n=700, 446 completed the protocol) who delivered in hands-and-knees position and the control group (n=700, 440 completed the protocol) who delivered in supine position. Women who could not maintain the randomised position during the second stage of labour were allowed to withdraw from the study. The primary maternal outcome measured was rate of episiotomy. Secondary outcomes included degree of perineum laceration, rate of emergency caesarean section, rate of shoulder dystocia, and duration of labour, postpartum bleeding, neonatal Apgar score, and the rate of neonatal asphyxia. Because outcome data were only collected for women who gave birth in the randomised position, per-protocol analyses were used to compare groups. The primary outcome, episiotomy, was also compared between groups using logistic regression adjusting for maternal age,gestational age at birth, whether the woman was primiparous, the process of second stage of labour and birthweight. as compared with the control group, the experimental group had lower rates of episiotomy and second-degree perineum laceration (including episiotomy), and higher rates of intact perineum and first-degree perineum laceration, with a longer duration of second stage of labour. No significant differences were found in the amount of postpartum bleeding, shoulder dystocia, neonatal asphyxia and neonatal Apgar scores at 1minute and 5minutes. Adjusted for maternal age, gestational

  14. Feasibility and outcomes of paid undergraduate student nurse positions.

    Science.gov (United States)

    Gamroth, Lucia; Budgen, Claire; Lougheed, Mary

    2006-09-01

    An Undergraduate Nurse Employment Demonstration Project (UNDP) was implemented in four Health Service Areas in British Columbia with a concurrent evaluation study. This demonstration project comprised the development and implementation of a new position in the BC healthcare system. The position enabled third- and fourth-year nursing students to be employed at their level of education. The purposes of the evaluation were to explore the feasibility and outcomes of this type of paid undergraduate student nurse employment. The three-year project and evaluation included both implementation and outcome analysis. The implementation evaluation design was descriptive and prospective, involving multiple data sources. The outcome evaluation design was quasi-experimental, with intervention and comparison groups. Learning outcomes for undergraduate nurses were increased confidence, organizational ability, competency and ability to work with a team. Workplace outcomes were increased unit morale, help with workload and improved patient care. New graduates with undergraduate nurse experience reported less time required for orientation and transition than other graduates who did not have this experience, and workplace nurses viewed these new graduates as more job-ready than other new graduates. After 21 months, new graduates with undergraduate nurse experience were less likely to move to other employment than other new graduates. Results from the four Health Service Areas indicated that the paid undergraduate nurse position was feasible and that outcomes benefited students, new graduates and workplaces. The undergraduate nurse position is now being implemented throughout all Health Service Areas in British Columbia.By 2000, concerns in British Columbia about the nursing workforce, workplace and patient safety had escalated to the point where diverse stakeholder groups were prepared to work together in new ways to prepare nursing graduates to be more job-ready, to recruit and retain

  15. Examining the relationships between posttraumatic stress disorder symptoms, positive smoking outcome expectancies, and cigarette smoking in people with substance use disorders: a multiple mediator model.

    Science.gov (United States)

    Hruska, Bryce; Bernier, Jennifer; Kenner, Frank; Kenne, Deric R; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L

    2014-01-01

    Cigarette smoking is highly prevalent in people with substance use disorders (SUDs) and is associated with significant physical health problems. Posttraumatic stress disorder (PTSD) is also highly associated with both SUDs and cigarette smoking and may serve as a barrier to smoking cessation efforts. In addition, people with PTSD are more likely to hold positive smoking outcome expectancies (i.e., beliefs that smoking cigarettes results in positive outcomes); these beliefs may contribute to cigarette smoking in people with SUDs experiencing PTSD symptoms. The present study examined the relationship between PTSD symptoms and typical daily cigarette smoking/cigarette dependence symptoms in a sample of 227 trauma-exposed current smokers with SUDs (59.9% male, 89.4% Caucasian) seeking detoxification treatment services. Additionally, the indirect effects of multiple types of positive smoking outcome expectancies on these relationships were examined. Participants completed questionnaires assessing PTSD symptoms, positive smoking outcome expectancies, cigarette consumption, and cigarette dependence symptoms. Results indicated that PTSD symptoms were not directly related to cigarette consumption or cigarette dependence symptoms. However, negative affect reduction outcome expectancies were shown to have a significant indirect effect between PTSD symptoms and cigarette consumption, while negative affect reduction, boredom reduction, and taste-sensorimotor manipulation outcome expectancies were all found to have significant indirect effects between PTSD symptoms and cigarette dependence symptoms. The indirect effect involving negative affect reduction outcome expectancies was statistically larger than that of taste sensorimotor manipulation outcome expectancies, while negative affect reduction and boredom reduction outcome expectancies were comparable in magnitude. These results suggest that expectancies that smoking can manage negative affective experiences are related to

  16. Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review.

    Science.gov (United States)

    Kruse, Clemens Scott; Beane, Amanda

    2018-02-05

    Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT's contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR). We narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively. A strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames. ©Clemens Scott Kruse, Amanda Beane. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.02.2018.

  17. The outcome of infected total knee arthroplasty: culture-positive versus culture-negative.

    Science.gov (United States)

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik; Kim, Dong-Jin

    2015-10-01

    We studied the outcome in culture-positive and culture-negative infected total knee arthroplasty (TKA). We retrospectively reviewed 140 patients with culture-positive and 102 patients with culture-negative infected TKAs. We determined the infection control rate and clinical outcome after repeated debridement, and repeated 2-stage TKA in the culture-positive and culture-negative groups. The mean follow-up was 9.3 years (range 5-14 years) in the culture-positive group and 10.6 years (5-22) in the culture-negative group. The overall infection control rate was 56 % in both groups after the first treatment. The overall infection control rate was 90 % in the culture-positive group and 95 % in the culture-negative group. A functional knee was obtained in 90 % in the culture-positive group and 95 % in the culture-negative group. The data suggest that treatment according to the types of infection in both culture-positive and culture-negative groups after TKA controlled infection and maintained functional TKA with a firm level of fixation for most patients. Repeated debridement and repeated two-stage exchange TKA further improved infection control rates after the initial treatment and increased the likelihood of maintaining a functional TKA.

  18. Predictors of Positive Outcomes in Offspring of Depressed Parents and Non-depressed Parents Across 20 Years

    Science.gov (United States)

    Verdeli, Helen; Wickramaratne, Priya; Warner, Virginia; Mancini, Anthony; Weissman, Myrna

    2014-01-01

    Understanding differences in factors leading to positive outcomes in high-risk and low-risk offspring has important implications for preventive interventions. We identified variables predicting positive outcomes in a cohort of 235 offspring from 76 families in which one, both, or neither parent had major depressive disorder. Positive outcomes were termed resilient in offspring of depressed parents, and competent in offspring of non-depressed parents, and defined by two separate criteria: absence of psychiatric diagnosis and consistently high functioning at 2, 10, and 20 years follow-up. In offspring of depressed parents, easier temperament and higher self-esteem were associated with greater odds of resilient outcome defined by absence of diagnosis. Lower maternal overprotection, greater offspring self-esteem, and higher IQ were associated with greater odds of resilient outcome defined by consistently high functioning. Multivariate analysis indicated that resilient outcome defined by absence of diagnosis was best predicted by offspring self-esteem; resilient outcome defined by functioning was best predicted by maternal overprotection and self-esteem. Among offspring of non-depressed parents, greater family cohesion, easier temperament and higher self-esteem were associated with greater odds of offspring competent outcome defined by absence of diagnosis. Higher maternal affection and greater offspring self-esteem were associated with greater odds of competent outcome, defined by consistently high functioning. Multivariate analysis for each criterion indicated that competent outcome was best predicted by offspring self-esteem. As the most robust predictor of positive outcomes in offspring of depressed and non-depressed parents, self-esteem is an important target for youth preventive interventions. PMID:25374449

  19. Positive interaction of social comparison and personal responsibility for outcomes.

    Science.gov (United States)

    Grygolec, Jaroslaw; Coricelli, Giorgio; Rustichini, Aldo

    2012-01-01

    We formulate and test a model that allows sharp separation between two different ways in which environment affects evaluation of outcomes, by comparing social vs. private and personal responsibility vs. chance. In the experiment, subjects chose between two lotteries, one low-risk and one high-risk. They could then observe the outcomes. By varying the environment between private (they could observe the outcome of the chosen lottery and the outcome of the lottery they had not chosen) and social (they could observe the outcome of the lottery chosen by another subject) we can differentiate the response and brain activity following the feedback in social and private settings. The evidence suggests that envy and pride are significant motives driving decisions and outcomes evaluation, stronger than private emotions like regret and rejoice, with ventral striatum playing a key role. When we focus on the outcome evaluation stage we demonstrate that BOLD signal in ventral striatum is increasing in the difference between obtained and counterfactual payoffs. For a given difference in payoffs, striatal responses are more pronounced in social than in private environment. Moreover, a positive interaction (complementarity) between social comparison and personal responsibility is reflected in the pattern of activity in the ventral striatum. At decision stage we observe getting ahead of the Joneses effect in ventral striatum with subjective value of risk larger in social than in private environment.

  20. The Effectiveness of CASAs in Achieving Positive Outcomes for Children.

    Science.gov (United States)

    Litzelfelner, Pat

    2000-01-01

    Evaluated effectiveness of court-appointed special advocates (CASAs) in achieving positive outcomes for children in the child welfare system, using data from court and CASA program files on 200 children. Found that CASAs may have reduced the number of placements and court continuances children experienced. More services were provided to children…

  1. Alternative outcomes create biased expectations regarding the received outcome: Evidence from event-related potentials.

    Science.gov (United States)

    Marciano, Déborah; Bentin, Shlomo; Deouell, Leon Y

    2018-05-01

    After choosing between uncertain options, one might get feedback on both the outcome of the chosen option and the outcome of the unchosen option (the alternative). Behavioral research has shown that in such cases people engage in outcome comparison, and that the alternative outcome influences the way one evaluates his own received outcome. Moreover, this influence differs whether one was responsible or not for the choice made. In two studies, we looked for the electrophysiological correlates of outcome comparison. Subjects chose one of two boxes shown on the screen, each box contained a gain or a loss. The alternative outcome was always revealed first, followed by the received outcome. In half of the trials the software picked one box instead of subjects. We tested whether the feedback-related negativity (FRN) and the P3 elicited by the received reflect outcome comparison. As expected, we found that the FRN and P3 were more positive when the received outcome was a gain (vs. a loss). The FRN and P3 were also sensitive to the value of the alternative outcome, but contrary to our predictions, they were more positive when the alternative outcome was a gain (vs. a loss). As the FRN and P3 are sensitive to expectations, we hypothesized that our findings might result from subjects' biased expectations: subjects might have wrongly believed that a good (bad) alternative outcome signaled a bad (good) received outcome. This hypothesis, coined as the Alternative Omen Effect, was confirmed in parallel in a series of behavioral experiments: people see an illusory negative correlation between the uncorrelated outcomes of choice options (reported in Marciano-Romm et al. (2016)). A challenge for future research will be to disentangle the effects of expectation from those of outcome comparison. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Outcomes of single organism peritonitis in peritoneal dialysis: gram negatives versus gram positives in the Network 9 Peritonitis Study.

    Science.gov (United States)

    Bunke, C M; Brier, M E; Golper, T A

    1997-08-01

    The use of the "peritonitis rate" in the management of patients undergoing peritoneal dialysis is assuming importance in comparing the prowess of facilities, care givers and new innovations. For this to be a meaningful outcome measure, the type of infection (causative pathogen) must have less clinical significance than the number of infections during a time interval. The natural history of Staphylococcus aureus, pseudomonas, and fungal peritonitis would not support that the outcome of an episode of peritonitis is independent of the causative pathogen. Could this concern be extended to other more frequently occurring pathogens? To address this, the Network 9 Peritonitis Study identified 530 episodes of single organism peritonitis caused by a gram positive organism and 136 episodes caused by a single non-pseudomonal gram negative (NPGN) pathogen. Coincidental soft tissue infections (exit site or tunnel) occurred equally in both groups. Outcomes of peritonitis were analyzed by organism classification and by presence or absence of a soft tissue infection. NPGN peritonitis was associated with significantly more frequent catheter loss, hospitalization, and technique failure and was less likely to resolve regardless of the presence or absence of a soft tissue infection. Hospitalization and death tended to occur more frequently with enterococcal peritonitis than with other gram positive peritonitis. The outcomes in the NPGN peritonitis group were significantly worse (resolution, catheter loss, hospitalization, technique failure) compared to coagulase negative staphylococcal or S. aureus peritonitis, regardless of the presence or absence of a coincidental soft tissue infection. Furthermore, for the first time, the poor outcomes of gram negative peritonitis are shown to be independent of pseudomonas or polymicrobial involvement or soft tissue infections. The gram negative organism appears to be the important factor. In addition, the outcome of peritonitis caused by S. aureus

  3. Outcome in clients with positive pregnancy test following IVF/ICSI ...

    African Journals Online (AJOL)

    Background: A retrospective analysis of the outcome of all patients who have recorded a positive pregnancy test following IVF/ICSI treatment from June 1999 to December 2002 was done. Materials and Methods: A total of 1256 treatment cycles were carried out using the long day 1 (early follicular phase) or day 21 ...

  4. Perinatal Outcomes in HIV Positive Pregnant Women with Concomitant Sexually Transmitted Infections

    Directory of Open Access Journals (Sweden)

    Erin Burnett

    2015-01-01

    Full Text Available Objective. To evaluate whether HIV infected pregnant women with concomitant sexually transmitted infection (STIs are at increased risk of adverse perinatal and neonatal outcomes. Methods. We conducted a cohort study of HIV positive women who delivered at an inner-city hospital in Atlanta, Georgia, from 2003 to 2013. Demographics, presence of concomitant STIs, prenatal care information, and maternal and neonatal outcomes were collected. The outcomes examined were the association of the presence of concomitant STIs on the risk of preterm birth (PTB, postpartum hemorrhage, chorioamnionitis, preeclampsia, intrauterine growth restriction, small for gestational age, low Apgar scores, and neonatal intensive care admission. Multiple logistic regression was performed to adjust for potential confounders. Results. HIV positive pregnant women with concomitant STIs had an increased risk of spontaneous PTB (odds ratio (OR 2.11, 95% confidence interval [CI] 1.12–3.97. After adjusting for a history of preterm birth, maternal age, and low CD4+ count at prenatal care entry the association between concomitant STIs and spontaneous PTB persisted (adjusted OR 1.96, 95% CI 1.01–3.78. Conclusions. HIV infected pregnant women with concomitant STIs relative to HIV positive pregnant women without a concomitant STI are at increased risk of spontaneous PTB.

  5. Does a positive pretransplant crossmatch affect long-term outcome in liver transplantation?

    LENUS (Irish Health Repository)

    Al-Sibae, Mohamad R

    2012-02-01

    Despite the historical success of liver transplantation in the face of a positive lymphocytic crossmatch, increased incidence of acute cellular rejection and graft loss have been reported in this setting. Given the potential adverse effects of antirejection treatment, especially in hepatitis C virus-positive recipients, identification of predisposing factors could allow for better surveillance, avoidance of rejection, and potentially better graft outcomes.

  6. Pregnancy outcomes in HIV-positive women: a retrospective cohort study.

    Science.gov (United States)

    Arab, Kholoud; Spence, Andrea R; Czuzoj-Shulman, Nicholas; Abenhaim, Haim A

    2017-03-01

    In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV. Multivariate logistic regression was used to estimate the adjusted effect of HIV status on obstetrical and neonatal outcomes. Among 7,772,999 births over the study period, 1997 were in HIV-positive women (an incidence of 25.7/100,000 births). HIV-infected patients had greater frequency of pre-existing diabetes and chronic hypertension, and use of cigarettes, drugs, and alcohol during pregnancy (p HIV-infected women had greater likelihood of antenatal complications: preterm premature rupture of membranes (OR 1.35, 95% CI 1.14-1.60) and urinary tract infections (OR 3.02, 95% CI 2.40-3.81). Delivery and postpartum complications were also increased among HIV-infected women: cesarean delivery (OR 3.06, 95% CI 2.79-3.36), postpartum sepsis (OR 8.05, 95% CI 5.44-11.90), venous thromboembolism (OR 2.21, 95% CI 1.46-3.33), blood transfusions (OR 3.67, 95% CI 3.01-4.49), postpartum infection (OR 3.00, 95% CI 2.37-3.80), and maternal mortality (OR 21.52, 95% CI 12.96-35.72). Neonates born to these mothers were at higher risk of prematurity and intrauterine growth restriction. Pregnancy in HIV-infected women is associated with adverse maternal and newborn complications. Pregnant HIV-positive women should be followed in high-risk healthcare centers.

  7. Branding MBA Programs: The Use of Target Market Desired Outcomes for Effective Brand Positioning

    Science.gov (United States)

    Heslop, Louise A.; Nadeau, John

    2010-01-01

    Branding is about delivering on desired outcomes. The importance of positioning program offerings on the basis of outcomes sought in the education market is illustrated in this study of choice of an MBA program by prospective students. MBA fair attendees were surveyed and multiple methods were employed to determine the importance of desired…

  8. Right ventricular pacemaker lead position is associated with differences in long-term outcomes and complications.

    Science.gov (United States)

    Witt, Chance M; Lenz, Charles J; Shih, Henry H; Ebrille, Elisa; Rosenbaum, Andrew N; van Zyl, Martin; Aung, Htin; Manocha, Kevin K; Deshmukh, Abhishek J; Hodge, David O; Mulpuru, Siva K; Cha, Yong-Mei; Espinosa, Raul E; Asirvatham, Samuel J; Mcleod, Christopher J

    2017-08-01

    Cardiac pacing from the right ventricular apex is associated with detrimental long-term effects and nonapical pacing locations may be associated with improved outcomes. There is little data regarding complications with nonapical lead positions. The aim of this study was to assess long-term outcomes and lead-related complications associated with differing ventricular lead tip position. All adult patients who underwent dual-chamber pacemaker implantation from 2004 to 2014 were included if they had postprocedure chest radiographs amenable to lead position determination. Long-term outcomes and lead-related complication rates were recorded. These were compared at 5 years between: (1) apical and septal leads, (2) apical and nonseptal nonapical (NSNA), and (3) apical and septal with >40% ventricular pacing. We retrospectively evaluated 3,450 patients, which included 238 with a septal position and 733 with NSNA lead positions. Septal lead position was associated with a lower mortality compared to apical leads (24% vs. 31%, P = 0.02). In patients with greater than 40% pacing, septal leads were associated with significantly higher rates of incident atrial fibrillation compared to apical leads (49% vs. 34%, P = 0.04). NSNA positions were associated with a significantly higher rate of lead dislodgement (4% vs. 2%, P = 0.005) and need for revision (8% vs. 5%, P = 0.005). Septal pacemaker lead position is associated with a lower mortality compared to apically placed leads, but a higher incidence of atrial fibrillation with higher percentage ventricular pacing. NSNA lead locations are associated with more complications and should be avoided. © 2017 Wiley Periodicals, Inc.

  9. Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study.

    Science.gov (United States)

    Dahlqvist, Kristina; Jonsson, Maria

    2017-11-14

    To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia. Cohort study from a university hospital in Sweden between 2004 and 2012. Information was collected from a local database of 35,546 births. Umbilical artery sampling was routine. Outcomes were: umbilical artery pH pushing, birth in occiput posterior compared with anterior position is not associated with acidaemia. The higher risk of neonatal morbidity is of concern and any long-term consequences need to be investigated in future studies.

  10. Is Family-to-Work Interference Related to Co-Workers' Work Outcomes?

    Science.gov (United States)

    ten Brummelhuis, Lieke L.; Bakker, Arnold B.; Euwema, Martin C.

    2010-01-01

    Previous studies have convincingly shown that employees' family lives can affect their work outcomes. We investigate whether family-to-work interference (FWI) experienced by the employee also affects the work outcomes of a co-worker. We predict that the employee's FWI has an effect on the co-worker's outcomes through the crossover of positive and…

  11. Network position and related power : how they affect and are affected by network management and outcomes

    NARCIS (Netherlands)

    Oukes, Tamara

    2018-01-01

    In network position and related power you learn more about how network position and related power affect and are affected by network management and outcomes. First, I expand our present understanding of how startups with a fragile network position manage business relationships by taking an

  12. Positive smoking outcome expectancies mediate the association between negative affect and smoking urge among women during a quit attempt.

    Science.gov (United States)

    Cano, Miguel Ángel; Lam, Cho Y; Chen, Minxing; Adams, Claire E; Correa-Fernández, Virmarie; Stewart, Diana W; McClure, Jennifer B; Cinciripini, Paul M; Wetter, David W

    2014-08-01

    Ecological momentary assessment was used to examine associations between negative affect, positive smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 302 female smokers who enrolled in an individually tailored smoking cessation treatment study. Multilevel mediation analysis was used to examine the temporal relationship among the following: (a) the effects of negative affect and positive smoking outcome expectancies at 1 assessment point (e.g., time j) on smoking urge at the subsequent time point (e.g., time j + 1) in Model 1; and, (b) the effects of negative affect and smoking urge at time j on positive smoking outcome expectancies at time j + 1 in Model 2. The results from Model 1 showed a statistically significant effect of negative affect at time j on smoking urge at time j + 1, and this effect was mediated by positive smoking outcome expectancies at time j, both within- and between-participants. In Model 2, the within-participant indirect effect of negative affect at time j on positive smoking outcome expectancies at time j + 1 through smoking urge at time j was nonsignificant. However, a statistically significant indirect between-participants effect was found in Model 2. The findings support the hypothesis that urge and positive smoking outcome expectancies increase as a function of negative affect, and suggest a stronger effect of expectancies on urge as opposed to the effect of urge on expectancies.

  13. Negative relationship behavior is more important than positive: Correlates of outcomes during stressful life events.

    Science.gov (United States)

    Rivers, Alannah Shelby; Sanford, Keith

    2018-04-01

    When people who are married or cohabiting face stressful life situations, their ability to cope may be associated with two separate dimensions of interpersonal behavior: positive and negative. These behaviors can be assessed with the Couple Resilience Inventory (CRI). It was expected that scales on this instrument would correlate with outcome variables regarding life well-being, stress, and relationship satisfaction. It was also expected that effects for negative behavior would be larger than effects for positive and that the effects might be curvilinear. Study 1 included 325 married or cohabiting people currently experiencing nonmedical major life stressors and Study 2 included 154 married or cohabiting people with current, serious medical conditions. All participants completed an online questionnaire including the CRI along with an alternate measure of couple behavior (to confirm scale validity), a measure of general coping style (to serve as a covariate), and measures of outcome variables regarding well-being, quality of life, perceived stress, and relationship satisfaction. The effects for negative behavior were larger than effects for positive in predicting most outcomes, and many effects were curvilinear. Notably, results remained significant after controlling for general coping style, and scales measuring positive and negative behavior demonstrated comparable levels of validity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  14. Questions never asked. Positive family outcomes of extremely premature childbirth

    DEFF Research Database (Denmark)

    Lou, Hanne; Pedersen, Birthe D; Hedegaard, Morten

    2009-01-01

    OBJECTIVE: To explore positive aspects of family life after extremely premature childbirth, thereby supplementing current literature on long-term family outcome. DESIGN: Semi-structured, qualitative research interviews were analysed according to the editing strategy described by Miller and Crabtree....... SETTING: Denmark, Europe. PARTICIPANTS: Nine fathers and 11 mothers of 14 children born before 28 completed weeks of gestation at a tertiary centre were interviewed when their children were 7-10 years old. RESULTS: Whereas developmental delay, functional limitations, family burden, and parental distress...

  15. Positive outcomes following gait therapy intervention for hip osteoarthritis: A longitudinal study.

    Science.gov (United States)

    Solomonow-Avnon, Deborah; Herman, Amir; Levin, Daniel; Rozen, Nimrod; Peled, Eli; Wolf, Alon

    2017-10-01

    Footwear-generated biomechanical manipulation of lower-limb joints was shown to beneficially impact gait and quality of life in knee osteoarthritis patients, but has not been tested in hip osteoarthritis patients. We examined a customized gait treatment program using a biomechanical device shown in previous investigations to be capable of manipulating hip biomechanics via foot center of pressure (COP) modulation. The objective of this study was to assess the treatment program for hip osteoarthritis patients, enrolled in a 1-year prospective investigation, by means of objective gait and spatiotemporal parameters, and subjective quality of life measures. Gait analysis and completion of questionnaires were performed at the start of the treatment (baseline), and after 3, 6, and 12 months. Outcome parameters were evaluated over time using linear mixed effects models, and association between improvement in quality of life measures and change in objective outcomes was tested using mixed effect linear regression models. Quality of life measures improved compared to baseline, accompanied by increased gait speed and cadence. Sagittal-plane hip joint kinetics, kinematics, and spatiotemporal parameters changed throughout the study compared to baseline, in a manner suggesting improvement of gait. The most substantial improvement occurred within 3 months after treatment initiation, after which improvement approximately plateaued, but was sustained at 12 months. Speed and cadence, as well as several sagittal-plane gait parameters, were significant predictors of improvement in quality of life. Evidence suggests that a biomechanical gait therapy program improves subjective and objective outcomes measures and is a valid treatment option for hip osteoarthritis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2222-2232, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  16. Green Schoolyards in Low-Income Urban Neighborhoods: Natural Spaces for Positive Youth Development Outcomes

    Directory of Open Access Journals (Sweden)

    Carolyn R. Bates

    2018-05-01

    Full Text Available Children from low-income families are increasingly growing up in urban areas with limited access to nature. In these environments, strategies that promote access to natural outdoor spaces, such as green schoolyards, may enhance positive youth development outcomes by promoting physical activity (PA and prosocial behavior, as well as increasing perceptions of safety. The current study examines children’s PA and social interactions, as well as caregiver and teacher perceptions of safety, injuries, teasing/bullying, and gang activity on three newly renovated green schoolyards in low-income urban neighborhoods. A multi-method strategy, including behavioral mapping and caregiver- and teacher-reported surveys, was utilized at three time points to examine positive youth development outcomes and maintenance of effects over time. Analyses revealed that children evidenced a range of PA on the green schoolyards and demonstrated significant decreases in sedentary activity over time. The majority of children were engaged in social interactions with peers on the green schoolyards when observed. Less than 3% of interactions were negative and follow-up analyses found significant increases in positive interactions on the green schoolyards up to 24 months post-renovation. Caregivers and teachers reported increased perceptions of safety, fewer injuries, less teasing/bullying, and less gang-related activity on the renovated green schoolyards in comparison to the pre-renovation schoolyards, and these effects were maintained up to 32 months post-renovation. Overall, the study suggests that green schoolyards may promote positive development outcomes among youth living in urban, low-income neighborhoods by providing natural and safe spaces for PA and prosocial behavior.

  17. Frequency of head-impact-related outcomes by position in NCAA division I collegiate football players.

    Science.gov (United States)

    Baugh, Christine M; Kiernan, Patrick T; Kroshus, Emily; Daneshvar, Daniel H; Montenigro, Philip H; McKee, Ann C; Stern, Robert A

    2015-03-01

    Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurological impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 National Collegiate Athletic Association Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and "dings" (pfootball season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full-contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent, but low-magnitude, head impacts, develop more postimpact symptoms than other playing positions, but do not report these symptoms as a concussion.

  18. Frequency of Head-Impact–Related Outcomes by Position in NCAA Division I Collegiate Football Players

    Science.gov (United States)

    Kiernan, Patrick T.; Kroshus, Emily; Daneshvar, Daniel H.; Montenigro, Philip H.; McKee, Ann C.; Stern, Robert A.

    2015-01-01

    Abstract Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurological impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 National Collegiate Athletic Association Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and “dings” (pfootball season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full-contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent, but low-magnitude, head impacts, develop more postimpact symptoms than other playing positions, but do not report these symptoms as a concussion. PMID:25155288

  19. IMPACT OF MEDICAL AND SOCIAL FACTORS ON SURGICAL OUTCOMES OF PULMONARY TUBERCULOSIS IN HIV POSITIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    D. V. Аlkаz

    2018-01-01

    Full Text Available The article presents the study of the impact of social and medical factors and bad habits on the outcomes of planned surgery in 95 patients with concurrent respiratory tuberculosis and HIV infection The correlation analysis was performed which discovered the factors providing a positive impact on treatment outcomes The following factors have the strongest association with treatment outcome: patient's regular job, family, no alcohol or nicotine addiction, a form of tuberculosis, and administration of antiretroviral therapy It was noted that surgery outcome could be predicted and potential complications prevented 

  20. Expressions of positive emotion in women's college yearbook pictures and their relationship to personality and life outcomes across adulthood.

    Science.gov (United States)

    Harker, L; Keltner, D

    2001-01-01

    To test hypotheses about positive emotion, the authors examined the relationship of positive emotional expression in women's college pictures to personality, observer ratings, and life outcomes. Consistent with the notion that positive emotions help build personal resources, positive emotional expression correlated with the self-reported personality traits of affiliation, competence, and low negative emotionality across adulthood and predicted changes in competence and negative emotionality. Observers rated women displaying more positive emotion more favorably on several personality dimensions and expected interactions with them to be more rewarding; thus, demonstrating the beneficial social consequences of positive emotions. Finally, positive emotional expression predicted favorable outcomes in marriage and personal well-being up to 30 years later. Controlling for physical attractiveness and social desirability had little impact on these findings.

  1. Positive Feedback From Male Authority Figures Boosts Women's Math Outcomes.

    Science.gov (United States)

    Park, Lora E; Kondrak, Cheryl L; Ward, Deborah E; Streamer, Lindsey

    2018-03-01

    People often search for cues in the environment to determine whether or not they will be judged or treated negatively based on their social identities. Accordingly, feedback from gatekeepers-members of majority groups who hold authority and power in a field-may be an especially important cue for those at risk of experiencing social identity threat, such as women in math settings. Across a series of studies, women who received positive ("Good job!") versus objective (score only) feedback from a male (vs. female) authority figure in math reported greater confidence; belonging; self-efficacy; more favorable Science, Technology, Engineering, and Mathematics (STEM) attitudes/identification/interest; and greater implicit identification with math. Men were affected only by the type of math feedback they received, not by the source of feedback. A meta-analysis across studies confirmed results. Together, these findings suggest that positive feedback from gatekeepers is an important situational cue that can improve the outcomes of negatively stereotyped groups.

  2. Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers.

    Science.gov (United States)

    Ogińska-Bulik, Nina

    2015-01-01

    The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event in their worksite were analyzed. The range of age of the participants was 21-57 years (M=35.27; SD=8.13). Polish versions of the Impact of Event Scale--Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive outcomes of the experienced event. A perceived social support scale was measured by the scale What support you can count on. The data obtained from the study revealed the negative dependence of social support from supervisors with PTSD symptoms and positive--social support from co-workers with post-traumatic growth. Moreover the results of the study indicate the positive relationship between negative and positive outcomes of experienced traumatic events in the workplace. Perceived social support plays a more important role in gaining benefits from trauma than preventing negative outcomes of the experienced traumatic event. Support from co-workers, compared to support from supervisors, has greater importance.

  3. Finding benefits from acculturative stress among Asian Americans: Self-reflection moderating the mediating effects of ethnocultural empathy on positive outcomes.

    Science.gov (United States)

    Wei, Meifen; Li, Chun-I; Wang, Cixin; Ko, Stacy Y

    2016-11-01

    This study examined a moderated mediation model to see whether self-reflection moderated (a) the association between acculturative stress and ethnocultural empathy and (b) the indirect effects of acculturative stress on 2 positive outcomes (i.e., bicultural competence and making positive sense of adversity) through ethnocultural empathy. A total of 330 Asian American college students from a West coast university participated in an online survey. Results from PROCESS supported hypotheses. First, self-reflection significantly moderated the effects of acculturative stress on ethnocultural empathy. Specifically, the effect of acculturative stress on ethnocultural empathy was significantly positive for those with lower self-reflection. Conversely, this effect was not significant for those with higher self-reflection, but ethnocultural empathy was consistently high across all levels of acculturative stress for those with higher self-reflection. Post hoc exploratory analyses examined the moderated mediation model using each of the 5 domains of acculturative stress as predictors; results supported the moderated mediation hypotheses for 2 domains, discrimination and cultural isolation. Second, self-reflection significantly moderated the indirect effects of acculturative stress on 2 positive outcomes through ethnocultural empathy. Results from conditional indirect effects suggested that the indirect effects of acculturative stress on 2 positive outcomes through ethnocultural empathy were significantly positive for those with lower self-reflection. Conversely, the indirect effects were not significant for those with higher self-reflection, but the 2 positive outcomes stayed high at all levels of acculturative stress. Post hoc analyses found that 5 of 6 components of bicultural competence used as outcome variables supported the moderation mediation hypotheses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Position of the American Dietetic Association and American Society for Nutrition: obesity, reproduction, and pregnancy outcomes.

    Science.gov (United States)

    Siega-Riz, Anna Maria; King, Janet C

    2009-05-01

    Given the detrimental influence of maternal overweight and obesity on reproductive and pregnancy outcomes for the mother and child, it is the position of the American Dietetic Association and the American Society for Nutrition that all overweight and obese women of reproductive age should receive counseling on the roles of diet and physical activity in reproductive health prior to pregnancy,during pregnancy, and in the inter conceptional period, in order to ameliorate these adverse outcomes. The effect of maternal nutritional status prior to pregnancy on reproduction and pregnancy outcomes is of great public health importance. Obesity in the United States and worldwide has grown to epidemic proportions, with an estimated 33% of US women classified as obese. This position paper has two objectives: (a) to help nutrition professionals become aware of the risks and possible complications of overweight and obesity for fertility,the course of pregnancy, birth outcomes, and short- and long-term maternal and child health outcomes;and (b) related to the commitment to research by the American Dietetic Association and the American Society for Nutrition, to identify the gaps in research to improve our knowledge of the risks and complications associated with being overweight and obese before and during pregnancy.Only with an increased knowledge of these risks and complications can health care professionals develop effective strategies that can be implemented before and during pregnancy as well as during the inter conceptional period to ameliorate adverse outcomes.

  5. Perioperative Desensitization Improves Outcomes Among Crossmatch Positive Recipients of Deceased Donor Renal Transplants.

    Science.gov (United States)

    Sharma, Amit; King, Anne; Kumar, Dhiren; Behnke, Martha; McDougan, Felecia; Kimball, Pamela M

    2016-06-01

    Graft failure due to chronic rejection is greater among renal transplant patients with donor-specific antibody (DSA) than among DSA-free patients. For patients dependent on deceased donor transplantation, preoperative desensitization to eliminate DSAs may be impractical. We speculated that perioperative desensitization might eliminate preexisting DSAs and prevent de novo DSAs and improve graft outcomes. We report that brief perioperative desensitization using either intravenous immunoglobulin (IVIG) or plasmapheresis/IVIG (PP/IVIG) treatment improves clinical outcomes among patients with positive crossmatches. Immediately following deceased donor transplantation, 235 renal recipients were assigned points for PRA and flow crossmatches (FCXM): delayed graft function (DGF) ≤ 1 point received standard therapy; 2 points received high-dose IVIG; and ≥3 points received PP/IVIG. The DSAs were serially monitored by single antigen bead luminex for 1 year. Five-year clinical outcomes were determined from the chart review. All desensitized patients had preoperatively positive FCXM with DSA. Rejection was more common (P desensitized than nonsensitized groups. However, overall graft survivals were similar between the groups (P = not significant) and superior to historic untreated patients (P 90% in all desensitizated patients with DSA elimination as well as PP/IVIG patients with residual DSA. In contrast, IVIG patients with persistent DSA had poorer graft survival (45%, P desensitization improved overall graft survival of sensitized patients compared to historic untreated patients. Plasmapheresis/IVIG had greater impact on DSA eradication and graft survival than IVIG alone. © 2016, NATCO.

  6. The role of positive/negative outcome expectancy and refusal self-efficacy of Internet use on Internet addiction among college students in Taiwan.

    Science.gov (United States)

    Lin, Min-Pei; Ko, Huei-Chen; Wu, Jo Yung-Wei

    2008-08-01

    Based on Bandura's social cognitive theory, this study was designed to examine positive and negative outcome expectancy and refusal self-efficacy of Internet use and their contribution to Internet addiction among college students by using hierarchical multiple regression analyses in a cross-sectional study design. Schools were first stratified into technical or nontechnical colleges and then into seven majors. A cluster random sampling by department was further applied to randomly choose participants from each major. A representative sample of 4,456 college students participated in this study. The Outcome Expectancy and Refusal Self-Efficacy of Internet Use Questionnaire and the Chen Internet Addiction Scale were used to assess the cognitive factors and the levels of Internet addiction. Results showed that both positive outcome expectancy and negative outcome expectancy were significantly and positively correlated with Internet addiction, and refusal self-efficacy of Internet use was significantly and negatively related to Internet addiction. Further analyses revealed that refusal self-efficacy of Internet use directly and negatively predicted Internet addiction. Moreover, we discovered that positive outcome expectancy positively predicted Internet addiction via refusal self-efficacy of Internet use; however, surprisingly, negative outcome expectancy had both a direct and indirect positive relationship in predicting Internet addiction via the refusal self-efficacy of Internet use. These results give empirical evidence to verify the theoretical effectiveness of the three cognitive factors to Internet addiction and should be incorporated when designing prevention programs and strategies for Internet addicted college students.

  7. Tape functionality: position, change in shape, and outcome after TVT procedure--mid-term results.

    Science.gov (United States)

    Kociszewski, Jacek; Rautenberg, Oliver; Kolben, Sebastian; Eberhard, Jakob; Hilgers, Reinhard; Viereck, Volker

    2010-07-01

    This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape-urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape-urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.

  8. Patient reported outcomes in pediatric oncology practice: suggestions for future usage by parents and pediatric oncologists

    NARCIS (Netherlands)

    Schepers, S. A.; Engelen, V. E.; Haverman, L.; Caron, H. N.; Hoogerbrugge, P. M.; Kaspers, G. J. L.; Egeler, R. M.; Grootenhuis, M. A.

    2014-01-01

    Several studies in adults have shown patient reported outcomes (PROs) to be effective in enhancing patient-physician communication and discussion of Health Related Quality of Life outcomes. Although less studied, positive results have been demonstrated in children. A PRO-intervention needs to be

  9. Tibial Sesamoid Position Influence on Functional Outcome and Satisfaction After Hallux Valgus Surgery.

    Science.gov (United States)

    Chen, Jerry Yongqiang; Rikhraj, Kiran; Gatot, Cheryl; Lee, Justine Yun Yu; Singh Rikhraj, Inderjeet

    2016-11-01

    During hallux valgus surgery, the abnormal position of the first metatarsal bone relative to the sesamoids is addressed. Our study aimed to investigate the influence of postoperative tibial sesamoid position (TSP) on functional outcome and patient satisfaction after hallux valgus surgery. Between February 2007 and November 2011, 250 patients who underwent hallux valgus surgery at our tertiary hospital were followed for 2 years after surgery. They were categorized into 2 groups based on Hardy and Clapham's TSP classification, recorded on postoperative weight-bearing anteroposterior (AP) radiographs: (1) normal (grades I-IV) and (2) outliers (grades V-VII). The mode TSP improved from grade VII preoperatively to grade IV postoperatively (P Hallux Metatarsophalangeal-Interphalangeal Scale was 6 (95% CI 2, 11) points higher in the normal group (P = .009). Patients in the outlier group were also more likely to be dissatisfied with the surgery performed when compared to the normal group (OR 3.881, 95% CI 1.689, 8.920, P = .001). We recommend correcting the TSP to grade of IV or less to improve functional outcome and satisfaction after hallux valgus surgery. Level III, retrospective comparative series. © The Author(s) 2016.

  10. Workaholism, work engagement and work-home outcomes: exploring the mediating role of positive and negative emotions.

    Science.gov (United States)

    Clark, Malissa A; Michel, Jesse S; Stevens, Gregory W; Howell, Julia W; Scruggs, Ross S

    2014-10-01

    This study examines the mechanisms through which workaholism and work engagement impact work-home conflict and enrichment, respectively. Specifically, we examine the mediating role of positive and negative emotions (e.g. joviality and guilt) in the relationship between workaholism, work engagement and work-home outcomes. Results, based on a sample of 340 working adults participating in a two-wave study, indicate that negative emotions-particularly anxiety, anger and disappointment-mediate the relationship between workaholism and work-home conflict and positive emotions-particularly joviality and self-assurance-mediate the relationship between work engagement and work-home enrichment. These results provide further evidence that workaholism and work engagement are related to distinct sets of emotional variables and disparate work and home outcomes. Copyright © 2013 John Wiley & Sons, Ltd.

  11. It gets better: resolution of internalized homophobia over time and associations with positive health outcomes among MSM.

    Science.gov (United States)

    Herrick, Amy L; Stall, Ron; Chmiel, Joan S; Guadamuz, Thomas E; Penniman, Typhanye; Shoptaw, Steven; Ostrow, David; Plankey, Michael W

    2013-05-01

    Health disparities research among gay and bisexual men has focused primarily on risk and deficits. However, a focus on resiliencies within this population may greatly benefit health promotion. We describe a pattern of resilience (internalized homophobia (IHP) resolution) over the life-course and its associations with current health outcomes. 1,541 gay and bisexual men from the Multi-Center AIDS Cohort study, an ongoing prospective study of the natural and treated histories of HIV, completed a survey about life-course events thought to be related to health. The majority of men resolved IHP over time independent of demographics. Men who resolved IHP had significantly higher odds of positive health outcomes compared to those who did not. These results provide evidence of resilience among participants that is associated with positive health outcomes. Understanding resiliencies and incorporating them into interventions may help to promote health and well-being among gay and bisexual men.

  12. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review

    NARCIS (Netherlands)

    Stansfeld, J.; Stoner, C.R.; Wenborn, J.; Vernooij-Dassen, M.J.F.J.; Moniz-Cook, E.; Orrell, M.

    2017-01-01

    BACKGROUND: Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and

  13. Risk associated with traumatic intracranial bleed and outcome in patients following a fall from a standing position.

    Science.gov (United States)

    Ahmed, N; Soroush, A; Kuo, Y-H; Davis, J M

    2015-06-01

    A fall from a standing position (FFS) is a low impact injury; however, in certain patient populations it can result in serious, complex injuries associated with significant morbidity and mortality. The purpose of the study was to identify the patient population, risk factors and outcomes of intracranial bleed (ICB) after a fall from a standing position. Data of all patients from the trauma database at State designated Trauma Center were analyzed who FFS. Patient's demography, clinical information was obtained. An ICB seen on computed tomography (CT) scan was considered positive. From January 2001 through December 2008, 163 patients admitted to the trauma center after FFS. Ninety-one out of 163 patients (56 %) had positive CT scan. There was no significant difference between the groups with a positive or negative CT regarding age (P = 0.07), gender (P = 0.58), race (P = 0.15), Glasgow Coma Scale (P = 0.27), aspirin use (P = 0.06), Plavix (P = 0.92), combination of aspirin and Plavix (P = 0.86) or use of Coumadin (P = 0.82). Patients with ICB had significantly higher injury severity score (ISS) than patients without ICB (P patient characteristic on the outcome of the disease, level III.

  14. ALK Positive Lung Cancer: Clinical Profile, Practice and Outcomes in a Developing Country.

    Directory of Open Access Journals (Sweden)

    Vanita Noronha

    Full Text Available To evaluate the performance and treatment profile of advanced EML4-ALK positive Non-small cell lung cancer (NSCLC patients in a developing country with potentially restricted access to Crizotinib.A retrospective analysis of advanced ALK positive NSCLC patients who were treated from June 2012 to September 2015 was conducted. The primary goal was to evaluate outcomes of advanced ALK positive NSCLC in our practice and examine the logistic constraints in procuring Crizotinib.94 patients were available for analysis. 21 (22.3% patients were started on Crizotinib upfront, 60 (63.8% on chemotherapy, 10 (10.6% on Tyrosine kinase inhibitors (in view of poor PS and 3 (3.2% patients were offered best supportive care. Reasons for not starting Crizotinib upfront included symptomatic patients needing early initiation of therapy (23.3%, ALK not tested upfront (23.3% and financial constraints (21.9%. 69 patients (73.4% received Crizotinib at some stage during treatment. Dose interruptions (> 1 week with Crizotinib were seen in 20 patients (29%, with drug toxicity being the commonest reason (85%. Median Progression free survival (PFS on first line therapy for the entire cohort was 10 months, with a significant difference between patients receiving Crizotinib and those who did not ever receive Crizotinib (10 months vs. 2 months, p = 0.028. Median Overall Survival (OS was not reached for the entire cohort, with 1 year survival being 81.2%. Patients with an ECOG Performance Status (PS of >2 had a significantly reduced PFS compared to patients with PS < = 2 (1.5 months vs. 11 months, p< 0.001. 47 patients with financial constraints (68.1% received Crizotinib completely free via various extramural support schemes.A majority of our ALK positive NSCLC patients were exposed to Crizotinib through the help of various support mechanisms and these patients had similar outcomes to that reported from previously published literature.

  15. Predictors and health-related outcomes of positive body image in adolescent girls: A prospective study.

    Science.gov (United States)

    Andrew, Rachel; Tiggemann, Marika; Clark, Levina

    2016-03-01

    This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential predictors, and a range of health outcomes, at 2 time points separated by 1 year. Longitudinal change regression models showed that perceived body acceptance by others (positively), self-objectification and social comparison (negatively), and body appreciation (positively) prospectively predicted intuitive eating 1 year later, consistent with the acceptance model of intuitive eating. Perceived body acceptance by others was the only proposed predictor to prospectively predict an increase in body appreciation over time. Time 1 body appreciation prospectively predicted a decrease in dieting, alcohol, and cigarette use, and an increase in physical activity 1 year later. In particular, girls with low body appreciation were more likely than girls with high body appreciation to take up alcohol and cigarette use between time points. The results highlight body appreciation as an important target for interventions designed to prevent or delay the uptake of alcohol and cigarette consumption among girls. More broadly, they suggest that a positive body image can confer considerable benefit for adolescent girls. (c) 2016 APA, all rights reserved).

  16. Self-regulation as a mediator between sibling relationship quality and early adolescents' positive and negative outcomes.

    Science.gov (United States)

    Padilla-Walker, Laura M; Harper, James M; Jensen, Alexander C

    2010-08-01

    The current study examined the role of adolescents' self-regulation as a mediator between sibling relationship quality and adolescent outcomes, after controlling for the quality of the parent-child relationship. Participants were 395 families (282 two parent; 113 single parent) with an adolescent child (M age of child at Time 1 = 11.15, SD = .96, 49% female) who took part in [project name masked for blind review] at both Time 1 and Time 2. Path analysis via structural equation modeling suggested that sibling affection was longitudinally and positively related to self-regulation and prosocial behaviors, and negatively related to externalizing behaviors; while sibling hostility was positively, and having a sister was negatively related to internalizing behaviors (in general, paths were stronger for adolescents from two- vs. single-parent families). There was also evidence that adolescents' self-regulation partially mediated the relation between sibling affection and positive and negative adolescent outcomes. The discussion focuses on the importance of continued research examining the mechanisms through which the sibling relationship influences development during adolescence.

  17. A study of the variation of colonic positioning in the pararenal space as shown by computed tomography

    International Nuclear Information System (INIS)

    Prassopoulos, P.; Gourtsoyiannis, N.; Cavouras, D.; Pantelidis, N.

    1990-01-01

    In a review of 1708 consecutive CT examinations of the abdomen the position of the ascending and descending colon in relation to the posterial and lateral edge of the kidney was studied. It was found that part of the colon was positioned posterior or posterolateral to the kidney's edge in percentages that varied between 14.2% and 0.9% in the different sex groups at the levels of upper, mid- and lower poles of the right and left kidney. It is concluded that this anatomical variation should be known if colon perforation is to be avoided during percutaneous nephrostomy of biopsy. (author). 15 refs.; 4 figs.; 2 tabs

  18. Event-related potential studies of outcome processing and feedback-guided learning

    Directory of Open Access Journals (Sweden)

    René eSan Martín

    2012-11-01

    Full Text Available In order to control behavior in an adaptive manner the brain has to learn how some situations and actions predict positive or negative outcomes. During the last decade cognitive neuroscientists have shown that the brain is able to evaluate and learn from outcomes within a few hundred milliseconds of their occurrence. This research has been primarily focused on the feedback-related negativity (FRN and the P3, two event-related potential (ERP components that are elicited by outcomes. The FRN is a frontally distributed negative-polarity ERP component that typically reaches its maximal amplitude 250 ms after outcome presentation and tends to be larger for negative than for positive outcomes. The FRN has been associated with activity in the anterior cingulate cortex. The P3 (~300-600 ms is a parietally distributed positive-polarity ERP component that tends to be larger for large magnitude than for small magnitude outcomes. The neural sources of the P3 are probably distributed over different regions of the cortex. This paper examines the theories that have been proposed to explain the functional role of these two ERP components during outcome processing. Special attention is paid to extant literature addressing how these ERP components are modulated by outcome valence (negative vs. positive, outcome magnitude (large vs. small, outcome probability (unlikely vs. likely and behavioral adjustment. The literature offers few generalizable conclusions, but is beset with a number of inconsistencies across studies. This paper discusses the potential reasons for these inconsistencies and points out some challenges that will shape the field over the next decade.

  19. Predictors and Health-Related Outcomes of Positive Body Image in Adolescent Girls: A Prospective Study

    Science.gov (United States)

    Andrew, Rachel; Tiggemann, Marika; Clark, Levina

    2016-01-01

    This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential…

  20. Treatment Adherence and Outcomes of Antiretroviral Agents in HIV Positive Patients

    International Nuclear Information System (INIS)

    Tahir, N. B.; Uddin, Q. T.

    2014-01-01

    Objective: To describe the treatment outcomes in terms of adherence, outcomes and side effects of antiretroviral (ARV) agents. Study Design: An observational study. Place and Duration of Study: Teaching Hospital of Khyber Medical University, Institute of Medical Sciences, Kohat, from February 2007 to December 2012. Methodology: Human Immunodeficiency Virus (HIV) positive patients, taking 1st line ARV agents for at least 6 months were included. Adherence was calculated by self report on asking the number of doses missed in last 30 days. ARVs were provided on monthly basis. Adherence data was noted over a period of 6 months. ARVs outcomes were recorded in the form of adherence, CD4 count, functional status of the patient, change in weight, further transmission of the disease, number of hospital admissions and deaths. Adverse Drug Reactions (ARDs) to ARVs were assessed clinically and by laboratory markers. Mean and standard deviation were calculated for numerical variables while frequencies and percentages were calculated for categorical variables. Results: Total number of patients included in this study were 107. Out of them, 66.4% were males and 33.6% were females. The mean age was 39.9 +- 13.80 years. Patients taking AZT/3TC/NVP, AZT/3TC/EFZ, D4T/3TC/NVP, D4T/3TC/EFZ, TNF/3TC/NVP or EFZ were 49.5%, 22.4%, 10.3%, 4.7% and 13% respectively. Most adverse affects were observed in 10 days to 90 days of initiation of therapy. Rash was observed in 71 (66.4%) patients, anaemia in 4 (3.7%) patients while only one patient (0.93%) had nausea / vomiting. Thirty (28%) patients reported no side effects. Out of 107 patients, 98 (91.5%) were alive whereas 9 (8.4%) died at the end of the study period. Twelve patients had one hospital admission (11.21%) whereas 9 (8.4%) patients had two admissions during the study period. The first mean CD4 was 325.27 cells /mcL whereas mean last CD4 count was 389.86 cells/mcL. Conclusion: ARVs have very satisfactory outcomes in HIV/AIDS patients

  1. Leisure Activity Engagement and Positive Affect Partially Mediate the Relationship Between Positive Views on Aging and Physical Health.

    Science.gov (United States)

    Hicks, Stephanie A; Siedlecki, Karen L

    2017-03-01

    To examine leisure activity engagement and positive affect as potential mediators for the relationships between positive views on aging (PVA) and two health outcomes: subjective health and physical limitations. Data from 5,194 participants from the German Ageing Survey (aged 40-91 years) were used to examine relationships between PVA to subjective health (assessed by self-rated health and perceived health change from past) and physical limitations (assessed via self-reported limitations on 10 activities). Leisure activity engagement and positive affect were examined as potential mediators in latent variable path analyses. Age moderation among these relationships was also examined. Leisure activity engagement and positive affect separately and jointly served to partially mediate the relationships between PVA and the health outcomes. When entered as joint mediators, positive affect no longer significantly predicted physical limitations, indicating a shared variance with leisure activity engagement. Age moderated the relationship between PVA and physical limitations; the relationship was stronger among older adults than among middle-aged adults. Leisure activity engagement and positive affect were shown to help explain the relationship between PVA and health, but differently for different health constructs and also among middle-aged and older adults. Findings provide further insight into ways in which PVA influence health. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Percutaneous left atrial appendage occlusion: Effect of device positioning on outcome.

    Science.gov (United States)

    Wolfrum, Mathias; Attinger-Toller, Adrian; Shakir, Samera; Gloekler, Steffen; Seifert, Burkhardt; Moschovitis, Aris; Khattab, Ahmed; Maisano, Francesco; Meier, Bernhard; Nietlispach, Fabian

    2016-10-01

    The study in patients with percutaneous left atrial appendage (LAA) occlusion investigates clinical outcomes according to the position of the Amplatzer Cardiac Plug (ACP) disc. The ACP consists of a disc and an anchoring lobe. The disc is meant to cover the ostium of the LAA, but frequently retracts partially or completely into the neck of the LAA. It is not known whether a retracted disc affects outcome. Outcomes of 169 consecutive patients (age 73.1 ± 10.4 years; 76% male) with successful LAA closure were analyzed according to the position of the ACP disc: group A had complete coverage of the LAA ostium; in group B the disc prolapsed partially or completely into the LAA-neck. Transesophageal echocardiography was performed 1-6 months after ACP implantation. The safety endpoint was the composite of clinically significant pericardial effusion, device embolization, procedure-related stroke/transient ischemic attack (TIA), major bleeding, or device thrombus. The efficacy endpoint was the composite of death, neurological events (ischemic and hemorrhagic stroke, TIA), or systemic embolism during follow-up. Group A comprised 76 patients (age 73.0 ± 9.9 years; 74% male) and group B 93 patients (age 73.3 ± 10.9 years; 79% male). Mean CHA 2 DS 2 -Vasc score and HASBLED score were 4.2 ± 1.7 (group A 4.3 ± 1.6; group B 4.2 ± 1.8) and 2.9 ± 1.1 (group A 2.9 ± 1.0; group B 3.0 ± 1.2), respectively. Mean follow-up of the study population was 13.0 ± 10.4 months. Overall, the composite safety and efficacy endpoints occurred in 20 (12%) and 6 patients (4%), respectively. There was no significant difference between groups A and B in the occurrence of the safety endpoint (13% vs. 11%, P = 0.64), or the efficacy endpoint (4% vs. 3%, P = 1.0). No evidence for a difference in the occurrence of the safety and efficacy endpoint was found between patients with complete vs. incomplete ACP disc coverage of the LAA ostium. The risk of

  3. A Ten-Year Review of Antenatal Complications and Pregnancy Outcomes Among HIV-Positive Pregnant Women.

    Science.gov (United States)

    Yudin, Mark H; Caprara, Daniela; MacGillivray, S Jay; Urquia, Marcelo; Shah, Rajiv R

    2016-01-01

    To review the incidence of antenatal complications among a cohort of HIV-positive pregnant women over a 10-year period. A retrospective review was performed of all HIV-positive pregnant women receiving multidisciplinary prenatal care at an urban tertiary care centre from March 2000 to March 2010. Collected data included the presence of additional infectious or medical conditions, genetic screening information, and the presence or absence of antenatal complications. One hundred and forty-two singleton pregnancies during the study period were identified. Almost 95% of women were taking combination antiretroviral therapy during pregnancy, and greater than 90% had viral loads less than 1000 copies/ml at delivery. The presence of co-infections was low. Forty-one women (29%) had other medical comorbidities. Genetic screening occurred in 104 pregnancies (73%); 4% were abnormal screens. Rates of any hypertension, gestational diabetes, and fetal growth restriction were all low. Thirty-two percent of women were colonized with group B streptococcus. This study adds strength to the argument that good outcomes can be achieved for HIV-positive pregnant women with good access to both prenatal and HIV care, and appropriate management. Women with HIV should be optimally cared for in advance of and during pregnancy in order to maximize the likelihood of good pregnancy outcomes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  4. Testing links between childhood positive peer relations and externalizing outcomes through a randomized controlled intervention study

    NARCIS (Netherlands)

    Witvliet, M.; van Lier, P.A.C.; Cuijpers, P.; Koot, H.M.

    2009-01-01

    In this study, the authors used a randomized controlled trial to explore the link between having positive peer relations and externalizing outcomes in 758 children followed from kindergarten to the end of 2nd grade. Children were randomly assigned to the Good Behavior Game (GBG), a universal

  5. Excursions out-of-lane versus standard deviation of lateral position as outcome measure of the on-the-road driving test

    NARCIS (Netherlands)

    Verster, Joris C; Roth, Thomas

    BACKGROUND: The traditional outcome measure of the Dutch on-the-road driving test is the standard deviation of lateral position (SDLP), the weaving of the car. This paper explores whether excursions out-of-lane are a suitable additional outcome measure to index driving impairment. METHODS: A

  6. [Congenital lens subluxation: visual acuity outcomes and intraocular lens postoperative position].

    Science.gov (United States)

    Arraes, Caroline; Endriss, Daniela; Lobato, Francisco; Arraes, João; Ventura, Marcelo

    2010-01-01

    To evaluate the visual acuity outcomes and to investigate the intraocular lens (IOL) and endocapsular ring positions with ultrasound biomicroscopy in 17 eyes of 10 patients with congenital lens subluxation who underwent the same surgical technique, by the same surgeon. The study was performed in the ''Hospital de Olhos de Pernambuco'' and ''Fundação Altino Ventura''. The surgical technique consisted of phacoaspiration with implant of endocapsular ring and intraocular lens with one loop haptic amputated. The age varied from 7 to 22 years. Data on visual acuity (VA) before and after surgery, surgery follow-up period, and complications were analyzed. All patients underwent ultrasound biomicroscopy. The mean follow-up period was 2.8 years. There was a VA improvement in 17 (100%) eyes: in 12 eyes (70.6%) the visual acuity was better than 20/40; 4 (23.5%) ranged from 20/40 to 20/100, and 1 (5.9%) had visual acuity worse than 20/100, however better than the preoperative visual acuity. The posterior capsular opacification occurred in 10 eyes (58.9%). Ultrasound biomicroscopy showed that all IOL were partially decentralized, however without surpassing the pupil border limit. Endocapsular ring position was correct and there was a good capsular support in all cases. The evaluated surgical treatment provided good intraocular lens and endocapsular ring position, with VA improvement Thus, this technique is a viable, effective and safe option for the visual rehabilitation of patients with congenital lens subluxation.

  7. Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya.

    Science.gov (United States)

    Obare, Francis; van der Kwaak, Anke; Birungi, Harriet

    2012-10-06

    Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15-19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8-2.0) while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1-0.2). Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6-4.0). In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1-0.9). However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5-3.3). There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5-1.5). The experience of repeat unintended pregnancies among HIV-positive female adolescents in the sample is partly due to inconsistent use of contraception to prevent

  8. Change for the better: an innovative model of care delivering positive patient and workforce outcomes.

    Science.gov (United States)

    Cann, Tina; Gardner, Anne

    2012-01-01

    To evaluate patient and workforce outcomes following the implementation of the Practice Partnership Model of Care. Pre-test-post-test design. A 29-bed surgical ward at a tertiary-level regional hospital. Summary de-identified data from all patients and ward nursing staff in the study period. The Practice Partnership Model of Care has four main components: working in partnership; clinical handover at the bedside; comfort rounds; and environmental modifications. These reflect patient-centered and quality focused initiatives and use a total quality improvement framework that aims to transform care at the bedside. Patient outcomes: changes in patient safety (measured by numbers of medication errors and patient falls); satisfaction with care (use of the call bell system, number of complaints and compliments). Workforce outcomes: changes in staff satisfaction (measured through staff sick leave). A statistically significant reduction in use of nurse call bells (p=<0.001) post-implementation. Medication errors and patient falls reduced, with an overall reduction of 4% in staff sick leave. The Practice Partnership Model of Care positively affected patient and workforce outcomes, suggesting further exploration of this model in other hospital contexts is warranted.

  9. How positioning strategies affect co-branding outcomes

    Directory of Open Access Journals (Sweden)

    Hilary Wason

    2015-12-01

    Full Text Available Co-branding is a widely applied strategy, with research indicating differential benefits to the parent brands. Past studies suggest the source of these differences may be due to the partners’ relative market position, and characteristics such as brand familiarity, brand equity and proximity to the consumer have been explored. However, the role of brand positioning has received little attention in the context of co-branding. The current study attempts to address this gap, considering the positioning of a brand and the impact of a co-branding strategy on customer perceptions. Using the Blankson and Kalafatis positioning typology, we explore the impact of co-branding on the parent brand perceptions from a hedonic vs. functional (utilitarian focus. The results suggest that for hedonically oriented positioning strategies, fit between the brands is more important than fit between the product categories in driving positive brand perceptions. For a functionally oriented positioning strategy, the reverse holds, with product fit a more important factor than brand fit in driving post-alliance perceptions.

  10. Morgellons disease: experiences of an integrated multidisciplinary dermatology team to achieve positive outcomes.

    Science.gov (United States)

    Mohandas, Padma; Bewley, Anthony; Taylor, Ruth

    2018-03-01

    In recent years, there has been a reported increase in affliction of the skin with small fibres or other particles. The condition has been referred to as Morgellons disease. Patients present with stinging, burning or crawling sensations of the skin, with perceived extrusion of inanimate material alongside fatigue and other systemic symptoms. Sufferers often experience significant morbidity and reduction in quality of life. We aimed to explore the various clinical presentations, management strategies and outcomes employed to treat this condition in our patients. We conducted a retrospective case notes review of 35 patients referred to our multidisciplinary psycho-dermatology clinic at the Royal London Hospital between January 2004 and January 2017. The majority of patients were women (25) 71.4%, with a mean age of 54.6 years (26-80 years). Most (26) 74.2% were living alone. The average duration of illness prior to presentation was 3.8 years (4 months-20 years). Many patients had perceived precipitating factors (54.2%) and often self-diagnosed (28.5%). Psychiatric co-morbidities included 42.8% with depressive symptoms and 25.7% with anxiety. Substance misuse was elicited in five patients (14%). Management of patients included both the treatment of skin disease and psychosocial co-morbidities. Out of the 35 patients who attended (14) 40% cleared or showed significant improvement. Sixteen (45.7%) patients were stable and under review. One patient declined treatment and three did not attend review. One patient died from disease unrelated to her skin condition. Morgellons disease is a condition, which is widely discussed on the internet and patients often self-diagnose. The course of the disease can be chronic and debilitating. For a positive outcome, it is important that a strong physican-patient relationship is cultivated. As demonstrated in this case series, managing patients holistically in an integrated multidisciplinary dermatology setting helps achieve

  11. Intuitive Choices Lead to Intensified Positive Emotions: An Overlooked Reason for "Intuition Bias"?

    Science.gov (United States)

    Kirkebøen, Geir; Nordbye, Gro H H

    2017-01-01

    People have, for many well-documented reasons, a tendency to overemphasize their intuitions and to follow them, even when they should not. This "intuition bias" leads to several kinds of specific intuitive biases in judgments and decision making. Previous studies have shown that characteristics of the decision process have a tendency to "leak" into the experience of the choice outcome. We explore whether intuitive choices influence the experience of the choice outcomes differently from "non-intuitive," analytic choices. Since intuition is feeling based, we examine in particular if intuitive choices have stronger affective consequences than non-intuitive ones. Participants in two scenario studies ( N = 90; N = 126) rated the feelings of decision makers who experienced a conflict between two options, one intuitively appealing and another that appeared preferable on analytic grounds. Choosing the intuitive alternative was anticipated to lead to somewhat more regret after negative outcomes and, in particular, much more satisfaction with positive outcomes. In two autobiographical studies, one with psychology students ( N = 88) and the other with experienced engineers ( N = 99), participants were asked to provide examples of choice conflicts between an intuitive and a non-intuitive option from their own private or professional lives. Both groups showed a tendency to report stronger emotions, in particular positive, after intuitive choices. One well-established explanation for intuition bias focuses on the nature of people's anticipated negative counterfactual thoughts if their decisions were to turn out badly. The present data indicate that intuitive choices intensify positive emotions, anticipated and real, after successful outcomes much more than negative emotions after failures. Positive outcomes are also more commonly expected than negative ones, when we make choices. We argue that markedly amplified emotions, mediated by stronger personal involvement, in the

  12. The impact of socioeconomic position on severe maternal morbidity outcomes among women in Australia: a national case-control study.

    Science.gov (United States)

    Lindquist, A; Noor, N; Sullivan, E; Knight, M

    2015-11-01

    Studies in other developed countries have suggested that socioeconomic position may be a risk factor for poorer pregnancy outcomes. This analysis aimed to explore the independent impact of socioeconomic position on selected severe maternal morbidities among women in Australia. A case-control study using data on severe maternal morbidities associated with direct maternal death collected through the Australasian Maternity Outcomes Surveillance System. Australia. 623 cases, 820 controls. Logistic regression analysis to investigate differences in outcomes among different socioeconomic groups, classified by Socio-Economic Indexes for Areas (SEIFA) quintile. Severe maternal morbidity (amniotic fluid embolism, placenta accreta, peripartum hysterectomy, eclampsia or pulmonary embolism). SEIFA quintile was statistically significantly associated with maternal morbidity, with cases being twice as likely as controls to reside in the most disadvantaged areas (adjusted OR 2.00, 95%CI 1.29-3.10). Maternal age [adjusted odds ratio (aOR) 2.20 for women aged 35 or over compared with women aged 25-29, 95%CI 1.64-3.15] and previous pregnancy complications (aOR 1.30, 95%CI 1.21-1.87) were significantly associated with morbidity. A parity of 1 or 2 was protective (aOR 0.58, 95%CI 0.43-0.79), whereas previous caesarean delivery was associated with maternal morbidity (aOR 2.20 for women with one caesarean delivery, 95%CI 1.44-2.85, compared with women with no caesareans). The risk of severe maternal morbidity among women in Australia is significantly increased by social disadvantage. This study suggests that future efforts in improving maternity care provision and maternal outcomes in Australia should include socioeconomic position as an independent risk factor for adverse outcome. © 2014 Royal College of Obstetricians and Gynaecologists.

  13. Effectiveness of an SMS-based maternal mHealth intervention to improve clinical outcomes of HIV-positive pregnant women.

    Science.gov (United States)

    Coleman, Jesse; Bohlin, Kate C; Thorson, Anna; Black, Vivian; Mechael, Patricia; Mangxaba, Josie; Eriksen, Jaran

    2017-07-01

    We conducted a retrospective study to investigate the effectiveness of an mHealth messaging intervention aiming to improve maternal health and HIV outcomes. Maternal health SMSs were sent to 235 HIV-infected pregnant women twice per week in pregnancy and continued until the infant's first birthday. The messages were timed to the stage of the pregnancy/infant age and covered maternal health and HIV-support information. Outcomes, measured as antenatal care (ANC) visits, birth outcomes and infant HIV testing, were compared to a control group of 586 HIV-infected pregnant women who received no SMS intervention. Results showed that intervention participants attended more ANC visits (5.16 vs. 3.95, p mHealth interventions can have a positive impact on health outcomes and should be scaled nationally following comprehensive evaluation.

  14. Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

    Science.gov (United States)

    Ivanovic, Jelena; Anstee, Caitlin; Ramsay, Tim; Gilbert, Sebastien; Maziak, Donna E; Shamji, Farid M; Sundaresan, R Sudhir; Villeneuve, P James; Seely, Andrew J E

    2015-10-01

    Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon's clinical performance. Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. Copyright © 2015 The Society of Thoracic

  15. Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings.

    Science.gov (United States)

    Behboodi, Firooz; Mohtasham-Amiri, Zahra; Masjedi, Navid; Shojaie, Reza; Sadri, Peyman

    2016-01-01

    Focused assessment with sonography for trauma (FAST) is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT) scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male). FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9%) cases. Finally, 12 (6.6%) patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006). Higher grading of spleen (p = 0.001) and hepatic (p = 0.038) ruptures increased the probability of need for laparotomy. 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy.

  16. Spontaneous Pushing in Lateral Position versus Valsalva Maneuver During Second Stage of Labor on Maternal and Fetal Outcomes: A Randomized Clinical Trial.

    Science.gov (United States)

    Vaziri, Farideh; Arzhe, Amene; Asadi, Nasrin; Pourahmad, Saeedeh; Moshfeghy, Zeinab

    2016-10-01

    There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor. Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the second stage of labor on maternal and fetal outcomes. Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparous mothers, live fetus with vertex presentation, gestational age of 37 - 40 weeks, spontaneous labor, and no complications. The intervention group pushed spontaneously while they were in the lateral position, whereas the control group pushed using Valsalva method while in the supine position at the onset of the second stage of labor. Maternal outcomes such as pain and fatigue severity and fetal outcomes such as pH and pO2 of the umbilical cord blood were measured. Data pertaining to 69 patients, divided into the intervention group (35 subjects) and control group (34 subjects), were analyzed statistically. The mean pain (7.80 ± 1.21 versus 9.05 ± 1.11) and fatigue scores (46.59 ± 21 versus 123.36 ± 43.20) of the two groups showed a statistically significant difference (P pushing in the lateral position reduced fatigue and pain severity of the mothers. Also, it did not worsen fetal outcomes. Thus, it can be used as an alternative method for the Valsalva maneuver.

  17. Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya

    Directory of Open Access Journals (Sweden)

    Obare Francis

    2012-10-01

    Full Text Available Abstract Background Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15–19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Methods Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Results Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8–2.0 while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1–0.2. Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6–4.0. In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1–0.9. However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5–3.3. There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5–1.5. Conclusions The experience of repeat unintended pregnancies among HIV-positive female adolescents

  18. Both preparing to teach and teaching positively impact learning outcomes for peer teachers.

    Science.gov (United States)

    Gregory, Alexander; Walker, Ian; McLaughlin, Kevin; Peets, Adam D

    2011-01-01

    We sought to evaluate the independent effects of preparing to teach and teaching on peer teacher learning outcomes. To evaluate the independent contributions of both preparing to teach and teaching to the learning of peer teachers in medical education. In total, 17 third-year medical students prepared to teach second-year students Advanced Cardiac Life Support algorithms and electrocardiogram (ECG) interpretation. Immediately prior to teaching they were randomly allocated to not teach, to teach algorithms, or to teach ECG. Peer teachers were tested on both topics prior to preparation, immediately after teaching and 60 days later. Compared to baseline, peer teachers' mean examination scores (±SD) demonstrated the greatest gains for content areas they prepared for and then taught (43.0% (13.9) vs. 66.3% (8.8), p teach but did not teach, less dramatic gains were evident (43.6% (8.3) vs. 54.7% (9.4), p teaching were greater than those for preparation (23.3% (10.9) vs. 8% (9.6), p teach and actively teaching may have independent positive effects on peer teacher learning outcomes.

  19. The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women.

    Science.gov (United States)

    Moraloglu, Ozlem; Kansu-Celik, Hatice; Tasci, Yasemin; Karakaya, Burcu Kısa; Yilmaz, Yasar; Cakir, Ebru; Yakut, Halil Ibrahim

    2017-01-01

    To assess the effects on neonatal and maternal outcomes of different pushing positions during the second stage of labor in nulliparous women. This prospective study included 102 healthy, pregnant, nulliparous women who were randomly allocated to either of two positions: a squatting using bars (n = 51), or a supine position modified to 45 degree of semi-fowler (n = 51) during the second stage of labor. Duration of the second stage of labor, maternal pain, postpartum blood loss, abnormal fetal heart rate patterns that required intervention, and newborn outcomes were compared between the two groups. The trial showed that women who adopted the squatting position using bars experienced a significant reduction in the duration of the second stage of labor; they were less likely to be induced, and their Visual Analog Scale score was lower than those who were allocated the supine position modified to 45 degree of semi-fowler during second stage of labor (p < 0.05). There were no significant differences with regard to postpartum blood loss, neonatal birth weight, Apgar score at one and five minutes, or admission to the Neonatal Intensive Care Unit. In healthy nulliparous women, adopting a squatting position using bars was associated with a shorter second stage of labor, lower Visual Analog Scale score, more satisfaction, and a reduction in oxytocin requirements compared with adopting the supine position. For Turkish women, the squatting position is easy to adopt as it is more appropriate in terms of Turkish social habits and traditions.

  20. Positive pregnancy outcomes in Mexican immigrants: what can we learn?

    Science.gov (United States)

    Page, Robin L

    2004-01-01

    To provide an integrated review of the literature of potential explanations for better than expected pregnancy outcomes in Mexican immigrants, focusing on socioeconomics, social support, desirability of pregnancy, nutrition, substance use, religion, acculturation, and prenatal care. Computerized searches of MEDLINE and CINAHL databases, as well as reference lists from published articles on low birth weight and prematurity in immigrants and acculturation in immigrants from January 1989 to December 2002. Search terms were Mexican immigrant women, childbearing, and pregnancy outcome, and only English-language articles were reviewed. Literature was selected from refereed publications in the areas of nursing, medicine, public health, family, and sociology. Data were extracted using keywords pertinent to pregnancy outcome in Mexican immigrants. Despite having many of the risk factors for poor pregnancy outcomes, Mexican immigrants have superior birth outcomes when compared to U.S.-born women. Social support, familism, healthy diet, limited use of cigarettes and alcohol, and religion may play a role in improved outcomes. The superior outcomes diminish with the process of acculturation as the individual adapts to her new culture. Low birth weight and prematurity are public health concerns in the United States. Through further study of the factors that lead to superior birth outcomes among Mexican immigrant women, rates of low birth weight and prematurity in the United States may be reduced.

  1. How positioning strategies affect co-branding outcomes

    OpenAIRE

    Wason, Hilary; Charlton, Nathalie

    2015-01-01

    Co-branding is a widely applied strategy, with research indicating differential benefits to the parent brands. Past studies suggest the source of these differences may be due to the partners’ relative market position, and characteristics such as brand familiarity, brand equity and proximity to the consumer have been explored. However, the role of brand positioning has received little attention in the context of co-branding. The current study attempts to address this gap, considering the posit...

  2. Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings

    Directory of Open Access Journals (Sweden)

    Firooz Behboodi

    2016-04-01

    Full Text Available Introduction: Focused assessment with sonography for trauma (FAST is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. Methods: The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. Results: 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male. FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9% cases. Finally, 12 (6.6% patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006. Higher grading of spleen (p = 0.001 and hepatic (p = 0.038 ruptures increased the probability of need for laparotomy. Conclusion: 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy.

  3. Long-term outcomes of kidney transplantation across a positive complement-dependent cytotoxicity crossmatch.

    Science.gov (United States)

    Riella, Leonardo V; Safa, Kassem; Yagan, Jude; Lee, Belinda; Azzi, Jamil; Najafian, Nader; Abdi, Reza; Milford, Edgar; Mah, Helen; Gabardi, Steven; Malek, Sayeed; Tullius, Stefan G; Magee, Colm; Chandraker, Anil

    2014-06-27

    More than 30% of potential kidney transplant recipients have pre-existing anti-human leukocyte antigen antibodies. This subgroup has significantly lower transplant rates and increased mortality. Desensitization has become an important tool to overcome this immunological barrier. However, limited data is available regarding long-term outcomes, in particular for the highest risk group with a positive complement-dependent cytotoxicity crossmatch (CDC XM) before desensitization. Between 2002 and 2010, 39 patients underwent living-kidney transplantation across a positive CDC XM against their donors at our center. The desensitization protocol involved pretransplant immunosuppression, plasmapheresis, and low-dose intravenous immunoglobulin±rituximab. Measured outcomes included patient survival, graft survival, renal function, rates of rejection, infection, and malignancy. The mean and median follow-up was 5.2 years. Patient survival was 95% at 1 year, 95% at 3 years, and 86% at 5 years. Death-censored graft survival was 94% at 1 year, 88% at 3 years, and 84% at 5 years. Uncensored graft survival was 87% at 1 year, 79% at 3 years, and 72% at 5 years. Twenty-four subjects (61%) developed acute antibody-mediated rejection of the allograft and one patient lost her graft because of hyperacute rejection. Infectious complications included pneumonia (17%), BK nephropathy (10%), and CMV disease (5%). Skin cancer was the most prevalent malignancy in 10% of patients. There were no cases of lymphoproliferative disorder. Mean serum creatinine was 1.7±1 mg/dL in functioning grafts at 5 years after transplantation. Despite high rates of early rejection, desensitization in living-kidney transplantation results in acceptable 5-year patient and graft survival rates.

  4. Toxicity and outcome of pelvic IMRT for node-positive prostate cancer

    International Nuclear Information System (INIS)

    Mueller, A.C.; Luetjens, J.; Eckert, F.; Bamberg, M.; Alber, M.; Schilling, D.; Belka, C.; Gaswindt, U.

    2012-01-01

    Background and purpose: This study reports on the treatment techniques, toxicity, and outcome of pelvic intensity-modulated radiotherapy (IMRT) for lymph node-positive prostate cancer (LNPPC, T1-4, c/pN1 cM0). Patients and methods: Pelvic IMRT to 45-50.4 Gy was applied in 39 cases either after previous surgery of involved lymph nodes (n = 18) or with a radiation boost to suspicious nodes (n = 21) with doses of 60-70 Gy, usually combined with androgen deprivation (n = 37). The prostate and seminal vesicles received 70-74 Gy. In cases of previous prostatectomy, prostatic fossa and remnants of seminal vesicles were given 66-70 Gy. Treatment-related acute and late toxicity was graded according to the RTOG criteria. Results: Acute radiation-related toxicity higher than grade 2 occurred in 2 patients (with the need for urinary catheter/subileus related to adhesions after surgery). Late toxicity was mild (grade 1-2) after a median follow-up of 70 months. Over 50% of the patients reported no late morbidity (grade 0). PSA control and cancer-specific survival reached 67% and 97% at over 5 years. Conclusion: Pelvic IMRT after the removal of affected nodes or with a radiation boost to clinically positive nodes led to an acceptable late toxicity (no grade 3/4 events), thus justifying further evaluation of this approach in a larger cohort. (orig.)

  5. Openness to Experience as a Predictor and Outcome of Upward Job Changes into Managerial and Professional Positions

    Science.gov (United States)

    Nieß, Christiane; Zacher, Hannes

    2015-01-01

    In industrial and organizational psychology, there is a long tradition of studying personality as an antecedent of work outcomes. Recently, however, scholars have suggested that personality characteristics may not only predict, but also change due to certain work experiences, a notion that is depicted in the dynamic developmental model (DDM) of personality and work. Upward job changes are an important part of employees’ careers and career success in particular, and we argue that these career transitions can shape personality over time. In this study, we investigate the Big Five personality characteristics as both predictors and outcomes of upward job changes into managerial and professional positions. We tested our hypotheses by applying event history analyses and propensity score matching to a longitudinal dataset collected over five years from employees in Australia. Results indicated that participants’ openness to experience not only predicted, but that changes in openness to experience also followed from upward job changes into managerial and professional positions. Our findings thus provide support for a dynamic perspective on personality characteristics in the context of work and careers. PMID:26110527

  6. Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea.

    Science.gov (United States)

    Ryan, Clodagh M; Bayley, Mark; Green, Robin; Murray, Brian J; Bradley, T Douglas

    2011-04-01

    In stroke patients, obstructive sleep apnea (OSA) is associated with poorer functional outcomes than in those without OSA. We hypothesized that treatment of OSA by continuous positive airway pressure (CPAP) in stroke patients would enhance motor, functional, and neurocognitive recovery. This was a randomized, open label, parallel group trial with blind assessment of outcomes performed in stroke patients with OSA in a stroke rehabilitation unit. Patients were assigned to standard rehabilitation alone (control group) or to CPAP (CPAP group). The primary outcomes were the Canadian Neurological scale, the 6-minute walk test distance, sustained attention response test, and the digit or spatial span-backward. Secondary outcomes included Epworth Sleepiness scale, Stanford Sleepiness scale, Functional Independence measure, Chedoke McMaster Stroke assessment, neurocognitive function, and Beck depression inventory. Tests were performed at baseline and 1 month later. Patients assigned to CPAP (n=22) experienced no adverse events. Regarding primary outcomes, compared to the control group (n=22), the CPAP group experienced improvement in stroke-related impairment (Canadian Neurological scale score, PStroke assessment of upper and lower limb motor recovery test of the leg (P=0.001), and the affective component of depression (P=0.006), but not neurocognitive function. Treatment of OSA by CPAP in stroke patients undergoing rehabilitation improved functional and motor, but not neurocognitive outcomes. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00221065.

  7. GEANT4 simulation diagram showing the architecture of the ATLAS test line: the detectors are positioned to receive the beam from the SPS. A muon particle which enters the magnet and crosses all detectors is shown (blue line).

    CERN Multimedia

    2004-01-01

    GEANT4 simulation diagram showing the architecture of the ATLAS test line: the detectors are positioned to receive the beam from the SPS. A muon particle which enters the magnet and crosses all detectors is shown (blue line).

  8. Sample size calculations based on a difference in medians for positively skewed outcomes in health care studies

    Directory of Open Access Journals (Sweden)

    Aidan G. O’Keeffe

    2017-12-01

    Full Text Available Abstract Background In healthcare research, outcomes with skewed probability distributions are common. Sample size calculations for such outcomes are typically based on estimates on a transformed scale (e.g. log which may sometimes be difficult to obtain. In contrast, estimates of median and variance on the untransformed scale are generally easier to pre-specify. The aim of this paper is to describe how to calculate a sample size for a two group comparison of interest based on median and untransformed variance estimates for log-normal outcome data. Methods A log-normal distribution for outcome data is assumed and a sample size calculation approach for a two-sample t-test that compares log-transformed outcome data is demonstrated where the change of interest is specified as difference in median values on the untransformed scale. A simulation study is used to compare the method with a non-parametric alternative (Mann-Whitney U test in a variety of scenarios and the method is applied to a real example in neurosurgery. Results The method attained a nominal power value in simulation studies and was favourable in comparison to a Mann-Whitney U test and a two-sample t-test of untransformed outcomes. In addition, the method can be adjusted and used in some situations where the outcome distribution is not strictly log-normal. Conclusions We recommend the use of this sample size calculation approach for outcome data that are expected to be positively skewed and where a two group comparison on a log-transformed scale is planned. An advantage of this method over usual calculations based on estimates on the log-transformed scale is that it allows clinical efficacy to be specified as a difference in medians and requires a variance estimate on the untransformed scale. Such estimates are often easier to obtain and more interpretable than those for log-transformed outcomes.

  9. Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.

    Science.gov (United States)

    Inaba, Shinji; Mintz, Gary S; Farhat, Naim Z; Fajadet, Jean; Dudek, Dariusz; Marzocchi, Antonio; Templin, Barry; Weisz, Giora; Xu, Ke; de Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

    2014-01-01

    This study investigated coronary artery remodeling patterns associated with clinical outcomes. In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling. Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI 1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort). Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions. The present study showed the novel concept that positive and negative lesion site remodeling was

  10. Importance of Local Control in Early-Stage Prostate Cancer: Outcomes of Patients With Positive Post-Radiation Therapy Biopsy Results Treated in RTOG 9408

    International Nuclear Information System (INIS)

    Krauss, Daniel J.; Hu, Chen; Bahary, Jean-Paul; Souhami, Luis; Gore, Elizabeth M.; Chafe, Susan Maria Jacinta; Leibenhaut, Mark H.; Narayan, Samir; Torres-Roca, Javier; Michalski, Jeff; Zeitzer, Kenneth L.; Donavanik, Viroon; Sandler, Howard; McGowan, David G.; Jones, Christopher U.; Shipley, William U.

    2015-01-01

    Purpose: The purpose of this study was to assess the association between positive post-radiation therapy (RT) biopsy results and subsequent clinical outcomes in males with localized prostate cancer. Methods and Materials: Radiation Therapy Oncology Group study 94-08 analyzed 1979 males with prostate cancer, stage T1b-T2b and prostate-specific antigen concentrations of ≤20 ng/dL, to investigate whether 4 months of total androgen suppression (TAS) added to RT improved survival compared to RT alone. Patients randomized to receive TAS received flutamide with luteinizing hormone releasing hormone (LHRH) agonist. According to protocol, patients without evidence of clinical recurrence or initiation of additional endocrine therapy underwent repeat prostate biopsy 2 years after RT completion. Statistical analysis was performed to evaluate the impact of positive post-RT biopsy results on clinical outcomes. Results: A total of 831 patients underwent post-RT biopsy, 398 were treated with RT alone and 433 with RT plus TAS. Patients with positive post-RT biopsy results had higher rates of biochemical failure (hazard ratio [HR] = 1.7; 95% confidence interval [CI] = 1.3-2.1) and distant metastasis (HR = 2.4; 95% CI = 1.3-4.4) and inferior disease-specific survival (HR = 3.8; 95% CI = 1.9-7.5). Positive biopsy results remained predictive of such outcomes after correction for potential confounders such as Gleason score, tumor stage, and TAS administration. Prior TAS therapy did not prevent elevated risk of adverse outcome in the setting of post-RT positive biopsy results. Patients with Gleason score ≥7 with a positive biopsy result additionally had inferior overall survival compared to those with a negative biopsy result (HR = 1.56; 95% CI = 1.04-2.35). Conclusions: Positive post-RT biopsy is associated with increased rates of distant metastases and inferior disease-specific survival in patients treated with definitive RT and was associated with inferior overall

  11. Returnees, Student-Migrants and Second Chance Learners: Case Studies of Positional and Transformative Outcomes of Australian International Education

    Science.gov (United States)

    Robertson, Shanthi; Hoare, Lynnel; Harwood, Aramiha

    2011-01-01

    There is a clear need for new research into the work and life outcomes for graduates of Australian international education. Drawing upon divergent post-study transitions, this article aims to present a multi-faceted, qualitative foundation for the consideration of both positional and transformative impacts of international education on graduates'…

  12. More than resisting temptation: Beneficial habits mediate the relationship between self-control and positive life outcomes.

    Science.gov (United States)

    Galla, Brian M; Duckworth, Angela L

    2015-09-01

    Why does self-control predict such a wide array of positive life outcomes? Conventional wisdom holds that self-control is used to effortfully inhibit maladaptive impulses, yet this view conflicts with emerging evidence that self-control is associated with less inhibition in daily life. We propose that one of the reasons individuals with better self-control use less effortful inhibition, yet make better progress on their goals is that they rely on beneficial habits. Across 6 studies (total N = 2,274), we found support for this hypothesis. In Study 1, habits for eating healthy snacks, exercising, and getting consistent sleep mediated the effect of self-control on both increased automaticity and lower reported effortful inhibition in enacting those behaviors. In Studies 2 and 3, study habits mediated the effect of self-control on reduced motivational interference during a work-leisure conflict and on greater ability to study even under difficult circumstances. In Study 4, homework habits mediated the effect of self-control on classroom engagement and homework completion. Study 5 was a prospective longitudinal study of teenage youth who participated in a 5-day meditation retreat. Better self-control before the retreat predicted stronger meditation habits 3 months after the retreat, and habits mediated the effect of self-control on successfully accomplishing meditation practice goals. Finally, in Study 6, study habits mediated the effect of self-control on homework completion and 2 objectively measured long-term academic outcomes: grade point average and first-year college persistence. Collectively, these results suggest that beneficial habits-perhaps more so than effortful inhibition-are an important factor linking self-control with positive life outcomes. (c) 2015 APA, all rights reserved).

  13. More than Resisting Temptation: Beneficial Habits Mediate the Relationship between Self-Control and Positive Life Outcomes

    Science.gov (United States)

    Galla, Brian M.; Duckworth, Angela L.

    2015-01-01

    Why does self-control predict such a wide array of positive life outcomes? Conventional wisdom holds that self-control is used to effortfully inhibit maladaptive impulses, yet this view conflicts with emerging evidence that self-control is associated with less inhibition in daily life. We propose that one of the reasons individuals with better self-control use less effortful inhibition, yet make better progress on their goals is that they rely on beneficial habits. Across six studies (total N = 2,274), we found support for this hypothesis. In Study 1, habits for eating healthy snacks, exercising, and getting consistent sleep mediated the effect of self-control on both increased automaticity and lower reported effortful inhibition in enacting those behaviors. In Studies 2 and 3, study habits mediated the effect of self-control on reduced motivational interference during a work-leisure conflict and on greater ability to study even under difficult circumstances. In Study 4, homework habits mediated the effect of self-control on classroom engagement and homework completion. Study 5 was a prospective longitudinal study of teenage youth who participated in a five-day meditation retreat. Better self-control before the retreat predicted stronger meditation habits three months after the retreat, and habits mediated the effect of self-control on successfully accomplishing meditation practice goals. Finally, in Study 6, study habits mediated the effect of self-control on homework completion and two objectively measured long-term academic outcomes: grade point average and first-year college persistence. Collectively, these results suggest that beneficial habits--perhaps more so than effortful inhibition--are an important factor linking self-control with positive life outcomes. PMID:25643222

  14. Do Job Demands of Chinese Manufacturing Employees Predict Positive or Negative Outcomes? A Test of Competing Hypotheses.

    Science.gov (United States)

    Cheung, Janelle H; Sinclair, Robert R; Shi, Junqi; Wang, Mo

    2015-12-01

    Karasek's job demands-control (JDC) model posits that job control can buffer against the harmful effects of demands experienced by employees. A large volume of JDC research has obtained support for the main effects of demands and control, but not the interactive effects. Recent research on the challenge-hindrance stressors framework, however, found that work stressors may not always be deleterious, suggesting alternative hypotheses about the effects of demands and control. The present study therefore examined competing hypotheses concerning the effects of job demands on occupational health outcomes. Using a sample of 316 employees in a Chinese manufacturing company, we found that, consistent with the challenge-hindrance framework, production demands were challenge stressors associated with favourable outcomes (i.e. job satisfaction and psychological well-being). In addition, results showed that the interactive role of job control depended on the nature of outcome variables. Future recommendations and implications of findings are discussed. Copyright © 2014 John Wiley & Sons, Ltd.

  15. Expression level of novel tumor suppressor gene FATS is associated with the outcome of node positive breast cancer

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jun; GU Lin; ZHAO Lu-jun; ZHANG Xi-feng; QIU Li; LI Zheng

    2011-01-01

    Background Recently, we reported the identification of a previously uncharacterized and evolutionarily conserved gene, fragile-site associated tumor suppressor (FATS), at a frequently deleted region in irradiation (IR)-induced tumors.However, the role of FATS in breast cancer development and its clinical significance has not been defined. The aim of this study was to determine the role of FA7S in breast cancer development and to evaluate its clinical significance in breast cancer.Methods The expression level of FATS mRNA was determined in 106 breast carcinomas and 23 paired normal breast tissues using quantitative real time reverse transcription-polymerase chain reaction (RT-PCR). The relationship between FATS expression and clinicopathological parameters were also analyzed.Results The mRNA level of FATS was down-regulated in breast cancer compared with paired normal tissues. Low expression of FATS was correlated with high nuclear grade. There was a tendency to a favorable outcome for patients with high expression of FATS (P=0.346). However, low expression of FATS was associated with poor outcome of breast cancer patients with node positive (P=0.011). Furthermore, the mRNA level of FATS showed an independent value in predicting the outcome of breast cancer patients with positive lymph nodes.Conclusion FATS is involved in the carcinogenesis and development of breast cancer and could be a potential biomarker and prognostic factor for breast cancer therapy.

  16. Risk factors for unfavorable outcome of pulmonary tuberculosis in adults in Taipei, Taiwan.

    Science.gov (United States)

    Yen, Yung-Feng; Yen, Muh-Yong; Shih, Hsiu-Chen; Deng, Chung-Yeh

    2012-05-01

    This study was undertaken to identify factors associated with unfavorable outcomes in patients with pulmonary tuberculosis (PTB) in Taipei, Taiwan in 2007-2008. Taiwanese adults with culture-positive PTB diagnosed in Taipei during the study period were included in this retrospective cohort study. Unfavorable outcomes were classified as treatment default, death, treatment failure, or transfer. Of 1616 eligible patients, 22.6% (365) had unfavorable outcomes, mainly death. After controlling for patient sociodemographic factors, clinical findings, and underlying disease, independent risk factors for unfavorable outcomes included advanced age, unemployment, end-stage renal disease requiring dialysis, malignancy, acid-fast bacilius smear-positivity, multidrug-resistant TB, and notification from ordinary ward or intensive care unit. In contrast, patients receiving directly observed treatment, and with a high school or higher education were significantly less likely to have unfavorable outcomes. This study advanced our understanding by revealing that a high school or higher education might lower the risk of an unfavorable outcome. Our results also confirmed the risk factors for unfavorable outcomes shown in previous research. Future TB control programmes in Taiwan should target particularly high-risk patients including those who had lower educational levels. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  17. Testing links between childhood positive peer relations and externalizing outcomes through a randomized controlled intervention study.

    Science.gov (United States)

    Witvliet, Miranda; van Lier, Pol A C; Cuijpers, Pim; Koot, Hans M

    2009-10-01

    In this study, the authors used a randomized controlled trial to explore the link between having positive peer relations and externalizing outcomes in 758 children followed from kindergarten to the end of 2nd grade. Children were randomly assigned to the Good Behavior Game (GBG), a universal classroom-based preventive intervention, or a control condition. Children's acceptance by peers, their number of mutual friends, and their proximity to others were assessed annually through peer ratings. Externalizing behavior was annually rated by teachers. Reductions in children's externalizing behavior and improvements in positive peer relations were found among GBG children, as compared with control-group children. Reductions in externalizing behavior appeared to be partly mediated by the improvements in peer acceptance. This mediating role of peer acceptance was found for boys only. The results suggest that positive peer relations are not just markers, but they are environmental mediators of boys' externalizing behavior development. Implications for research and prevention are discussed. (c) 2009 APA, all rights reserved.

  18. Identification of a subset of perpheral T-cell lymphoma, not otherwise specified, characterized by FOXP3-positive regulatory T-cell phenotype, HTLV-1 negativity and poor outcome

    DEFF Research Database (Denmark)

    Pedersen, Martin Bjerregård; Hamilton-Dutoit, Stephen Jacques; Bendix, Knud

    2014-01-01

    Identification of a subset of perpheral T-cell lymphoma, not otherwise specified, characterized by FOXP3-positive regulatory T-cell phenotype, HTLV-1 negativity and poor outcome.......Identification of a subset of perpheral T-cell lymphoma, not otherwise specified, characterized by FOXP3-positive regulatory T-cell phenotype, HTLV-1 negativity and poor outcome....

  19. Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Susan Ash

    2014-01-01

    Full Text Available In Chronic Kidney Disease (CKD, management of diet is important in prevention of disease progression and symptom management, however evidence on nutrition prescription is limited. Recent international CKD guidelines and literature was reviewed to address the following question “What is the appropriate nutrition prescription to achieve positive outcomes in adult patients with chronic kidney disease?” Databases included in the search were Medline and CINAHL using EBSCOhost search engine, Embase and the Cochrane Database of Systematic Reviews published from 2000 to 2009. International guidelines pertaining to nutrition prescription in CKD were also reviewed from 2000 to 2013. Three hundred and eleven papers and eight guidelines were reviewed by three reviewers. Evidence was graded as per the National Health and Medical Research Council of Australia criteria. The evidence from thirty six papers was tabulated under the following headings: protein, weight loss, enteral support, vitamin D, sodium, fat, fibre, oral nutrition supplements, nutrition counselling, including protein and phosphate, nutrients in peritoneal dialysis solution and intradialytic parenteral nutrition, and was compared to international guidelines. While more evidence based studies are warranted, the customary nutrition prescription remains satisfactory with the exception of Vitamin D and phosphate. In these two areas, additional research is urgently needed given the potential of adverse outcomes for the CKD patient.

  20. Lung-protective ventilation in intensive care unit and operation room : Tidal volume size, level of positive end-expiratory pressure and driving pressure

    NARCIS (Netherlands)

    Serpa Neto, A.

    2017-01-01

    Several investigations have shown independent associations between three ventilator settings – tidal volume size, positive end–expiratory pressure (PEEP) and driving pressure – and outcomes in patients with the acute respiratory distress syndrome (ARDS). There is an increasing notion that similar

  1. Matched Cohort Analysis of Outcomes of Definitive Radiotherapy for Prostate Cancer in Human Immunodeficiency Virus-Positive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kahn, Shannon, E-mail: shannonkahn@yahoo.com [Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA (United States); Jani, Ashesh; Edelman, Scott; Rossi, Peter; Godette, Karen; Landry, Jerome; Anderson, Cynthia [Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA (United States); Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA (United States)

    2012-05-01

    Purpose: To compare the biochemical outcome and toxicity scores of men with human immunodeficiency virus (HIV) and prostate cancer with a matched control population with negative or unknown HIV status when treated with external-beam radiotherapy (EBRT). Methods and Materials: A single-institution database of men with prostate cancer treated with EBRT from 1999 to 2009 was reviewed. Thirteen men with HIV were identified and matched to 2 control patients according to age, race, T stage, prostate-specific antigen level, Gleason score, RT dose, intensity-modulated RT vs. three-dimensional conformal RT, and whole-pelvis vs. prostate-only RT, for a total of 39 cases. The median follow-up time was 39 months (range, 3-110 months). Results: The 4-year biochemical failure (BF)-free survival rate was 87% in the HIV-positive group vs. 89% in the controls (p = 0.94). Pre- and post-RT viral loads were found to be predictive of BF (p = 0.04 and p = 0.04, respectively). No men with HIV died, whereas 2 in the control group died of causes unrelated to prostate cancer. Acute and chronic genitourinary and gastrointestinal toxicity were less in the HIV-positive patients than in controls (p < 0.001, p < 0.001, p = 0.003, and p < 0.001, respectively). The HIV-positive men experienced an average decline in CD4 count of 193 cells/mm{sup 3}. Conclusions: Our findings suggest that men with HIV treated with EBRT have a similar risk of BF; however, high viral loads may contribute to an increased risk. This analysis supports that HIV-positive men with prostate cancer can be treated with definitive EBRT with similar disease control and toxicity outcomes as in the general population.

  2. Pregnancy Outcomes in Booked HIV Positive Women Initiating ...

    African Journals Online (AJOL)

    Saharan Africa which bears the highest burden of the disease. To evaluate pregnancy outcomes in booked preg-nant women on Highly Active Antiretroviral Therapy (HAART) at the University of Ilorin Teach-ing Hospital (UITH), Ilorin, Nigeria; ...

  3. Matched Cohort Analysis of Outcomes of Definitive Radiotherapy for Prostate Cancer in Human Immunodeficiency Virus-Positive Patients

    International Nuclear Information System (INIS)

    Kahn, Shannon; Jani, Ashesh; Edelman, Scott; Rossi, Peter; Godette, Karen; Landry, Jerome; Anderson, Cynthia

    2012-01-01

    Purpose: To compare the biochemical outcome and toxicity scores of men with human immunodeficiency virus (HIV) and prostate cancer with a matched control population with negative or unknown HIV status when treated with external-beam radiotherapy (EBRT). Methods and Materials: A single-institution database of men with prostate cancer treated with EBRT from 1999 to 2009 was reviewed. Thirteen men with HIV were identified and matched to 2 control patients according to age, race, T stage, prostate-specific antigen level, Gleason score, RT dose, intensity-modulated RT vs. three-dimensional conformal RT, and whole-pelvis vs. prostate-only RT, for a total of 39 cases. The median follow-up time was 39 months (range, 3–110 months). Results: The 4-year biochemical failure (BF)-free survival rate was 87% in the HIV-positive group vs. 89% in the controls (p = 0.94). Pre- and post-RT viral loads were found to be predictive of BF (p = 0.04 and p = 0.04, respectively). No men with HIV died, whereas 2 in the control group died of causes unrelated to prostate cancer. Acute and chronic genitourinary and gastrointestinal toxicity were less in the HIV-positive patients than in controls (p 3 . Conclusions: Our findings suggest that men with HIV treated with EBRT have a similar risk of BF; however, high viral loads may contribute to an increased risk. This analysis supports that HIV-positive men with prostate cancer can be treated with definitive EBRT with similar disease control and toxicity outcomes as in the general population.

  4. Impact of positive chest X-ray findings and blood cultures on adverse outcomes following hospitalized pneumococcal lower respiratory tract infection

    DEFF Research Database (Denmark)

    Skovgaard, Marlene; Schønheyder, Henrik Carl; Benfield, Thomas

    2013-01-01

    Little is known about the clinical presentation and outcome of pneumococcal lower respiratory tract infection (LRTI) without positive chest X-ray findings and blood cultures. We investigated the prognostic impact of a pulmonary infiltrate and bacteraemia on the clinical course of hospitalized...

  5. Maternal periodontal disease, pregnancy, and neonatal outcomes.

    Science.gov (United States)

    Dasanayake, Ananda P; Gennaro, Susan; Hendricks-Muñoz, Karen D; Chhun, Nok

    2008-01-01

    The purpose of this article is to review the current literature on the association between maternal periodontal disease and poor pregnancy and neonatal outcomes and outline the role nurses can play in improving the oral health of pregnant women. Maternal periodontal disease is linked to preterm birth, low birthweight, and preterm low birthweight, but treatment of periodontal disease during pregnancy has been shown to be safe and effective. Nurses, nurse practitioners, and nurse-midwives are in a position to educate pregnant women on the benefits of good oral health and identify and refer women who are in need of dental care for treatment.

  6. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2016-12-01

    To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. Copyright © 2016

  7. Outcome of wide local excision in dermatofibrosarcoma protuberans and use of radiotherapy for margin-positive disease

    Directory of Open Access Journals (Sweden)

    Raashid Hamid

    2013-01-01

    Full Text Available Purpose: Wide local excision (WLE is the preferred treatment of dermatofibrosarcoma protuberans (DFSP. The aim is to achieve negtive margins. We followed the impact of radiotherapy used postoperatively for both margin-negative and margin-positive DFSP tumors. Materials and Methods: Outcome of treatment of 36 patients of DFSP treated at our hospital was assessed. Thirty patients received radiotherapy postoperatively and six patients received radiotherapy alone. The maximum dimension of the lesion was 15 cm 2 . Patients were followed up for varying periods of time for any recurrence. Results: 10-year actuarial local control rate was determined. Local control was realized in six patients who were treated with radiotherapy alone. 30 patients were treated by radiotherapy and surgery. Out of these 30 patients, there were 6 local failures (failure rate 10%. Actuarial control rate was 82%. The failures were among patients who had positive margins. Conclusion: Radiotherapy is effective, and it decreases the recurrence rate in the treatment of DFSP. It is especially helpful in margin-positive disease. This appears true for patients treated with radiotherapy alone or radiotherapy used postoperatively.

  8. Pregnancy, Obstetric and Neonatal Outcomes in HIV Positive ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Keywords: Pregnancy, delivery, HIV, neonate, adverse outcome. Introduction. HIV-1 infection has remained a major public health challenge in sub-Saharan Africa, accounting ... practice have greatly reduced both maternal deaths .... 2010 we reverted back to triple ARV .... between the two groups in the rates of obstetric.

  9. How related multiscreening could positively affect advertising outcomes

    NARCIS (Netherlands)

    Segijn, C.M.; Voorveld, H.A.M.; Smit, E.G.

    2017-01-01

    The use of multiple screens, also known as multiscreening, is assumed to have detrimental consequences for advertising outcomes. However, many people are engaging in this form of media multitasking on a daily basis. Therefore, it is important to focus on how to improve the effectiveness of

  10. From Parent-Child Mutuality to Security to Socialization Outcomes: Developmental Cascade toward Positive Adaptation in Preadolescence

    Science.gov (United States)

    Kim, Sanghag; Boldt, Lea J.; Kochanska, Grazyna

    2016-01-01

    A developmental cascade from positive early parent-child relationship to child security with the parent to adaptive socialization outcomes, proposed in attachment theory and often implicitly accepted but rarely formally tested, was examined in 100 mothers, fathers, and children followed from toddler age to preadolescence. Parent-child Mutually Responsive Orientation (MRO) was observed in lengthy interactions at 38, 52, 67, and 80 months; children reported their security with parents at age 8. Socialization outcomes (parent- and child-reported cooperation with parental monitoring and teacher-reported school competence) were assessed at age 10. Mediation was tested with PROCESS (Hayes, 2013). The parent-child history of MRO significantly predicted both mother-child and father-child security. For mother-child dyads, security mediated links between history of MRO and cooperation with maternal monitoring and school competence, controlling for developmental continuity of the studied constructs. For father-child dyads, the mediation effect was not evident. PMID:26258443

  11. Give what you get: capuchin monkeys (Cebus apella and 4-year-old children pay forward positive and negative outcomes to conspecifics.

    Directory of Open Access Journals (Sweden)

    Kristin L Leimgruber

    Full Text Available The breadth of human generosity is unparalleled in the natural world, and much research has explored the mechanisms underlying and motivating human prosocial behavior. Recent work has focused on the spread of prosocial behavior within groups through paying-it-forward, a case of human prosociality in which a recipient of generosity pays a good deed forward to a third individual, rather than back to the original source of generosity. While research shows that human adults do indeed pay forward generosity, little is known about the origins of this behavior. Here, we show that both capuchin monkeys (Cebus apella and 4-year-old children pay forward positive and negative outcomes in an identical testing paradigm. These results suggest that a cognitively simple mechanism present early in phylogeny and ontogeny leads to paying forward positive, as well as negative, outcomes.

  12. Alloimmunization due to red cell antibodies in Rhesus positive Omani Pregnant Women: Maternal and Perinatal outcome

    Directory of Open Access Journals (Sweden)

    Tamima Al-Dughaishi

    2015-01-01

    Full Text Available Objective: This study is aimed to determine the prevalence of alloimmunization due to antibodies to red blood cell (RBC antigens (other than rhesus [Rh] antigen and report the maternal, perinatal, and neonatal outcomes. Materials and Methods: A retrospective review of medical records of all patients with minor RBCs antibodies alloimmunization who were followed and delivered at Sultan Qaboos University Hospital, Oman from June 2011 to June 2013. Maternal characteristics, antibody type, antibody titer in addition to perinatal and neonatal outcomes were reviewed. Results: There were 1160 patients with Rh positive status in the study. The most common ABO blood group was O, followed by A, B, and AB. We found 33 out of 1160 Rh positive women alloimmunized with minor RBCs antibodies that gave a prevalence of minor RBCs alloimmunization of 2.7%. The most frequent antibody was anti-E 38%, followed by anti-c 17% and anti-kell 17%. 6 of these 33 patients were identified to have significant antibody titer, and two cases showed evidence of fetal anemia. Only one case required an intrauterine blood transfusion. The most common neonatal complication was jaundice in 53%, followed by respiratory distress syndrome in 28%. Two cases complicated by neonatal anemia required a postnatal blood transfusion. Conclusion: Alloimmunization with anti-E, anti-c, and anti-kell were the most common antibodies among the study group. Minor RBCs alloimmunization was an important cause of neonatal morbidity.

  13. Engaging children in the development of obesity interventions: exploring outcomes that matter most among obesity positive outliers

    OpenAIRE

    Sharifi, Mona; Marshall, Gareth; Goldman, Roberta E.; Cunningham, Courtney; Marshall, Richard; Taveras, Elsie M

    2015-01-01

    Objective To explore outcomes and measures of success that matter most to 'positive outlier' children who improved their body mass index (BMI) despite living in obesogenic neighborhoods. Methods We collected residential address and longitudinal height/weight data from electronic health records of 22,657 children ages 6–12 years in Massachusetts. We defined obesity “hotspots” as zip codes where >15% of children had a BMI ≥95th percentile. Using linear mixed effects models, we gener...

  14. Effect of Supine vs Prone Position on Outcomes of Percutaneous Nephrolithotomy in Staghorn Calculi: Results From the Clinical Research Office of the Endourology Society Study

    DEFF Research Database (Denmark)

    Astroza, Gaston; Lipkin, Michael; Neisius, Andreas

    2013-01-01

    To analyze the effect of patient positioning on outcomes of percutaneous nephrolithotomy (PNL) among patients with staghorn stones. The choice of optimal position for these patients undergoing PNL remains challenging. No previous studies exclusively addressing this point have been performed....

  15. The processing of unexpected positive response outcomes in the mediofrontal cortex.

    Science.gov (United States)

    Ferdinand, Nicola K; Mecklinger, Axel; Kray, Jutta; Gehring, William J

    2012-08-29

    The human mediofrontal cortex, especially the anterior cingulate cortex, is commonly assumed to contribute to higher cognitive functions like performance monitoring. How exactly this is achieved is currently the subject of lively debate but there is evidence that an event's valence and its expectancy play important roles. One prominent theory, the reinforcement learning theory by Holroyd and colleagues (2002, 2008), assigns a special role to feedback valence, while the prediction of response-outcome (PRO) model by Alexander and Brown (2010, 2011) claims that the mediofrontal cortex is sensitive to unexpected events regardless of their valence. However, paradigms examining this issue have included confounds that fail to separate valence and expectancy. In the present study, we tested the two competing theories of performance monitoring by using an experimental task that separates valence and unexpectedness of performance feedback. The feedback-related negativity of the event-related potential, which is commonly assumed to be a reflection of mediofrontal cortex activity, was elicited not only by unexpected negative feedback, but also by unexpected positive feedback. This implies that the mediofrontal cortex is sensitive to the unexpectedness of events in general rather than their valence and by this supports the PRO model.

  16. Positive outcomes influence the rate and time to publication, but not the impact factor of publications of clinical trial results.

    Directory of Open Access Journals (Sweden)

    Pilar Suñé

    Full Text Available OBJECTIVES: Publication bias may affect the validity of evidence based medical decisions. The aim of this study is to assess whether research outcomes affect the dissemination of clinical trial findings, in terms of rate, time to publication, and impact factor of journal publications. METHODS AND FINDINGS: All drug-evaluating clinical trials submitted to and approved by a general hospital ethics committee between 1997 and 2004 were prospectively followed to analyze their fate and publication. Published articles were identified by searching Pubmed and other electronic databases. Clinical study final reports submitted to the ethics committee, final reports synopses available online and meeting abstracts were also considered as sources of study results. Study outcomes were classified as positive (when statistical significance favoring experimental drug was achieved, negative (when no statistical significance was achieved or it favored control drug and descriptive (for non-controlled studies. Time to publication was defined as time from study closure to publication. A survival analysis was performed using a Cox regression model to analyze time to publication. Journal impact factors of identified publications were recorded. Publication rate was 48·4% (380/785. Study results were identified for 68·9% of all completed clinical trials (541/785. Publication rate was 84·9% (180/212 for studies with results classified as positive and 68·9% (128/186 for studies with results classified as negative (p<0·001. Median time to publication was 2·09 years (IC95 1·61-2·56 for studies with results classified as positive and 3·21 years (IC95 2·69-3·70 for studies with results classified as negative (hazard ratio 1·99 (IC95 1·55-2·55. No differences were found in publication impact factor between positive (median 6·308, interquartile range: 3·141-28·409 and negative result studies (median 8·266, interquartile range: 4·135-17·157. CONCLUSIONS

  17. Socioeconomic position and ten-year survival and virologic outcomes in a Ugandan HIV cohort receiving antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Andrew G Flynn

    Full Text Available Lifelong ART is essential to reducing HIV mortality and ending the epidemic, however the interplay between socioeconomic position and long-term outcomes of HIV-infected persons receiving antiretroviral therapy (ART in sub-Saharan Africa is unknown. Furthering the understanding of factors related to long-term ART outcomes in this important region will aid the successful scale-up of ART programs. We enrolled 559 HIV-infected Ugandan adults starting ART in 2004-2005 at the Infectious Diseases Institute in Kampala, Uganda and followed them for 10 years. We documented baseline employment status, regular household income, education level, housing description, physical ability, and CD4 count. Viral load was measured every six months. Proportional hazard regression tested for associations between baseline characteristics and 1 mortality, 2 virologic failure, and 3 mortality or virologic failure as a composite outcome. Over ten years 23% (n = 127 of participants died, 6% (n = 31 were lost-to-follow-up and 23% (107/472 experienced virologic treatment failure. In Kaplan-Meier analysis we observed an association between employment and mortality, with the highest cumulative probability of death occurring in unemployed individuals. In univariate analysis unemployment and disease severity were associated with mortality, but in multivariable analysis the only association with mortality was disease severity. We observed an association between higher household income and an increased incidence of both virologic failure and the combined outcome, and an association between self-employment and lower incidence of virologic failure and the combined outcome when compared to unemployment. Formal education level and housing status were unrelated to outcomes. It is feasible to achieve good ten-year survival, retention-in-care, and viral suppression in a socioeconomically diverse population in a resource-limited setting. Unemployment appears to be related to adverse 10

  18. HIV self-care practices during pregnancy and maternal health outcomes among HIV-positive postnatal mothers aged 18-35 years at Mbuya Nehanda maternity hospital.

    Science.gov (United States)

    Dodzo, Lilian Gertrude; Mahaka, Hilda Tandazani; Mukona, Doreen; Zvinavashe, Mathilda; Haruzivishe, Clara

    2017-06-01

    HIV-related conditions are one of the indirect causes of maternal deaths in Zimbabwe and the prevalence rate was estimated to be 13.63% in 2009. The study utilised a descriptive correlational design on 80 pregnant women who were HIV positive at Mbuya Nehanda maternity hospital in Harare, Zimbabwe. Participants comprised a random sample of 80 postnatal mothers. Permission to carry out the study was obtained from the respective review boards. Participants signed an informed consent. Data were collected using a structured questionnaire and record review from 1 to 20 March 2012. Interviews were done in a private room and code numbers were used to identify the participants. Completed questionnaires were kept in a lockable cupboard and the researcher had sole access to them. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 12. Descriptive statistics were used to analyse data on demographics, maternal health outcomes and self-care practices. Inferential statistics (Pearson's correlation and regression analysis) were used to analyse the relationship between self-care practices and maternal health outcomes. Self-care practices were good with a mean score of 8 out of 16. Majority (71.3%) fell within the good category. Maternal outcomes were poor with a mean score of 28 out of 62 and 67.5% falling in the poor category. Pearson's correlation indicated a weak significant positive relationship (r = .317, p = <.01). Regression analysis (R 2 ) was .10 implying that self-care practices explained 10% of the variance observed in maternal health outcomes. More research needs to be carried out to identify other variables affecting maternal outcomes in HIV-positive pregnant women.

  19. Radical prostatectomy and positive surgical margins: relationship with prostate cancer outcome

    Directory of Open Access Journals (Sweden)

    Ricardo L. R. Felts de La Roca

    2014-06-01

    Full Text Available Introduction Positive surgical margins (PSMs are an adverse factor that may predict a worse outcome in patients submitted to radical prostatectomy (RP. However, not all of these cases will evolve to biochemical (BCR or clinical (CR recurrence, therefore relationship between PSMs and these recurrent events has to be correlated with other clinical and pathologic findings to indicate complementary treatment for selected patients. Materials and Methods Of 1250 patients submitted to open retropubic radical prostatectomy (RRP, between March 1991 and June 2008, the outcome of 161 patients with PSMs and of 67 without PSMs as a control group, comprising a total of 228 cases were retrospectively reviewed. A minimum follow-up time of 2 years after surgery was considered. BCR was determined when PSA ≥ 0.2ng/mL. CR was determined whenever there was clinical evidence of tumor. Chi-square test was used to correlate clinical and pathologic variables with PSMs. Time interval to biochemical recurrence was analyzed by the Kaplan-Meier product limit analysis using the log-rank test for comparison between groups. Univariate and multivariate Cox stepwise logistic regression models were used to identify significant predictors of risk of shorter intervals to BCR. Results Prostate circumference margin was the most common site with 78 cases (48.44%. Regarding the outcome of 228 cases from both groups, BCR occurred in 68 patients (29.82%, and CR in 10 (4.38%. Univariate analysis showed statistically significant associations (p < 0.001 between presence of PSMs with BCR, but not with CR (p = 0.05. At follow-up of the 161 patients with PSMs, only 61(37.8% presented BCR, while 100 (62.8% did not. BCR correlated with pathologic stage; Gleason score; preoperative PSA; tumor volume in the specimen; capsular and perineural invasion; presence and number of PSMs. CR correlated only with angiolymphatic invasion and Gleason score. Considering univariate analysis of clinical and

  20. Distant metastasis in p16-positive oropharyngeal squamous cell carcinoma: a critical analysis of patterns and outcomes.

    Science.gov (United States)

    Sinha, P; Thorstad, W T; Nussenbaum, B; Haughey, B H; Adkins, D R; Kallogjeri, D; Lewis, J S

    2014-01-01

    With good loco-regional control, disease failure in p16-positive oropharyngeal squamous cell carcinoma (OPSCC) mainly results from distant metastasis (DM). Our objective was to characterize the patterns and clinical outcomes of DM in p16-positive OPSCC and compare these to patients with p16-negative disease. Primary OPSCC patients who developed DM after completing surgical or non-surgical treatment were identified and p16 status was evaluated. Patterns of DM and post-DM progression-free (PFS) and disease-specific survival (DSS) were assessed. Forty-one of the 66 (62%) patients with DM were p16-positive. DM patterns were not statistically different by p16 status. However, p16-positive patients developed DM later in their course and had longer survival. All p16-negative patients either had progression or died within 24 months of DM detection whereas the 2-year post-DM PFS in the p16-positive group was 20% (95% CI: 8-32.5%, p=0.003). The 3-year post-DM disease-specific survival (DSS) estimate in the p16-positive patients was 16% (95% CI: 7-18%) while all p16-negative patients died within 34 months (p<0.001). p16-negativity, loco-regional disease, and no/palliative versus curative intent treatment were all associated with reduced post-DM DSS in multivariate analysis. The DM pattern did not differ remarkably between p16-positive and negative OPSCC patients in our practice. In p16-positive OPSCC with pulmonary oligometastatic disease, curative intent treatment and optimized locoregional control for the index primary prolonged survival. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Positive and negative volume-outcome relationships in the geriatric trauma population.

    Science.gov (United States)

    Matsushima, Kazuhide; Schaefer, Eric W; Won, Eugene J; Armen, Scott B; Indeck, Matthew C; Soybel, David I

    2014-04-01

    In trauma populations, improvements in outcome are documented in institutions with higher case volumes. However, it is not known whether improved outcomes are attributable to the case volume within specific higher-risk groups, such as the elderly, or to the case volume among all trauma patients treated by an institution. To test the hypothesis that outcomes of trauma care for geriatric patients are affected differently by the volume of geriatric cases and nongeriatric cases of an institution. This retrospective cohort study using a statewide trauma registry was set in state-designated levels 1 and 2 trauma centers in Pennsylvania. It included 39 431 eligible geriatric trauma patients (aged >65 years) in the Pennsylvania Trauma Outcomes Study. In-hospital mortality, major complications, and mortality after major complications (failure to rescue). Between 2001 and 2010, 39 431 geriatric trauma patients and 105 046 nongeriatric patients were captured in a review of outcomes in 20 state-designated levels 1 and 2 trauma centers. Larger volumes of geriatric trauma patients were significantly associated with lower odds of in-hospital mortality, major complications, and failure to rescue. In contrast, larger nongeriatric trauma volumes were significantly associated with higher odds of major complications in geriatric patients. Higher rates of in-hospital mortality, major complications, and failure to rescue were associated with lower volumes of geriatric trauma care and paradoxically with higher volumes of trauma care for younger patients. These findings offer the possibility that outcomes might be improved with differentiated pathways of care for geriatric trauma patients.

  2. Faculty Perceptions of Conflict with Administrators: An Analysis of the Associations between the Nature of Conflict and Positive and Negative Outcomes

    Science.gov (United States)

    Hancks, Meredith L.

    2013-01-01

    This study examines the perceptions of faculty members regarding conflict experiences with administrators. It is driven by the question, "To what extent are faculty perceptions of positive and negative outcomes of faculty-administrator conflict associated with domain, nature and disciplinary context of the conflict," where domain refers…

  3. The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth.

    Science.gov (United States)

    Smokowski, Paul R; Bacallao, Martica L; Cotter, Katie L; Evans, Caroline B R

    2015-06-01

    The quality of parent-child relationships has a significant impact on adolescent developmental outcomes, especially mental health. Given the lack of research on rural adolescent mental health in general and rural parent-child relationships in particular, the current longitudinal study explores how rural adolescents' (N = 2,617) perceptions of parenting practices effect their mental health (i.e., anxiety, depression, aggression, self-esteem, future optimism, and school satisfaction) over a 1 year period. Regression models showed that current parenting practices (i.e., in Year 2) were strongly associated with current adolescent mental health outcomes. Negative current parenting, manifesting in parent-adolescent conflict, was related to higher adolescent anxiety, depression, and aggression and lower self-esteem, and school satisfaction. Past parent-adolescent conflict (i.e., in Year 1) also positively predicted adolescent aggression in the present. Current positive parenting (i.e., parent support, parent-child future orientation, and parent education support) was significantly associated with less depression and higher self-esteem, future optimism, and school satisfaction. Past parent education support was also related to current adolescent future optimism. Implications for practice and limitations were discussed.

  4. Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

    Science.gov (United States)

    Spjut Jansson, Birgitta; Miniscalco, Carmela; Westerlund, Joakim; Kantzer, Anne-Katrin; Fernell, Elisabeth; Gillberg, Christopher

    2016-01-01

    Background Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL) – in two settings, which included home- and preschool-based (IL Regular) and only home-based (IL Modified) and eclectic interventions. Results There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. PMID:27621636

  5. Effect of cocaine use on outcomes in traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Jacky T Yeung

    2013-01-01

    Full Text Available Context: Animal and molecular studies have shown that cocaine exerts a neuroprotective effect against cerebral ischemia. Aims: To determine if the presence of cocaine metabolites on admission following traumatic brain injury (TBI is associated with better outcomes. Settings and Design: Level-1 trauma center, retrospective cohort. Materials and Methods: After obtaining Institutional Review Board (IRB approval, the trauma registry was searched from 2006 to 2009 for all patients aged 15-55 years with blunt head trauma and non-head AIS <3. Exclusion criteria were pre-existing brain pathology and death within 30 min of admission. The primary outcome was in-hospital mortality; secondary outcomes were hospital length of stay (LOS, and Glasgow Outcome Score (GOS. Statistical Analysis: Logistic regression was used to determine the independent effect of cocaine on mortality. Hospital LOS was compared with multiple linear regression. Results: A total of 741 patients met criteria and had drug screens. The screened versus unscreened groups were similar. Cocaine positive patients were predominantly African-American (46% vs. 21%, P < 0.0001, older (40 years vs. 30 years, P < 0.0001, and had ethanol present more often (50.7% vs. 37.8%, P = 0.01. There were no differences in mortality (cocaine-positive 1.4% vs. cocaine-negative 2.7%, P = 0.6 on both univariate and multivariate analysis. Conclusions: Positive cocaine screening was not associated with mortality in TBI. An effect may not have been detected because of the low mortality rate. LOS is affected by many factors unrelated to the injury and may not be a good surrogate for recovery. Similarly, GOS may be too coarse a measure to identify a benefit.

  6. Using a retention in care protocol to promote positive health and systems related outcomes.

    Science.gov (United States)

    Larbi, Alfred A; Spielberg, Freya; Kamanu Elias, Nnemdi; Athey, Erin; Ogbuawa, Ngozi; Murphy, Nancy

    2018-04-18

    People living with HIV can experience the full benefits of retention when they are continuously engaged in care. Continuous engagement in care promotes improved adherence to ART and positive health outcomes. An infectious disease clinic has implemented a protocol to primarily improve patient retention. The retrospective, facility-based, costing study took place in an infectious disease clinic in Washington DC. Retention was defined in two ways and over a 12-month period. Micro-costing direct measurement methods were used to collect unit costs in time series. Return on investment accounted for the cost of treatment based on CD4 strata. ROI was expressed in 2016USD. The difference in CD4 and viral load levels between the two periods of analysis were determined for active patients, infected with HIV. The year before the intervention was compared to the year of the intervention. Total treatment expenditure decreased from $2,435,653.00 to $2,283,296.23, resulting in a $152,356.77 gain from investment for the healthcare system over a 12-month investment period. The viral load suppression rate increased from 81 to 95 (p = 0.04) over the investment period. The number of patients in need of HIV related opportunistic infection prophylaxis decreased from 21 to 13 (p = 0.06). Improved immunologic, virologic and healthcare expenditure outcomes can be linked to the quality of retention practice.

  7. Effects of Continuous Positive Airway Pressure on Cognitive and Functional Outcome of Stroke Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Aaronson, Justine A.; Hofman, Winni F.; van Bennekom, Coen A. M.; van Bezeij, Tijs; van den Aardweg, Joost G.; Groet, Erny; Kylstra, Wytske A.; Schmand, Ben

    2016-01-01

    Obstructive sleep apnea (OSA) in stroke patients is associated with worse functional and cognitive status during inpatient rehabilitation. We hypothesized that a four-week period of continuous positive airway pressure (CPAP) treatment would improve cognitive and functional outcomes. We performed a

  8. The false positive exercise test

    International Nuclear Information System (INIS)

    Moritani, Kohshiro; Matsuda, Yasuo; Ozaki, Masaharu; Ogawa, Hiroshi; Ichiyama, Masaji; Matsuda, Masako; Kusukawa, Reizo

    1986-01-01

    Exercise tests with sublingual nitroglycerin were performed on 7 patients with true positive and 8 patients with false positive exercise test results. Four of 7 patients with true positive changes and 8 patients with false positive changes underwent exercise cardiac scintigraphy. Scintigrams showed perfusion defects in 4 patients with true positive outcomes, and no perfusion defect in 8 patients with false positive outcomes. Exercise tests with sublingual nitroglycerin were performed with the same load as that without nitroglycerin. In all 7 patients with true positive exercise test results, ST segment depression observed in the control exercise test was not observed in the nitroglycerin exercise test. In the false positive patients, ST segment depression observed in the control exercise test remained unchanged in 7 of 8 patients receiving nitroglycerin. Exercise tests with sublingual nitroglycerin as well as exercise cardiac scintigraphy are valuable tods in differentiating false positive from true positive patients. Furthermore, these data suggest that ST segment depression in the false positive patients may not be related to myocardial ischemia. (author)

  9. Not all developmental assets are related to positive health outcomes in college students

    Directory of Open Access Journals (Sweden)

    Teoli Daniel A

    2011-07-01

    Full Text Available Abstract Background The purpose of this investigation was to model the relationships between developmental assets, life satisfaction, and health-related quality of life (HRQOL among a stratified, random sample (n = 765, 56% response rate of college students. Methods Structural equation modeling techniques were employed to test the relationships using Mplus v4.21; Model evaluations were based on 1 theoretical salience, 2 global fit indices (chi-square goodness of fit, comparative fit index: CFI and Tucker-Lewis Index: TLI, 3 microfit indices (parameter estimates, root mean squared error of approximation: RMSEA and residuals and 4 parsimony. Results The model fit the data well: χ2(n = 581, 515 = 1252.23, CFI = .94, TLI = .93 and RMSEA = .05. First, participants who reported increased Family Communication also reported higher levels of life satisfaction. Second, as participants reported having more Non-Parental Role Models, life satisfaction decreased and poor mental HRQOL days increased. Finally increased Future Aspirations was related to increased poor mental HRQOL days. Results were variant across gender. Conclusions Preliminary results suggest not all developmental assets are related to positive health outcomes among college students, particularly mental health outcomes. While the findings for Family Communication were expected, the findings for Non-Parental Role Models suggest interactions with potential role models in college settings may be naturally less supportive. Future Aspirations findings suggest college students may harbor a greater temporal urgency for the rigors of an increasingly competitive work world. In both cases, these assets appear associated with increased poor mental HRQOL days.

  10. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients

    Directory of Open Access Journals (Sweden)

    Rouleau CR

    2015-06-01

    Full Text Available Codie R Rouleau,1 Sheila N Garland,2 Linda E Carlson3 1Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada; 2Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 3Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Abstract: Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness. This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients – namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic–pituitary–adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes. Keywords: mindfulness-based intervention

  11. The Impact of Simulated Nature on Patient Outcomes: A Study of Photographic Sky Compositions.

    Science.gov (United States)

    Pati, Debajyoti; Freier, Patricia; O'Boyle, Michael; Amor, Cherif; Valipoor, Shabboo

    2016-01-01

    To examine whether incorporation of simulated nature, in the form of ceiling mounted photographic sky compositions, influences patient outcomes. Previous studies have shown that most forms of nature exposure have a positive influence on patients. However, earlier studies have mostly focused on wall-hung nature representations. The emergence of simulated nature products has raised the question regarding the effects of the new product on patient outcomes. A between-subject experimental design was adopted, where outcomes from five inpatient rooms with sky composition ceiling fixture were compared to corresponding outcomes in five identical rooms without the intervention. Data were collected from a total of 181 subjects on 11 outcomes. Independent sample tests were performed to identify differences in mean outcomes. Significant positive outcomes were observed in environmental satisfaction and diastolic blood pressure (BP). Environmental satisfaction in the experimental group was 12.4% higher than the control group. Direction of association for diastolic BP, nausea/indigestion medication, acute stress, anxiety, pain, and environmental satisfaction were consistent with a priori hypothesis. A post hoc exploratory assessment involving patients who did not self-request additional pain and sleep medication demonstrated confirmatory directions for all outcomes except Systolic BP, and statistically significant outcomes for Acute Stress and Anxiety-Acute Stress and Anxiety levels of the experimental group subjects was 53.4% and 34.79% lower, respectively, than that of the control group subjects. Salutogenic benefits of photographic sky compositions render them better than traditional ceiling tiles and offer an alternative to other nature interventions. © The Author(s) 2015.

  12. Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities.

    Science.gov (United States)

    Chiò, A; Bottacchi, E; Buffa, C; Mutani, R; Mora, G

    2006-08-01

    To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.

  13. Negative attentional bias for positive recovery-related words as a predictor of treatment success among individuals with an alcohol use disorder.

    Science.gov (United States)

    Rettie, Hannah C; Hogan, Lee M; Cox, W Miles

    2018-09-01

    This study assessed relationships between clients' attentional bias (AB) for different types of stimuli and their treatment outcomes. Alcohol AB during detoxification has previously been shown to predict relapse, but further research was needed to clarify this relationship. The current study determined whether AB for recovery-related words would also predict treatment outcome. Participants were 45 clients undergoing alcohol detoxification, and a control group of 36 staff members. They rated words for personal relevance in four categories (alcohol-related, neutral, positive change-related, and negative change-related). Participants completed an individualized Stroop task containing their chosen words. They were also assessed on readiness-to-change, difficulties with emotion regulation, drinking problems, anxiety, and depression. Clients were interviewed at a three-month follow-up to determine their treatment outcome. As predicted, questionnaire measures did not predict clients' treatment outcome (p > .05). A logistic regression model indicated that the best predictor of treatment outcome was AB for positive change-related words (p = .048), with successful individuals having less AB for these words than for the other word categories. Although this finding was unexpected, it was supported by significant relationships between positive change-related interference scores and continuous measures of drinking at follow-up [i.e. number of units drunk (p = .039) and number of drinking days (p = .018)]. The results suggest that positive change-related words are a better predictor of treatment outcome than are either alcohol-related words or negative change-related words. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Novel approaches to target HER2-positive breast cancer: trastuzumab emtansine

    International Nuclear Information System (INIS)

    Recondo, Gonzalo Jr; Vega, Maximo de la; Galanternik, Fernando; Díaz-Cantón, Enrique; Leone, Bernardo Amadeo; Leone, José Pablo

    2016-01-01

    The human epidermal growth factor receptor 2 (HER2) is overexpressed in 20% of breast carcinomas. Prior to the development of targeted therapies, HER2-positive breast cancer was associated with more aggressive disease and poor prognosis. Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate that results from the combination of trastuzumab and DM1, a derivative of the antimicrotubule agent maytansine. This molecule has the ability to enhance cytotoxic drug delivery to specifically targeted cells that overexpress HER2, therefore, maximizing efficacy while sparing toxicity. In recent years, T-DM1 has shown to improve outcomes in metastatic HER2-positive breast cancer that is resistant to trastuzumab. In addition, T-DM1 is currently being tested in the neoadjuvant and adjuvant settings to identify patients who may benefit from this therapy. This review focuses on the mechanism of action, early and late-phase clinical trials, and ongoing studies of T-DM1 in HER2-positive breast cancer

  15. Cerebral oxygenation in patients undergoing shoulder surgery in beach chair position: comparing general to regional anesthesia and the impact on neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, J; Borgeat, A; Trachsel, T; Cobo Del Prado, I; De Andrés, J; Bühler, P

    2014-02-01

    Ischemic brain damage has been reported in healthy patients after beach chair position for surgery due to cerebral hypoperfusion. Near-infrared spectroscopy has been described as a non-invasive, continuous method to monitor cerebral oxygen saturation. However, its impact on neurobehavioral outcome comparing different anesthesia regimens has been poorly described. In this prospective, assessor-blinded study, 90 patients undergoing shoulder surgery in beach chair position following general (G-group, n=45) or regional anesthesia (R-group; n=45) were enrolled to assess the prevalence of cerebral desaturation events comparing anesthesia regimens and their impact on neurobehavioral and neurological outcome. Anesthesiologists were blinded to regional cerebral oxygen saturation values. Baseline data assessed the day before surgery included neurological and neurobehavioral tests, which were repeated the day after surgery. The baseline data for regional cerebral oxygen saturation/bispectral index and invasive blood pressure both at heart and auditory meatus levels were taken prior to anesthesia, 5 min after induction of anesthesia, 5 min after beach chair positioning, after skin incision and thereafter all 20 min until discharge. Patients in the R-group showed significantly less cerebral desaturation events (psurgery (pshoulder surgery in beach chair position influencing neurobehavioral test results at 24h. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  16. Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, José A; Märzendorfer, Olivia; Brada, Muriel; Saporito, Andrea; Borgeat, Alain; Bühler, Philipp

    2016-12-01

    Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. University hospital operating room. Forty patients with American Society of Anesthesiologists classes I-II physical status scheduled for elective shoulder surgery. Cerebral saturation and blood flow of the middle cerebral artery were measured prior to anesthesia and continued after beach chair positioning until discharge to the postanesthesia care unit. The anesthesiologist was blinded for these values. Controlled hypotension with systolic blood pressure≤100mm Hg was maintained during surgery. Neurobehavioral tests and values of regional cerebral saturation, bispectral index, the mean maximal blood flow of the middle cerebral artery, and invasive blood pressure were measured prior to regional anesthesia, and measurements were repeated after placement of the patient on the beach chair position and every 20 minutes thereafter until discharge to postanesthesia care unit. The neurobehavioral tests were repeated the day after surgery. The incidence of cerebral desaturation events was 5%. All patients had a significant blood pressure drop 5 minutes after beach chair positioning, measured at the heart as well as the acoustic meatus levels, when compared with baseline values (Psurgery (Pshoulder surgery had no major impact on cerebral blood flow and cerebral oxygenation. However, some impact on neurobehavioral outcome 24 hours after surgery was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Commentary: Positive Youth Development Goes Mainstream.

    Science.gov (United States)

    Moore, Kristin A

    2017-07-01

    Evidence has accumulated that confirms the success of a positive youth development (PYD) approach. Importantly, a positive development approach is just that-an approach. It is not a particular program or curriculum but a set of practices designed to achieve one or more positive outcomes. As such, PYD practices can be added onto other programs to make positive outcomes more likely. For example, a tutoring program can work hard to hire and train staff to work with students in a trusting, respectful relationship. Camp counselors can be encouraged to build rapport and positive bonds among the campers. © 2017 The Author. Child Development © 2017 Society for Research in Child Development, Inc.

  18. Feedback-related negativity codes outcome valence, but not outcome expectancy, during reversal learning.

    Science.gov (United States)

    von Borries, A K L; Verkes, R J; Bulten, B H; Cools, R; de Bruijn, E R A

    2013-12-01

    Optimal behavior depends on the ability to assess the predictive value of events and to adjust behavior accordingly. Outcome processing can be studied by using its electrophysiological signatures--that is, the feedback-related negativity (FRN) and the P300. A prominent reinforcement-learning model predicts an FRN on negative prediction errors, as well as implying a role for the FRN in learning and the adaptation of behavior. However, these predictions have recently been challenged. Notably, studies so far have used tasks in which the outcomes have been contingent on the response. In these paradigms, the need to adapt behavioral responses is present only for negative, not for positive feedback. The goal of the present study was to investigate the effects of positive as well as negative violations of expectancy on FRN amplitudes, without the usual confound of behavioral adjustments. A reversal-learning task was employed in which outcome value and outcome expectancy were orthogonalized; that is, both positive and negative outcomes were equally unexpected. The results revealed a double dissociation, with effects of valence but not expectancy on the FRN and, conversely, effects of expectancy but not valence on the P300. While FRN amplitudes were largest for negative-outcome trials, irrespective of outcome expectancy, P300 amplitudes were largest for unexpected-outcome trials, irrespective of outcome valence. These FRN effects were interpreted to reflect an evaluation along a good-bad dimension, rather than reflecting a negative prediction error or a role in behavioral adaptation. By contrast, the P300 reflects the updating of information relevant for behavior in a changing context.

  19. Genetic and Environmental Influences on Achievement Outcomes Based on Family History of Learning Disabilities Status.

    Science.gov (United States)

    Erbeli, Florina; Hart, Sara A; Taylor, Jeanette

    2018-05-01

    A risk to develop a learning disability has been shown to run in families. Having a positive family history of learning disability seems to account for mean differences in achievement outcomes (reading, math) in that children with a positive family history score significantly lower compared to their peers with no such family history. However, the role of family history status in explaining etiological (genetic and environmental) differences among these subgroups of children has yet to be established. The present study of 872 twins ( M age = 13.30, SD age = 1.40) from the Florida Twin Project on Reading, Behavior, and Environment utilized a multigroup approach to examine etiological differences on reading, spelling, and math among two subgroups defined by family history status. Results showed significant mean differences on all achievement outcomes, aside from math; however, no significant etiological differences on any achievement outcome were found among the two subgroups. Results support previous literature that the risk for developing a learning disability is transmitted through a family, but this is seemingly not manifested by differential etiology.

  20. The Effect of Positive and Negative Feedback on Risk-Taking across Different Contexts.

    Science.gov (United States)

    Losecaat Vermeer, Annabel B; Sanfey, Alan G

    2015-01-01

    Preferences for risky choices have often been shown to be unstable and context-dependent. Though people generally avoid gambles with mixed outcomes, a phenomenon often attributed to loss aversion, contextual factors can impact this dramatically. For example, people typically prefer risky options after a financial loss, while generally choosing safer options after a monetary gain. However, it is unclear what exactly contributes to these preference shifts as a function of prior outcomes, as these gain/loss outcomes are usually confounded with participant performance, and therefore it is unclear whether these effects are driven purely by the monetary gains or losses, or rather by success or failure at the actual task. Here, we experimentally separated the effects of monetary gains/losses from performance success/failure prior to a standard risky choice. Participants performed a task in which they experienced contextual effects: 1) monetary gain or loss based directly on performance, 2) monetary gain or loss that was randomly awarded and was, crucially, independent from performance, and 3) success or failure feedback based on performance, but without any monetary incentive. Immediately following these positive/negative contexts, participants were presented with a gain-loss gamble that they had to decide to either play or pass. We found that risk preferences for identical sets of gambles were biased by positive and negative contexts containing monetary gains and losses, but not by contexts containing performance feedback. This data suggests that the observed framing effects are driven by aversion for monetary losses and not simply by the positive or negative valence of the context, or by potential moods resulting from positive or negative contexts. These results highlight the specific context dependence of risk preferences.

  1. Effect of socioeconomic position on patient outcome after hysterectomy

    DEFF Research Database (Denmark)

    Daugbjerg, Signe B; Cesaroni, Giulia; Ottesen, Bent

    2014-01-01

    OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... significantly higher odds of complications following hysterectomy compared with women with a high socioeconomic position. Unhealthy lifestyle and presence of co-morbidity in women with low socioeconomic position partially explains the differences in complications.......OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... and employed women. Furthermore, unemployed women had higher odds of hospitalization >4 days than women in employment. Lifestyle factors (smoking and body mass index) and co-morbidity status seemed to explain most of the social differences. However, an association between women with less than high school...

  2. Diversity climate enhances work outcomes through trust and openness in workgroup communication.

    Science.gov (United States)

    Hofhuis, Joep; van der Rijt, Pernill G A; Vlug, Martijn

    2016-01-01

    Diversity climate, defined as an organizational climate characterized by openness towards and appreciation of individual differences, has been shown to enhance outcomes in culturally diverse teams. To date, it remains unclear which processes are responsible for these findings. This paper presents two quantitative studies (n = 91; 246) that identify trust and openness in workgroup communication as possible mediators. We replicate earlier findings that perceived diversity climate positively relates to job satisfaction, sense of inclusion, work group identification and knowledge sharing in teams. In study 1, trust is shown to mediate the effects of perceived diversity climate on team members' sense of inclusion. In study 2, trust mediates the relationship between perceived diversity climate and workgroup identification and openness mediates its relationship with knowledge sharing.

  3. Organisational stressors, coping, and outcomes in competitive sport.

    Science.gov (United States)

    Arnold, Rachel; Fletcher, David; Daniels, Kevin

    2017-04-01

    Organisational stressors are associated with positive and negative outcomes in extant literature; however, little is known about which demands predict which outcomes. Extant theory and literature also suggests that coping style may influence an individual's resilience or vulnerability to stressors and, subsequently, their psychological responses and outcomes. The purpose of this study was, therefore, to examine the main effects of organisational stressors and coping styles on various outcomes (e.g., positive and negative affect, performance satisfaction). Sport performers (n = 414) completed measures of organisational stressors, coping styles, positive and negative affect, and performance satisfaction. Multiple regression analyses revealed positive relationships of both goals and development stressors (duration and intensity) and team and culture stressors (frequency and intensity) on negative affect. Furthermore, problem-focused coping was positively related to positive affect, and emotion-focused coping was positively related to negative affect. This study furthers theoretical knowledge regarding the associations that both organisational stressors (and their dimensions) and coping styles can have with various outcomes, and practical understanding regarding the optimal design of stress management interventions.

  4. The effects of intraoperative positioning on patients undergoing early definitive care for femoral shaft fractures.

    Science.gov (United States)

    Apostle, K L; Lefaivre, K A; Guy, P; Broekhuyse, H M; Blachut, P A; O'Brien, P J; Meek, R N

    2009-10-01

    To determine if there is a difference in morbidity and mortality in orthopaedic trauma patients with femoral shaft fractures undergoing early definitive care with intramedullary (IM) nails in the supine versus the lateral position. Retrospective cohort study, single centered. One level 1 trauma center. Nine hundred eighty-eight patients representing 1027 femoral shaft fractures treated with IM nails were identified through a prospectively gathered database between 1987 and 2006. Antegrade IM nail insertion with reaming of the femoral canal in either the supine or lateral position. Mortality was the primary outcome. Admission to intensive care unit (ICU) was the secondary outcome measure and a surrogate measure of morbidity. Literature review was performed to identify factors shown to contribute to morbidity and mortality in orthopaedic trauma patients. Intraoperative position in either the supine or lateral position was added to this list. Logistic regression analysis was performed to determine the magnitude and effect of the independent variables on each of the study end points. To determine if a more significant trend toward less favorable outcomes was observed with increasing severity of injury, particularly injuries of the chest and thorax, subgroup analysis was performed for all those with a femur fracture and an Injury Severity Score > or =18 and all those with a femur fracture and an Abbreviated Injury Score chest > or =3. Intraoperative position in either the supine or lateral position was not a significant predictor of mortality or ICU admission for the original cohort or the subgroup of Injury Severity Score > or =18. However, for the subgroup of Abbreviated Injury Score chest > or =3, intraoperative positioning in the lateral position had a statistically significant protective effect against ICU admission (P = 0.044). For polytrauma patients with femoral shaft fractures, surgical stabilization using IM nails inserted with reaming of the femoral canal in

  5. Posttraumatic Stress Symptoms and Their Association With Smoking Outcome Expectancies Among Homeless Smokers in Boston.

    Science.gov (United States)

    Baggett, Travis P; Campbell, Eric G; Chang, Yuchiao; Magid, Leah M; Rigotti, Nancy A

    2016-06-01

    Cigarette smoking and traumatic life experiences are each common among homeless adults, but the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms among homeless smokers are not known. We assessed symptoms of PTSD and their association with smoking outcome expectancies in a sample of homeless smokers in Boston. We used time-location sampling to conduct an in-person survey of homeless adult smokers using Boston Health Care for the Homeless Program clinical services. We assessed symptoms of PTSD with the PTSD Checklist-Civilian version and considered scores at least 14 as positive. We used the Smoking Effects Questionnaire to assess positive and negative smoking outcome expectancies. We modeled the associations between PTSD screening status and smoking expectancies using design-adjusted linear regression. Eighty-six percent of eligible individuals participated (N = 306). Sixty-eight percent of participants screened positive for PTSD. Screen-positive respondents were younger (P = .001), more likely to report fair/poor health (P = .01), chronic obstructive pulmonary disease (P = .02), and past-month hallucinations (P = .004), and had greater drug (P smokers and strongly associated with positive smoking outcome expectancies. Tobacco cessation programs for this population should consider screening for PTSD and fostering a trauma-sensitive treatment environment. In this study of homeless cigarette smokers in Boston, over two-thirds of participants screened positive for PTSD. PTSD screen-positive respondents more strongly endorsed multiple positive smoking outcome expectancies than screen-negative individuals. These findings suggest that the psychological sequelae of trauma may be a pervasive but under-recognized factor impacting the persistence of smoking among homeless people. Tobacco cessation programs for this population should consider screening for PTSD, fostering a trauma-sensitive treatment environment, and incorporating strategies that have

  6. Management of gallbladder dyskinesia: patient outcomes following positive 99mtechnetium (Tc)-labelled hepatic iminodiacetic acid (HIDA) scintigraphy with cholecystokinin (CCK) provocation and laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Dave, R.V.; Pathak, S.; Cockbain, A.J.; Lodge, J.P.; Smith, A.M.; Chowdhury, F.U.; Toogood, G.J.

    2015-01-01

    Aims: To evaluate clinical outcomes in patients with typical biliary pain, normal ultrasonic findings, and a positive 99m technetium (Tc)-labelled hepatic iminodiacetic acid analogue (HIDA) scintigraphy with cholecystokinin (CCK) provocation indicating gallbladder dyskinesia, as per Rome III criteria, undergoing laparoscopic cholecystectomy (LC). Methods and materials: Consecutive patients undergoing LC for gallbladder dyskinesia were identified retrospectively. They were followed up by telephone interview and review of the electronic case records to assess symptom resolution. Results: One hundred consecutive patients (median age 44; 80% female) with abnormal gallbladder ejection fraction (GB-EF <35%) were followed up for a median of 12 months (range 2–80 months). Following LC, 84% reported symptomatic improvement and 52% had no residual pain. Twelve percent had persisting preoperative-type pain of either unchanged or worsening severity. Neither pathological features of chronic cholecystitis (87% of 92 incidences when histology available) nor reproduction of pain on CCK injection were significantly predictive of symptom outcome or pain relief post-LC. Conclusion: In one of the largest outcome series of gallbladder dyskinesia patients in the UK with a positive provocation HIDA scintigraphy examination and LC, the present study shows that the test is a useful functional diagnostic tool in the management of patients with typical biliary pain and normal ultrasound, with favourable outcomes following surgery. - Highlights: • Gallbladder dyskinesia (GD) is a challenging condition to diagnose and treat. • This study evaluated clinical outcomes following laparoscopic cholecystectomy (LC). • There was sustained symptomatic benefit in >80% following surgery. • Pre-operative counselling before LC is important

  7. Positive Outcomes Following Bereavement: Paths to Posttraumatic Growth

    Directory of Open Access Journals (Sweden)

    Lawrence G Calhoun

    2010-09-01

    Full Text Available Recent theory and research have drawn attention to the need to better understand the positive changes, termed posttraumatic growth, that often occur in bereaved individuals; even as negative emotions related to grief persist. We describe five dimensions of posttraumatic growth and present a model for understanding how the loss of a close other can eventually lead to a recognition of important positive personal changes. Loss, especially unexpected loss, disrupts an individual's beliefs about the world and initiates a process of rebuilding an understanding. During this process, many people come to realise their own strengths, appreciate the impact of their relationships, and have new spiritual insights. A strategy for facilitating growth during clinical work also is described.

  8. Engaging children in the development of obesity interventions: Exploring outcomes that matter most among obesity positive outliers.

    Science.gov (United States)

    Sharifi, Mona; Marshall, Gareth; Goldman, Roberta E; Cunningham, Courtney; Marshall, Richard; Taveras, Elsie M

    2015-11-01

    To explore outcomes and measures of success that matter most to 'positive outlier' children who improved their body mass index (BMI) despite living in obesogenic neighborhoods. We collected residential address and longitudinal height/weight data from electronic health records of 22,657 children ages 6-12 years in Massachusetts. We defined obesity "hotspots" as zip codes where >15% of children had a BMI ≥95th percentile. Using linear mixed effects models, we generated a BMI z-score slope for each child with a history of obesity. We recruited 10-12 year-olds with negative slopes living in hotspots for focus groups. We analyzed group transcripts and discussed emerging themes in iterative meetings using an immersion/crystallization approach. We reached thematic saturation after 4 focus groups with 21 children. Children identified bullying and negative peer comparisons related to physical appearance, clothing size, and athletic ability as motivating them to achieve a healthier weight, and they measured success as improvement in these domains. Positive relationships with friends and family facilitated both behavior change initiation and maintenance. The perspectives of positive outlier children can provide insight into children's motivations leading to successful obesity management. Child/family engagement should guide the development of patient-centered obesity interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Age but not Philadelphia positivity impairs outcome in older/elderly patients with acute lymphoblastic leukemia in Sweden.

    Science.gov (United States)

    Kozlowski, Piotr; Lennmyr, Emma; Ahlberg, Lucia; Bernell, Per; Hulegårdh, Erik; Karbach, Holger; Karlsson, Karin; Tomaszewska-Toporska, Beata; Åström, Maria; Hallböök, Heléne

    2017-08-01

    Older/elderly patients with acute lymphoblastic leukemia (ALL) are poorly represented in clinical trials. Using Swedish national leukemia registries, we investigated disease/patient characteristics, treatment choices, outcome, and the impact of an age-adapted protocol (introduced in 2009) in this population-based study of patients aged 55-85 years, diagnosed with ALL 2005-2012. Of 174 patients, 82% had B-phenotype, 11% Burkitt leukemia (excluded), and 7% T-phenotype. Philadelphia chromosome positivity (Ph+) occurred in 35%. Of the 155 B- and T-ALL patients, 80% were treated with intensive protocols, and 20% with a palliative approach. Higher age and WHO performance status ≥2 influenced the choice of palliation. Intensive, palliative, and both approaches resulted in complete remission rate 83/16/70% and 3-year overall survival (OS) 32/3/26%. The age-adapted protocol did not improve outcome. With intensive treatment, platelet count ≤35×10 9 /L and age ≥75 years were adverse prognostic factors for OS, Ph+ was not. Male sex was an adverse prognostic factor in the 55-64 year age-group. We report a high frequency of Ph+ in older/elderly patients, with no evidence of poorer outcome compared to Ph-negative disease. Overall prognosis for elderly patients with ALL remains dismal, despite the use of age-adapted treatment. © 2017 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd.

  10. A tribute to Charlie Chaplin: Induced positive affect improves reward-based decision-learning in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    K. Richard eRidderinkhof

    2012-06-01

    Full Text Available Reward-based decision-learning refers to the process of learning to select those actions that lead to rewards while avoiding actions that lead to punishments. This process, known to rely on dopaminergic activity in striatal brain regions, is compromised in Parkinson’s disease (PD. We hypothesized that such decision-learning deficits are alleviated by induced positive affect, which is thought to incur transient boosts in midbrain and striatal dopaminergic activity. Computational measures of probabilistic reward-based decision-learning were determined for 51 patients diagnosed with PD. Previous work has shown these measures to rely on the nucleus caudatus (outcome evaluation during the early phases of learning and the putamen (reward prediction during later phases of learning. We observed that induced positive affect facilitated learning, through its effects on reward prediction rather than outcome evaluation. Viewing a few minutes of comedy clips served to remedy dopamine-related problems in putamen-based frontostriatal circuitry and, consequently, in learning to predict which actions will yield reward.

  11. Nutrition and HIV-Positive Pregnancy

    OpenAIRE

    Montgomery, Kristen S.

    2003-01-01

    When an HIV-positive woman becomes pregnant, additional nutritional considerations are warranted. Compared to routine prenatal nutritional assessment and intervention, pregnant HIV-positive women have increased needs to promote a healthy outcome. This column contains information on HIV and pregnancy, nutrition and infection, and nutrition for HIV-positive pregnancy. This content can be integrated into childbirth education settings to improve care to women who are HIV-positive.

  12. The significance of pretreatment CD4 count on the outcome and treatment tolerance of HIV-positive patients with anal cancer

    International Nuclear Information System (INIS)

    Hoffman, Rex; Welton, Mark L.; Klencke, Barbara; Weinberg, Vivian; Krieg, Richard

    1999-01-01

    Purpose: To assess the outcome and tolerance of HIV-positive patients with anal cancer to standard therapy based on their pretreatment CD4 count. Methods and Materials: Between 1991 and 1997, 17 HIV-positive patients with anal cancer and documented pretreatment CD4 counts were treated at the University of California, San Francisco or its affiliated hospitals with either concurrent chemotherapy and radiation or radiation alone. The outcome and complications of treatment were correlated with the patients' pretreatment CD4 count. Results: Disease for all 9 patients with pretreatment CD4 counts ≥ 200 was controlled with chemoradiation. Although four required a treatment break of 2 weeks because of toxicity, none required hospitalization. Of the 8 patients with pretreatment CD4 counts < 200, 4 experienced decreased counts, intractable diarrhea, or moist desquamation requiring hospitalization. Additionally, 4 of these 8 ultimately required a colostomy either for a therapy-related complication or for salvage. Nevertheless, 6/7 in this group who received concurrent chemotherapy and radiation had their disease controlled, whereas the patient treated with radiation alone failed and required a colostomy for salvage. Conclusion: Patients with CD4 ≥ 200 had excellent disease control with acceptable morbidity. Patients with CD4 < 200 had markedly increased morbidity; however, disease was ultimately controlled in 7/8 patients

  13. Radiographic positioning

    International Nuclear Information System (INIS)

    Eisenberg, R.L.; Dennis, C.A.; May, C.

    1989-01-01

    This book concentrates on the routine radiographic examinations commonly performed. It details the wide variety of examinations possible and their place in initial learning and in the radiology department as references for those occasions when an unusual examination is requested. This book provides information ranging from basic terminology to skeletal positioning to special procedures. Positions are discussed and supplemented with a picture of a patient, the resulting radiograph, and a labeled diagram. Immobilization and proper shielding of the patient are also shown

  14. Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement.

    Science.gov (United States)

    Stewart, Simon; Riegel, Barbara; Boyd, Cynthia; Ahamed, Yasmin; Thompson, David R; Burrell, Louise M; Carrington, Melinda J; Coats, Andrew; Granger, Bradi B; Hides, Julie; Weintraub, William S; Moser, Debra K; Dickson, Victoria Vaughan; McDermott, Cressida J; Keates, Ashley K; Rich, Michael W

    2016-06-01

    Multimorbidity in heart failure (HF), defined as HF of any aetiology and multiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions. From these data we describe a clinical framework, comprising five key steps, to potentially improve historically poor health outcomes in this patient population. We identified five key steps (ARISE-HF) that could potentially improve clinical outcomes if applied in a systematic manner: 1) Acknowledge multimorbidity as a clinical syndrome that is associated with poor health outcomes, 2) Routinely profile (using a standardised protocol - adapted to the local health care system) all patients hospitalised with HF to determine the extent of concurrent multimorbidity, 3) Identify individualised priorities and person-centred goals based on the extent and nature of multimorbidity, 4) Support individualised, home-based, multidisciplinary, case management to supplement standard HF management, and 5) Evaluate health outcomes well beyond acute hospitalisation and encompass all-cause events and a person-centred perspective in affected individuals. We propose ARISE-HF as a framework for improving typically poor health outcomes in those affected by multimorbidity in HF. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. The Effect of Positive and Negative Feedback on Risk-Taking across Different Contexts.

    Directory of Open Access Journals (Sweden)

    Annabel B Losecaat Vermeer

    Full Text Available Preferences for risky choices have often been shown to be unstable and context-dependent. Though people generally avoid gambles with mixed outcomes, a phenomenon often attributed to loss aversion, contextual factors can impact this dramatically. For example, people typically prefer risky options after a financial loss, while generally choosing safer options after a monetary gain. However, it is unclear what exactly contributes to these preference shifts as a function of prior outcomes, as these gain/loss outcomes are usually confounded with participant performance, and therefore it is unclear whether these effects are driven purely by the monetary gains or losses, or rather by success or failure at the actual task. Here, we experimentally separated the effects of monetary gains/losses from performance success/failure prior to a standard risky choice. Participants performed a task in which they experienced contextual effects: 1 monetary gain or loss based directly on performance, 2 monetary gain or loss that was randomly awarded and was, crucially, independent from performance, and 3 success or failure feedback based on performance, but without any monetary incentive. Immediately following these positive/negative contexts, participants were presented with a gain-loss gamble that they had to decide to either play or pass. We found that risk preferences for identical sets of gambles were biased by positive and negative contexts containing monetary gains and losses, but not by contexts containing performance feedback. This data suggests that the observed framing effects are driven by aversion for monetary losses and not simply by the positive or negative valence of the context, or by potential moods resulting from positive or negative contexts. These results highlight the specific context dependence of risk preferences.

  16. Respiratory Outcomes of the Surfactant Positive Pressure and Oximetry Randomized Trial

    Science.gov (United States)

    Stevens, Timothy P.; Finer, Neil N.; Carlo, Waldemar A.; Szilagyi, Peter G.; Phelps, Dale L.; Walsh, Michele C.; Gantz, Marie G.; Laptook, Abbot R.; Yoder, Bradley A.; Faix, Roger G.; Newman, Jamie E.; Das, Abhik; Do, Barbara T.; Schibler, Kurt; Rich, Wade; Newman, Nancy S.; Ehrenkranz, Richard A.; Peralta-Carcelen, Myriam; Vohr, Betty R.; Wilson-Costello, Deanne E.; Yolton, Kimberly; Heyne, Roy J.; Evans, Patricia W.; Vaucher, Yvonne E.; Adams-Chapman, Ira; McGowan, Elisabeth C.; Bodnar, Anna; Pappas, Athina; Hintz, Susan R.; Acarregui, Michael J.; Fuller, Janell; Goldstein, Ricki F.; Bauer, Charles R.; O’Shea, T. Michael; Myers, Gary J.; Higgins, Rosemary D.

    2014-01-01

    Objective To explore the early childhood pulmonary outcomes of infants who participated in the NICHD SUPPORT Trial, using a factorial design that randomized extremely preterm infants to lower vs. higher oxygen saturation targets and delivery room CPAP vs. intubation/surfactant, found no significant difference in the primary composite outcome of death or BPD. Study design The Breathing Outcomes Study, a prospective secondary to SUPPORT, assessed respiratory morbidity at 6 month intervals from hospital discharge to 18–22 months corrected age (CA). Two pre-specified primary outcomes, wheezing more than twice per week during the worst 2 week period and cough longer than 3 days without a cold were compared between each randomized intervention. Results One or more interviews were completed for 918 of 922 eligible infants. The incidence of wheezing and cough were 47.9% and 31.0%, respectively, and did not differ between study arms of either randomized intervention. Infants randomized to lower vs. higher oxygen saturation targets had similar risks of death or respiratory morbidities (except for croup, treatment with oxygen or diuretics at home). Infants randomized to CPAP vs. intubation/surfactant had fewer episodes of wheezing without a cold (28.9% vs. 36.5%, pCPAP rather than intubation/surfactant is associated with less respiratory morbidity by 18–22 months CA. Longitudinal assessment of pulmonary morbidity is necessary to fully evaluate the potential benefits of respiratory interventions for neonates. PMID:24725582

  17. Circle Solutions, a philosophy and pedagogy for learning positive relationships: What promotes and inhibits sustainable outcomes?

    Directory of Open Access Journals (Sweden)

    Florence McCarthy

    2013-04-01

    Full Text Available Educators are increasingly aware that the efficacy of social and emotional learning (SEL is dependent on implementation factors, not just program content. These include the philosophy underpinning an intervention, the beliefs as well as the skills of facilitators, and the classroom/whole school context in which the intervention takes place. This article outlines the philosophy and pedagogy of Circle Solutions and presents findings from research where 18 undergraduate students supported and developed ‘Circle Time’ in 8 Greater Western Sydney primary schools for a university module on community service. The study indicates that when there is full teacher participation within the principles of the Circle philosophy, together with activeschool support that promotes relational values, the learning outcomes for positive relationship building are more sustainable.

  18. The effect of obesity prevention interventions according to socioeconomic position: a systematic review.

    Science.gov (United States)

    Beauchamp, A; Backholer, K; Magliano, D; Peeters, A

    2014-07-01

    Obesity prevention is a major public health priority. It is important that all groups benefit from measures to prevent obesity, but we know little about the differential effectiveness of such interventions within particular population subgroups. This review aimed to identify interventions for obesity prevention that evaluated a change in adiposity according to socioeconomic position (SEP) and to determine the effectiveness of these interventions across different socioeconomic groups. A systematic search of published and grey literature was conducted. Studies that described an obesity prevention intervention and reported anthropometric outcomes according to a measure of SEP were included. Evidence was synthesized using narrative analysis. A total of 14 studies were analysed, representing a range of study designs and settings. All studies were from developed countries, with eight conducted among children. Three studies were shown to have no effect on anthropometric outcomes and were not further analysed. Interventions shown to be ineffective in lower SEP participants were primarily based on information provision directed at individual behaviour change. Studies that were shown to be effective in lower SEP participants primarily included community-based strategies or policies aimed at structural changes to the environment. Interventions targeting individual-level behaviour change may be less successful in lower SEP populations. It is essential that our efforts to prevent obesity do not leave behind the most disadvantaged members of society. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

  19. Measuring Population Health Outcomes

    OpenAIRE

    Parrish, R. Gibson

    2010-01-01

    An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

  20. Nutrition and HIV-Positive Pregnancy

    Science.gov (United States)

    Montgomery, Kristen S.

    2003-01-01

    When an HIV-positive woman becomes pregnant, additional nutritional considerations are warranted. Compared to routine prenatal nutritional assessment and intervention, pregnant HIV-positive women have increased needs to promote a healthy outcome. This column contains information on HIV and pregnancy, nutrition and infection, and nutrition for HIV-positive pregnancy. This content can be integrated into childbirth education settings to improve care to women who are HIV-positive. PMID:17273329

  1. Positioning intermediary organisations in innovation

    NARCIS (Netherlands)

    Lente, van H.; Boon, W.P.C.; Klerkx, L.W.A.

    2010-01-01

    Abstract: Intermediary organisations are important in innovation systems and their contributions seem to increase. The central ambition of this paper is to understand and analyse the position of intermediaries within innovation networks. We use so-called positioning theory, where roles are outcomes

  2. Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care.

    Science.gov (United States)

    Onwuneme, Chike; Carroll, Aoife; Doherty, Dermot; Bruell, Heike; Segurado, Ricardo; Kilbane, Mark; Murphy, Nuala; McKenna, Malachi J; Molloy, Eleanor J

    2015-10-01

    This study aimed to assess vitamin D status, and its determinants, in paediatric patients with suspected sepsis who were admitted to a paediatric intensive care unit (PICU). We also investigated the association between vitamin D status and clinical outcomes. Serum 25-hydroxy vitamin D (25OHD) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU. The relationship between 25OHD and clinical outcomes was evaluated. Vitamin D status was also assessed in control children of a similar age. We enrolled 120 children with suspected sepsis admitted to the PICU and 30 paediatric controls. 25OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25OHD was strongly associated with culture positive sepsis (p < 0.001), the paediatric index of mortality (p = 0.026) and the duration of mechanical ventilation (p = 0.008). There was a negative correlation between 25OHD and C-reactive protein (CRP): each 0.1% decrease in 25OHD increased CRP (p = 0.04). Children admitted to the PICU with suspected sepsis had lower 25OHD than controls and inadequate 25OHD status was associated with confirmed sepsis and poor outcomes. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  3. Impact of viral E2-gene status on outcome after radiotherapy for patients with human papillomavirus 16-positive cancer of the uterine cervix

    International Nuclear Information System (INIS)

    Lindel, Katja; Villiers, Ethel-Michele de; Burri, Philipp; Studer, Ueli; Altermatt, Hans J.; Greiner, Richard H.; Gruber, Guenther

    2006-01-01

    Purpose: Integration of high-risk papillomavirus DNA has been considered an important step in oncogenic progression to cervical carcinoma. Disruption of the human papillomavirus (HPV) genome within the E2 gene is frequently a consequence. This study investigated the influence of episomal viral DNA on outcome in patients with advanced cervical cancer treated with primary radiotherapy. Methods and Materials: Paraffin-embedded biopsies of 82 women with locally advanced cervical cancer could be analyzed for HPV infection by multiplex polymerase chain reaction (PCR) by use of SPF1/2 primers. E2-gene intactness of HPV-16-positive samples was analyzed in 3 separate amplification reactions by use of the E2A, E2B, E2C primers. Statistical analyses (Kaplan-Meier method; log-rank test) were performed for overall survival (OS), disease-free survival (DFS), local progression-free survival (LPFS), and distant metastases-free survival (DMFS). Results: Sixty-one (75%) of 82 carcinomas were HPV positive, 44 of them for HPV-16 (72%). Seventeen of the 44 HPV-16-positive tumors (39%) had an intact E2 gene. Patients with a HPV-16-positive tumor and an intact E2 gene showed a trend for a better DFS (58% vs. 38%, p = 0.06) compared with those with a disrupted E2 gene. A nonsignificant difference occurred regarding OS (87% vs. 66%, p = 0.16) and DMFS (57% vs. 48%, p = 0.15). Conclusion: E2-gene status may be a promising new target, but more studies are required to elucidate the effect of the viral E2 gene on outcome after radiotherapy in HPV-positive tumors

  4. Functional Outcomes After De-escalated Chemoradiation Therapy for Human Papillomavirus-Positive Oropharyngeal Cancer: Secondary Analysis of a Phase 2 Trial.

    Science.gov (United States)

    Hegde, John V; Shaverdian, Narek; Felix, Carol; Wang, Pin-Chieh; Veruttipong, Darlene; Hsu, Sophia; Riess, Jonathan W; Rao, Shyam D; Daly, Megan E; Chen, Allen M

    2018-03-01

    To analyze functional outcomes for patients treated on a phase 2 trial of de-escalated chemoradiation therapy for human papillomavirus-positive oropharyngeal cancer. Patient eligibility included p16-positive, stage III or IV oropharyngeal squamous cell carcinoma and a Zubrod performance status of 0 to 1. Treatment was induction chemotherapy with paclitaxel, 175 mg/m 2 , and carboplatin, area under the curve (AUC) of 6 mg/ml/min, for 2 cycles every 21 days, followed by concurrent paclitaxel, 30 mg/m 2 , every 7 days with dose-reduced radiation therapy of 54 or 60 Gy. Trends in body weight and body mass index (BMI) were analyzed with gastrostomy tube and narcotic use rates. Functional outcomes were assessed using the University of Washington Quality of Life Scale and the Functional Assessment of Cancer Therapy-Head and Neck Scale. Forty-five patients were registered, of whom 40 were evaluable. Only 1 patient had a BMI deemed unhealthy at the completion of treatment. For the 15 patients (38%) with a normal BMI (18-25 kg/m 2 ) before treatment, recovery back to baseline occurred at approximately 18 months (average BMI, 23.2 kg/m 2 vs 22.3 kg/m 2 ; P=.09). In 2 patients (5%), gastrostomy tubes were placed during treatment. No patient was enteral feeding tube-dependent at 6 months after treatment. Ninety-five percent of patients tolerated a normal regular diet at last follow-up. De-escalated chemoradiation therapy may improve functional outcomes as indicated by the relatively low incidence of gastrostomy tube placement and long-term dysphagia. In patients with a normal BMI prior to chemoradiation therapy, BMI recovered to baseline levels. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Intralabyrinthine schwannoma shown by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Saeed, S.R.; Birzgalis, A.R.; Ramsden, R.T.

    1994-01-01

    Intralabyrinthine schwannomas are rare benign tumours which present with progressive or fluctuant audiovestibular symptoms and may mimic Menieres disease. The size and position of these lesions make preoperative diagnosis unusual and most are discovered incidentally at labyrinthectomy. A case is reported which was diagnosed on magnetic resonance imaging and confirmed at surgery. (orig.)

  6. The navicular position test - a reliable measure of the navicular bone position during rest and loading

    DEFF Research Database (Denmark)

    Spörndly-Nees, Søren; Dåsberg, Brian; Nielsen, Rasmus Oestergaard

    2011-01-01

    .08 degrees, ICC = 0.91. Discussion: The present data support The Navicular Position Test as a reliable test of the navicular bone position during rest and loading measured in a simple test set-up. Conclusion: The Navicular Position Test was shown to have a high intraday-, intra- and inter-tester reliability...

  7. Asthma outcomes improve with continuous positive airway pressure for obstructive sleep apnea.

    Science.gov (United States)

    Serrano-Pariente, J; Plaza, V; Soriano, J B; Mayos, M; López-Viña, A; Picado, C; Vigil, L

    2017-05-01

    Continuous positive airway pressure (CPAP) in asthma patients with concomitant obstructive sleep apnea syndrome (OSAS) seems to have a favorable impact on asthma, but data are inconsistent due to methodological limitations of previous studies. Prospective, multicenter study. We examined asthma outcomes after 6 months of CPAP in 99 adult asthma patients (mean age 57 years) with OSAS (respiratory disturbance index ≥20). Asthma control and quality of life were assessed with the Asthma Control Questionnaire (ACQ) and the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), respectively. Data were analyzed by intention-to-treat basis. The mean ± SD score of the ACQ decreased from 1.39 ± 0.91 at baseline to 1.0 ± 0.78 at 6 months (P = 0.003), the percentage of patients with uncontrolled asthma from 41.4% to 17.2% (P = 0.006), and the percentage of patients with asthma attacks in the 6 months before and after treatment from 35.4% to 17.2% (P = 0.015). The score of the mAQLQ increased from 5.12 ± 1.38 to 5.63 ± 1.17 (P = 0.009). There were also significant improvements in symptoms of gastroesophageal reflux and rhinitis, bronchial reversibility, and exhaled nitric oxide values (all P obstructive sleep apnea syndrome. © 2016 The Authors. Allergy published by John Wiley & Sons Ltd.

  8. Testing an mHealth momentary assessment Routine Outcome Monitoring application: a focus on restoration of daily life positive mood states.

    Directory of Open Access Journals (Sweden)

    Jim van Os

    Full Text Available Routine Outcome Monitoring (ROM is used as a means to enrich the process of treatment with feedback on patient outcomes, facilitating patient involvement and shared decision making. While traditional ROM measures focus on retrospective accounts of symptoms, novel mHealth technology makes it possible to collect real life, in-the-moment ambulatory data that allow for an ecologically valid assessment of personalized and contextualized emotional and behavioural adjustment in the flow daily life (mROM.In a sample of 34 patients with major depressive disorder, treated with antidepressants, the combined effect of treatment and natural course was examined over a period of 18 weeks with Ecological Momentary Assessment (EMA. EMA consisted of repeated, within-subject, mini-measurements of experience (eg positive affect, negative affect, medication side effects and context (eg stressors, situations, activities at 10 unselected semi-random moments per day, for a period of six days, repeated three times over the 18-week period (baseline, week 6 and week 18.EMA measures of emotional and behavioural adjustment were sensitive to the effects of treatment and natural course over the 18-week period, particularly EMA measures focussing on positive mood states and the ability to use natural rewards (impact of positive events on positive mood states, with standardized effect sizes of 0.4-0.5. EMA measures of activities, social interaction, stress-sensitivity and negative mood states were also sensitive to change over time.This study supports the use of mROM as a means to involve the patient in the process of needs assessment and treatment. EMA data are meaningful to the patient, as they reflect daily life circumstances. Assessment of treatment response with mROM data allows for an interpretation of the effect of treatment at the level of daily life emotional and social adjustment--as an index of health, obviating the need for an exclusive focus on traditional measures

  9. Frequency and Therapeutic Outcomes of Culture Positive Invasive ...

    African Journals Online (AJOL)

    From May 2012 to July 2013, all cases from consults sent to the clinical microbiologists for review and patients with positive samples were identified from the mycology laboratory registers. Hospital based frequency of Invasive Fungal Infections was 42.5%. Patients' ages ranged from 5 days to 71 years with a median of 29 ...

  10. Whole pelvis radiotherapy for pathological node-positive prostate cancer. Oncological outcome and prognostic factors

    Energy Technology Data Exchange (ETDEWEB)

    Poelaert, Filip; Decaestecker, Karel; Claeys, Tom; Dhondt, Bert; Lumen, Nicolaas [Ghent University Hospital, Department of Urology, Ghent (Belgium); Fonteyne, Valerie; Ost, Piet [Ghent University Hospital, Department of Radiation Oncology, Ghent (Belgium); Troyer, Bart de [AZ Nikolaas, Department of Urology, Sint-Niklaas (Belgium); Meerleer, Gert de [University Hospitals Leuven, Department of Radiation Oncology, Leuven (Belgium); Visschere, Pieter de [Ghent University Hospital, Department of Radiology, Ghent (Belgium)

    2017-06-15

    The goal of this work was to investigate the oncological outcome of whole pelvis radiotherapy (wpRT) in pathologic pelvic lymph node-positive (pN1) prostate cancer (PCa), evaluate the location of relapse, and identify potential prognostic factors. All patients undergoing pelvic lymph node dissection (PLND) since the year 2000 at a single tertiary care center were evaluated. A total of 154 patients with pN1 PCa were treated with wpRT (39 in an adjuvant setting) and 2-3 years of androgen deprivation therapy (ADT). Kaplan-Meier analysis was performed to estimate biochemical recurrence-free survival (bRFS), clinical progression-free survival (cPFS), and prostate cancer-specific survival (CSS). Uni- and multivariate regression analyses were performed to identify prognostic factors. Estimated bRFS was 67%, cPFS was 71%, and CSS was 96% at 5 years. Median follow-up was 55 months (interquartile range 25-87). Multivariate analysis identified having only 1 positive lymph node, a shorter time between diagnosis and PLND, and older age as independent favorable prognostic factors for biochemical and clinical recurrence. The number of positive lymph nodes was prognostic for CSS (hazard ratio [HR] 1.34, 95% confidence interval 1.17-1.54) and OS (HR 1.22, 95% confidence interval 1.10-1.36). Bone metastases were the most frequent location of PCa relapse (n = 32, 64%). Patients with pN1 PCa treated with wpRT and 2-3 years ADT have an encouraging 5-year CSS. Understaging of the disease extent may be the most important enemy in definitive pN1 PCa treatment. (orig.) [German] Das Ziel dieser Studie war es, das onkologische Outcome der Bestrahlung des gesamten Beckens (wpRT) beim histologisch gesicherten nodal metastasierten Prostatakarzinom zu untersuchen, die Lokalisation eines eventuellen Rezidivs zu charakterisieren und moegliche prognostische Faktoren zu identifizieren. Alle Patienten, bei denen seit dem Jahr 2000 eine pelvine Lymphknotendissektion (PLND) durchgefuehrt worden war

  11. Nuclear HER4 mediates acquired resistance to trastuzumab and is associated with poor outcome in HER2 positive breast cancer

    Science.gov (United States)

    Nafi, Siti Norasikin Mohd; Generali, Daniele; Kramer-Marek, Gabriela; Gijsen, Merel; Strina, Carla; Cappelletti, Mariarosa; Andreis, Daniele; Haider, Syed; Li, Ji-Liang; Bridges, Esther; Capala, Jacek; Ioannis, Roxanis; Harris, Adrian L; Kong, Anthony

    2014-01-01

    The role of HER4 in breast cancer is controversial and its role in relation to trastuzumab resistance remains unclear. We showed that trastuzumab treatment and its acquired resistance induced HER4 upregulation, cleavage and nuclear translocation. However, knockdown of HER4 by specific siRNAs increased trastuzumab sensitivity and reversed its resistance in HER2 positive breast cancer cells. Preventing HER4 cleavage by a γ-secretase inhibitor and inhibiting HER4 tyrosine kinase activity by neratinib decreased trastuzumab-induced HER4 nuclear translocation and enhanced trastuzumab response. There was also increased nuclear HER4 staining in the tumours from BT474 xenograft mice and human patients treated with trastuzumab. Furthermore, nuclear HER4 predicted poor clinical response to trastuzumab monotherapy in patients undergoing a window study and was shown to be an independent poor prognostic factor in HER2 positive breast cancer. Our data suggest that HER4 plays a key role in relation to trastuzumab resistance in HER2 positive breast cancer. Therefore, our study provides novel findings that HER4 activation, cleavage and nuclear translocation influence trastuzumab sensitivity and resistance in HER2 positive breast cancer. Nuclear HER4 could be a potential prognostic and predictive biomarker and understanding the role of HER4 may provide strategies to overcome trastuzumab resistance in HER2 positive breast cancer. PMID:25153719

  12. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Shah U

    2015-04-01

    Full Text Available Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA. Patient satisfaction is a complex concept that is influenced by multiple factors. A patient's viewpoint and knowledge plays an influential role in patient satisfaction with ambulatory surgery. Medical optimization and psychological preparation of the patient plays a pivotal role in the success of ambulatory surgery. Postoperative pain, nausea, and vomiting are the most important symptoms for the patient and can be addressed by multimodal drug regimens. Shared decision making, patient–provider relationship, communication, and continuity of care form the main pillars of patient satisfaction. Various psychometrically developed instruments are available to measure patient satisfaction, such as the Iowa Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, but none have been developed specifically for ambulatory surgery. The ASA has made recommendations for data collection for patient satisfaction surveys and emphasized the importance of reporting the data to the Anesthesia Quality Institute. Future research is warranted to develop a validated tool to measure patient satisfaction in ambulatory surgery. Keywords: patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives

  13. Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD

    DEFF Research Database (Denmark)

    Mäkelä, Mika J; Backer, Vibeke; Hedegaard, Morten

    2013-01-01

    Suboptimal adherence to pharmacological treatment of asthma and chronic obstructive pulmonary disease (COPD) has adverse effects on disease control and treatment costs. The reasons behind non-adherence revolve around patient knowledge/education, inhaler device convenience and satisfaction, age...... and clinical efficacy is positive, with improved symptom control and lung function shown in most studies of adults, adolescents and children. Satisfaction with inhaler devices is also positively correlated with improved adherence and clinical outcomes, and reduced costs. Reductions in healthcare utilisation......, adverse effects and medication costs. Age is of particular concern given the increasing prevalence of asthma in the young and increased rates of non-adherence in adolescents compared with children and adults. The correlation between adherence to inhaled pharmacological therapies for asthma and COPD...

  14. Systematic review on the association between employee worktime control and work-non-work balance, health and well-being, and job-related outcomes.

    Science.gov (United States)

    Nijp, Hylco H; Beckers, Debby G J; Geurts, Sabine A E; Tucker, Philip; Kompier, Michiel A J

    2012-07-01

    The aim of this review was to assess systematically the empirical evidence for associations between employee worktime control (WTC) and work-non-work balance, health/well-being, and job-related outcomes (eg, job satisfaction, job performance). A systematic search of empirical studies published between 1995-2011 resulted in 63 relevant papers from 53 studies. Five different categories of WTC measurements were distinguished (global WTC, multidimensional WTC, flextime, leave control, and "other subdimensions of WTC"). For each WTC category, we examined the strength of evidence for an association with (i) work-non-work balance, (ii) health/well-being, and (iii) job-related outcomes. We distinguished between cross-sectional, longitudinal, and intervention studies. Evidence strength was assessed based on the number of studies and their convergence in terms of study findings. (Moderately) strong cross-sectional evidence was found for positive associations between global WTC and both work-non-work balance and job-related outcomes, whereas no consistent evidence was found regarding health/well-being. Intervention studies on global WTC found moderately strong evidence for a positive causal association with work-non-work balance and no or insufficient evidence for health/well-being and job-related outcomes. Limited to moderately strong cross-sectional evidence was found for positive associations between multidimensional WTC and our outcome categories. Moderately strong cross-sectional evidence was found for positive associations between flextime and all outcome categories. The lack of intervention or longitudinal studies restricts clear causal inferences. This review has shown that there are theoretical and empirical reasons to view WTC as a promising tool for the maintenance of employees' work-non-work balance, health and well-being, and job-related outcomes. At the same time, however, the current state of evidence allows only very limited causal inferences to be made

  15. Gender differences in cue exposure reactivity and 9-month outcome.

    Science.gov (United States)

    Sterling, Robert C; Dean, Jessica; Weinstein, Stephen P; Murphy, Jennifer; Gottheil, Edward

    2004-07-01

    Gender differences have been shown to be related to the course of cocaine dependence and treatment. While previous research has shown cue exposure procedures to be somewhat effective at reducing reactivity of substance dependent individuals to drug related stimuli, the few studies that have examined gender differences in craving and cue-reactivity have yielded equivocal results. We have recently demonstrated that an active cue-exposure procedure that featured cocaine-dependent individuals receiving immediate feedback about their level of physiological arousal following videotaped exposure to cocaine-related stimuli was capable of positively influencing in-treatment (helplessness, abstinence efficacy) as well as 9-month followup outcome (i.e., urinalysis) indices (Sterling, R., Gottheil, E., Murphy, J., & Weinstein, S. (2001). Cue exposure and abstinence efficacy. College on Problems of Drug Dependence, Phoenix, AZ, June 17, 2001). The purpose of the present study was to determine whether differential in-treatment or 9-month followup outcomes were obtained for male and female study participants. Subjects in this study were 81 individuals (47 male/34 female) who met DSM-IV criteria for cocaine dependence and who had consented to be randomly assigned to either the active cue-exposure or control conditions. Participants were compared along a myriad of pre-treatment, in-treatment, and 9-month followup measures. Other than males reporting more recent employment, there was no obvious systematic pattern of differences on pre-treatment indices. No gender differences in treatment retention were observed. With respect to 9-month followup, no gender differences on measures of addiction severity, psychological functioning, or urinalyses were noted. However males were more "cue-reactive" and more successful at establishing control over their reactivity to the cocaine stimuli. Additional research is needed to determine whether these differences in reactivity can be more clearly

  16. Combined Modality Treatment for PET-Positive Non-Hodgkin Lymphoma: Favorable Outcomes of Combined Modality Treatment for Patients With Non-Hodgkin Lymphoma and Positive Interim or Postchemotherapy FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Halasz, Lia M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Jacene, Heather A. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Catalano, Paul J. [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Van den Abbeele, Annick D. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); LaCasce, Ann [Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Mauch, Peter M. [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Ng, Andrea K., E-mail: ang@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States)

    2012-08-01

    Purpose: To evaluate outcomes of patients treated for aggressive non-Hodgkin lymphoma (NHL) with combined modality therapy based on [{sup 18}F]fluoro-2-deoxy-2-D-glucose positron emission tomography (FDG-PET) response. Methods and Materials: We studied 59 patients with aggressive NHL, who received chemotherapy and radiation therapy (RT) from 2001 to 2008. Among them, 83% of patients had stage I/II disease. Patients with B-cell lymphoma received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy, and 1 patient with anaplastic lymphoma kinase-negative anaplastic T-cell lymphoma received CHOP therapy. Interim and postchemotherapy FDG-PET or FDG-PET/computed tomography (CT) scans were performed for restaging. All patients received consolidated involved-field RT. Median RT dose was 36 Gy (range, 28.8-50 Gy). Progression-free survival (PFS) and local control (LC) rates were calculated with and without a negative interim or postchemotherapy FDG-PET scan. Results: Median follow-up was 46.5 months. Thirty-nine patients had negative FDG-PET results by the end of chemotherapy, including 12 patients who had a negative interim FDG-PET scan and no postchemotherapy PET. Twenty patients were FDG-PET-positive, including 7 patients with positive interim FDG-PET and no postchemotherapy FDG-PET scans. The 3-year actuarial PFS rates for patients with negative versus positive FDG-PET scans were 97% and 90%, respectively. The 3-year actuarial LC rates for patients with negative versus positive FDG-PET scans were 100% and 90%, respectively. Conclusions: Patients who had a positive interim or postchemotherapy FDG-PET had a PFS rate of 90% at 3 years after combined modality treatment, suggesting that a large proportion of these patients can be cured with consolidated RT.

  17. Long-Term Outcomes of Homografts in the Aortic Valve and Root Position: A 20-Year Experience

    Directory of Open Access Journals (Sweden)

    Joo Yeon Kim

    2016-08-01

    Full Text Available Background: The advantages of using a homograft in valve replacement surgery are the excellent hemodynamic profile, low risk of thromboembolism, and low risk of prosthetic valve infection. The aim of this study was to evaluate the long-term outcomes of homograft implantation in the aortic valve position. Methods: This is a retrospective study of 33 patients (>20 years old who underwent aortic valve replacement or root replacement with homografts between April 1995 and May 2015. Valves were collected within 24 hours from explanted hearts of heart transplant recipients (<60 years and organ donors who were not suitable for heart transplantation. The median follow-up duration was 35.6 months (range, 0 to 168 months. Results: Aortic homografts were used in all patients. The 30-day mortality rate was 9.1%. The 1- and 5-year survival rates were 80.0%±7.3% and 60.8%±10.1%, respectively. The 1-, 5-, and 10-year freedom from reoperation rates were 92.3%±5.2%, 68.9%±10.2%, and 50.3%±13.6%, respectively. The 1-, 5-, and 10-year freedom from significant aortic dysfunction rates were 91.7%±8.0%, 41.7%±14.2%, and 25.0%±12.5%, respectively. Conclusion: Homografts had the advantages of a good hemodynamic profile and low risk of thromboembolic events, and with good outcomes in cases of aortitis.

  18. Outcome of deliveries in healthy but obese women: obesity and delivery outcome

    Directory of Open Access Journals (Sweden)

    Kaplan-Sturk Rebecka

    2013-02-01

    Full Text Available Abstract Background Obesity among fertile women is a global problem. 25% of pregnant Swedish women are overweight at admission to the antenatal clinic and 12% of them are considered as obese. Previous studies have shown an increased risk of delivery complications with an elevated maternal BMI. The aim of this study was to evaluate delivery outcomes in relation to maternal BMI on admission to the antenatal clinic. A healthy group of 787 women with full-term pregnancies and spontaneous onset of labor were included in the study. Delivery outcome was assessed in relation to maternal BMI when attending the antenatal clinic. Results The results indicated that in deliveries where the maternal BMI was >30 a high frequency of abnormal CTG trace during the last 30 minutes of labor was shown. A blood sample for evaluation of risk of fetal hypoxia was performed in only eight percent of these deliveries. A spontaneous vaginal delivery without intervention was noted in 85.7%, and 12% of neonates were delivered with an adverse fetal outcome compared to 2.8% in the group with a maternal BMI Conclusion These results indicate an increased risk at delivery for healthy, but obese women in labor. Furthermore, the delivery management may not always be optimal in these deliveries.

  19. Theoretical approach towards increasing effectiveness of palatal surgery in obstructive sleep apnea: role for concomitant positional therapy?

    Science.gov (United States)

    van Maanen, J P; Witte, B I; de Vries, N

    2014-05-01

    The aims of this study are to evaluate the effect of palatal surgery (uvulopalatopharyngoplasty (UPPP) or Z-palatoplasty (ZPP)) with or without (+/-) concomitant radiofrequent ablation of the base of the tongue (RFTB) on body position-specific apnea-hypopnea index (AHI) values in patients with obstructive sleep apnea (OSA) and to compare this treatment outcome to the theoretical effect of (addition of) positional therapy (PT). Retrospective analysis of pre- and posttreatment polysomnographies in 139 patients who had undergone UPPP/ZPP +/- RFTB was performed. Hypothetical evaluation of the effects of (addition of) ideal PT on AHI in positional OSA (POSA) patients was carried out. Median AHI significantly decreased from 18.0 to 11.2 (p effect of body position needs to be taken into account. PT, either as monotherapy or in addition to surgery, theoretically has shown to improve treatment results dramatically in POSA patients. Prospective, controlled trials focusing on the effects of this combination of treatments should further evaluate this hypothetical conclusion.

  20. Pre-treatment double- or triple-positive tumor markers are predictive of a poor outcome for patients undergoing radiofrequency ablation for hepatocellular carcinoma.

    Science.gov (United States)

    Nitta, Hidetoshi; Nakagawa, Shigeki; Kaida, Takayoshi; Arima, Kota; Higashi, Takaaki; Taki, Katsunobu; Okabe, Hirohisa; Hayashi, Hiromitsu; Hashimoto, Daisuke; Chikamoto, Akira; Ishiko, Takatoshi; Beppu, Toru; Baba, Hideo

    2017-03-01

    We evaluated the therapeutic effect of radiofrequency ablation (RFA) on hepatocellular carcinoma (HCC) according to the number of positive tumor markers. The subjects of this study were 160 patients who underwent percutaneous and surgical RFA for HCC. Patients were divided into negative (n = 51), single- (n = 69), double- (n = 31), and triple-positive (n = 9) tumor marker groups according to the pre-treatment expression of these markers. We looked for any relationships among clinical parameters, outcomes, and tumor markers. The 3-year recurrence-free and overall survival rates of the negative, single-, double-, and triple-positive groups were 30, 19, 16, and 11 % (P = 0.02), and 94, 88, 67, and 37 % (P tumor marker profile was independently associated with local recurrence [hazard ratio (HR) 5.48, 95 % confidence interval (CI) 2.44-12.33, P tumor markers.

  1. Early Adolescent Affect Predicts Later Life Outcomes.

    Science.gov (United States)

    Kansky, Jessica; Allen, Joseph P; Diener, Ed

    2016-07-01

    Subjective well-being as a predictor for later behavior and health has highlighted its relationship to health, work performance, and social relationships. However, the majority of such studies neglect the developmental nature of well-being in contributing to important changes across the transition to adulthood. To examine the potential role of subjective well-being as a long-term predictor of critical life outcomes, we examined indicators of positive and negative affect at age 14 as predictors of relationship, adjustment, self-worth, and career outcomes a decade later at ages 23 to 25, controlling for family income and gender. We utilised multi-informant methods including reports from the target participant, close friends, and romantic partners in a demographically diverse community sample of 184 participants. Early adolescent positive affect predicted fewer relationship problems (less self-reported and partner-reported conflict, and greater friendship attachment as rated by close peers) and healthy adjustment to adulthood (lower levels of depression, anxiety, and loneliness). It also predicted positive work functioning (higher levels of career satisfaction and job competence) and increased self-worth. Negative affect did not significantly predict any of these important life outcomes. In addition to predicting desirable mean levels of later outcomes, early positive affect predicted beneficial changes across time in many outcomes. The findings extend early research on the beneficial outcomes of subjective well-being by having an earlier assessment of well-being, including informant reports in measuring a large variety of outcome variables, and by extending the findings to a lower socioeconomic group of a diverse and younger sample. The results highlight the importance of considering positive affect as an important component of subjective well-being distinct from negative affect. © 2016 The International Association of Applied Psychology.

  2. Why victimology should stay positive: The ongoing need for positive victimology

    Directory of Open Access Journals (Sweden)

    Ronel Natti

    2015-01-01

    Full Text Available This paper presents the need for positive victimology and its unique contribution to victimology. Victimology presented a shift in attention and awareness in practice, research and theory, by focusing on victims of crime and of abuse of power, and on victims’ rights and victims’ services. Positive victimology indicates a more specified shift in attention and awareness, within the larger shift of victimology. This shift stands in line with positive psychology, positive criminology and the idea of victims’ victimology. It denotes an approach to provide the following, as much as possible: 1. A wide range of social responses to the victims and their victimization that victims can experience as positive, 2. Positive outcomes of healing and recovery for victims, and 3. Positive integration of victims. Within each of those, positive victimology suggests a pragmatic coordinated system that ranges from definitions of negative poles to those of positive ones. When moving towards the positive pole at any given coordinate, a sense of justice is an important factor that might reduce the impact of the harm. Support is also a crucial factor and at the very positive pole, stands human, inter-personal love.

  3. Time and outcome framing in intertemporal tradeoffs.

    Science.gov (United States)

    Scholten, Marc; Read, Daniel

    2013-07-01

    A robust anomaly in intertemporal choice is the delay-speedup asymmetry: Receipts are discounted more, and payments are discounted less, when delayed than when expedited over the same interval. We developed 2 versions of the tradeoff model (Scholten & Read, 2010) to address such situations, in which an outcome is expected at a given time but then its timing is changed. The outcome framing model generalizes the approach taken by the hyperbolic discounting model (Loewenstein & Prelec, 1992): Not obtaining a positive outcome when expected is a worse than expected state, to which people are over-responsive, or hypersensitive, and not incurring a negative outcome when expected is a better than expected state, to which people are under-responsive, or hyposensitive. The time framing model takes a new approach: Delaying a positive outcome or speeding up a negative one involves a loss of time to which people are hypersensitive, and speeding up a positive outcome or delaying a negative one involves a gain of time to which people are hyposensitive. We compare the models on their quantitative predictions of indifference data from matching and preference data from choice. The time framing model systematically outperforms the outcome framing model. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  4. Reliability, Validity, and Responsiveness of InFLUenza Patient-Reported Outcome (FLU-PRO©) Scores in Influenza-Positive Patients.

    Science.gov (United States)

    Powers, John H; Bacci, Elizabeth D; Guerrero, M Lourdes; Leidy, Nancy Kline; Stringer, Sonja; Kim, Katherine; Memoli, Matthew J; Han, Alison; Fairchok, Mary P; Chen, Wei-Ju; Arnold, John C; Danaher, Patrick J; Lalani, Tahaniyat; Ridoré, Michelande; Burgess, Timothy H; Millar, Eugene V; Hernández, Andrés; Rodríguez-Zulueta, Patricia; Smolskis, Mary C; Ortega-Gallegos, Hilda; Pett, Sarah; Fischer, William; Gillor, Daniel; Macias, Laura Moreno; DuVal, Anna; Rothman, Richard; Dugas, Andrea; Ruiz-Palacios, Guillermo M

    2018-02-01

    To assess the reliability, validity, and responsiveness of InFLUenza Patient-Reported Outcome (FLU-PRO©) scores for quantifying the presence and severity of influenza symptoms. An observational prospective cohort study of adults (≥18 years) with influenza-like illness in the United States, the United Kingdom, Mexico, and South America was conducted. Participants completed the 37-item draft FLU-PRO daily for up to 14 days. Item-level and factor analyses were used to remove items and determine factor structure. Reliability of the final tool was estimated using Cronbach α and intraclass correlation coefficients (2-day reliability). Convergent and known-groups validity and responsiveness were assessed using global assessments of influenza severity and return to usual health. Of the 536 patients enrolled, 221 influenza-positive subjects comprised the analytical sample. The mean age of the patients was 40.7 years, 60.2% were women, and 59.7% were white. The final 32-item measure has six factors/domains (nose, throat, eyes, chest/respiratory, gastrointestinal, and body/systemic), with a higher order factor representing symptom severity overall (comparative fit index = 0.92; root mean square error of approximation = 0.06). Cronbach α was high (total = 0.92; domain range = 0.71-0.87); test-retest reliability (intraclass correlation coefficient, day 1-day 2) was 0.83 for total scores and 0.57 to 0.79 for domains. Day 1 FLU-PRO domain and total scores were moderately to highly correlated (≥0.30) with Patient Global Rating of Flu Severity (except nose and throat). Consistent with known-groups validity, scores differentiated severity groups on the basis of global rating (total: F = 57.2, P FLU-PRO score improvement by day 7 than did those who did not, suggesting score responsiveness. Results suggest that FLU-PRO scores are reliable, valid, and responsive to change in influenza-positive adults. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes

  5. Impact of helminth diagnostic test performance on estimation of risk factors and outcomes in HIV-positive adults.

    Directory of Open Access Journals (Sweden)

    Michael B Arndt

    Full Text Available BACKGROUND: Traditional methods using microscopy for the detection of helminth infections have limited sensitivity. Polymerase chain reaction (PCR assays enhance detection of helminths, particularly low burden infections. However, differences in test performance may modify the ability to detect associations between helminth infection, risk factors, and sequelae. We compared these associations using microscopy and PCR. METHODS: This cross-sectional study was nested within a randomized clinical trial conducted at 3 sites in Kenya. We performed microscopy and real-time multiplex PCR for the stool detection and quantification of Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, Strongyloides stercoralis, and Schistosoma species. We utilized regression to evaluate associations between potential risk factors or outcomes and infection as detected by either method. RESULTS: Of 153 HIV-positive adults surveyed, 55(36.0% and 20(13.1% were positive for one or more helminth species by PCR and microscopy, respectively (p<0.001. PCR-detected infections were associated with farming (Prevalence Ratio 1.57, 95% CI: 1.02, 2.40, communal water source (PR 3.80, 95% CI: 1.01, 14.27, and no primary education (PR 1.54, 95% CI: 1.14, 2.33, whereas microscopy-detected infections were not associated with any risk factors under investigation. Microscopy-detected infections were associated with significantly lower hematocrit and hemoglobin (means of -3.56% and -0.77 g/dl and a 48% higher risk of anemia (PR 1.48, 95% CI: 1.17, 1.88 compared to uninfected. Such associations were absent for PCR-detected infections unless infection intensity was considered, Infections diagnosed with either method were associated with increased risk of eosinophilia (PCR PR 2.42, 95% CI: 1.02, 5.76; microscopy PR 2.92, 95% CI: 1.29, 6.60. CONCLUSION: Newer diagnostic methods, including PCR, improve the detection of helminth infections. This heightened sensitivity may improve the

  6. Product Differentiation and Positioning: Confused Concepts

    OpenAIRE

    Shaheen Borna; Joseph Chapman

    1993-01-01

    This article examines two common marketing terms: product positioning and product differentiation. Many authors use these terms interchangeably, yet most marketing texts treat product positioning and product differentiation as two seperate concepts. This article attempts to identify the underlying concepts of both product differentiation and product positioning. Product differentiation is shown to be a special case of product positioning: therefore, it is suggested that marketers may want to ...

  7. Associations between positive end-expiratory pressure and outcome of patients without ARDS at onset of ventilation: a systematic review and meta-analysis of randomized controlled trials

    NARCIS (Netherlands)

    Serpa Neto, Ary; Filho, Roberto Rabello; Cherpanath, Thomas; Determann, Rogier; Dongelmans, Dave A.; Paulus, Frederique; Tuinman, Pieter Roel; Pelosi, Paolo; de Abreu, Marcelo Gama; Schultz, Marcus J.

    2016-01-01

    The aim of this investigation was to compare ventilation at different levels of positive end-expiratory pressure (PEEP) with regard to clinical important outcomes of intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) at onset of ventilation. Meta-analysis of

  8. What Are We Drinking? Beverages Shown in Adolescents' Favorite Television Shows.

    Science.gov (United States)

    Eisenberg, Marla E; Larson, Nicole I; Gollust, Sarah E; Neumark-Sztainer, Dianne

    2017-05-01

    Media use has been shown to contribute to poor dietary intake; however, little attention has been paid to programming content. The portrayal of health behaviors in television (TV) programming contributes to social norms among viewers, which have been shown to influence adolescent behavior. This study reports on a content analysis of beverages shown in a sample of TV shows popular with a large, diverse group of adolescents, with attention to the types of beverages and differences across shows and characters. Favorite TV shows were assessed in an in-school survey in 2010. Three episodes of each of the top 25 shows were analyzed, using a detailed coding instrument. Beverage incidents (ie, beverage shown or described) were recorded. Beverage types included milk, sugar-sweetened beverages (SSBs), diet beverages, juice, water, alcoholic drinks, and coffee. Characters were coded with regard to gender, age group, race, and weight status. Shows were rated for a youth, general, or adult audience. χ 2 tests were used to compare the prevalence of each type of beverage across show ratings (youth, general, adult), and to compare characteristics of those involved in each type of beverage incident. Beverage incidents were common (mean=7.4 incidents/episode, range=0 to 25). Alcohol was the most commonly shown (38.8%); milk (5.8%) and juice (5.8%) were least common; 11.0% of incidents included SSBs. Significant differences in all types of beverage were found across characters' age groups. Almost half of young adults' (49.2%) or adults' (42.0%) beverage incidents included alcohol. Beverages are often portrayed on TV shows viewed by adolescents, and common beverages (alcohol, SSBs) may have adverse consequences for health. The portrayal of these beverages likely contributes to social norms regarding their desirability; nutrition and health professionals should talk with youth about TV portrayals to prevent the adoption of unhealthy beverage behaviors. Copyright © 2017 Academy of

  9. What are we drinking? Beverages shown in adolescents’ favorite TV shows

    Science.gov (United States)

    Eisenberg, Marla E.; Larson, Nicole I.; Gollust, Sarah E.; Neumark-Sztainer, Dianne

    2016-01-01

    Background Media use has been shown to contribute to poor dietary intake; however, little attention has been paid to programming content. The portrayal of health behaviors in television (TV) programming contributes to social norms among viewers, which have been shown to influence adolescent behavior. Objective This study reports on a content analysis of beverages shown in a sample of TV shows popular with a large, diverse group of adolescents, with attention to the types of beverages and differences across shows and characters. Design Favorite TV shows were assessed in an in-school survey in 2010. Three episodes of each of the top 25 shows were analyzed using a detailed coding instrument. Key measures Beverage incidents (i.e. beverage shown or described) were recorded. Beverage types included milk, sugar-sweetened beverages (SSB), diet beverages, juice, water, alcoholic drinks and coffee. Characters were coded with regards to gender, age group, race, and weight status. Shows were rated for a youth, general or adult audience. Statistical analyses Chi-square tests were used to compare the prevalence of each type of beverage across show ratings (youth, general, adult), and to compare characteristics of those involved in each type of beverage incident. Results Beverage incidents were common (mean=7.4 incidents/episode, range=0–25). Alcohol was the most commonly shown (38.8%); milk (5.8%) and juice (5.8%) were least common; 11.0% of incidents included SSB. Significant differences in all types of beverage were found across age groups. Almost half of young adults’ (49.2%) or adults’ (42.0%) beverage incidents included alcohol. Conclusions Beverages are often portrayed on TV shows viewed by adolescents, and common beverages (alcohol, SSB) may have adverse consequences for health. The portrayal of these beverages likely contributes to social norms regarding their desirability; nutrition and health professionals should talk with youth about TV portrayals to prevent the

  10. Patient positioning and ventilator-associated pneumonia.

    Science.gov (United States)

    Hess, Dean R

    2005-07-01

    Rotational beds, prone position, and semi-recumbent position have been proposed as procedures to prevent ventilator-associated pneumonia (VAP). Rotational therapy uses a special bed designed to turn continuously, or nearly continuously, the patient from side to side; specific designs include kinetic therapy and continuous lateral rotation therapy. A meta-analysis of studies evaluating the effect of rotational bed therapy shows a decrease in the risk of pneumonia but no effect on mortality. Two studies reported a lower risk of VAP in patients placed in a prone position, with no effect on mortality. Studies using radiolabeled enteral feeding solutions in mechanically ventilated patients have reported that aspiration of gastric contents occurs to a greater degree when patients are in the supine position, compared with the semirecumbent position. One study reported a lower rate of VAP in patients randomized to semi-recumbent compared to supine position. Although each of the techniques discussed in this paper has been shown to reduce the risk of VAP, none has been shown to affect mortality. The available evidence suggests that semi-recumbent position should be used routinely, rotational therapy should be considered in selected patients, and prone position should not be used as a technique to reduce the risk of VAP.

  11. Alterations of the genes involved in the PI3K and estrogen-receptor pathways influence outcome in human epidermal growth factor receptor 2-positive and hormone receptor-positive breast cancer patients treated with trastuzumab-containing neoadjuvant chemotherapy

    International Nuclear Information System (INIS)

    Takada, Mamoru; Miyazaki, Masaru; Sato-Otsubo, Aiko; Ogawa, Seishi; Kaneko, Yasuhiko; Higuchi, Toru; Tozuka, Katsunori; Takei, Hiroyuki; Haruta, Masayuki; Watanabe, Junko; Kasai, Fumio; Inoue, Kenichi; Kurosumi, Masafumi

    2013-01-01

    Chemotherapy with trastuzumab is widely used for patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer, but a significant number of patients with the tumor fail to respond, or relapse. The mechanisms of recurrence and biomarkers that indicate the response to the chemotherapy and outcome are not fully investigated. Genomic alterations were analyzed using single-nucleotide polymorphism arrays in 46 HER2 immunohistochemistry (IHC) 3+ or 2+/fluorescent in situ hybridization (FISH)+ breast cancers that were treated with neoadjuvant chemotherapy with paclitaxel, cyclophosphamid, epirubicin, fluorouracil, and trastuzumab. Patients were classified into two groups based on presence or absence of alterations of 65 cancer-associated genes, and the two groups were further classified into four groups based on genomic HER2 copy numbers or hormone receptor status (HR+/−). Pathological complete response (pCR) and relapse-free survival (RFS) rates were compared between any two of the groups. The pCR rate was 54% in 37 patients, and the RFS rate at 3 years was 72% (95% CI, 0.55-0.89) in 42 patients. The analysis disclosed 8 tumors with nonamplified HER2 and 38 tumors with HER2 amplification, indicating the presence of discordance in tumors diagnosed using current HER2 testing. The 8 patients showed more difficulty in achieving pCR (P=0.019), more frequent relapse (P=0.018), and more frequent alterations of genes in the PI3K pathway (P=0.009) than the patients with HER2 amplification. The alterations of the PI3K and estrogen receptor (ER) pathway genes generally indicated worse RFS rates. The prognostic significance of the alterations was shown in patients with a HR+ tumor, but not in patients with a HR- tumor when divided. Alterations of the PI3K and ER pathway genes found in patients with a HR+ tumor with poor outcome suggested that crosstalk between the two pathways may be involved in resistance to the current chemotherapy with trastuzumab. We

  12. Discounting Models for Outcomes over Continuous Time

    DEFF Research Database (Denmark)

    Harvey, Charles M.; Østerdal, Lars Peter

    Events that occur over a period of time can be described either as sequences of outcomes at discrete times or as functions of outcomes in an interval of time. This paper presents discounting models for events of the latter type. Conditions on preferences are shown to be satisfied if and only if t...... if the preferences are represented by a function that is an integral of a discounting function times a scale defined on outcomes at instants of time....

  13. Noise in position measurement by centroid calculation

    International Nuclear Information System (INIS)

    Volkov, P.

    1996-01-01

    The position of a particle trajectory in a gaseous (or semiconductor) detector can be measured by calculating the centroid of the induced charge on the cathode plane. The charge amplifiers attached to each cathode strip introduce noise which is added to the signal. This noise broadens the position resolution line. Our article gives an analytical tool to estimate the resolution broadening due to the noise per strip and the number of strips involved in the centroid calculation. It is shown that the position resolution increases faster than the square root of the number of strips involved. We also consider the consequence of added interstrip capacitors, intended to diminish the differential nonlinearity. It is shown that the position error increases slower than linearly with the interstrip capacities, due to the cancellation of correlated noise. The estimation we give, can be applied to calculations of position broadening other than the centroid finding. (orig.)

  14. "I am a scientist": How setting conditions that enhance focused concentration positively relate to student motivation and achievement outcomes in inquiry-based science

    Science.gov (United States)

    Ellwood, Robin B.

    This research investigated how student social interactions within two approaches to an inquiry-based science curriculum could be related to student motivation and achievement outcomes. This qualitative case study consisted of two cases, Off-Campus and On-Campus, and used ethnographic techniques of participant observation. Research participants included eight eighth grade girls, aged thirteen to fourteen years old. Data sources included formal and informal participant interviews, participant journal reflections, curriculum artifacts including quizzes, worksheets, and student-generated research posters, digital video and audio recordings, photographs, and researcher field notes. Data were transcribed verbatim and coded, then collapsed into emergent themes using NVIVO 9. The results of this research illustrate how setting conditions that promote focused concentration and communicative interactions can be positively related to student motivation and achievement outcomes in inquiry-based science. Participants in the Off-Campus case experienced more frequent states of focused concentration and out performed their peers in the On-Campus case on forty-six percent of classroom assignments. Off-Campus participants also designed and implemented a more cognitively complex research project, provided more in-depth analyses of their research results, and expanded their perceptions of what it means to act like a scientist to a greater extent than participants in the On-Campus case. These results can be understood in relation to Flow Theory. Student interactions that promoted the criteria necessary for initiating flow, which included having clearly defined goals, receiving immediate feedback, and maintaining a balance between challenges and skills, fostered enhanced student motivation and achievement outcomes. This research also illustrates the positive gains in motivation and achievement outcomes that emerge from student experiences with extended time in isolated areas referred to

  15. Magnitude of income-related disparities in adverse perinatal outcomes.

    Science.gov (United States)

    Shankardass, Ketan; O'Campo, Patricia; Dodds, Linda; Fahey, John; Joseph, Ks; Morinis, Julia; Allen, Victoria M

    2014-03-04

    To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 117734 singleton births between 1988 and 2003. Models for after tax family income were also adjusted for neighborhood deprivation to gauge the relative magnitude of effects related to SEP at both levels. Effects of SEP were stratified by single- versus multiple-parent family composition, and by urban versus rural location of residence. The risk of small for gestational age and spontaneous preterm birth was higher across all the indicators of lower SEP, while risk for large for gestational age was lower across indicators of lower SEP. Higher risk of postneonatal death was demonstrated for several measures of lower SEP. Higher material deprivation in the neighborhood of residence was associated with increased risk for perinatal death, small for gestational age birth, and iatrogenic and spontaneous preterm birth. Family composition and urbanicity were shown to modify the association between income and some perinatal outcomes. This study highlights the importance of understanding the definitions of SEP and the mechanisms that lead to the association between income and poor perinatal outcomes, and broadening the types of SEP measures used in some cases.

  16. Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

    Directory of Open Access Journals (Sweden)

    HUGO KARLING MORESCHI

    2015-02-01

    Full Text Available Background General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods Length of stay (LOS, Global Assessment of Functioning (variation and at discharge and Clinical Global Impression (severity and improvement were used to build a ten-point improvement index (I-Index. Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint “behavioral change/aggressiveness” and psychotic features. Multivariate analysis found a higher OR for diagnoses of “psychotic disorders” and “personality disorders” and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

  17. The effects on health behavior and health outcomes of Internet-based asynchronous communication between health providers and patients with a chronic condition: a systematic review.

    Science.gov (United States)

    de Jong, Catharina Carolina; Ros, Wynand Jg; Schrijvers, Guus

    2014-01-16

    In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. The effect of

  18. Clinical characteristics and treatment outcomes for benign paroxysmal positional vertigo comorbid with hypertension.

    Science.gov (United States)

    Tan, Jun; Deng, Yuxiao; Zhang, Tianyu; Wang, Menghong

    2017-05-01

    Patients with BPPV comorbid with hypertension (h-BPPV) tend to receive a delayed diagnosis of BPPV. Comorbidity with hypertension did not influence the efficacy of the repositioning maneuver; however, comorbidity with hypertension was associated with an increased recurrence rate of BPPV. To determine the clinical characteristics and outcomes of h-BPPV, as well as the clinical differences between h-BPPV and idiopathic BPPV (i-BPPV). The authors reviewed the medical records of 41 consecutive patients with h-BPPV (the h-BPPV group) from March to December 2014 and 47 patients with i-BPPV (the i-BPPV group) during the same period. There were no significant differences in age, sex ratio, or the affected side between the h-BPPV and i-BPPV groups. The proportion of patients reporting an initial episode of positional vertigo was significantly lower in the h-BPPV group (51.22% vs 74.47%; p = .024). Patients in the h-BPPV group reported a longer median episode duration than did those in the i-BPPV group (60 days vs 15 days; p = .017). The results of treatment using repositioning maneuvers were similar between the two groups. At follow-up, 13 patients in the h-BPPV group were diagnosed with recurrent BPPV compared with six in the i-BPPV group (p = .031).

  19. Effects of central nervous system drugs on driving: speed variability versus standard deviation of lateral position as outcome measure of the on-the-road driving test.

    Science.gov (United States)

    Verster, Joris C; Roth, Thomas

    2014-01-01

    The on-the-road driving test in normal traffic is used to examine the impact of drugs on driving performance. This paper compares the sensitivity of standard deviation of lateral position (SDLP) and SD speed in detecting driving impairment. A literature search was conducted to identify studies applying the on-the-road driving test, examining the effects of anxiolytics, antidepressants, antihistamines, and hypnotics. The proportion of comparisons (treatment versus placebo) where a significant impairment was detected with SDLP and SD speed was compared. About 40% of 53 relevant papers did not report data on SD speed and/or SDLP. After placebo administration, the correlation between SDLP and SD speed was significant but did not explain much variance (r = 0.253, p = 0.0001). A significant correlation was found between ΔSDLP and ΔSD speed (treatment-placebo), explaining 48% of variance. When using SDLP as outcome measure, 67 significant treatment-placebo comparisons were found. Only 17 (25.4%) were significant when SD speed was used as outcome measure. Alternatively, for five treatment-placebo comparisons, a significant difference was found for SD speed but not for SDLP. Standard deviation of lateral position is a more sensitive outcome measure to detect driving impairment than speed variability.

  20. Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

    Science.gov (United States)

    Caissutti, Claudia; Khalifeh, Adeeb; Saccone, Gabriele; Berghella, Vincenzo

    2018-02-01

    The aim of this study was to evaluate if women meeting criteria for gestational diabetes mellitus (GDM) by the One Step test as per International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by other less strict criteria have adverse pregnancy outcomes compared with GDM-negative controls. The primary outcome was the incidence of macrosomia, defined as birthweight > 4000 g. Electronic databases were searched from their inception until May 2017. All studies identifying pregnant women negative at the Two Step test, but positive at the One Step test for IADPSG criteria were included. We excluded studies that randomized women to the One Step vs. the Two Step tests; studies that compared different criteria within the same screening method; randomized studies comparing treatments for GDM; and studies comparing incidence of GDM in women doing the One Step test vs. the Two Step test. Eight retrospective cohort studies, including 29 983 women, were included. Five study groups and four control groups were identified. The heterogeneity between the studies was high. Gestational hypertension, preeclampsia and large for gestational age, as well as in some analyses cesarean delivery, macrosomia and preterm birth, were significantly more frequent, and small for gestational age in some analyses significantly less frequent, in women GDM-positive by the One Step, but not the Two Step. Women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria have an increased risk of adverse pregnancy outcomes such as gestational hypertension, preeclampsia and large for gestational age, compared with GDM-negative controls. Based on these findings, and evidence from other studies that treatment decreases these adverse outcomes, we suggest screening for GDM using the One Step IADPSG criteria. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  1. Serial position learning in honeybees.

    Directory of Open Access Journals (Sweden)

    Randolf Menzel

    Full Text Available Learning of stimulus sequences is considered as a characteristic feature of episodic memory since it contains not only a particular item but also the experience of preceding and following events. In sensorimotor tasks resembling navigational performance, the serial order of objects is intimately connected with spatial order. Mammals and birds develop episodic(-like memory in serial spatio-temporal tasks, and the honeybee learns spatio-temporal order when navigating between the nest and a food source. Here I examine the structure of the bees' memory for a combined spatio-temporal task. I ask whether discrimination and generalization are based solely on simple forms of stimulus-reward learning or whether they require sequential configurations. Animals were trained to fly either left or right in a continuous T-maze. The correct choice was signaled by the sequence of colors (blue, yellow at four positions in the access arm. If only one of the possible 4 signals is shown (either blue or yellow, the rank order of position salience is 1, 2 and 3 (numbered from T-junction. No learning is found if the signal appears at position 4. If two signals are shown, differences at positions 1 and 2 are learned best, those at position 3 at a low level, and those at position 4 not at all. If three or more signals are shown these results are corroborated. This salience rank order again appeared in transfer tests, but additional configural phenomena emerged. Most of the results can be explained with a simple model based on the assumption that the four positions are equipped with different salience scores and that these add up independently. However, deviations from the model are interpreted by assuming stimulus configuration of sequential patterns. It is concluded that, under the conditions chosen, bees rely most strongly on memories developed during simple forms of associative reward learning, but memories of configural serial patterns contribute, too.

  2. Pairing attachment theory and social learning theory in video-feedback intervention to promote positive parenting.

    Science.gov (United States)

    Juffer, Femmie; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H

    2017-06-01

    Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) is a social-learning and attachment-based intervention using video feedback to support sensitive parenting and at the same time setting firm limits. Empirical studies and meta-analyses have shown that sensitive parenting is the key determinant to promote secure child-parent attachment relationships and that adequate parental discipline contributes to fewer behavior problems in children. Building on this evidence, VIPP-SD has been tested in various populations of at-risk parents and vulnerable children (in the age range of zero to six years), as well as in the context of child care. In twelve randomized controlled trials including 1116 parents and caregivers, VIPP-SD proved to be effective in promoting sensitive caregiving, while positive social-emotional child outcomes were also found. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Positive academic emotions moderate the relationship between self-regulation and academic achievement.

    Science.gov (United States)

    Villavicencio, Felicidad T; Bernardo, Allan B I

    2013-06-01

    Research has shown how academic emotions are related to achievement and to cognitive/motivational variables that promote achievement. Mediated models have been proposed to account for the relationships among academic emotions, cognitive/motivational variables, and achievement, and research has supported such mediated models, particularly with negative emotions. The study tested the hypotheses: (1) self-regulation and the positive academic emotions of enjoyment and pride are positive predictors of achievement; and (2) enjoyment and pride both moderate the relationship between self-regulation and achievement. Participants were 1,345 students enrolled in various trigonometry classes in one university. Participants answered the Academic Emotions Questionnaire-Math (Pekrun, Goetz, & Frenzel, 2005) and a self-regulation scale (Pintrich, Smith, Garcia, & McKeachie, 1991) halfway through their trigonometry class. The students' final grades in the course were regressed to self-regulation, positive emotions, and the interaction terms to test the moderation effects. Enjoyment and pride were both positive predictors of grades; more importantly, both moderated the relationship between self-regulation and grades. For students who report higher levels of both positive emotions, self-regulation was positively associated with grades. However, for those who report lower levels of pride, self-regulation was not related to grades; and, for those who reported lower levels of enjoyment, self-regulation was negatively related to grades. The results are discussed in terms of how positive emotions indicate positive appraisals of task/outcome value, and thus enhance the positive links between cognitive/motivational variables and learning. ©2012 The British Psychological Society.

  4. Factors Affecting Outcomes in Cochlear Implant Recipients Implanted With a Perimodiolar Electrode Array Located in Scala Tympani.

    Science.gov (United States)

    Holden, Laura K; Firszt, Jill B; Reeder, Ruth M; Uchanski, Rosalie M; Dwyer, Noël Y; Holden, Timothy A

    2016-12-01

    To identify primary biographic and audiologic factors contributing to cochlear implant (CI) performance variability in quiet and noise by controlling electrode array type and electrode position within the cochlea. Although CI outcomes have improved over time, considerable outcome variability still exists. Biographic, audiologic, and device-related factors have been shown to influence performance. Examining CI recipients with consistent array type and electrode position may allow focused investigation into outcome variability resulting from biographic and audiologic factors. Thirty-nine adults (40 ears) implanted for at least 6 months with a perimodiolar electrode array known (via computed tomography [CT] imaging) to be in scala tympani participated. Test materials, administered CI only, included monosyllabic words, sentences in quiet and noise, and spectral ripple discrimination. In quiet, scores were high with mean word and sentence scores of 76 and 87%, respectively; however, sentence scores decreased by an average of 35 percentage points when noise was added. A principal components (PC) analysis of biographic and audiologic factors found three distinct factors, PC1 Age, PC2 Duration, and PC3 Pre-op Hearing. PC1 Age was the only factor that correlated, albeit modestly, with speech recognition in quiet and noise. Spectral ripple discrimination strongly correlated with speech measures. For these recipients with consistent electrode position, PC1 Age was related to speech recognition performance. Consistent electrode position may have contributed to high speech understanding in quiet. Inter-subject variability in noise may have been influenced by auditory/cognitive processing, known to decline with age, and mechanisms that underlie spectral resolution ability.

  5. Influence of upper extremity positioning on pain, paresthesia, and tolerance: advancing current practice.

    Science.gov (United States)

    Lester, Mark E; Hazelton, Jill; Dewey, William S; Casey, James C; Richard, Reginald

    2013-01-01

    Loss of upper extremity motion caused by axillary burn scar contracture is a major complication of burn injury. Positioning acutely injured patients with axillary burns in positions above 90° of shoulder abduction may improve shoulder motion and minimize scar contracture. However, these positions may increase injury risk to the nerves of the brachial plexus. This study evaluated the occurrence of paresthesias, pain, and positional intolerance in four shoulder abduction positions in healthy adults. Sixty men and women were placed in four randomly assigned shoulder abduction positions for up to 2 hours: 1) 90° with elbow extension (90 ABD); 2) 130° with elbow flexion at 110° (130 ABD); 3) 150° with elbow extension (150 ABD); and 4) 170° with elbow extension (170 ABD). Outcome measures were assessed at baseline and every 30 minutes and included the occurrence of upper extremity paresthesias, position comfort/tolerance, and pain. Transient paresthesias, lasting less than 3 minutes, occurred in all test positions in 10 to 37% of the cases. Significantly fewer subjects reported paresthesias in the 90 ABD position compared with the other positions (P < .01). Pain was reported more frequently in the 170° position (68%) compared with the other positions (P < .01). Positioning with the elbow flexed or in terminal extension is not recommended, regardless of the degree of shoulder abduction. Positioning patients in a position of 150° of shoulder abduction was shown to be safe and well tolerated. Consideration of positions above this range should be undertaken cautiously and only with strict monitoring in alert and oriented patients for short time periods.

  6. The Aesthetically Ideal Position of the Nipple-Areola Complex on the Breast.

    Science.gov (United States)

    Lewin, Richard; Amoroso, Matteo; Plate, Nikolina; Trogen, Clara; Selvaggi, Gennaro

    2016-10-01

    Several studies have attempted to identify an objective description of the aesthetically ideal breast, but they have all suffered in their reliability because of having several intrinsic limitations. It is therefore essential to design a template of ideal breast features in order to predict and evaluate aesthetic outcomes in both reconstructive and cosmetic breast surgery. The aim of this study was to determine the aesthetically preferred position of the nipple-areola complex on the breast. A questionnaire was sent by regular mail to 1000 men and 1000 women aged between 16 and 74 years. They were asked to rank the attractiveness of a series of breasts of women in images with different NAC positions. The images showed breasts from two different angles: 12 frontal-view images with both breasts shown, and five side-view images with only one breast shown. All of the breasts had equal dimensions and proportions, with the same areola size but different NAC positions. Statistical analysis of data was carried out. Eight hundred and thirteen of 2000 participants completed the questionnaire. The NAC placement preferred by both genders had a ratio of 40:60 x and 50:50 y, which means that it was best situated in the middle of the breast gland vertically and slightly lateral to the midpoint horizontally. Significant differences were found between the age and gender subgroup preferences. This study identified the preferred position of the nipple-areola complex on the female breast in the general population. This is an important information when planning breast reconstructive and cosmetic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  7. Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

    OpenAIRE

    Kruse, Clemens Scott; Beane, Amanda

    2018-01-01

    Background Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT’s contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. Objective The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is...

  8. Correlation of Internet Use for Health Care Engagement Purposes and HIV Clinical Outcomes Among HIV-Positive Individuals Using Online Social Media.

    Science.gov (United States)

    Saberi, Parya; Johnson, Mallory O

    2015-01-01

    The authors aimed to describe cell phone and Internet use and assess the correlation of Internet use for health care engagement purposes and HIV clinical outcomes among HIV-positive individuals. The authors conducted a national survey using online social media to examine cell phone and Internet use, self-reported HIV viral load (detectable vs. undetectable), and antiretroviral adherence rating (excellent vs. less than excellent). Participants (N = 1,494) were asked about their Internet use for health care engagement purposes (including e-mailing health care providers, refilling medications online, and making medical appointments online). Approximately 95% of participants accessed the Internet nearly daily or daily in the past month (mean hours on Internet use per day = 5.2) and 55.5% used the Internet for health care engagement purposes. Those who used the Internet for any health care engagement purposes had a 1.52-fold odds of reporting an undetectable viral load (p = .009) and a 1.49-fold odds of reporting excellent adherence (p = .001). Although Internet access and use were similar across racial/ethnic, educational, and socioeconomic groups, disparities existed with the use of the Internet for health care engagement purposes among racial/ethnic minorities, those with low to moderate financial stability, lower education, and history of incarceration. The authors' data reveal that among HIV-positive users of online social media, use of the Internet for health care engagement purposes is associated with better self-reported virologic and adherence outcomes.

  9. Attributions of responsibility and affective reactions to decision outcomes.

    Science.gov (United States)

    Zeelenberg, M; van der Pligt, J; de Vries, N K

    2000-06-01

    Immediate affective reactions to outcomes are more intense following decisions to act than following decisions not to act. This finding holds for both positive and negative outcomes. We relate this "actor-effect" to attribution theory and argue that decision makers are seen as more responsible for outcomes when these are the result of a decision to act as compared to a decision not to act. Experiment 1 (N = 80) tests the main assumption underlying our reasoning and shows that affective reactions to decision outcomes are indeed more intense when the decision maker is seen as more responsible. Experiment 2 (N = 40) tests whether the actor effect can be predicted on the basis of differential attributions following action and inaction. Participants read vignettes in which active and passive actors obtained a positive or negative outcome. Action resulted in more intense affect than inaction, and positive outcomes resulted in more intense affect than negative outcomes. Experiment 2 further shows that responsibility attributions and affective reactions to outcomes are highly correlated; that is, more extreme affective reactions are associated with more internal attributions. We discuss the implications for research on post-decisional reactions.

  10. Identification of a robust gene signature that predicts breast cancer outcome in independent data sets

    International Nuclear Information System (INIS)

    Korkola, James E; Waldman, Frederic M; Blaveri, Ekaterina; DeVries, Sandy; Moore, Dan H II; Hwang, E Shelley; Chen, Yunn-Yi; Estep, Anne LH; Chew, Karen L; Jensen, Ronald H

    2007-01-01

    Breast cancer is a heterogeneous disease, presenting with a wide range of histologic, clinical, and genetic features. Microarray technology has shown promise in predicting outcome in these patients. We profiled 162 breast tumors using expression microarrays to stratify tumors based on gene expression. A subset of 55 tumors with extensive follow-up was used to identify gene sets that predicted outcome. The predictive gene set was further tested in previously published data sets. We used different statistical methods to identify three gene sets associated with disease free survival. A fourth gene set, consisting of 21 genes in common to all three sets, also had the ability to predict patient outcome. To validate the predictive utility of this derived gene set, it was tested in two published data sets from other groups. This gene set resulted in significant separation of patients on the basis of survival in these data sets, correctly predicting outcome in 62–65% of patients. By comparing outcome prediction within subgroups based on ER status, grade, and nodal status, we found that our gene set was most effective in predicting outcome in ER positive and node negative tumors. This robust gene selection with extensive validation has identified a predictive gene set that may have clinical utility for outcome prediction in breast cancer patients

  11. Maternal knowledge, outcome expectancies and normative beliefs as determinants of cessation of exclusive breastfeeding: a cross-sectional study in rural Kenya.

    Science.gov (United States)

    Gewa, Constance A; Chepkemboi, Joan

    2016-03-09

    Despite the importance of multiple psychosocial factors on nutrition-related behavior, very few studies have explored beyond the role of mothers' knowledge and perception of child-focused outcomes on the duration of exclusive breastfeeding in Africa. Our objective was to determine the relationships among mothers' knowledge, outcome expectancies, normative beliefs, and cessation of exclusive breastfeeding in rural Kenya. A cross-sectional survey was conducted among 400 mothers of children, 0-24 months old, in rural Kenya. Early child-feeding practices, knowledge of breastfeeding recommendations, beliefs associated with impact of exclusive breastfeeding on child- and mother-focused outcomes and perception of acceptability of exclusive breastfeeding by important others were examined. Cox regression analysis was used to assess the relationship between independent variables of interest and cessation of exclusive breastfeeding. Being knowledgeable of breastfeeding-related recommendations, positive beliefs on the impact of exclusive breastfeeding on child- focused outcomes, having a more positive perception of the impact of exclusive breastfeeding on mother-focused outcomes and a more positive perception of acceptability of exclusive breastfeeding by important others were associated with significantly lower risks of premature cessation of exclusive breastfeeding. In addition to knowledge levels, mothers' beliefs play an important role in mothers' decisions to practice exclusive breastfeeding. Mother's beliefs on the impact of exclusive breastfeeding on the mother's health, physical appearance and ability to engage in other activities were shown to have the strongest relationship with premature cessation of exclusive breastfeeding. Addressing these beliefs has the potential to contribute to more effective exclusive breastfeeding promotion efforts in rural Kenya.

  12. Positive Youth Development and Nutrition: Interdisciplinary Strategies to Enhance Student Outcomes

    Science.gov (United States)

    Edwards, Oliver W.; Cheeley, Taylor

    2016-01-01

    Educational policies require the use of data and progress monitoring frameworks to guide instruction and intervention in schools. As a result, different problem-solving models such as multitiered systems of supports (MTSS) have emerged that use these frameworks to improve student outcomes. However, problem-focused models emphasize negative…

  13. Comparison of Positive Youth Development for Youth With Chronic Conditions With Healthy Peers.

    Science.gov (United States)

    Maslow, Gary R; Hill, Sherika N; Pollock, McLean D

    2016-12-01

    Adolescents with childhood-onset chronic condition (COCC) are at increased risk for physical and psychological problems. Despite being at greater risk and having to deal with traumatic experiences and uncertainty, most adolescents with COCC do well across many domains. The Positive Youth Development (PYD) perspective provides a framework for examining thriving in youth and has been useful in understanding positive outcomes for general populations of youth as well as at-risk youth. This study aimed to compare levels of PYD assets between youth with COCC and youth without illness. Participants with COCC were recruited from specialty pediatric clinics while healthy participants were recruited from a large pediatric primary care practice. Inclusion criteria for participants included being (1) English speaking, (2) no documented intellectual disability in electronic medical record, and (3) aged between 13 and 18 years during the recruitment period. Univariate and bivariate analyses on key variables were conducted for adolescents with and without COCC. Finally, we performed multivariable linear regressions for PYD and its subdomains. There were no significant differences between overall PYD or any of the subdomains between the two groups. Multivariable linear regression models showed no statistically significant relationship between chronic condition status and PYD or the subdomains. The findings from this study support the application of the PYD perspective to this population of youth. The results of this study suggest that approaches shown to benefit healthy youth, could be used to promote positive outcomes for youth with COCC. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Evaluating treatment outcomes and durations among cases of smear-positive pulmonary tuberculosis in Yemen: a prospective follow-up study.

    Science.gov (United States)

    Jaber, Ammar Ali Saleh; Khan, Amer Hayat; Sulaiman, Syed Azhar Syed

    2017-01-01

    Evaluating outcomes after tuberculosis (TB) treatment can help identify the primary reasons for treatment success or failure. However, Yemen has a treatment success rate that remains below the World Health Organization's target. This study aimed to identify factors that were associated with unsuccessful treatment and prolonged treatment (>1 year). Newly diagnosed cases of smear-positive pulmonary TB were prospectively followed at two centers (Taiz and Alhodidah, Yemen) between April 2014 and March 2015. Standardized forms were used to obtain information from the patients regarding their socio-demographic and clinical characteristics, treatment duration, and TB-related information. Multivariate logistic regression analyses were performed to identify factors that were associated with unsuccessful treatment and prolonged treatment (>1 year). The study included data from 273 cases of newly diagnosed TB, with treatment being successful in 227 cases (83.1%) and unsuccessful in 46 cases (16.9%). Among the 46 patients with unsuccessful treatment, 29 patients (10.6%) stopped treatment, 6 patients (2.2%) transferred to another facility, 6 patients (2.2%) experienced treatment failure, and 5 patients (1.8%) died. The multivariate logistic regression analyses revealed that unsuccessful treatment was associated with female sex, illiterate status, and the presence of comorbidities. Prolonged treatment durations were associated with living in a rural area, smoking, chewing khat, a cough that lasted for >3 weeks at the beginning of treatment, and bilateral cavities during radiography. These results confirm that the treatment success rate in Yemen is lower than the World Health Organization's target for smear-positive pulmonary tuberculosis. Targeting the risk factors that we identified may help improve treatment outcomes. Furthermore, it may not be prudent to re-treat patients using first-line TB drugs after an initial treatment failure.

  15. A-KAM, bracket positioning device

    Directory of Open Access Journals (Sweden)

    Anand Ambekar

    2018-01-01

    Full Text Available Bracket positioning is the heart of preadjusted edgewise appliance. Accuracy of bracket positioning directly affects the treatment outcome. A number of hand-held instruments are available for bracket positioning accuracy including Boon's gauge, MBT gauges, and various other modifications. However, the most commonly used MBT gauges come in a set of two or four jigs with gauges on each end of the instrument making it difficult to carry in the instrument tray for the orthodontists. Our new bracket positioning instrument, A-KAM, bracket positioning device surpasses these difficulties and can be used for reproducible bracket placement from 2.5 mm to 5.5 mm from the base of bracket.

  16. Outcomes in culture positive and culture negative ascitic fluid infection in patients with viral cirrhosis: cohort study

    Directory of Open Access Journals (Sweden)

    Ali Ailia W

    2008-12-01

    Full Text Available Abstract Background Ascitic fluid infection (AFI in cirrhotic patients has a high morbidity and mortality. It has two variants namely, spontaneous bacterial peritonitis (SBP and culture negative neutrocytic ascites (CNNA. The aim of this study was to determine the outcome in cirrhotic patients with culture positive (SBP and culture negative neutrocytic ascites. Methods We analyzed 675 consecutive hepatitis B and/or C related cirrhosis patients with ascites admitted in our hospital from November 2005 to December 2007. Of these, 187 patients had AFI; clinical and laboratory parameters of these patients including causes of cirrhosis, Child Turcotte Pugh (CTP score were recorded. Results Out of 187 patients with AFI, 44 (23.5% had SBP while 143 (76.4% had CNNA. Hepatitis C virus (HCV infection was the most common cause of cirrhosis in 139 (74.3% patients. Patients with SBP had high CTP score as compared to CNNA (12.52 ± 1.45 vs. 11.44 ± 1.66; p 9/L as compared to CNNA (132 ± 91 × 109/L, p = 0.005. We found a high creatinine (mg/dl (1.95 ± 1.0 vs. 1.44 ± 0.85, (p = 0.003 and high prothrombin time (PT in seconds (24.8 ± 6.6 vs. 22.4 ± 7.2 (p = 0.04 in SBP as compared to CNNA. More patients with SBP (14/44; 31.8% had blood culture positivity as compare to CNNA (14/143; 9.8%, p = 0.002. Escherichia. Coli was the commonest organism in blood culture in 15/28 (53.5% patients. SBP group had a higher mortality (11/44; 25% as compared to CNNA (12/143; 8.4%, p = 0.003. On multiple logistic regression analysis, creatinine >1.1 mg/dl and positive blood culture were the independent predictors of mortality in patients with SBP. Conclusion Patients with SBP have a higher mortality than CNNA. Independent predictors of mortality in SBP are raised serum creatinine and a positive blood culture.

  17. Endophthalmitis caused by gram-positive bacteria resistant to vancomycin: Clinical settings, causative organisms, antimicrobial susceptibilities, and treatment outcomes

    Directory of Open Access Journals (Sweden)

    Hegde Sharat Shivaramaiah

    2018-06-01

    Full Text Available Purpose: To report the clinical settings, causative organisms, antimicrobial susceptibilities, and treatment outcomes of patients with endophthalmitis caused by gram-positive bacteria resistant to vancomycin. Methods: Retrospective case series of all patients with culture-proven endophthalmitis caused by gram-positive bacteria resistant to vancomycin between January 2010 and December 2016 in LV Prasad Eye Institute, Visakhapatnam, India. Results: The current study included 14 patients. The clinical settings were post-cataract surgery in 8/14 (57.1% and open globe injury in 6/14 (42.8%. Primary intervention for all patients included tap and intravitreal antibiotic injection. During subsequent follow-up, pars plana vitrectomy was performed in 6 patients and one patient underwent penetrating keratoplasty. Mean number of intravitreal antibiotic injections performed were 3.4 per patient. The most common organisms isolated were coagulase-negative Staphylococci in 6/14 (42.8%, Staphylococcus aureus in 5/14 (35.7%, Streptococcus sp in 2/14 (14.2% and Bacillus sp in 1/14 (7.14%. In addition to vancomycin, resistance to multiple drugs (three or more groups of antibiotics was found in all 14 cases. Antimicrobial susceptibility results showed susceptibility to amikacin in 7/14 (50.0%, gatifloxacin in 6/14 (42.8%, moxifloxacin in 3/13 (23.0%, cefazoline in 5/14 (35.7%, cefuroxime in 3/14 (21.4%, ciprofloxacin in 2/14 (14.2% and linezolid in 5/5 (100%. The mean duration of follow-up was 30.7 weeks (6 weeks–90 weeks. At last follow-up, visual acuity (VA of 20/200 or better was recorded in 7/14 (50% and VA < 5/200 occurred in 7/14 (50%. Conclusion and importance: Antimicrobial susceptibility testing may help in selection of suitable antimicrobial agents for repeat intravitreal injection. Inspite of retreatment with intravitreal antibiotics, these patients generally had poor VA outcomes. Keywords: Coagulase-negative Staphylococci, Endophthalmitis

  18. The Outcome for Patients With Pathologic Node-Positive Prostate Cancer Treated With Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy: A Case-Matched Analysis of pN1 and pN0 Patients

    International Nuclear Information System (INIS)

    Van Hemelryk, Annelies; De Meerleer, Gert; Ost, Piet; Poelaert, Filip; De Gersem, Werner; Decaestecker, Karel; De Visschere, Pieter; Fonteyne, Valérie

    2016-01-01

    Purpose: Improved outcome is reported after surgery or external beam radiation therapy (EBRT) plus androgen deprivation therapy (ADT) for patients with lymph node (LN) positive (N1) prostate cancer (PC). Surgical series have shown that pathologic (p)N1 PC does not behave the same in all patients. The aim of this study was to perform a matched-case analysis to compare the outcome of pN1 and pN0 PC after high-dose EBRT plus ADT. Methods and Materials: Radiation therapy up to 80 Gy was delivered to the prostate with a minimal dose of 45 Gy to the pelvis for pN1 patients. After matching, Kaplan-Meier statistics were used to compare the 5-year biochemical and clinical relapse-free survival (bRFS and cRFS), prostate cancer–specific survival (PCSS), and overall survival (OS). Acute and late rectal and urinary toxicity was evaluated. Results: Sixty-nine pN1 PC patients were matched 1:1 with pN0 PC patients. The median follow-up time was 60 months. The 5-year bRFS and cRFS for pN1 versus pN0 PC patients were 65% ± 7% versus 79% ± 5% (P=.08) and 70% ± 6% versus 83% ± 5% (P=.04) respectively. No significant difference was found in bRFS or cRFS rates between low volume pN1 (≤2 positive LNs) and pN0 patients. The 5-year PCSS and OS were comparable between pN1 and pN0 PC patients: PCSS: 92% ± 4% versus 93% ± 3% (P=.66); OS: 82% ± 5% versus 80% ± 5% (P=.58). Severe toxicity was rare for both groups, although pN1 patients experienced significantly more acute grade 2 rectal toxicity. Conclusion: Primary EBRT plus 2 to 3 years of ADT is a legitimate treatment option for pN1 PC patients, especially those with ≤2 positive LNs, and this with bRFS and cRFS rates comparable to those in pN0 PC patients. For pN1 PC patients with >2 positive LNs, bRFS and cRFS are worse than in pN0 patients, but even in this subgroup, long-term disease control is obtained.

  19. The Outcome for Patients With Pathologic Node-Positive Prostate Cancer Treated With Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy: A Case-Matched Analysis of pN1 and pN0 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Van Hemelryk, Annelies [Department of Urology, Ghent University Hospital, Ghent (Belgium); De Meerleer, Gert; Ost, Piet [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Poelaert, Filip [Department of Urology, Ghent University Hospital, Ghent (Belgium); De Gersem, Werner [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Decaestecker, Karel [Department of Urology, Ghent University Hospital, Ghent (Belgium); De Visschere, Pieter [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Fonteyne, Valérie, E-mail: valerie.fonteyne@uzgent.be [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium)

    2016-10-01

    Purpose: Improved outcome is reported after surgery or external beam radiation therapy (EBRT) plus androgen deprivation therapy (ADT) for patients with lymph node (LN) positive (N1) prostate cancer (PC). Surgical series have shown that pathologic (p)N1 PC does not behave the same in all patients. The aim of this study was to perform a matched-case analysis to compare the outcome of pN1 and pN0 PC after high-dose EBRT plus ADT. Methods and Materials: Radiation therapy up to 80 Gy was delivered to the prostate with a minimal dose of 45 Gy to the pelvis for pN1 patients. After matching, Kaplan-Meier statistics were used to compare the 5-year biochemical and clinical relapse-free survival (bRFS and cRFS), prostate cancer–specific survival (PCSS), and overall survival (OS). Acute and late rectal and urinary toxicity was evaluated. Results: Sixty-nine pN1 PC patients were matched 1:1 with pN0 PC patients. The median follow-up time was 60 months. The 5-year bRFS and cRFS for pN1 versus pN0 PC patients were 65% ± 7% versus 79% ± 5% (P=.08) and 70% ± 6% versus 83% ± 5% (P=.04) respectively. No significant difference was found in bRFS or cRFS rates between low volume pN1 (≤2 positive LNs) and pN0 patients. The 5-year PCSS and OS were comparable between pN1 and pN0 PC patients: PCSS: 92% ± 4% versus 93% ± 3% (P=.66); OS: 82% ± 5% versus 80% ± 5% (P=.58). Severe toxicity was rare for both groups, although pN1 patients experienced significantly more acute grade 2 rectal toxicity. Conclusion: Primary EBRT plus 2 to 3 years of ADT is a legitimate treatment option for pN1 PC patients, especially those with ≤2 positive LNs, and this with bRFS and cRFS rates comparable to those in pN0 PC patients. For pN1 PC patients with >2 positive LNs, bRFS and cRFS are worse than in pN0 patients, but even in this subgroup, long-term disease control is obtained.

  20. Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate.

    Science.gov (United States)

    Hystad, Sigurd W; Bartone, Paul T; Eid, Jarle

    2014-01-01

    Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents.

  1. Assessing local outcomes in heterogeneous gliomas

    International Nuclear Information System (INIS)

    Dowson, Nicholas; Bourgeat, Pierrick; Salvado, Olivier; Rose, Stephen; Thomas, Paul; Fay, Michael; Jeffree, Rosalind L; Winter, Craig; Coulthard, Alan; Smith, Jye; Gal, Yaniv; Crozier, Stuart

    2014-01-01

    Tumours are known to be heterogeneous, yet typical treatment plans consider them as a single unit. This may influence treatment outcomes. However, treatment cannot be customised to intra-tumour variation without a method to establish outcomes at an intra-tumour scale. This work proposes a method to both assess and measure outcomes locally within tumours. Methods: Four patients were scanned at two post-surgery time points using contrast enhanced MRI and 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (18F-DOPA) PET. The shell of active tumour tissue is divided into a set of small subregions at both time points. Local outcome is measured from changes in subregion volume over time. The utility of the proposed approach is evaluated by measuring the correlation between PET uptake and documented growth. Correlation with overall survival time was also examined. Results: Local outcomes were heterogeneous and evidence of a positive correlation between local 18F-DOPA uptake and local progression was observed. Conclusions: Given that intra-tumour outcomes are heterogeneous the consistently positive correlation between FDOPA uptake and progression, local analysis of tumours could prove useful for treatment planning.

  2. Positive Youth Development from Sport to Life: Explicit or Implicit Transfer?

    Science.gov (United States)

    Turnnidge, Jennifer; Côté, Jean; Hancock, David J.

    2014-01-01

    While previous studies indicate that participation in sport has the potential to facilitate positive developmental outcomes, there is a lack of consensus regarding the possible transfer of these outcomes to other environments (i.e., school or work). An important issue within the positive development literature concerns how sport programs should…

  3. Pregnancy outcomes in HIV-positive women in Ukraine, 2000-12 (European Collaborative Study in EuroCoord): an observational cohort study.

    Science.gov (United States)

    Bagkeris, Emmanouil; Malyuta, Ruslan; Volokha, Alla; Cortina-Borja, Mario; Bailey, Heather; Townsend, Claire L; Thorne, Claire

    2015-09-01

    Women living with HIV are potentially at increased risk of adverse pregnancy outcomes, due to a range of factors, including immunosuppression, use of combination antiretroviral therapy (ART), and injecting drug use. Rates of mother-to-child transmission of HIV in Ukraine have declined to around 2-4%, but little is known about other pregnancy outcomes in this setting. We used data from an observational prospective cohort study to assess pregnancy outcomes among HIV-positive women in Ukraine. The European Collaborative Study (ECS) in EuroCoord is a continuing cohort study, established in Ukraine in 2000. Eligible women are those with a diagnosis of HIV infection before or during pregnancy (including intrapartum) who deliver liveborn babies at seven sites. Maternal sociodemographic, HIV-related, and delivery (mother and infant) data were collected with study-specific questionnaires. We used Poisson regression models to identify factors associated with preterm delivery (before 37 weeks' gestation) and small weight for gestational age (less than the tenth percentile of weight for gestational age), based on complete cases. Between January, 2000, and July, 2012, data were collected on 8884 HIV-positive mother and liveborn infant pairs. Median maternal age was 26·5 years (IQR 23·1-30·3). 832 (11%) women had WHO stage 3 or 4 HIV and 1474 (17%) had a history of injecting drug use. 7348 (83%) had received antenatal ART. Among 7435 for whom ART type was available, 4396 (50%) had received zidovudine monotherapy and 2949 (33%) combination ART. Preterm delivery was seen in 780 (9%, 95% CI 8-9) of 8860 births overall and in 77 (9%, 7-11) of 889 babies with small size for gestational age. Factors associated with preterm delivery were history of injecting drug use (adjusted risk ratio 1·64, 95% CI 1·38-1·95), no ART (2·94, 2·43-3·57 vs zidovudine monotherapy), antenatal combination ART (1·40, 1·14-1·73 vs zidovudine monotherapy), WHO stage 4 HIV (2·42, 1·71-3·41 vs

  4. Validated Outcomes in the Grafting of Autologous Fat to the Breast: The VOGUE Study. Development of a Core Outcome Set for Research and Audit.

    Science.gov (United States)

    Agha, Riaz A; Pidgeon, Thomas E; Borrelli, Mimi R; Dowlut, Naeem; Orkar, Ter-Er K; Ahmed, Maziyah; Pujji, Ojas; Orgill, Dennis P

    2018-05-01

    Autologous fat grafting is an important part of the reconstructive surgeon's toolbox when treating women affected by breast cancer and subsequent tumor extirpation. The debate over safety and efficacy of autologous fat grafting continues within the literature. However, work performed by the authors' group has shown significant heterogeneity in outcome reporting. Core outcome sets have been shown to reduce heterogeneity in outcome reporting. The authors' goal was to develop a core outcome set for autologous fat grafting in breast reconstruction. The authors published their protocol a priori. A Delphi consensus exercise among key stakeholders was conducted using a list of outcomes generated from their previous work. These outcomes were divided into six domains: oncologic, clinical, aesthetic and functional, patient-reported, process, and radiologic. In the first round, 55 of 78 participants (71 percent) completed the Delphi consensus exercise. Consensus was reached on nine of the 13 outcomes. The clarity of the results and lack of additional suggested outcomes deemed further rounds to be unnecessary. The VOGUE Study has led to the development of a much-needed core outcome set in the active research front and clinical area of autologous fat grafting. The authors hope that clinicians will use this core outcome set to audit their practice, and that researchers will implement these outcomes in their study design and reporting of autologous fat grafting outcomes. The authors encourage journals and surgical societies to endorse and encourage use of this core outcome set to help refine the scientific quality of the debate, the discourse, and the literature. Therapeutic, V.

  5. Improving surgical outcomes

    Directory of Open Access Journals (Sweden)

    Tony Walia

    2008-12-01

    Full Text Available Outcomes of cataract surgery are worse than we would like them to be. Community-based studies show that up to 40% of eyes have a postoperative presenting vision of < 6/60. Eyes with intraocular lenses (IOLs do better; however, it has been shown that even in prosperous middle-income countries, such as Venezuela, in 20% of pseudophakic eyes presenting vision was < 6/60 and in 15% best corrected vision was worse than 6/60.Poor outcomes matter. Patients deserve improved vision whenever possible and poor outcomes deter prospective patients from coming for surgery and probably reduce their willingness to pay for their treatment – particularly if they have to pay in advance!In this article, we offer some suggestions for improving the quality of cataract surgery. We admit that there is little evidence base for most of these suggestions and that some of them are controversial. However, we hope to stimulate debate.

  6. Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

    Directory of Open Access Journals (Sweden)

    Spjut Jansson B

    2016-09-01

    Full Text Available Birgitta Spjut Jansson,1–3 Carmela Miniscalco,1,4 Joakim Westerlund,1,5 Anne-Katrin Kantzer,1,6 Elisabeth Fernell,1 Christopher Gillberg1 1Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, 2Unit of Child and Adolescent Habilitation, 3Department of Psychology, University of Gothenburg, 4Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, 5Department of Psychology, University of Stockholm, Stockholm, 6Department of Child and Adolescent Psychiatry, NU Hospital Organization, Trollhättan, Sweden Background: Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods: Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL – in two settings, which included home- and preschool-based (IL Regular and only home-based (IL Modified and eclectic interventions.Results: There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion: The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. Keywords: autism spectrum disorder, preschool children, early intervention, ABA, cognitive function, follow-up

  7. Epidemiologic research using probabilistic outcome definitions.

    Science.gov (United States)

    Cai, Bing; Hennessy, Sean; Lo Re, Vincent; Small, Dylan S

    2015-01-01

    Epidemiologic studies using electronic healthcare data often define the presence or absence of binary clinical outcomes by using algorithms with imperfect specificity, sensitivity, and positive predictive value. This results in misclassification and bias in study results. We describe and evaluate a new method called probabilistic outcome definition (POD) that uses logistic regression to estimate the probability of a clinical outcome using multiple potential algorithms and then uses multiple imputation to make valid inferences about the risk ratio or other epidemiologic parameters of interest. We conducted a simulation to evaluate the performance of the POD method with two variables that can predict the true outcome and compared the POD method with the conventional method. The simulation results showed that when the true risk ratio is equal to 1.0 (null), the conventional method based on a binary outcome provides unbiased estimates. However, when the risk ratio is not equal to 1.0, the traditional method, either using one predictive variable or both predictive variables to define the outcome, is biased when the positive predictive value is value is poor (less than 0.75 in our simulation). In contrast, the POD method provides unbiased estimates of the risk ratio both when this measure of effect is equal to 1.0 and not equal to 1.0. Even when the sensitivity and positive predictive value are low, the POD method continues to provide unbiased estimates of the risk ratio. The POD method provides an improved way to define outcomes in database research. This method has a major advantage over the conventional method in that it provided unbiased estimates of risk ratios and it is easy to use. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Lateral positioning for critically ill adult patients.

    Science.gov (United States)

    Hewitt, Nicky; Bucknall, Tracey; Faraone, Nardene M

    2016-05-12

    Critically ill patients require regular body position changes to minimize the adverse effects of bed rest, inactivity and immobilization. However, uncertainty surrounds the effectiveness of lateral positioning for improving pulmonary gas exchange, aiding drainage of tracheobronchial secretions and preventing morbidity. In addition, it is unclear whether the perceived risk levied by respiratory and haemodynamic instability upon turning critically ill patients outweighs the respiratory benefits of side-to-side rotation. Thus, lack of certainty may contribute to variation in positioning practice and equivocal patient outcomes. To evaluate effects of the lateral position compared with other body positions on patient outcomes (mortality, morbidity and clinical adverse events) in critically ill adult patients. (Clinical adverse events include hypoxaemia, hypotension, low oxygen delivery and global indicators of impaired tissue oxygenation.) We examined single use of the lateral position (i.e. on the right or left side) and repeat use of the lateral position (i.e. lateral positioning) within a positioning schedule. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 5), MEDLINE (1950 to 23 May 2015), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1937 to 23 May 2015), the Allied and Complementary Medicine Database (AMED) (1984 to 23 May 2015), Latin American Caribbean Health Sciences Literature (LILACS) (1901 to 23 May 2015), Web of Science (1945 to 23 May 2015), Index to Theses in Great Britain and Ireland (1950 to 23 May 2015), Trove (2009 to 23 May 2015; previously Australasian Digital Theses Program (1997 to December 2008)) and Proquest Dissertations and Theses (2009 to 23 May 2015; previously Proquest Digital Dissertations (1980 to 23 May 2015)). We handsearched the reference lists of potentially relevant reports and two nursing journals. We included randomized and quasi-randomized trials examining effects of

  9. Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate

    Science.gov (United States)

    Hystad, Sigurd W.; Bartone, Paul T.; Eid, Jarle

    2013-01-01

    Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents. PMID:24454524

  10. Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework

    Directory of Open Access Journals (Sweden)

    H. Orpana

    2016-01-01

    Full Text Available Introduction: The Mental Health Strategy for Canada identified a need to enhance the collection of data on mental health in Canada. While surveillance systems on mental illness have been established, a data gap for monitoring positive mental health and its determinants was identified. The goal of this project was to develop a Positive Mental Health Surveillance Indicator Framework, to provide a picture of the state of positive mental health and its determinants in Canada. Data from this surveillance framework will be used to inform programs and policies to improve the mental health of Canadians. Methods: A literature review and environmental scan were conducted to provide the theoretical base for the framework, and to identify potential positive mental health outcomes and risk and protective factors. The Public Health Agency of Canada’s definition of positive mental health was adopted as the conceptual basis for the outcomes of this framework. After identifying a comprehensive list of risk and protective factors, mental health experts, other governmental partners and non-governmental stakeholders were consulted to prioritize these indicators. Subsequently, these groups were consulted to identify the most promising measurement approaches for each indicator. Results: A conceptual framework for surveillance of positive mental health and its determinants has been developed to contain 5 outcome indicators and 25 determinant indicators organized within 4 domains at the individual, family, community and societal level. This indicator framework addresses a data gap identified in Canada’s strategy for mental health and will be used to inform programs and policies to improve the mental health status of Canadians throughout the life course.

  11. Positive sliding mode control for blood glucose regulation

    Science.gov (United States)

    Menani, Karima; Mohammadridha, Taghreed; Magdelaine, Nicolas; Abdelaziz, Mourad; Moog, Claude H.

    2017-11-01

    Biological systems involving positive variables as concentrations are some examples of so-called positive systems. This is the case of the glycemia-insulinemia system considered in this paper. To cope with these physical constraints, it is shown that a positive sliding mode control (SMC) can be designed for glycemia regulation. The largest positive invariant set (PIS) is obtained for the insulinemia subsystem in open and closed loop. The existence of a positive SMC for glycemia regulation is shown here for the first time. Necessary conditions to design the sliding surface and the discontinuity gain are derived to guarantee a positive SMC for the insulin dynamics. SMC is designed to be positive everywhere in the largest closed-loop PIS of plasma insulin system. Two-stage SMC is employed; the last stage SMC2 block uses the glycemia error to design the desired insulin trajectory. Then the plasma insulin state is forced to track the reference via SMC1. The resulting desired insulin trajectory is the required virtual control input of the glycemia system to eliminate blood glucose (BG) error. The positive control is tested in silico on type-1 diabetic patients model derived from real-life clinical data.

  12. Nutrition Habits and Health Outcomes of Breastfeeding HIV-positive mothers in the Dschang Health District, West Region Cameroon.

    Science.gov (United States)

    Sanou Sobze, Martin; Kien-Atsu, Tsi; Djeunang Dongho, Bruna; Fotso, Jimmy Roger; TiotsiaTsapi, Armand; Azeufack Ngueko, Yannick; Ben Bechir, Sali; Pana, Augusto; Ercoli, Lucia; Colizzi, Vittorio; Russo, Gianluca

    2016-01-01

    Amongst the different at-risk periods for mother-to-child HIV transmission that is, during pregnancy, labor and delivery and breastfeeding, much care and attention needs to be given, not only to the child as concerns its feeding options, but also to the mother. The aim of this study was to determine the nutritional habits and health outcomes of HIV-positive breastfeeding mothers in the Dschang Health District, in the context of prevention of mother-to-child transmission (PMTCT) activities. A cross-sectional study was carried out from September 2014 to February 2015, at the Dschang District Day Care Hospital. A standard questionnaire was administered by face-to-face interview to 56 breastfeeding HIV-positive mothers. Anthropometric parameters of the mothers were measured (weight and height), and a physical check-up performed, with examination of the mothers' conjunctiva and palms. Clinical status was determined by anemia test using the Tallquist hemoglobin test. Data collected were analyzed using Epi Info version 7.1.3.3 and Excel 2013. The mean age of participants was 33 years. Most women ate three meals per day (53.6%, n=30/56), while 26,8% (15/56) ate two. Staples (27.27%) and fruits (33.68%) were found to be the most consumed foods per week and green leafy and yellow vegetables the least consumed (13.74%). Body mass index was used to evaluate the nutritional status of participating women: 26.9% (n=14/52) were in the normal range of weight, slightly more than half were overweight (51.9%, n=27/52) and 21.2% (n=11/52) were obese. All mothers were on antiretroviral therapy (ART). Recent CD4 count results were available for about half of the women and the mean was 293 cells/mmc (range 97-798). Physical checkup showed that 64.3% (n=36/56) and 67.9% (n=38/56) of women respectively had moderately colored conjunctiva and palms, while 10.7% (n=6/56) and 12.5% (n=7/56) respectively had pale conjunctiva and palms, considered to be clinical signs of anemia. About 74.1% (n=40

  13. Maternal knowledge, outcome expectancies and normative beliefs as determinants of cessation of exclusive breastfeeding: a cross-sectional study in rural Kenya

    Directory of Open Access Journals (Sweden)

    Constance A. Gewa

    2016-03-01

    Full Text Available Abstract Background Despite the importance of multiple psychosocial factors on nutrition-related behavior, very few studies have explored beyond the role of mothers’ knowledge and perception of child-focused outcomes on the duration of exclusive breastfeeding in Africa. Our objective was to determine the relationships among mothers’ knowledge, outcome expectancies, normative beliefs, and cessation of exclusive breastfeeding in rural Kenya. Methods A cross-sectional survey was conducted among 400 mothers of children, 0-24 months old, in rural Kenya. Early child-feeding practices, knowledge of breastfeeding recommendations, beliefs associated with impact of exclusive breastfeeding on child- and mother-focused outcomes and perception of acceptability of exclusive breastfeeding by important others were examined. Cox regression analysis was used to assess the relationship between independent variables of interest and cessation of exclusive breastfeeding. Results Being knowledgeable of breastfeeding-related recommendations, positive beliefs on the impact of exclusive breastfeeding on child- focused outcomes, having a more positive perception of the impact of exclusive breastfeeding on mother-focused outcomes and a more positive perception of acceptability of exclusive breastfeeding by important others were associated with significantly lower risks of premature cessation of exclusive breastfeeding. Conclusion In addition to knowledge levels, mothers’ beliefs play an important role in mothers’ decisions to practice exclusive breastfeeding. Mother’s beliefs on the impact of exclusive breastfeeding on the mother’s health, physical appearance and ability to engage in other activities were shown to have the strongest relationship with premature cessation of exclusive breastfeeding. Addressing these beliefs has the potential to contribute to more effective exclusive breastfeeding promotion efforts in rural Kenya.

  14. The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments.

    Science.gov (United States)

    Shatté, Andrew; Perlman, Adam; Smith, Brad; Lynch, Wendy D

    2017-02-01

    To examine whether resilience has a protective effect in difficult work environments. A survey of 2063 individuals measured individual resilience, stress, burnout, sleep problems, likelihood of depression, job satisfaction, intent to quit, absences, and productivity. It also measured work characteristics: job demands, job influence, and social support. Multivariate and logistic regression models examined the main effects and interactions of resilience and job characteristics. High strain work environments (high demand, low influence, and low support) have an unfavorable effect on all outcomes. Resilience has a protective effect on all outcomes. For stress, burnout, and sleep, higher resilience has a more protective effect under low-strain conditions. For depression, absence and productivity, resilience has a more protective effect when job strain is high. Workers with high resilience have better outcomes in difficult work environments.

  15. Transitions of interaction outcomes in a uni-directional consumer-resource system

    Science.gov (United States)

    Wang, Y.; DeAngelis, D.L.

    2011-01-01

    A uni-directional consumer-resource system of two species is analyzed. Our aim is to understand the mechanisms that determine how the interaction outcomes depend on the context of the interaction; that is, on the model parameters. The dynamic behavior of the model is described and, in particular, it is demonstrated that no periodic orbits exist. Then the parameter (factor) space is shown to be divided into four regions, which correspond to the four forms of interaction outcomes; i.e. mutualism, commensalism, parasitism and amensalism. It is shown that the interaction outcomes of the system transition smoothly among these four forms when the parameters of the system are varied continuously. Varying each parameter individually or varying pairs of parameters can also lead to smooth transitions between the interaction outcomes. The analysis leads to both conditions for which each species achieves its maximal density, and situations in which periodic oscillations of the interaction outcomes emerge. ?? 2011 Elsevier Ltd.

  16. The relationship between salivary bacterial flora and adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Sadeghi R

    2011-04-01

    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Many studies have shown that periodontal pathogens are emerging as a risk factor for preterm delivery and low birth weight, but there are few studies about the relationship between other oral bacteria and pregnancy outcomes. The aim of the present study was to determine the relationship between salivary bacteria and pregnancy outcomes."n"nMethods: This cohort study was performed on 300 pregnant women who were recruited from the prenatal clinic of Zeynab Hospital in Tehran during 2009-2010. The patients' demographic and pregnancy data were recorded. Using samplers, saliva samples were collected about one hour after breakfast. Microbial evaluation was performed by counting the bacteria based on their shape and the Gram reaction. The studied bacteria were composed of gram-positive and negative cocci, gram-positive and negative bacilli, spirilla, spirochetes, yeasts, fusiform bacteria and actinomycetes."n"nResults: The data on the bacteriological profile and pregnancy outcome of 243 out of the 300 eligible participants of the study were completed. Five cases (2% had intra uterine fetal death (IUFD while 238 (98% delivered live infants. There was a significant statistical relationship between the mean of gram-negative cocci and IUFD (P=0.04. 10 cases (4.1% of 243, experienced adverse delivery outcomes and 233 cases (95% had normal delivery. The adverse pregnancy outcomes had a significant relationship with the presence of spirochetes in saliva (P<0.05 but this relationship was not

  17. Strong subjective recovery as a protective factor against the effects of positive symptoms on quality of life outcomes in schizophrenia.

    Science.gov (United States)

    Kukla, Marina; Lysaker, Paul H; Roe, David

    2014-08-01

    Interest in recovery from schizophrenia has been growing steadily, with much of the focus on remission from psychotic symptoms and a return to functioning. Less is known about the experience of subjective recovery and its relationships with other important outcomes, such as quality of life and the formation and sustenance of social connections. This study sought to address this gap in knowledge by examining the links between self perceived recovery, symptoms, and the social components of quality of life. Sixty eight veterans with schizophrenia-spectrum disorders who were participating in a study of cognitive remediation and work were concurrently administered the Recovery Assessment Scale, Positive and Negative Syndrome Scale, and the Heinrichs-Carpenter Quality of Life Scale (QLS). Linear regression analyses demonstrated that subjective recovery moderated the relationship between positive symptoms and both QLS intrapsychic foundations scores and QLS instrumental role functioning after controlling for negative symptoms. Further examination of this interaction revealed that for individuals with substantial positive symptoms, higher levels of subjective recovery were associated with better instrumental role functioning and intrapsychic foundational abilities. Greater self perceived recovery is linked with stronger quality of life, both in regards to the cognitive and affective bases for socialization and active community involvement, even in the presence of substantial psychotic symptoms. Clinical implications of these findings are discussed. Published by Elsevier Inc.

  18. Specifying the effects of physician's communication on patients' outcomes: A randomised controlled trial.

    Science.gov (United States)

    van Osch, Mara; van Dulmen, Sandra; van Vliet, Liesbeth; Bensing, Jozien

    2017-08-01

    To experimentally test the effects of physician's affect-oriented communication and inducing expectations on outcomes in patients with menstrual pain. Using a 2×2 RCT design, four videotaped simulated medical consultations were used, depicting a physician and a patient with menstrual pain. In the videos, two elements of physician's communication were manipulated: (1) affect-oriented communication (positive: warm, emphatic; versus negative: cold, formal), and (2) outcome expectation induction (positive versus uncertain). Participants (293 women with menstrual pain), acting as analogue patients, viewed one of the four videos. Pre- and post video participants' outcomes (anxiety, mood, self-efficacy, outcome expectations, and satisfaction) were assessed. Positive affect-oriented communication reduced anxiety (pcommunication. Positive expectations increased feelings of self-efficacy (pcommunication and a positive expectation reduced anxiety (p=0.02), increased outcome expectancies (p=0.01) and satisfaction (p=0.001). Being empathic and inducing positive expectations have distinct and combined effects, demonstrating that both are needed to influence patients' outcomes for the best. Continued medical training is needed to harness placebo-effects of medical communication into practice. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Components of Camp Experiences for Positive Youth Development

    Directory of Open Access Journals (Sweden)

    Karla A. Henderson

    2007-03-01

    Full Text Available Youth development specialists advocate that well designed, implemented, and staffed youth centered programs result in positive outcomes for young people. Youth organizations have provided opportunities for young people to participate in camping experiences for over a century. The purpose of this paper is to describe what program components were related to camp environments and positive youth development. We describe these program components related to positive youth development based on a large scale national study of ACA (American Camp Association accredited camps that included independent, religiously affiliated, government, and not-for-profit organizations. Based on the responses given by camp directors, contact and leadership from trained staff and the supportive relationships they provided were essential elements of camp. Other aspects leading to positive youth development in camps were program mission and structure along with elements of accountability, assessment of outcomes, and opportunities for skill building.

  20. Efficacy of an Ergonomic Ankle Support Aid for Squatting Position in Improving Pushing Skills and Birth Outcomes During the Second Stage of Labor: A Randomized Controlled Trial.

    Science.gov (United States)

    Lin, Yu-Ching; Gau, Meei-Ling; Kao, Ghi-Hwei; Lee, Hung-Chang

    2018-03-16

    The physical positions that are adopted by women during childbirth significantly impact their childbirth outcomes and experiences. Literature studies have associated using a squatting position with reduced childbirth pain and increased comfort and pushing efficiency. However, the major disadvantage of the squatting position is that women may lack the muscular fitness and stamina necessary to sustain this position for a long period. The aim of this study was to compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women during the 38th to 42nd gestational weeks. None of the participants received epidural analgesia during labor, and all were free of pregnancy and labor-related complications. During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while using the ergonomically designed ankle support. For purposes of comparison, Comparison Group A was asked to push in the squatting position without the use of the support, and Comparison Group B was asked to push in a standard semirecumbent position. All of the participants completed a demographic and obstetrics data sheet, the short-form McGill Pain Questionnaire, and the Labor Pushing Experience scale within 4 hours postpartum. In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.79 minutes less (F = 6.02, p pushing to infant birth averaged 25.21 minutes less for the experimental group than for Comparison Group B (F = 6.14, p pushing experiences than the comparison groups (F = 14.69, p pushing, squatting with the aid of ergonomically designed ankle

  1. Two Sides of the Same Coin: The Positive and Negative Impact of Spiritual Religious Coping on Quality of Life and Depression in Dialysis Patients.

    Science.gov (United States)

    Vitorino, Luciano Magalhães; Soares, Renata de Castro E Santos; Santos, Ana Eliza Oliveira; Lucchetti, Alessandra Lamas Granero; Cruz, Jonas Preposi; Cortez, Paulo José Oliveira; Lucchetti, Giancarlo

    2017-08-01

    Studies have shown that spiritual/religious beliefs are associated with mental health and health-related quality of life (HRQoL). However, few studies evaluated how spiritual/religious coping (SRC) could affect hemodialysis patients. The present study investigated the role of SRC behaviors on HRQoL and depressive symptoms in hemodialysis patients. This was cross-sectional study with 184 patients. Patients completed the Beck Depression Inventory, Brief SRC Scale, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and a Sociodemographic and Health Characterization Questionnaire. From 218 patients, 184 (84.4%) were included (53.8% male with a median age of 55.9 years). Negative SRC, but not positive SRC, was associated with depressive symptoms. Positive SRC presented significant effects in SF-36 pain and physical and social functioning. On the other hand, negative SRC exhibited significant effects in SF-36 role emotional, energy/fatigue, pain, and physical functioning. SRC influences the mental health and HRQoL in Brazilian hemodialysis patients in two distinct ways. If used positively, it may have positive outcomes. However, if used negatively, it may lead to dysfunctional consequences such as greater depressive symptomatology and affect HRQoL. Health professionals must be aware of these "two sides of the same coin."

  2. Comparison of bladder neck position in nulliparous and parous women using MR images in the sitting position

    International Nuclear Information System (INIS)

    Masaki, Kiyoko; Okayama, Hisayo; Tuchikawa, Sachi; Saito, Yoshino; Endo, Yoshihiro; Morikawa, Shigehiro; Ninomiya, Sanae; Saito, Izumi; Hiraiwa, Yasuyuki

    2011-01-01

    The purpose of this study was to investigate the influence of childbirth on pelvic floor relaxation in females using the bladder neck position. The position of bladder neck was examined in 17 nulligravid (19-24 years of age) and 55 parous women (35-54) using MR images in the sitting position. The position of bladder neck from pubococcygeal line was 13.4 mm (mean) in nulligravid women, and 8.5 mm in parous women (p<0.05). The bladder neck position in parous women was significantly lower than that in nulligravid women. Therefore, it was clearly shown that childbirth causes the pelvic floor relaxation. (author)

  3. Enhancing Learning Outcomes through Application Driven Activities in Marketing

    Science.gov (United States)

    Stegemann, Nicole; Sutton-Brady, Catherine

    2013-01-01

    This paper introduces an activity used in class to allow students to apply previously acquired information to a hands-on task. As the authors have previously shown active learning is a way to effectively facilitate and improve students' learning outcomes. As a result to improve learning outcomes we have overtime developed a series of learning…

  4. Religiousness is positively associated with quality of life of ALS caregivers.

    Science.gov (United States)

    Calvo, Andrea; Moglia, Cristina; Ilardi, Antonio; Cammarosano, Stefania; Gallo, Sara; Canosa, Antonio; Mastro, Enza; Montuschi, Anna; Chiò, Adriano

    2011-05-01

    It has been repeatedly shown that religiousness and spirituality have positive effects on quality of life (QoL) and outcome in ALS patients. here are, however, very few data on the impact of religiousness/spirituality on ALS caregivers. We determined the impact of religiousness on caregivers and its correlation with quality of life, depression and anxiety. A total of 75 consecutive ALS patients and their informal caregivers were interviewed using tests evaluating religiousness, depression, anxiety, quality of life and satisfaction with life. Results showed that there was a significant correlation between patients and caregivers' public and total religiousness. Caregivers' private religiousness was related to their age and education level, while their public religiousness was related only to their education level. Caregivers' quality of life was related to their private religiousness and satisfaction with life with their total religiousness. We conclude that religiousness is positively associated with ALS caregivers' quality of life and satisfaction with life, in a measure similar to that observed in ALS patients. Health care professionals caring for ALS patients should consider that the needs of the caregivers include religious/spiritual concerns.

  5. Nomogram for predicting the probability of the positive outcome of ...

    African Journals Online (AJOL)

    F.A. Yeboah

    distribution, the median and inter quartile (IQR) values were used. ... Crude or adjusted odds ratios and ... model, the estimated probability of a positive biopsy was calcu- ..... Gratitude goes to workers at Department of Surgery (Urology Unit).

  6. The Indirect Effect of Positive Parenting on the Relationship Between Parent and Sibling Bereavement Outcomes After the Death of a Child.

    Science.gov (United States)

    Morris, Adam T; Gabert-Quillen, Crystal; Friebert, Sarah; Carst, Nancy; Delahanty, Douglas L

    2016-01-01

    Families are referred to pediatric palliative care (PPC) programs when a child is diagnosed with a medical condition associated with less than a full life expectancy. When a child dies, PPC programs typically offer a range of bereavement interventions to these families, often focusing on parents. Currently, it is unclear which factors increase the likelihood that bereaved siblings will experience negative outcomes, limiting the development of empirically supported interventions that can be delivered in PPC programs. The present study explored the relationship between parents' and surviving sibling's mental health symptoms (i.e., post-traumatic stress disorder [PTSD], prolonged grief disorder (PGD), and depression symptoms) after a child's death. Additionally, the extent to which parent functioning indirectly impacted sibling functioning through parenting behaviors (i.e., positive parenting and parent involvement) was also examined, with a specific focus on differences based on parent gender. Sixty bereaved parents and siblings (aged 8-18) who enrolled in a PPC program from 2008 to 2013 completed measures of PTSD, PGD, and depression related to the loss of a child/sibling. Siblings also completed a measure of general parenting behaviors. Maternal, but not paternal, symptoms of PTSD and PGD were directly associated with sibling outcomes. Paternal symptoms were associated with sibling symptoms indirectly, through parenting behaviors (i.e., via decreasing positive parenting). These results underscore the importance of examining both maternal and paternal influences after the death of a child, demonstrate differential impact of maternal vs. paternal symptoms on siblings, and stress the importance of addressing postloss symptoms from a family systems perspective. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Brain potentials associated with the outcome processing in framing effects.

    Science.gov (United States)

    Ma, Qingguo; Feng, Yandong; Xu, Qing; Bian, Jun; Tang, Huixian

    2012-10-24

    Framing effect is a cognitive bias referring to the phenomenon that people respond differently to different but objectively equivalent descriptions of the same problem. By measuring event-related potentials, the present study aimed to investigate the neural mechanisms underlying the framing effect, especially how the negative and positive frames influence the outcome processing in our brain. Participants were presented directly with outcomes framed either positively in terms of lives saved or negatively in terms of lives lost in large and small group conditions, and were asked to rate the favorableness of each of them. The behavioral results showed that the framing effect occurred in both group size conditions, with more favorable evaluations associated with positive framing. Compared with outcomes in positive framing condition, a significant feedback-related negativity (FRN) effect was elicited by outcomes in negative framing condition, even though the outcomes in different conditions were objectively equivalent. The results are explained in terms of the associative model of attribute framing effect which states that attribute framing effect occurs as a result of a valence-based associative processing. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Reducing negative affect and increasing rapport improve interracial mentorship outcomes.

    Science.gov (United States)

    Leitner, Jordan B; Ayduk, Özlem; Boykin, C Malik; Mendoza-Denton, Rodolfo

    2018-01-01

    Research suggests that interracial mentoring relationships are strained by negative affect and low rapport. As such, it stands to reason that strategies that decrease negative affect and increase rapport should improve these relationships. However, previous research has not tested this possibility. In video-chats (Studies 1 and 2) and face-to-face meetings (Study 3), we manipulated the degree of mutual self-disclosure between mentees and mentors, a strategy that has been shown to reduce negative affect and increase rapport. We then measured negative affect and rapport as mediators, and mentee performance (quality of speech delivered; Studies 1 and 3) and mentor performance (warmth and helpfulness; Studies 2 and 3) as key outcomes. Results revealed that increased self-disclosure decreased negative affect and increased rapport for both mentees and mentors. Among mentees, decreased negative affect predicted better performance (Studies 1 and 3). Among mentors, increased rapport predicted warmer feedback (Studies 2 and 3). These effects remained significant when we meta-analyzed data across studies (Study 4), and also revealed the relationship of rapport to more helpful feedback. Findings suggest that affect and rapport are key features in facilitating positive outcomes in interracial mentoring relationships.

  9. Cam Mover Alignment System positioning with the Wire Positioning with the Wire Position Sensor Feedback for CLIC

    CERN Document Server

    AUTHOR|(CDS)2077936; Mainaud Durand, Helene; Kostka, Z.S.

    2016-01-01

    Compact Linear Collider (CLIC) is a study of an electron-positron collider with nominal energy of 3 TeV and luminosity of 2 ∙ 1034 cm-2s-1. The luminosity goal leads to stringent alignment requirements for single quadrupole magnets. Vertical and lateral offset deviations with regards to a given orbit reference in both ends of a quadrupole shall be below 1 μm and quadrupole roll deviation shall be below 100 μrad. Translation in the direction of particle beam is not controlled but mechanically locked. A parallel kinematic platform based on cam movers was chosen as system for detailed studies. Earlier studies have shown that cam movers can reach the CLIC requirements through an iterative process. The paper presents new modular off-the-shelf control electronics and software including three optional positioning algorithms based on iterations as well as a more advanced algorithm which can reach target position in one movement. The advanced algorithm reads wire position sensors (WPS), calculates quadrupole orien...

  10. High-performance HR practices, positive affect and employee outcomes

    OpenAIRE

    Mostafa, Ahmed

    2017-01-01

    Purpose – The purpose of this paper is to provide insight into the affective or emotional mechanisms that underlie the relationship between high-performance HR practices (HPHRP) and employee attitudes and behaviours. Drawing on affective events theory (AET), this paper examines a mediation model in which HPHRP influence positive affect which in turn affects job satisfaction and organizational citizenship behaviours (OCBs). Design/methodology/approach – Two-wave data was collected from a sampl...

  11. Prenatal lignan exposures, pregnancy urine estrogen profiles and birth outcomes

    International Nuclear Information System (INIS)

    Tang, Rong; Chen, Minjian; Zhou, Kun; Chen, Daozhen; Yu, Jing; Hu, Weiyue; Song, Ling; Hang, Bo; Wang, Xinru; Xia, Yankai

    2015-01-01

    During pregnancy, human exposure to endogenous estrogens and xenoestrogens (such as lignans) may comprehensively impact the gestational maintenance and fetal growth. We measured the concentrations of 5 lignans and the profile of 13 estrogen metabolites (EMs) in the urine samples of 328 pregnant women and examined their associations with birth outcomes. We found significantly positive associations between gestational age and urinary matairesinol (MAT), enterodiol (END) and enterolactone (ENL), as well as 16-hydroxylation pathway EMs. There were consistently positive relationships between END and the 16-hydroxylation pathway EMs. The positive relationships of MAT, END and ENL exposures with the length of gestation were mainly in the low exposure strata of the levels of these EMs. This study reveals that MAT, END and ENL as well as 16-hydroxylation pathway EMs are associated with birth outcomes, and that there are interactive relationships between lignans and 16-hydroxylation pathway EMs with birth outcomes. - Highlights: • We examined relations between prenatal lignan exposures and birth outcomes. • We examined relations between pregnancy urine estrogen profiles and birth outcomes. • MAT, END and ENL are associated with birth outcomes. • 16-hydroxylation pathway EMs are associated with birth outcomes. • There are interactive relationships between ligans and EMs with birth outcomes. - Prenatal lignan exposures and EM levels were interactively related to birth outcomes

  12. BAS-drive trait modulates dorsomedial striatum activity during reward response-outcome associations.

    Science.gov (United States)

    Costumero, Víctor; Barrós-Loscertales, Alfonso; Fuentes, Paola; Rosell-Negre, Patricia; Bustamante, Juan Carlos; Ávila, César

    2016-09-01

    According to the Reinforcement Sensitivity Theory, behavioral studies have found that individuals with stronger reward sensitivity easily detect cues of reward and establish faster associations between instrumental responses and reward. Neuroimaging studies have shown that processing anticipatory cues of reward is accompanied by stronger ventral striatum activity in individuals with stronger reward sensitivity. Even though establishing response-outcome contingencies has been consistently associated with dorsal striatum, individual differences in this process are poorly understood. Here, we aimed to study the relation between reward sensitivity and brain activity while processing response-reward contingencies. Forty-five participants completed the BIS/BAS questionnaire and performed a gambling task paradigm in which they received monetary rewards or punishments. Overall, our task replicated previous results that have related processing high reward outcomes with activation of striatum and medial frontal areas, whereas processing high punishment outcomes was associated with stronger activity in insula and middle cingulate. As expected, the individual differences in the activity of dorsomedial striatum correlated positively with BAS-Drive. Our results agree with previous studies that have related the dorsomedial striatum with instrumental performance, and suggest that the individual differences in this area may form part of the neural substrate responsible for modulating instrumental conditioning by reward sensitivity.

  13. Positioning and early mobilisation in stroke.

    Science.gov (United States)

    Keating, Moira; Penney, Maree; Russell, Petra; Bailey, Emma

    Stroke unit care, providing early rehabilitation, improves long-term outcomes for patients following a stroke. Early mobilisation and good positioning are recognised as key aspects of care in stroke units. Nurses working on stroke units have an important role because they are able to implement positioning and early mobilisation strategies 24 hours a day, reducing the risk of complications and improving functional recovery. Patients benefit if nurses work effectively with the therapy team in positioning and early mobilisation. Nurses also need appropriate training and expertise to make best use of specialist equipment.

  14. Trust, Behavior, and High School Outcomes

    Science.gov (United States)

    Romero, Lisa S.

    2015-01-01

    Purpose: The purpose of this paper is to contribute to the literature on student trust and to examine the relationship between student trust, behavior, and academic outcomes in high school. It asks, first, does trust have a positive effect on high school outcomes? Second, does trust influence student behavior, exerting an indirect effect on…

  15. Favorable outcome in non-infant children with MLL-AF4-positive acute lymphoblastic leukemia: a report from the Tokyo Children's Cancer Study Group.

    Science.gov (United States)

    Tomizawa, Daisuke; Kato, Motohiro; Takahashi, Hiroyuki; Fujimura, Junya; Inukai, Takeshi; Fukushima, Takashi; Kiyokawa, Nobutaka; Koh, Katsuyoshi; Manabe, Atsushi; Ohara, Akira

    2015-11-01

    Unlike acute lymphoblastic leukemia (ALL) in infants, MLL gene rearrangement (MLL-r) is rare in ALL children (≥1 year old). The outcome and optimal treatment options for MLL-r ALL remain controversial. Among the 1827 children enrolled in the Tokyo Children's Cancer Study Group ALL studies L95-14, L99-15, L99-1502, L04-16, and L07-1602 (1995-2009), 25 MLL-r ALL patients (1.3 %) were identified. Their median age and leukocyte count at diagnosis was 2 years old (range 1-15 years) and 27,690/μL (range 1800-1,113,000/μL), respectively. All but one patient achieved complete remission (CR) after induction therapy, and 19 underwent allogeneic hematopoietic stem cell transplantation (HSCT) in first CR according to the protocol. The 5-year event-free survival (EFS) and overall survival (OS) rate were 60.0 % [standard error (SE), 9.7 %] and 64.0 % (SE 9.6 %), respectively. Notably, 9/12 cases with MLL-AF4-positive ALL are alive in continuous CR with a 75.0 % (SE 12.5 %) EFS rate. The causes of treatment failure were as follows: one induction failure, five relapses, and five transplant-related deaths. With intensive chemotherapy and allogeneic HSCT, favorable outcome of children (≥1 year old) with MLL-AF4-positive ALL was observed. However, considering the risk of acute and late toxicities associated with HSCT, its indication should be restricted.

  16. Nomogram for predicting the probability of the positive outcome of ...

    African Journals Online (AJOL)

    F.A. Yeboah

    Abstract. Introduction and objectives: Several existing models have been developed to predict positive prostate biopsy among men undergoing evaluation for prostate cancer (PCa). However, most of these models have come from industrialized countries. We therefore, developed a prostate disease nomogram model to ...

  17. Empathy in intimate relationships : The role of positive illusions

    NARCIS (Netherlands)

    Dijkstra, Pieternel; Barelds, Dick P.H.; Groothof, Hinke A.K.; Van Bruggen, Marnix

    2014-01-01

    Previous studies have shown empathy to be an important aspect of a high quality intimate relationship. Likewise, positive illusions about a partner's characteristics have been shown to contribute to relationship quality. The present study connects these issues by examining the degree to which

  18. Obstetric and newborn outcomes and risk factors for low birth weight ...

    African Journals Online (AJOL)

    There remains uncertainty about the impact of HIV on pregnancy outcomes and effects of highly active antiretroviral therapy on fetal development. This study describes obstetric outcomes among HIV positive parturients at the University College Hospital, Ibadan. HIV positive parturients were identified in the birth register.

  19. POSITIVE EDUCATION: EDUCATING FOR ACADEMIC SUCCESS AND FOR A FULFILLING LIFE

    Directory of Open Access Journals (Sweden)

    Alejandro Adler

    2017-01-01

    Full Text Available Traditional education has focused on teaching individuals the tools to succeed academically and professionally, and students’ progress has been measured according to their performance within this limited paradigm of success. Various decades of rigorous international research have shown that skills exist for building the elements of well-being, and that these can be taught and learned. Furthermore, these skills should be taught, since well-being has both intrinsic value (human beings innately desire well-being as well as instrumental value (well-being generates desirable life outcomes, including physical health, professional and academic success, better relationships with others, less violence and drug consumption, among others. Based on the most rigorous scientific research, positive education teaches the skills and knowledge that individuals need to have successful academic and professional lives, as well as to flourish as human beings and live a fulfilling life.

  20. Detecting Position Using ARKit II: Generating Position-Time Graphs in Realtime and Further Information on Limitations of ARKit

    Science.gov (United States)

    Dilek, Ufuk; Erol, Mustafa

    2018-01-01

    ARKit is a framework which allows developers to create augmented reality apps for the iPhone and iPad. In a previous study, we had shown that it could be used to detect position in educational physics experiments and emphasized that the ability to provide position data in real-time was one of the prominent features of this newly emerging…

  1. Permanent pacemaker implantation in octogenarians with unexplained syncope and positive electrophysiologic testing.

    Science.gov (United States)

    Giannopoulos, Georgios; Kossyvakis, Charalampos; Panagopoulou, Vasiliki; Tsiachris, Dimitrios; Doudoumis, Konstantinos; Mavri, Maria; Vrachatis, Dimitrios; Letsas, Konstantinos; Efremidis, Michael; Katsivas, Apostolos; Lekakis, John; Deftereos, Spyridon

    2017-05-01

    Syncope is a common problem in the elderly, and a permanent pacemaker is a therapeutic option when a bradycardic etiology is revealed. However, the benefit of pacing when no association of symptoms to bradycardia has been shown is not clear, especially in the elderly. The aim of this study was to evaluate the effect of pacing on syncope-free mortality in patients aged 80 years or older with unexplained syncope and "positive" invasive electrophysiologic testing (EPT). This was an observational study. A positive EPT for the purposes of this study was defined by at least 1 of the following: a corrected sinus node recovery time of >525 ms, a basic HV interval of >55 ms, detection of infra-Hisian block, or appearance of second-degree atrioventricular block on atrial decremental pacing at a paced cycle length of >400 ms. Among the 2435 screened patients, 228 eligible patients were identified, 145 of whom were implanted with a pacemaker. Kaplan-Meier analysis determined that time to event (syncope or death) was 50.1 months (95% confidence interval 45.4-54.8 months) with a pacemaker vs 37.8 months (95% confidence interval 31.3-44.4 months) without a pacemaker (log-rank test, P = .001). The 4-year time-dependent estimate of the rate of syncope was 12% vs 44% (P pacemaker implantation was independently associated with longer syncope-free survival. Significant differences were also shown in the individual components of the primary outcome measure (syncope and death from any cause). Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  2. Positive and Negative Syndrome Scale as a long-term outcome measurement tool in patients receiving clozapine ODT- A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Shankar G

    2007-03-01

    Full Text Available Objective: This pilot, twelve-week, open-label study examined the effect of clozapine orally disintegrating tablet or ODT in patients with schizophrenia and schizoaffective disorder utilizing Positive and Negative Syndrome Scale (PANSS as a long-term outcome measurement tool.Methods: The final study sample consisted of nineteen subjects who were residents a long-term care psychiatric facility in Pomona, California. Subjects were using clozapine ODT (FazaClo® at the most clinically effective dosage depending on their symptoms and at the discretion of the psychiatrist and psychopharm consultant. PANSS were administered at baseline, week-4, week-8 and week-12. Paired sample t-tests were used to calculate the statistical significance of the mean differences for scores at baseline and week-12. Results: Mean differences from baseline indicated significant improvement on total score, as well as positive, negative, cognitive and general psychopathology subscales after twelve weeks of treatment. The greater average reduction in the negative syndrome subscale across the twelve weeks possibly illustrates the ability of clozapine ODT in improving negative symptoms, including cognitive function which is their ability to participate in their personal care and creative expressions in dance, arts, games, poetry to a greater extent their overall, quality of life and living along with the effect on positive symptoms.Conclusion: Overall, clozapine proved to affect a broad range of psychopathology including cognitive functions in this schizophrenic sample.

  3. Social Support, Treatment Adherence and Outcome among ...

    African Journals Online (AJOL)

    2017-06-02

    Jun 2, 2017 ... Access to family support did not positively influence medication adherence, while access to financial support marginally impacted on outcome among hypertensive and T2D patients. However, un- wavering tendency for therapy affordability significantly influenced adherence and outcome, thus, the need for ...

  4. Surgical Outcomes After Open, Laparoscopic, and Robotic Gastrectomy for Gastric Cancer.

    Science.gov (United States)

    Yang, Seung Yoon; Roh, Kun Ho; Kim, You-Na; Cho, Minah; Lim, Seung Hyun; Son, Taeil; Hyung, Woo Jin; Kim, Hyoung-Il

    2017-07-01

    In contrast to the significant advantages of laparoscopic versus open gastrectomy, robotic gastrectomy has shown little benefit over laparoscopic gastrectomy. This study aimed to compare multi-dimensional aspects of surgical outcomes after open, laparoscopic, and robotic gastrectomy. Data from 915 gastric cancer patients who underwent gastrectomy by one surgeon between March 2009 and May 2015 were retrospectively reviewed. Perioperative parameters were analyzed for short-term outcomes. Surgical success was defined as the absence of conversion to open surgery, major complications, readmission, positive resection margin, or fewer than 16 retrieved lymph nodes. This study investigated 241 patients undergoing open gastrectomy, 511 patients undergoing laparoscopic gastrectomy, and 173 patients undergoing robotic gastrectomy. For each approach, the respective incidences were as follows: conversion to open surgery (not applicable, 0.4%, and 0%; p = 0.444), in-hospital major complications (5.8, 2.7, and 1.2%; p = 0.020), delayed complications requiring readmission (2.9, 2.0, and 1.2%; p = 0.453), positive resection margin (1.7, 0, and 0%; p = 0.003), and inadequate number of retrieved lymph nodes (0.4, 4.1, and 1.7%; p = 0.010). Compared with open and laparoscopic surgery, robotic gastrectomy had the highest surgical success rate (90, 90.8, and 96.0%). Learning-curve analysis of success using cumulative sum plots showed success with the robotic approach from the start. Multivariate analyses identified age, sex, and gastrectomy extent as significant independent parameters affecting surgical success. Surgical approach was not a contributing factor. Open, laparoscopic, and robotic gastrectomy exhibited different incidences and causes of surgical failure. Robotic gastrectomy produced the best surgical outcomes, although the approach method itself was not an independent factor for success.

  5. Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

    International Nuclear Information System (INIS)

    La Roca, Ricardo L.R. Felts de; Fonseca, Francisco Paula da; Cunha, Isabela Werneck da; Bezerra, Stephania Martins

    2013-01-01

    Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA ≥ 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

  6. Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

    Energy Technology Data Exchange (ETDEWEB)

    La Roca, Ricardo L.R. Felts de, E-mail: Ricardo@delarocaurologia.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil); Fonseca, Francisco Paula da, E-mail: fpf@uol.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Divisao de Urologia. Dept. de Cirurgia Pelvica; Cunha, Isabela Werneck da; Bezerra, Stephania Martins, E-mail: iwerneck@gmail.com, E-mail: stephaniab@gmail.com [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Patologia

    2013-07-01

    Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA {>=} 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

  7. The SystHERs registry: an observational cohort study of treatment patterns and outcomes in patients with human epidermal growth factor receptor 2–positive metastatic breast cancer

    International Nuclear Information System (INIS)

    Tripathy, Debu; Lai, Catherine; Masaquel, Anthony; Hurvitz, Sara; Rugo, Hope S; Kaufman, Peter A; Swain, Sandra; O’Shaughnessy, Joyce; Jahanzeb, Mohammad; Mason, Ginny; Beattie, Mary; Yoo, Bongin

    2014-01-01

    Amplification of the human epidermal growth factor receptor 2 (HER2) gene occurs in approximately 20% of invasive breast cancer cases and is associated with a more aggressive disease course than HER2-negative breast cancer. HER2-targeted therapies have altered the natural history of HER2-positive breast cancer, a trend that will likely further improve with the recent approval of new agents. A prospective, observational cohort study was designed and initiated to provide real-world insights into current treatment patterns, long-term survival, and patients’ experiences with initial and subsequent treatments for HER2-positive metastatic breast cancer (MBC). The Systematic Therapies for HER2-positive Metastatic Breast Cancer Study (SystHERs) is a US-based prospective observational cohort study enrolling patients ≥18 years of age with recently diagnosed HER2-positive MBC not previously treated with systemic therapy in the metastatic setting. The primary objective of the study is to identify treatment patterns and clinical outcomes in recently diagnosed patients in a variety of practice settings. Secondary objectives include comparative efficacy, safety, and patient-reported outcomes (PROs). Healthcare resource utilization is an exploratory end point. Tumor tissue and blood sample collection is optional. The SystHERs registry will enroll approximately 1000 patients over a 3-year period, after which the study will continue for ≥5 years, allowing for a maximum follow-up of 8 years. The treating physician will determine all care and the frequency of visits. PRO measures will be completed at study enrollment and every 90 days. Clinical data will be abstracted quarterly from patient records. The first patient was enrolled in June 2012, and preliminary descriptive data based on 25% to 30% of the final study population are expected at the end of 2013, and as of April 25, 2014, 386 patients are enrolled. SystHERs is expected to provide in-depth data on demographic

  8. Mast cell-mediated and associated disorders in pregnancy: a risky game with an uncertain outcome?

    Science.gov (United States)

    Woidacki, Katja; Zenclussen, Ana Claudia; Siebenhaar, Frank

    2014-01-01

    During pregnancy, the maternal organism is under the influence of tremendous endocrine as well as immunological changes as an adaptation to the implanted and developing fetus. In most cases, the maternal adaptations to pregnancy ensure both, the protection against harmful pathogens and the tolerance toward the growing semi-allogeneic fetus. However, under certain circumstances the unique hormonal milieu during pregnancy is causative of a shift into an unfavorable direction. Of particular importance are cellular disorders previous to pregnancy that involve cell types known for their susceptibility to hormones. One interesting cell type is the mast cell (MC), one of the key figures in allergic disorders. While physiological numbers of MCs were shown to positively influence pregnancy outcome, at least in mouse models, uncontrolled augmentations in quantity, and/or activation can lead to pregnancy complications. Women that have the desire of getting pregnant and been diagnosed with MC mediated disorders such as urticaria and mastocytosis or chronic inflammatory diseases in which MCs are involved, including atopic dermatitis, asthma, or psoriasis, may benefit from specialized medical assistance to ensure a positive pregnancy outcome. In the present review, we address the course of pregnancy in women affected by MC mediated or associated disorders.

  9. Efficiency of the modified Sims maternal position in the rotation of persistent occiput posterior position during labor: A randomized clinical trial.

    Science.gov (United States)

    Bueno-Lopez, Vanessa; Fuentelsaz-Gallego, Carmen; Casellas-Caro, Manel; Falgueras-Serrano, Ana Maria; Crespo-Berros, Silvia; Silvano-Cocinero, Ana Maria; Alcaine-Guisado, Carolina; Zamoro Fuentes, Manuela; Carreras, Elena; Terré-Rull, Carmen

    2018-03-14

    Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. This is an open, randomized controlled, clinical trial. One hundred and twenty women in labor with fetuses in POP position were included. The diagnosis was performed through digital vaginal examination and confirmed with an ultrasound scan. Women were randomized into the free position group or the modified Sims on the side of the fetal spine. The primary outcome was rotation to occiput anterior, and secondary outcomes were type of delivery, postpartum perineal condition, perinatal results, and maternal satisfaction. In pregnant women undergoing labor in the Sims position, fetuses in POP rotated to occiput anterior in 50.8% of cases, whilst in the free position group, the rotation occurred in 21.7% (P = .001). The rate of vaginal deliveries was higher in the Sims group compared with the free position group (84.7% vs 68.3%, P = .035). The modified Sims position is a maternal posture intervention efficient in POP rotation, which decreases cesarean delivery rate. It is a simple and noninvasive intervention, reproducible, and well tolerated by pregnant women. © 2018 Wiley Periodicals, Inc.

  10. Foreign language affects the contribution of intentions and outcomes to moral judgment.

    Science.gov (United States)

    Geipel, Janet; Hadjichristidis, Constantinos; Surian, Luca

    2016-09-01

    We examine whether the use of a foreign language, as opposed to the native language, influences the relative weight intentions versus outcomes carry in moral evaluations. In Study 1, participants were presented with actions that had positive outcomes but were motivated by dubious intentions, while in Study 2 with actions that had negative outcomes but were motivated by positive intentions. Participants received the materials either in their native or a foreign language. Foreign language prompted more positive moral evaluations in Study 1 and less positive evaluations in Study 2. These results show that foreign language reduces the relative weight placed on intentions versus outcomes. We discuss several theoretical accounts that are consistent with the results such as that foreign language attenuates emotions (triggered by intentions) or it depletes cognitive resources. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome

    Directory of Open Access Journals (Sweden)

    Shahvaiz Magsi

    2016-01-01

    Full Text Available Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS, in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA. Bilateral EDAS was done in the same year, after which his symptoms improved and patient had moderate functional recovery. Conclusion. A rare disease, moyamoya has been left unexplored in Pakistan; physicians and surgeons when dealing with cases in the pediatric population presenting with symptoms of stroke, signs of generalized weakness, and seizures should consider moyamoya disease as a possibility. Furthermore, this case demonstrates the effectiveness of EDAS procedure for the treatment of moyamoya disease.

  12. Periodicity and positivity of a class of fractional differential equations.

    Science.gov (United States)

    Ibrahim, Rabha W; Ahmad, M Z; Mohammed, M Jasim

    2016-01-01

    Fractional differential equations have been discussed in this study. We utilize the Riemann-Liouville fractional calculus to implement it within the generalization of the well known class of differential equations. The Rayleigh differential equation has been generalized of fractional second order. The existence of periodic and positive outcome is established in a new method. The solution is described in a fractional periodic Sobolev space. Positivity of outcomes is considered under certain requirements. We develop and extend some recent works. An example is constructed.

  13. Marijuana and Children. Position Statement

    Science.gov (United States)

    Endsley, Patricia; Embrey, Mary Louise

    2014-01-01

    Registered professional school nurses (hereinafter referred to as school nurses) promote wellness and disease prevention to improve health outcomes for our nation's children. It is the position of the National Association of School Nurses (NASN) that the marijuana plant remain under the United States Drug Enforcement Agency's (DEA) Schedule I…

  14. A positive bacterial culture during re-implantation is associated with a poor outcome in two-stage exchange arthroplasty for deep infection.

    Science.gov (United States)

    Akgün, D; Müller, M; Perka, C; Winkler, T

    2017-11-01

    The aim of this study was to identify the incidence of positive cultures during the second stage of a two-stage revision arthroplasty and to analyse the association between positive cultures and an infection-free outcome. This single-centre retrospective review of prospectively collected data included patients with a periprosthetic joint infection (PJI) of either the hip or the knee between 2013 and 2015, who were treated using a standardised diagnostic and therapeutic algorithm with two-stage exchange. Failure of treatment was assessed according to a definition determined by a Delphi-based consensus. Logistic regression analysis was performed to assess the predictors of positive culture and risk factors for failure. The mean follow-up was 33 months (24 to 48). A total of 163 two-stage revision arthroplasties involving 84 total hip arthroplasties (THAs) and 79 total knee arthroplasties (TKAs) were reviewed. In 27 patients (16.6%), ≥ 1 positive culture was identified at re-implantation and eight (29.6%) of these subsequently failed compared with 20 (14.7%) patients who were culture-negative. The same initially infecting organism was isolated at re-implantation in nine of 27 patients (33.3%). The organism causing re-infection in none of the patients was the same as that isolated at re-implantation. The risk of the failure of treatment was significantly higher in patients with a positive culture (odds ratio (OR) 1.7; 95% confidence interval (CI) 1.0 to 3.0; p = 0.049) and in patients with a higher Charlson Comorbidity Index (OR 1.5; 95% CI 1.6 to 1.8; p = 0.001). Positive culture at re-implantation was independently associated with subsequent failure. Surgeons need to be aware of this association and should consider the medical optimisation of patients with severe comorbidities both before and during treatment. Cite this article: Bone Joint J 2017;99-B:1490-5. ©2017 The British Editorial Society of Bone & Joint Surgery.

  15. Do positive children become positive adults? Evidence from a longitudinal birth cohort study.

    Science.gov (United States)

    Richards, Marcus; Huppert, Felicia A

    2011-02-10

    activity, or work satisfaction. While childhood conduct and emotional problems were associated with few of the social and life satisfaction outcomes, the former were negatively associated with educational and occupational attainment, and positively with divorce, whereas the latter were negatively associated with being married. CONCLUSIONS: Prospectively rated childhood wellbeing has long-term beneficial links to adult functioning; our results also support the view that positive wellbeing has a unique impact on these outcomes, and does not merely represent the absence of mental ill-health.

  16. Improving Pupil Referral Unit Outcomes: Pupil Perspectives

    Science.gov (United States)

    Michael, Siobhan; Frederickson, Norah

    2013-01-01

    Concern has been expressed about the quality of alternative provision for young people with social, emotional and behavioural difficulties, and the poor academic and social outcomes many experience. Little research has sought the views of the young people themselves regarding the enablers and barriers to positive outcomes they have encountered. A…

  17. Sonographic evaluation of the fetal spine position and success rate of manual rotation of the fetus in occiput posterior position: A randomized controlled trial.

    Science.gov (United States)

    Masturzo, Bianca; Farina, Antonio; Attamante, Lorenza; Piazzese, Annalisa; Rolfo, Alessandro; Gaglioti, Pietro; Todros, Tullia

    2017-10-01

    To evaluate whether sonographic (US) diagnosis of the fetal spine position could increase the success rate of manual rotation of the fetal occiput (MRFO) in second-stage arrest in persistent occiput posterior position (OPP). In this randomized controlled parallel single-center trial, 58 nulliparous in second-stage arrest of labor with fetus in cephalic presentation and OPP diagnosed by US were randomly assigned to group A where the fetal spine position was not known by the operator or to group B where the operator knew it. The main outcome was the success of MRFO in the two groups. Secondary outcomes were perineal injuries, blood loss, duration of expulsive period, and neonatal APGAR at 5 minutes. A priori knowledge of the spine position improves the success of the MRFO (41.4% group A versus 82.8% group B, p value < 0.001), the percentage of spontaneous deliveries (27.6% group A versus 69% group B, p value = 0.01), and maternal outcome (intact perineum and blood loss). No differences were detected on the neonatal side. MRFO is a safe and useful procedure that should be performed in second-stage arrest in OPP. A better performance was observed when supported by the US knowledge of the spine position. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:472-476, 2017. © 2017 Wiley Periodicals, Inc.

  18. Heterogeneity in outcomes of treated HIV-positive patients in Europe and North America

    DEFF Research Database (Denmark)

    May, Margaret T; Hogg, Robert S; Justice, Amy C

    2012-01-01

    HIV cohort collaborations, which pool data from diverse patient cohorts, have provided key insights into outcomes of antiretroviral therapy (ART). However, the extent of, and reasons for, between-cohort heterogeneity in rates of AIDS and mortality are unclear....

  19. Nucleosome Positioning and Epigenetics

    Science.gov (United States)

    Schwab, David; Bruinsma, Robijn

    2008-03-01

    The role of chromatin structure in gene regulation has recently taken center stage in the field of epigenetics, phenomena that change the phenotype without changing the DNA sequence. Recent work has also shown that nucleosomes, a complex of DNA wrapped around a histone octamer, experience a sequence dependent energy landscape due to the variation in DNA bend stiffness with sequence composition. In this talk, we consider the role nucleosome positioning might play in the formation of heterochromatin, a compact form of DNA generically responsible for gene silencing. In particular, we discuss how different patterns of nucleosome positions, periodic or random, could either facilitate or suppress heterochromatin stability and formation.

  20. Cognitive Engagement Mediates the Relationship between Positive Life Events and Positive Emotionality

    Directory of Open Access Journals (Sweden)

    Alexander Strobel

    2017-10-01

    Full Text Available Need for Cognition (NFC is conceptualized as an individuals’ tendency to engage in and enjoy effortful cognitive activity and, thus, captures one’s cognitive engagement. It plays a well-established role in information processing in experimental or academic contexts. However, so far comparably little is known about its consequences for other than purely cognitive or academic outcomes. Indeed, NFC is positively associated with personality traits pertaining to Positive Emotionality (PE and negatively to traits related to Negative Emotionality (NE. Moreover, evidence suggests NFC to be related to an active, problem-focused coping style. We therefore hypothesized NFC to mediate between life events and individual differences in PE and NE. In a sample of N = 202 volunteers from the general population, we observed that the number of past positive and negative life events had direct effects on PE, and NE, respectively, and that for positive life events, a mediating effect on PE via NFC was observed, with a higher number of past positive life events being related to higher NFC that in turn was related to increased PE. Thus, the present results lend support to the notion of NFC as an important factor supporting personal well-being by way of its mediating role between the number of past positive life events and positive affect.

  1. New Schemes for Positive Real Truncation

    Directory of Open Access Journals (Sweden)

    Kari Unneland

    2007-07-01

    Full Text Available Model reduction, based on balanced truncation, of stable and of positive real systems are considered. An overview over some of the already existing techniques are given: Lyapunov balancing and stochastic balancing, which includes Riccati balancing. A novel scheme for positive real balanced truncation is then proposed, which is a combination of the already existing Lyapunov balancing and Riccati balancing. Using Riccati balancing, the solution of two Riccati equations are needed to obtain positive real reduced order systems. For the suggested method, only one Lyapunov equation and one Riccati equation are solved in order to obtain positive real reduced order systems, which is less computationally demanding. Further it is shown, that in order to get positive real reduced order systems, only one Riccati equation needs to be solved. Finally, this is used to obtain positive real frequency weighted balanced truncation.

  2. Value of Hipparcos Catalogue shown by planet assessments

    Science.gov (United States)

    1996-08-01

    Catalogue and the distribution of the data to collaborating scientists. The Catalogue lists the positions, distances, motions and brightnesses of 118,000 stars, within a self-consistent framework for the whole sky. The results include remarkable detail on the orbits of double stars and the changing light output of variable stars. Thanks to the unprecedented accuracy of space observations with a specially conceived satellite, the Hipparcos Catalogue gives positions of the stars to much better than a millionth of a degree. This is over one hundred times more accurate than the most careful fixes of stars from observatories on the ground. With the Catalogue's completion, the Hipparcos mission achieves its purpose of revolutionizing astrometry, the positional science that has underpinned mankind's studies of the Universe since the satellite's namesake Hipparchus the Greek surveyed the sky in the 2nd Century BC. Another pioneer of astrometry was Tycho the Dane (16th Century AD) and he is commemorated in a second product of the Hipparcos mission. The Tycho Catalogue, which is nearing completion, lists a far larger number of stars, slightly more than a million. Their positions will be less precise than in the Hipparcos Catalogue, but still far better than the ground-based results, and will include valuable data on the colours of stars. The first chance to cull discoveries from the Hipparcos data resides with the teams in nine European countries who have laboured to achieve this breakthrough in astronomy. For some team members the effort goes back thirty years, to the first proposal of an astrometric satellite in France in 1966. ESA approved the mission in 1980 and Hipparcos was launched in August 1989. Despite finding itself in the wrong orbit, Hipparcos operated successfully until March 1993. Three more years have gone into data analysis, using computers in a dozen institutes across Europe for the most elaborate calculations in the history of astronomy. Members of the teams will

  3. Common Factor Mechanisms in Clinical Practice and Their Relationship with Outcome.

    Science.gov (United States)

    Gaitan-Sierra, Carolina; Hyland, Michael E

    2015-01-01

    This study investigates three common factor mechanisms that could affect outcome in clinical practice: response expectancy, the affective expectation model and motivational concordance. Clients attending a gestalt therapy clinic (30 clients), a sophrology (therapeutic technique) clinic (33 clients) and a homeopathy clinic (31 clients) completed measures of expectancy and the Positive Affect and Negative Affect Schedule (PANAS) before their first session. After 1 month, they completed PANAS and measures of intrinsic motivation, perceived effort and empowerment. Expectancy was not associated with better outcome and was no different between treatments. Although some of the 54 clients who endorsed highest expectations showed substantial improvement, others did not: 19 had no change or deteriorated in positive affect, and 18 had the same result for negative affect. Intrinsic motivation independently predicted changes in negative affect (β = -0.23). Intrinsic motivation (β = 0.24), effort (β = 0.23) and empowerment (β = 0.20) independently predicted positive affect change. Expectancy (β = -0.17) negatively affected changes in positive affect. Clients found gestalt and sophrology to be more intrinsically motivating, empowering and effortful compared with homeopathy. Greater improvement in mood was found for sophrology and gestalt than for homeopathy clients. These findings are inconsistent with response expectancy as a common factor mechanism in clinical practice. The results support motivational concordance (outcome influenced by the intrinsic enjoyment of the therapy) and the affective expectation model (high expectations can lead for some clients to worse outcome). When expectancy correlates with outcome in some other studies, this may be due to confound between expectancy and intrinsic enjoyment. Common factors play an important role in outcome. Intrinsic enjoyment of a therapeutic treatment is associated with better outcome. Active engagement with a

  4. Economic Outcomes in Prosthodontics

    NARCIS (Netherlands)

    Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad W.; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

    2013-01-01

    Purpose: A systematic literature review was conducted to identify the types of economic measures currently used in implant prosthodontics and determine the degree to which cost of care is considered in the context of any positive outcome of the care provided. Materials and Methods: A literature

  5. Ad-Coop Positioning System (ACPS)

    DEFF Research Database (Denmark)

    Frattasi, Simone; Monti, Marco

    2008-01-01

    In this paper, we propose an innovative solution for positioning determination in 4G wireless networks by introducing the Ad-Coop Positioning System (ACPS). The ACPS is supported by a hybrid cellular ad-hoc architecture, where the cellular network has a centralized control over the ad-hoc connect......In this paper, we propose an innovative solution for positioning determination in 4G wireless networks by introducing the Ad-Coop Positioning System (ACPS). The ACPS is supported by a hybrid cellular ad-hoc architecture, where the cellular network has a centralized control over the ad...... method for the ACPS, which appropriately combines and weights the long- and short-range location information in a non-linear least square (NLLS) minimization procedure. The numerical results shown in the paper demonstrate that the ACPS enhances the location estimation accuracy with respect...

  6. Allied health research positions: a qualitative evaluation of their impact.

    Science.gov (United States)

    Wenke, Rachel J; Ward, Elizabeth C; Hickman, Ingrid; Hulcombe, Julie; Phillips, Rachel; Mickan, Sharon

    2017-02-06

    Research positions embedded within healthcare settings have been identified as an enabler to allied health professional (AHP) research capacity; however, there is currently limited research formally evaluating their impact. In 2008, a Health Practitioner industrial agreement funded a research capacity building initiative within Queensland Health, Australia, which included 15 new allied health research positions. The present project used a qualitative and realist approach to explore the impact of these research positions, as well as the mechanisms which facilitated or hindered their success within their respective organisations. Forty-four AHP employees from six governmental health services in Queensland, Australia, participated in the study. Individual interviews were undertaken, with individuals in research positions (n = 8) and their reporting line managers (n = 8). Four stakeholder focus groups were also conducted with clinicians, team leaders and professional heads who had engaged with the research positions. Nine key outcomes of the research positions were identified across individual, team/service and organisational/community levels. These outcomes included clinician skill development, increased research activity, clinical and service changes, increased research outputs and collaborations, enhanced research and workplace culture, improved profile of allied health, development of research infrastructure, and professional development of individuals in the research positions. Different mechanisms that influenced these outcomes were identified. These mechanisms were grouped by those related to the (1) research position itself, (2) organisational factors and (3) implementation factors. The present findings highlight the potential value of the research positions for individuals, teams and clinical services across different governmental healthcare services, and demonstrate the impact of the roles on building the internal and external profile of allied health

  7. Self-declared stock ownership and association with positive trial outcome in randomized controlled trials with binary outcomes published in general medical journals: a cross-sectional study.

    Science.gov (United States)

    Falk Delgado, Alberto; Falk Delgado, Anna

    2017-07-26

    Describe the prevalence and types of conflicts of interest (COI) in published randomized controlled trials (RCTs) in general medical journals with a binary primary outcome and assess the association between conflicts of interest and favorable outcome. Parallel-group RCTs with a binary primary outcome published in three general medical journals during 2013-2015 were identified. COI type, funding source, and outcome were extracted. Binomial logistic regression model was performed to assess association between COI and funding source with outcome. A total of 509 consecutive parallel-group RCTs were included in the study. COI was reported in 74% in mixed funded RCTs and in 99% in for-profit funded RCTs. Stock ownership was reported in none of the non-profit RCTs, in 7% of mixed funded RCTs, and in 50% of for-profit funded RCTs. Mixed-funded RCTs had employees from the funding company in 11% and for-profit RCTs in 76%. Multivariable logistic regression revealed that stock ownership in the funding company among any of the authors was associated with a favorable outcome (odds ratio = 3.53; 95% confidence interval = 1.59-7.86; p < 0.01). COI in for-profit funded RCTs is extensive, because the factors related to COI are not fully independent, a multivariable analysis should be cautiously interpreted. However, after multivariable adjustment only stock ownership from the funding company among authors is associated with a favorable outcome.

  8. Nutritional Recovery Outcome among Moderately Malnourished ...

    African Journals Online (AJOL)

    Nutritional Recovery Outcome among Moderately Malnourished Under-five Children in Communities Implementing Positive Deviance - Hearth or Community Health Workers' Nutrition Promotion Approaches in Karusi and Kirundo Provinces, Burundi.

  9. Cognitive Dysfunction, Locus of Control and Treatment Outcome among Chronic Alcoholics.

    Science.gov (United States)

    Abbott, Max W.

    While alcoholism is no longer regarded as a unitary disorder, conventional measures of congition and personality have yet to be shown capable of consistently predicting clinical outcomes. To investigate cognitive dysfunction and locus of control as predictors of post treatment outcome in a large sample of alcoholics, 106 alcoholics (74 men, 32…

  10. Hepatitis C virus reinfection incidence and treatment outcome among HIV-positive MSM.

    Science.gov (United States)

    Martin, Thomas C S; Martin, Natasha K; Hickman, Matthew; Vickerman, Peter; Page, Emma E; Everett, Rhiannon; Gazzard, Brian G; Nelson, Mark

    2013-10-23

    Liver disease secondary to hepatitis C virus (HCV) infection in the context of HIV infection is one of the leading non-AIDS causes of death. Sexual transmission of HCV infection among HIV-positive MSM appears to be leading to increased reports of acute HCV infection. Reinfection after successful treatment or spontaneous clearance is reported among HIV-positive MSM but the scale of reinfection is unknown. We calculate and compare HCV reinfection rates among HIV-positive MSM after spontaneous clearance and successful medical treatment of infection. Retrospective analysis of HIV-positive MSM with sexually acquired HCV who subsequently spontaneously cleared or underwent successful HCV treatment between 2004 and 2012. Among 191 individuals infected with HCV, 44 were reinfected over 562 person-years (py) of follow-up with an overall reinfection rate of 7.8/100 py [95% confidence interval (CI) 5.8-10.5]. Eight individuals were subsequently reinfected a second time at a rate of 15.5/100 py (95% CI 7.7-31.0). Combining all reinfections, 20% resulted in spontaneous clearance and treatment sustained viral response rates were 73% (16/22) for genotypes one and four and 100% (2/2) for genotypes two and three. Among 145 individuals with a documented primary infection, the reinfection rate was 8.0 per 100 py (95% CI 5.7-11.3) overall, 9.6/100 py (95% CI 6.6-14.1) among those successfully treated and 4.2/100 py (95% CI 1.7-10.0) among those who spontaneously cleared. The secondary reinfection rate was 23.2/100 py (95% CI 11.6-46.4). Despite efforts at reducing risk behaviour, HIV-positive MSM who clear HCV infection remain at high risk of reinfection. This emphasizes the need for increased sexual education, surveillance and preventive intervention work.

  11. Primary Endoscopic Transnasal Transsphenoidal Surgery for Magnetic Resonance Image-Positive Cushing Disease: Outcomes of a Series over 14 Years.

    Science.gov (United States)

    Kuo, Chao-Hung; Yen, Yu-Shu; Wu, Jau-Ching; Chen, Yu-Chun; Huang, Wen-Cheng; Cheng, Henrich

    2015-09-01

    There are scant data of endoscopic transsphenoidal surgery (ETS) with adjuvant therapies of Cushing disease (CD). To report the remission rate, secondary management, and outcomes of a series of CD patients. Patients with CD with magnetic resonance imaging (MRI)-positive adenoma who underwent ETS as the first and primary treatment were included. The diagnostic criteria were a combination of 24-hour urine-free cortisol, elevated serum cortisol levels, or other tests (e.g., inferior petrosal sinus sampling). All clinical and laboratory evaluations and radiological examinations were reviewed. Forty consecutive CD patients, with an average age of 41.0 years, were analyzed with a mean follow-up of 40.2 ± 29.6 months. These included 22 patients with microadenoma and 18 with macroadenoma, including 9 cavernous invasions. The overall remission rate of CD after ETS was 72.5% throughout the entire follow-up. Patients with microadenoma or noninvasive macroadenoma had a higher remission rate than those who had macroadenoma with cavernous sinus invasion (81.8% or 77.8% vs. 44.4%, P = 0.02). After ETS, the patients who had adrenocorticotropic hormone-positive adenoma had a higher remission rate than those who had not (76.5% vs. 50%, P = 0.03). In the 11 patients who had persistent/recurrent CD after the first ETS, 1 underwent secondary ETS, 8 received gamma-knife radiosurgery (GKRS), and 2 underwent both. At the study end point, two (5%) of these CD patients had persistent CD and were under the medication of ketoconazole. For MRI-positive CD patients, primary (i.e., the first) ETS yielded an overall remission rate of 72.5%. Adjuvant therapies, including secondary ETS, GKRS, or both, yielded an ultimate remission rate of 95%. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Normative evaluations and frequency expectations regarding positive versus negative outcome allocations between groups

    NARCIS (Netherlands)

    Blanz, M; Mummendey, A; Otten, S

    1997-01-01

    Data from several recent studies consistently show a positive-negative asymmetry in social discrimination: within a minimal social situation tendencies cowards ingroup favouritism which usually appear in allocations of positively valenced resources are absent in the domain of negatively valenced

  13. Successful use of non-invasive positive pressure ventilation in a complicated flail chest

    International Nuclear Information System (INIS)

    Al-Ansari, Mariam A.

    2006-01-01

    The current advanced trauma life support manual states that patients with significant hypoxia (namely, SaO2<90% on room air) as a result of pulmonary contusion should be intubated and ventilated within the first hour of injury. Recently, several researchers have shown improved outcomes when patients with acute respiratory failure are managed with noninvasive positive pressure ventilation (NIPPV). Trauma patients may also benefit from this therapy. We report a case of 15-year-old boy who isolated flail chest and pulmonary contusion, who was intubated in the emergency room, and was managed successfully with the NIPPV in the intensive care unit (ICU) despite, having had aspiration pneumonia early in the course of her stay. After initial stabilization, he failed a spontaneous breathing trial. Due to absence of contraindications to the use of NIPPV, the patient was extubated on day 7 (from pressure ventilation of 15 cmH2O and positive end expiratory pressure of 8 cm H2O) to immediate NIPPV use. Three days later (after a total of 50 hours of NIPPV use in the ICU) the patient was successfully discharged home. (author)

  14. Association between organisational and workplace cultures, and patient outcomes: systematic review.

    Science.gov (United States)

    Braithwaite, Jeffrey; Herkes, Jessica; Ludlow, Kristiana; Testa, Luke; Lamprell, Gina

    2017-11-08

    Every organisation has a unique culture. There is a widely held view that a positive organisational culture is related to positive patient outcomes. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses statement, we systematically reviewed and synthesised the evidence on the extent to which organisational and workplace cultures are associated with patient outcomes. A variety of healthcare facilities, including hospitals, general practices, pharmacies, military hospitals, aged care facilities, mental health and other healthcare contexts. The articles included were heterogeneous in terms of participants. This was expected as we allowed scope for wide-ranging health contexts to be included in the review. Patient outcomes, inclusive of specific outcomes such as pain level, as well as broader outcomes such as patient experience. The search strategy identified 2049 relevant articles. A review of abstracts using the inclusion criteria yielded 204 articles eligible for full-text review. Sixty-two articles were included in the final analysis. We assessed studies for risk of bias and quality of evidence. The majority of studies (84%) were from North America or Europe, and conducted in hospital settings (89%). They were largely quantitative (94%) and cross-sectional (81%). The review identified four interventional studies, and no randomised controlled trials, but many good quality social science studies. We found that overall, positive organisational and workplace cultures were consistently associated with a wide range of patient outcomes such as reduced mortality rates, falls, hospital acquired infections and increased patient satisfaction. Synthesised, although there was no level 1 evidence, our review found a consistently positive association held between culture and outcomes across multiple studies, settings and countries. This supports the argument in favour of activities that promote positive cultures in order to enhance outcomes in healthcare

  15. Macau, world capital for gambling: A longitudinal study of a youth program designed to instill positive values

    Directory of Open Access Journals (Sweden)

    Andrew Leung Luk

    2013-11-01

    Full Text Available Macau, world capital for gambling: A longitudinal study of a youth program designed to instil positive valuesABSTRACTThis study investigated the effectiveness of a positive youth development program for Chinese Secondary 3 students in two schools, who had been followed up since their entry to Secondary 1. A mixed research method was carried out using a pre- and post-test pre-experimental design and a focus group for the participants. The subjective outcome evaluations included participants’ perceptions of the program, program instructors, benefits of the program and overall satisfaction, and were positive. The longitudinal data from the objective outcome evaluation showed some notable improvements, and the overall effect of the program was also found to be positive for newcomers in the junior secondary years. The focus group interviews revealed mostly positive feedback in terms of the students’ general impressions of the program, with the majority of participants perceiving benefits to themselves from the program. The findings offer positive evidence of the effectiveness of the program. KEYWORDS: adolescents, positive youth development, objective outcome evaluation, subjective outcome evaluation

  16. A randomized controlled trial of positioning treatments in infants with positional head shape deformities.

    Science.gov (United States)

    Hutchison, B Lynne; Stewart, Alistair W; De Chalain, Tristan B; Mitchell, Edwin A

    2010-10-01

    Randomized controlled trials of treatment for deformational plagiocephaly and brachycephaly have been lacking in the literature. Infants (n = 126) presenting to a plagiocephaly clinic were randomized to either positioning strategies or to positioning plus the use of a Safe T Sleep™ positioning wrap. Head shape was measured using a digital photographic technique, and neck function was assessed. They were followed up at home 3, 6 and 12 months later. There was no difference in head shape outcomes for the two treatment groups after 12 months of follow-up, with 42% of infants having head shapes in the normal range by that time. Eighty per cent of children showed good improvement. Those that had poor improvement were more likely to have both plagiocephaly and brachycephaly and to have presented later to clinic. Most infants improved over the 12-month study period, although the use of a sleep positioning wrap did not increase the rate of improvement. © 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.

  17. Incidental emotions influence risk preference and outcome evaluation.

    Science.gov (United States)

    Zhao, Ding; Gu, Ruolei; Tang, Ping; Yang, Qiwei; Luo, Yue-Jia

    2016-10-01

    Incidental emotions, which are irrelevant to the current decision, play a significant role in the decision-making process. In this study, to investigate the influence of incidental emotions on behavioral, psychological, and electrophysiological responses in the process of decision making, participants were required to perform a monetary gambling task. During the selection stage, an emotional picture, which was chosen from the Chinese Affective Picture System and fell into one of three categories: negative, neutral, and positive, was presented between two alternatives (small/large amount of bet). The pictures were provided to induce incidental emotions. ERPs and self-rating emotional experiences to outcome feedback were recorded during the task. Behavioral results showed that positive incidental emotions elicited risk preference, but emotional experiences to outcome feedback were not influenced by incidental emotions. The feedback-related negativity amplitudes were larger in the positive emotion condition than in the negative and neutral emotion conditions for small outcomes (including wins and losses), whereas there was no difference between the three conditions for large outcomes. In addition, the amplitudes of P3 were reduced overall in the negative emotion condition. We suggest that incidental emotions have modulated both the option assessment stage (manifested in behavioral choices) and the outcome evaluation stage (manifested in ERP amplitudes) of decision making unconsciously (indicated by unchanged subjective emotional experiences). The current findings have expanded our understanding of the role of incidental emotion in decision making. © 2016 Society for Psychophysiological Research.

  18. Does quality improvement work in neonatology improve clinical outcomes?

    Science.gov (United States)

    Ellsbury, Dan L; Clark, Reese H

    2017-04-01

    Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care. Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants. Declines in morbidities, resource use, and length of stay have been associated with reductions in healthcare costs. Recent quality improvement work has shown evidence of improvement in clinical outcomes in neonatal intensive care patients. These improvements have important implications for the reduction of healthcare costs in this population.

  19. Optimal Skin-to-Stone Distance Is a Positive Predictor for Successful Outcomes in Upper Ureter Calculi following Extracorporeal Shock Wave Lithotripsy: A Bayesian Model Averaging Approach.

    Directory of Open Access Journals (Sweden)

    Kang Su Cho

    Full Text Available To investigate whether skin-to-stone distance (SSD, which remains controversial in patients with ureter stones, can be a predicting factor for one session success following extracorporeal shock wave lithotripsy (ESWL in patients with upper ureter stones.We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4-20 mm and were eligible for our analyses. Maximal stone length, mean stone density (HU, and SSD were determined on pretreatment non-contrast computed tomography (NCCT. For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile.In analyses of group 2 patients versus others, there were no statistical differences in mean age, stone length and density. However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P = 0.032. The multivariate logistic regression model revealed that shorter stone length, lower stone density, and the group 2 SSD were positive predictors for successful outcomes in ESWL. Using the Bayesian model-averaging approach, longer stone length, lower stone density, and group 2 SSD can be also positive predictors for successful outcomes following ESWL.Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL.

  20. Reality television predicts both positive and negative outcomes for adolescent girls.

    Science.gov (United States)

    Ferguson, Christopher J; Salmond, Kimberlee; Modi, Kamla

    2013-06-01

    To assess the influence of media, specifically reality television, on adolescent behavior. A total of 1141 preteen and adolescent girls (age range 11-17) answered questions related to their reality television viewing, personality, self-esteem, relational aggression, appearance focus, and desire for fame. Our results indicated that the influence of reality television on adolescent behavior is complex and potentially related to the adolescents' intended uses and gratifications for using reality television. Reality television viewing was positively related to increased self-esteem and expectations of respect in dating relationships. However, watching reality television also was related to an increased focus on appearance and willingness to compromise other values for fame. Reality television viewing did not predict relational aggression. The potential influences of reality television use on adolescent girls are both positive and negative, defying easy categorization. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Anti-CagA positivity in duodenal ulcer and functional dyspepsia patients infected with Helicobacter pylori and its effect on the outcome of eradication treatment

    Directory of Open Access Journals (Sweden)

    Yaşar Nazlıgül

    2011-03-01

    Full Text Available Objectives: CagA positive H. pylori strains are considered to be more virulent than other strains. In this study, we aimed to investigate the rate of CagA positivity in duodenal ulcer (DU and functional dyspepsia (FD, and its effect on H. pylori eradication response.Materials and methods: The study was performed on H. pylori positive 60 patients with DU and 50 patients with FD, who underwent upper gastrointestinal endoscopy. H. pylori infection was identified by histology. All patients received a quadriple therapy consisted of esomeprazole 20 mg b.i.d., colloidal bismuth subcitrate 600 mg b.i.d., tetracycline 500 mg q.i.d. and metronidazole 500 mg t.i.d. for 7 days. H.pylori status was rechecked using C14-urea breath test 6 weeks after the end of treatment to confirm cure. Specific IgG antibodies for CagA status were determined by enzyme linked immunosorbent assay.Results: CagA positivities in the patients with DU and FD were calculated respectivily 70% and 68% (P>0.05. H. pylori was eradicated in 85.5% of the patients infected with CagA (+ strains, in 50% of those infected with CagA (- strains (P=0.001. The eradication rates were 95.2% and 55.6% in CagA positive and negative DU subgroups (P=0.001, and 73.5% and 43.8% in CagA positive and negative FD subgroups (P=0.04.Conclusion: CagA positivities were not different in duodenal ulcer and functional dyspepsia. CagA (+ strains was susceptible to the eradication treatment. The titres of serum anti-CagA antibodies may be used in the prediction of eradication outcome, and the modification of eradication therapy.

  2. Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes.

    Science.gov (United States)

    Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

    2015-11-01

    The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.

  3. Presence and Positioning as Components of Online Instructor Persona

    Science.gov (United States)

    Dennen, Vanessa Paz

    2007-01-01

    Instructor persona in online discussion may set the tone for a variety of course outcomes. Instructors establish persona via both presence (amount of instructor posts) and position (interaction relative to those in the student role). In this paper, three online classes were studied using positioning theory as a grounding framework to elicit ways…

  4. Brucellosis in pregnancy: clinical aspects and obstetric outcomes.

    Science.gov (United States)

    Vilchez, Gustavo; Espinoza, Miguel; D'Onadio, Guery; Saona, Pedro; Gotuzzo, Eduardo

    2015-09-01

    Brucellosis is a zoonosis with high morbidity in humans. This disease has gained interest recently due to its re-emergence and potential for weaponization. Pregnant women with this disease can develop severe complications. Its association with adverse obstetric outcomes is not clearly understood. The objective of this study was to describe the obstetric outcomes of brucellosis in pregnancy. Cases of pregnant women with active brucellosis seen at the Hospital Nacional Cayetano Heredia from 1970 to 2012 were reviewed. Diagnostic criteria were a positive agglutination test and/or positive blood/bone marrow culture. Presentation and outcomes data were collected. The Chi-square test was used for nominal variables. A p-value of brucellosis in 6.4%. The most common treatment was aminoglycosides plus rifampicin (42.2% of cases). Complication rates decreased if treatment was started within 2 weeks of presentation (p brucellosis in pregnancy reported in the literature. Brucella presents adverse obstetric outcomes including fetal and maternal/neonatal death. Cases with unexplained spontaneous abortion should be investigated for brucellosis. Prompt treatment is paramount to decrease the devastating outcomes. Copyright © 2015. Published by Elsevier Ltd.

  5. Current Evidence of Gait Modification with Real-time Biofeedback to Alter Kinetic, Temporospatial, and Function-Related Outcomes: A Review

    Directory of Open Access Journals (Sweden)

    Oladipo Eddo

    2017-07-01

    Full Text Available Background: Gait retraining using real-time biofeedback (RTB may have positive outcomes in decreasing knee adduction moment (KAM in healthy individuals and has shown equal likelihood in patients with knee osteoarthritis (OA. Currently, there is no consensus regarding the most effective gait modification strategy, mode of biofeedback or treatment dosage. Objective: The purpose of this review was: i to assess if gait retraining interventions using RTB are valuable to reduce KAM, pain, and improve function in individuals with knee osteoarthritis, ii to evaluate the effectiveness of different gait modifications and modes of RTB in reducing KAM in healthy individuals, and iii to assess the impact of gait retraining interventions with RTB on other variables that may affect clinical outcomes. Methods: Seven electronic databases were searched using five search terms. Studies that utilized any form of gait retraining with RTB to improve one or a combination of the following measures were included: KAM, knee pain, and function. Twelve studies met the inclusion criteria, evaluating eleven distinctive gait modifications and three modes of RTB. Results: All but one study showed positive outcomes. Self-selected and multi-parameter gait modifications showed the greatest reductions in KAM with visual and haptic RTB being more effective than auditory. Conclusions: Current evidence suggests that gait modification using RTB can Positively alter KAM in asymptomatic and symptomatic participants. However, the existing literature is limited and of low quality, with the optimal combination strategies remaining unclear (gait and biofeedback mode. Future studies should employ randomized controlled study designs to compare the effects of different gait modification strategies and biofeedback modes on individuals with knee OA.

  6. Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes.

    Science.gov (United States)

    Mohr, David C; Schult, Tamara; Eaton, Jennifer Lipkowitz; Awosika, Ebi; McPhaul, Kathleen M

    2016-05-01

    The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.

  7. Determinants of Network Outcomes

    DEFF Research Database (Denmark)

    Ysa, Tamyko; Sierra, Vicenta; Esteve, Marc

    2014-01-01

    The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization...... networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network...... outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more...

  8. Risk of breast cancer after false-positive test results in screening mammography

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My Catarina; Risør, Louise Madeleine; Thorsted, Brian Larsen

    2012-01-01

    Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests...

  9. Caregiver-mediated exercises for improving outcomes after stroke

    NARCIS (Netherlands)

    Vloothuis, Judith D.M.; Mulder, Marijn; Veerbeek, Janne M.; Konijnenbelt, Manin; Visser-Meily, Johanna M.A.; Ket, Johannes C.F.; Kwakkel, Gert; van Wegen, Erwin E.H.

    2016-01-01

    Background: Stroke is a major cause of long-term disability in adults. Several systematic reviews have shown that a higher intensity of training can lead to better functional outcomes after stroke. Currently, the resources in inpatient settings are not always sufficient and innovative methods are

  10. Perfiles de organizaciones positivas. Análisis de características percibidas según variables individuales, organizacionales y de resultado (Positive organization profiles. Analysis of perceived characteristics according to individual, organizational, and outcome variables

    Directory of Open Access Journals (Sweden)

    María Laura Lupano Perugini

    2016-08-01

    Full Text Available This study analysed the profiles of organizations based on employee perceptions of their workplace. The sample consisted of 459 Argentinian employees (232 men; average age, 36.3 years (SD = 11.7. The participants worked for public companies (17.2%, n = 79 or private companies (82.6%, n = 379. Most of them lived in Buenos Aires and surrounding areas (96.5%, n = 443. A protocol was used for data collection, in which the participants were asked to report positive and negative characteristics associated with their organization. A content analysis of the answers given by the participants was performed, from which different categories of characteristics were derived (e.g., work climate, commitment, values. Several multiple correspondence analyses were conducted to generate profiles according to individual variables (i.e., gender, age, and position, organizational variables (i.e., size, typology, and type, and outcome variables (i.e., performance and job satisfaction. One of the most significant profiles showed associations between the perception of positive characteristics, such as values and outcomes, and high levels of satisfaction and individual/organizational performance.

  11. An intervention to improve program implementation: findings from a two-year cluster randomized trial of Assets-Getting To Outcomes

    Science.gov (United States)

    2013-01-01

    Background Studies have shown that communities have not always been able to implement evidence-based prevention programs with quality and achieve outcomes demonstrated by prevention science. Implementation support interventions are needed to bridge this gap between science and practice. The purpose of this article is to present two-year outcomes from an evaluation of the Assets Getting To Outcomes (AGTO) intervention in 12 Maine communities engaged in promoting Developmental Assets, a positive youth development approach to prevention. AGTO is an implementation support intervention that consists of: a manual of text and tools; face-to-face training, and onsite technical assistance, focused on activities shown to be associated with obtaining positive results across any prevention program. Methods This study uses a nested and cross-sectional, cluster randomized controlled design. Participants were coalition members and program staff from 12 communities in Maine. Each coalition nominated up to five prevention programs to participate. At random, six coalitions and their respective 30 programs received the two-year AGTO intervention and the other six maintained routine operations. The study assessed prevention practitioner capacity (efficacy and behaviors), practitioner exposure to and use of AGTO, practitioner perceptions of AGTO, and prevention program performance. Capacity of coalition members and performance of their programs were compared between the two groups across the baseline, one-, and two-year time points. Results We found no significant differences between AGTO and control group’s prevention capacity. However, within the AGTO group, significant differences were found between those with greater exposure to and use of AGTO. Programs that received the highest number of technical assistance hours showed the most program improvement. Conclusions This study is the first of its kind to show that use of an implementation support intervention-AGTO -yielded

  12. 76 FR 1440 - Notice of Revised Child Outcomes Framework

    Science.gov (United States)

    2011-01-10

    ... Outcomes Framework, renamed The Head Start Child Development and Learning Framework: Promoting Positive Outcomes in Early Childhood Programs Serving Children 3-5 Years Old. The Framework was revised to give more... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Notice of Revised...

  13. Occupational therapy practitioners' perceptions of rehabilitation managers' leadership styles and the outcomes of leadership.

    Science.gov (United States)

    Jeff, Snodgrass; Douthitt, Shannon; Ellis, Rachel; Wade, Shelly; Plemons, Josh

    2008-01-01

    The purpose of this research was to serve as a pilot study to investigate the association between occupational therapy practitioners' perceptions of rehabilitation managers' leadership styles and the outcomes of leadership. Data for this study were collected using the Multifactor Leadership Questionnaire Form 5X and a self-designed demographic questionnaire. The study working sample included 73 occupational therapy practitioners. Major findings from the study indicate that overall, transformational, and transactional leadership styles are associated with leadership outcomes. Transformational leadership had a significant (p leadership outcomes, whereas transactional leadership had a significant (p leadership outcomes. The contingent reward leadership attribute (although belonging to the transactional leadership construct) was found to be positively associated with leadership outcomes, similar to the transformational leadership constructs. The results of this research suggest that transformational leadership styles have a positive association with leadership outcomes, whereas transactional leadership styles have a negative association, excluding the positive transactional contingent reward attribute. A larger, random sample is recommended as a follow-up study.

  14. A global assessment of the social and conservation outcomes of protected areas.

    Science.gov (United States)

    Oldekop, J A; Holmes, G; Harris, W E; Evans, K L

    2016-02-01

    Protected areas (PAs) are a key strategy for protecting biological resources, but they vary considerably in their effectiveness and are frequently reported as having negative impacts on local people. This has contributed to a divisive and unresolved debate concerning the compatibility of environmental and socioeconomic development goals. Elucidating the relationship between positive and negative social impacts and conservation outcomes of PAs is key for the development of more effective and socially just conservation. We conducted a global meta-analysis on 165 PAs using data from 171 published studies. We assessed how PAs affect the well-being of local people, the factors associated with these impacts, and crucially the relationship between PAs' conservation and socioeconomic outcomes. Protected areas associated with positive socioeconomic outcomes were more likely to report positive conservation outcomes. Positive conservation and socioeconomic outcomes were more likely to occur when PAs adopted comanagement regimes, empowered local people, reduced economic inequalities, and maintained cultural and livelihood benefits. Whereas the strictest regimes of PA management attempted to exclude anthropogenic influences to achieve biological conservation objectives, PAs that explicitly integrated local people as stakeholders tended to be more effective at achieving joint biological conservation and socioeconomic development outcomes. Strict protection may be needed in some circumstances, yet our results demonstrate that conservation and development objectives can be synergistic and highlight management strategies that increase the probability of maximizing both conservation performance and development outcomes of PAs. © 2015 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  15. Guillain-Barré syndrome: rehabilitation outcome and recent developments.

    OpenAIRE

    Melillo, E. M.; Sethi, J. M.; Mohsenin, V.

    1998-01-01

    Guillain-Barré syndrome is the most common polyneuropathy causing major disability and respiratory failure. Respiratory complications are the main cause of death. Improved respiratory care and new treatment strategies such as plasmaphoresis and immunoglobulin have been shown to improve outcome. We studied the course and outcome of 37 patients with Guillain-Barré syndrome who were admitted to a rehabilitation and respiratory care facility over a 10-year period. There were 21 males and 16 femal...

  16. Positive organizational potential as a valuable resource of the contemporary company

    Directory of Open Access Journals (Sweden)

    Bohdan Godziszewski

    2014-12-01

    Full Text Available The main aim of the article is to present an outcome of the research project concerning the essence and importance of positive organizational potential understood as state, levels and configurations of companies’ resources which stimulate positive organizational climate, positive organizational culture and positive employees’ behaviour, supporting comprehensive companies’ development. Within the project framework was necessary to identify the internal structure of positive potential, positive culture, positive climate and positive employees’ behaviours. Correlations among the above phenomena and companies’ performances were calculated, within a group of 103 Polish companies, as well.

  17. Navigation studies based on the ubiquitous positioning technologies

    Science.gov (United States)

    Ye, Lei; Mi, Weijie; Wang, Defeng

    2007-11-01

    This paper summarized the nowadays positioning technologies, such as absolute positioning methods and relative positioning methods, indoor positioning and outdoor positioning, active positioning and passive positioning. Global Navigation Satellite System (GNSS) technologies were introduced as the omnipresent out-door positioning technologies, including GPS, GLONASS, Galileo and BD-1/2. After analysis of the shortcomings of GNSS, indoor positioning technologies were discussed and compared, including A-GPS, Cellular network, Infrared, Electromagnetism, Computer Vision Cognition, Embedded Pressure Sensor, Ultrasonic, RFID (Radio Frequency IDentification), Bluetooth, WLAN etc.. Then the concept and characteristics of Ubiquitous Positioning was proposed. After the ubiquitous positioning technologies contrast and selection followed by system engineering methodology, a navigation system model based on Incorporate Indoor-Outdoor Positioning Solution was proposed. And this model was simulated in the Galileo Demonstration for World Expo Shanghai project. In the conclusion, the prospects of ubiquitous positioning based navigation were shown, especially to satisfy the public location information acquiring requirement.

  18. Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data.

    Science.gov (United States)

    Kutney-Lee, Ann; Wu, Evan S; Sloane, Douglas M; Aiken, Linda H

    2013-02-01

    One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intention to leave current position, and job dissatisfaction, and to classify the quality of nurses' work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intention to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intention to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β=-6.42%, pjob dissatisfaction (β=-8.00%, pburnout, intention to leave current position, and job dissatisfaction. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Positive Psychology in Cancer Care : A Story Line Resistant to Evidence

    NARCIS (Netherlands)

    Coyne, James C.; Tennen, Howard; Ranchor, Adelita V.

    Aspinwall and Tedeschi (Ann Behav Med, 2010) summarize evidence they view as supporting links between positive psychological states, including sense of coherence (SOC) and optimism and health outcomes, and they refer to persistent assumptions that interfere with understanding how positive states

  20. The sooner, the better: exercise outcome proximity and intrinsic motivation.

    Science.gov (United States)

    Evans, M Blair; Cooke, Lisa M; Murray, Robyn A; Wilson, Anne E

    2014-11-01

    Despite evidence that outcomes are highly valued when they are expected sooner rather than further into the future (Ainslie, 1975), limited research effort has been devoted to understanding the role of exercise outcome proximity. The purpose of this study was to examine how temporal proximity to positive outcomes influences exercisers' intrinsic motivation. We expected that focusing people on temporally proximal exercise outcomes would increase intrinsic motivation, especially among low-frequency exercisers. This online experimental study was completed by 135 community exercisers (Mage  = 31.11, SD = 10.29; 62% female) who reported an average of 4.86 exercise bouts per week (SD = 2.12). Participants were randomly assigned to a condition that primed temporally proximal positive exercise outcomes (i.e. experienced during or directly following an exercise bout) or temporally distal outcomes (i.e. experienced after days, months, or years of regular exercise). Participants then reported perceptions of behavioral regulation in exercise. As expected, the proximal exercise outcome condition elicited increased intrinsic regulation among those participants who exercised less frequently (i.e. 1 SD below the mean). This study reveals the importance of considering proximity as an important dimension of exercise outcomes-particularly when promoting intrinsic motivation among relatively infrequent exercisers. © 2014 The International Association of Applied Psychology.

  1. Reduction of in utero lead exposures in South African populations: Positive impact of unleaded petrol.

    Directory of Open Access Journals (Sweden)

    Halina B Röllin

    Full Text Available Prenatal exposure to lead (Pb has been shown to have negative and irreversible health impacts on foetal and early childhood development, affecting morbidity and mortality in adulthood. This study aimed to assess in utero Pb exposure, examine birth outcomes, and identify confounding factors in the large cohort of South African population, following the legislated removal of Pb from petrol.Lead was measured in the maternal blood, urine and cord blood using Inductive Coupled Plasma Mass spectrometry (ICP-MS. The statistical analyses included Spearman's correlation, Wilcoxon rank sum (Mann Whitney, Kruskal-Wallis rank tests and multivariate linear regression.Overall, the geometric mean (GM of Pb in maternal blood (PbB was 1.32 μg/dL (n = 640; 95% CI, 1.24-1.40. In the subset cohort, the GM of paired maternal PbB and cord blood (PbC was 1.73 μg/dL (n = 350; 95% CI, 1.60-1.86 and 1.26 μg/dL (n = 317; 95% CI, 1.18-1.35, respectively with a positive correlation between the log PbB and the log PbC (rho = 0.65, p = <0.001. Birth outcomes showed geographical differences in the gestational age (p<0.001, birth length (p = 0.028 and head circumference (p<0.001, Apgar score at 5 min (p<0.001 and parity (p<0.002. In female neonates, a positive association was found between PbC and head circumference (rho = 0.243; p<0.016. The maternal PbB levels were positively correlated with race, educational status, water sources, cooking fuels and use of pesticides at home.This study has demonstrated not only the positive impact that the introduction of unleaded petrol and lead-free paint has had on in utero exposure to Pb in South Africa, but has also contributed new data on the topic, in a region where such data and scientific investigations in this field are lacking. Future research should evaluate if similar effects can be detected in young children and the adult population.

  2. Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke.

    Science.gov (United States)

    Anderson, Craig S; Arima, Hisatomi; Lavados, Pablo; Billot, Laurent; Hackett, Maree L; Olavarría, Verónica V; Muñoz Venturelli, Paula; Brunser, Alejandro; Peng, Bin; Cui, Liying; Song, Lily; Rogers, Kris; Middleton, Sandy; Lim, Joyce Y; Forshaw, Denise; Lightbody, C Elizabeth; Woodward, Mark; Pontes-Neto, Octavio; De Silva, H Asita; Lin, Ruey-Tay; Lee, Tsong-Hai; Pandian, Jeyaraj D; Mead, Gillian E; Robinson, Thompson; Watkins, Caroline

    2017-06-22

    The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours. The primary outcome was degree of disability at 90 days, as assessed with the use of the modified Rankin scale (scores range from 0 to 6, with higher scores indicating greater disability and a score of 6 indicating death). The median interval between the onset of stroke symptoms and the initiation of the assigned position was 14 hours (interquartile range, 5 to 35). Patients in the lying-flat group were less likely than patients in the sitting-up group to maintain the position for 24 hours (87% vs. 95%, P<0.001). In a proportional-odds model, there was no significant shift in the distribution of 90-day disability outcomes on the global modified Rankin scale between patients in the lying-flat group and patients in the sitting-up group (unadjusted odds ratio for a difference in the distribution of scores on the modified Rankin scale in the lying-flat group, 1.01; 95% confidence interval, 0.92 to 1.10; P=0.84). Mortality within 90 days was 7.3% among the patients in the lying-flat group and 7.4% among the patients in the sitting-up group (P=0.83). There were

  3. Positive media portrayals of obese persons: impact on attitudes and image preferences.

    Science.gov (United States)

    Pearl, Rebecca L; Puhl, Rebecca M; Brownell, Kelly D

    2012-11-01

    The purpose of this research was to assess the impact of nonstereotypical, positive media portrayals of obese persons on biased attitudes, as well as propose a change in media practices that could reduce public weight bias and consequent negative health outcomes for those who experience weight stigma. Two online experiments were conducted in which participants viewed either a stigmatizing or a positive photograph of an obese model. In Experiment 1 (N = 146), participants viewed a photograph of either a Caucasian or African American obese woman; in Experiment 2 (N = 145), participants viewed either a Caucasian male or female obese model. Multiple linear regression models were used to analyze outcomes for social distance attitudes toward the obese models depicted in the images, in addition to other negative attitudes and image preferences. Participants who viewed the stigmatizing images endorsed stronger social distance attitudes and more negative attitudes toward obese persons than participants who viewed the positive images, and there was a stronger preference for the positive images than the stigmatizing images. These results were consistent regardless of the race or gender of the obese model pictured. The findings indicate that more positive media portrayals of obese individuals may help reduce weight stigma and its associated negative health outcomes.

  4. The profile and treatment outcomes of sputum smear positive pulmonary tuberculosis re-treatment cases, in a district medical college of West Bengal, India

    Directory of Open Access Journals (Sweden)

    Abinash Agarwala

    2014-01-01

    Full Text Available Background: In a high tuberculosis (TB burden county like India with different regional demography, knowledge about patient profile has a pivotal role in determining and identifying the factors associated with poor treatment outcomes among TB re-treatment cases. Aim: The aim was to describe the demography and clinical characteristics of TB re-treatment cases and to evaluate the factors associated with poor treatment outcomes among those patients. Settings and Design: A prospective longitudinal cohort study was carried out at chest medicine outdoor from February, 2011 to 2014 in a district medical college of West Bengal, India. Materials and Methods: Sputum smear positive re-treatment pulmonary TB patients attending our chest medicine outdoor during the 3 years study period were evaluated for demographic and clinical characteristics on the basis of previous treatment history and records at the beginning of the study. Patients were followed-up during the 8 months treatment period (Category II treatment regimen under Revised National TB Control Program. At the end of the study period, treatment outcomes were analyzed and factors associated with poor treatment outcomes were identified. Statistical Analysis: All variables were described by proportions, and differences between independent groups were compared using the Chi-square test and Fisher′s exact test, as applicable. Results: Among 74 patients, re-treatment was successful in 75.7% of relapse case, 66.7% of loss to follow-up cases and 53.8% of failure cases. Re-treatment failure was higher (38.5% in treatment failure cases compare to relapse cases (10.8% and initial loss to follow-up cases (16.7%. Young age, male, unmarried, employed who work outside appears to be the risk factors for loss to follow-up. Low body mass index, treatment from the private sector, history of alcoholism, radiological cavitory lesion, larger duration of previous treatment, lesser gap from previous treatment has

  5. Cultural intelligence and work-related outcomes

    DEFF Research Database (Denmark)

    Schlaegel, Christopher; Richter, Nicole Franziska; Taras, Vas

    2017-01-01

    ) the results of the bivariate metaanalyses indicate that CQ and its underlying dimensions are positively associated with expatriation intention, job satisfaction, cultural adjustment, transformational leadership, and different performance outcomes (task performance, contextual performance, and team performance...

  6. Treatment outcomes in 4 modes of orthodontic practice.

    Science.gov (United States)

    Poulton, Donald; Vlaskalic, Vicki; Baumrind, Sheldon

    2005-03-01

    This study is a continuation of a previously published report on the outcome of orthodontic treatment provided in offices representing different modes of practice. The sample consisted of duplicate pretreatment (T1) and posttreatment (T2) dental casts of 348 patients from traditional private orthodontic practices (5 offices, 134 patients), company-owned practices (5 offices, 107 patients), offices associated with practice-management organizations (2 offices, 60 patients), and general dental practices (2 offices, 47 patients). Methods were used to obtain random, representative samples from each office, starting with lists of patients who were treated consecutively with full fixed orthodontic appliances. The dental casts were measured by 2 independent judges who used the unweighted PAR score. Good interjudge agreement was shown on the initial casts, but the agreement was not as strong on the final casts. The measurements showed that treatment outcomes were generally satisfactory, although some significant differences between offices and management modes were shown.

  7. Evaluation of Occlusion Treatment Outcomes for Unilateral Amblyopia Using Different Definitions of Outcome.

    Science.gov (United States)

    Su, Liping; Yan, Hong; Xing, Yongxin; Zhang, Yuhai; Zhu, Baoyi

    2016-01-01

    We studied 87 cases of children aged 3 to 10 with unilateral amblyopia (with types of anisometropia, strabismus, or both) who received good recovery after occlusion therapy. The proportional improvement had moderate positive correlation with amblyopic eye improvement (p amblyopia (p amblyopia residual had no correlation with amblyopic eye improvement (p occlusion therapy group displayed the best outcome (p amblyopia eye and residual amblyopia are simple and direct indicators for clinical application. The proportion of the deficit-corrected method should be graded as the proportion of change in visual acuity with respect to the absolute potential for improvement, and these optimum outcomes can provide powerful evidence for good therapeutic effect.

  8. Impact of Project Leadership Facets on Project Outcome

    Directory of Open Access Journals (Sweden)

    Arslan Ayub

    2015-08-01

    Full Text Available The study analyzes the role of project leadership facets on effective project outcome. Numerous such initiatives have already been taken on project outcome/performance in the context of apposite leadership styles or project management. However, the current study is unique in the milieu of project outcome that it introduces a new leadership approach, which throws light on the significance of variant leadership facets on project outcome. The study uses explanatory approach; primary data is collected from project management professionals working in different project organizations. The study uses structural equation model (SEM technique to test the hypothesis. The study found a positive relationship between project leadership facets and project outcome.

  9. The Stereotype-Matching Effect: Greater Influence on Functioning When Age Stereotypes Correspond to Outcomes

    Science.gov (United States)

    Levy, Becca R.; Leifheit-Limson, Erica

    2009-01-01

    Older individuals assimilate, and are targeted by, contradictory positive and negative age stereotypes. It was unknown whether the influence of stereotype valence is stronger when the stereotype content corresponds to the outcome domain. We randomly assigned older individuals to either positive-cognitive, negative-cognitive, positive-physical, or negative-physical subliminal-age-stereotype groups and assessed cognitive and physical outcomes. As predicted, when the age stereotypes corresponded to the outcome domains, their valence had a significantly greater impact on cognitive and physical performance. This suggests that if a match occurs, it is more likely to generate expectations that become self-fulfilling prophecies. PMID:19290757

  10. Early nasal continuous positive airway pressure in a cohort of the smallest infants in Denmark

    DEFF Research Database (Denmark)

    Hansen, Bo M; Esbjørn, Barbara Hoff; Greisen, G

    2004-01-01

    To evaluate neurodevelopmental outcome at age 5 y of age in a cohort of preterm children treated mainly with nasal continuous positive airway pressure (CPAP) in the neonatal period.......To evaluate neurodevelopmental outcome at age 5 y of age in a cohort of preterm children treated mainly with nasal continuous positive airway pressure (CPAP) in the neonatal period....

  11. Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

    Directory of Open Access Journals (Sweden)

    Chiwata Ichiro

    2010-03-01

    Full Text Available Abstract Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs. However, a recent report described a discrepancy between the habitual occlusal position (HOP and the bite plate-induced occlusal position (BPOP and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI and the Helkimo Clinical Dysfunction Index (CDI before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p 0.1. Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted.

  12. The Effects of Positive and Negative Mood on Cognition and Motivation in Multimedia Learning Environment

    Science.gov (United States)

    Liew, Tze Wei; Tan, Su-Mae

    2016-01-01

    The Cognitive-Affective Theory of Learning with Media framework posits that the multimedia learning process is mediated by the learner's mood. Recent studies have shown that positive mood has a facilitating effect on multimedia learning. Though literature has shown that negative mood encourages an individual to engage in a more systematic,…

  13. Outcome expectancy and self-efficacy: theoretical implications of an unresolved contradiction.

    Science.gov (United States)

    Williams, David M

    2010-11-01

    According to self-efficacy theory, self-efficacy--defined as perceived capability to perform a behavior--causally influences expected outcomes of behavior, but not vice versa. However, research has shown that expected outcomes causally influence self-efficacy judgments, and some authors have argued that this relationship invalidates self-efficacy theory. Bandura has rebutted those arguments saying that self-efficacy judgments are not invalidated when influenced by expected outcomes. This article focuses on a contradiction in Bandura's rebuttal. Specifically, Bandura has argued (a) expected outcomes cannot causally influence self-efficacy, but (b) self-efficacy judgments remain valid when causally influenced by expected outcomes. While the debate regarding outcome expectancies and self-efficacy has subsided in recent years, the inattention to this contradiction has led to a disproportionate focus on self-efficacy as a causal determinant of behavior at the expense of expected outcomes.

  14. HIV infection in pregnancy: maternal and perinatal outcomes in a tertiary care hospital in Calabar, Nigeria.

    Science.gov (United States)

    Ikpim, Ekott Mabel; Edet, Udo Atim; Bassey, Akpan Ubong; Asuquo, Otu Akaninyene; Inyang, Ekanem Etim

    2016-04-01

    Human immunodeficiency virus (HIV) infection is likely to have untoward effects on pregnancy and its outcome. This study assessed the impact of maternal HIV infection on pregnancy outcomes in a tertiary centre in Calabar, Nigeria. This retrospective study analysed delivery records of 258 HIV-positive and 257 HIV-negative women for pregnancy and delivery complications. Maternal and fetal outcomes of HIV-positive pregnancies were compared with those of HIV-negative controls. Adverse pregnancy outcomes significantly associated with HIV status were: anaemia: 33 (8.1%) vs. 8 (3.1%) in controls; puerperal sepsis: 18 (7%) vs. 2 (0.8%); and low birth weight: 56 (21.7%) vs. 37 (14.4%). Caesarean delivery was higher among HIV-positive women than controls: 96 (37.2%) vs. 58 (22.6%). Preterm births were higher in those HIV cohorts who did not receive antiretroviral therapy (ART): 13 (16.9%) vs. 7 (3.9%). HIV-positive status increased adverse birth outcome of pregnancy. ART appeared to reduce the risk of preterm births in HIV-positive cohorts. © The Author(s) 2015.

  15. A Multicenter, Randomized Trial of Ramped Position vs Sniffing Position During Endotracheal Intubation of Critically Ill Adults.

    Science.gov (United States)

    Semler, Matthew W; Janz, David R; Russell, Derek W; Casey, Jonathan D; Lentz, Robert J; Zouk, Aline N; deBoisblanc, Bennett P; Santanilla, Jairo I; Khan, Yasin A; Joffe, Aaron M; Stigler, William S; Rice, Todd W

    2017-10-01

    Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room. Multicenter, randomized trial comparing the ramped position (head of the bed elevated to 25°) with the sniffing position (torso supine, neck flexed, and head extended) among 260 adults undergoing endotracheal intubation by pulmonary and critical care medicine fellows in four ICUs between July 22, 2015, and July 19, 2016. The primary outcome was lowest arterial oxygen saturation between induction and 2 minutes after intubation. Secondary outcomes included Cormack-Lehane grade of glottic view, difficulty of intubation, and number of laryngoscopy attempts. The median lowest arterial oxygen saturation was 93% (interquartile range [IQR], 84%-99%) with the ramped position vs 92% (IQR, 79%-98%) with the sniffing position (P = .27). The ramped position appeared to increase the incidence of grade III or IV view (25.4% vs 11.5%, P = .01), increase the incidence of difficult intubation (12.3% vs 4.6%, P = .04), and decrease the rate of intubation on the first attempt (76.2% vs 85.4%, P = .02), respectively. In this multicenter trial, the ramped position did not improve oxygenation during endotracheal intubation of critically ill adults compared with the sniffing position. The ramped position may worsen glottic view and increase the number of laryngoscopy attempts required for successful intubation. ClinicalTrials.gov; No.: NCT02497729; URL: www.clinicaltrials.gov. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  16. Power plant instrumentation and control. Innovations shown at the Interkama '99 trade fair

    International Nuclear Information System (INIS)

    Ullemeyer, M.; Fritz, P.

    2000-01-01

    At the Interkama '99 trade fair, innovative software and hardware solutions for the power industry 'from power plant to the plug' were shown. The report mentions the companies and explains their new developments and systems. (orig./CB) [de

  17. Validation of ISTTOK Plasma Position Controller

    International Nuclear Information System (INIS)

    Valcarcel, D. F.; Carvalho, I. S.; Carvalho, B. B.; Fernandes, H.; Silva, C.; Duarte, P.; Duarte, A.; Carvalho, P. J.; Pereira, T.

    2008-01-01

    Active control of plasma position on the ISTTOK tokamak is of extreme importance due to the inherent instability caused by an unfavourable curvature of the external equilibrium magnetic field. The consequences of this instability can be suppressed by applying a dynamic equilibrium field. A digital real-time plasma position control system for ISTTOK has been developed to perform this task. This system uses magnetic measurements to determine the plasma position and feeds the control signal to power supplies that generate the equilibrium fields. After commissioning, the results obtained have shown some discrepancies between the magnetic plasma position reconstruction and several other diagnostics, such as tomography. This discrepancy at some extent is due to the effect of the external magnetic fields on the poloidal magnetic measurements. This work presents a study that addresses this issue. In a future work it will lead to the development of a corrected plasma position algorithm, aiming at obtaining improved performance of plasma discharges and controlled plasma column displacements

  18. Terrorism, post-traumatic stress, coping strategies, and spiritual outcomes.

    Science.gov (United States)

    Meisenhelder, Janice Bell; Marcum, John P

    2009-03-01

    This mail survey measured post-traumatic stress symptoms, spiritual and non-spiritual coping strategies, and positive spiritual outcomes following the tragedies of 9/11/01 in a national, random sample of 1,056 Presbyterians. Respondents reported mild to moderate degrees of re-experiencing and hyper-arousal symptoms of post-traumatic stress, unrelated to location or knowing someone involved. People experiencing high stress used greater frequency and variety of both spiritual and non-spiritual types of coping strategies. Positive spiritual outcomes were remarkably related to positive spiritual coping strategies, in contrast to no association with negative coping. This study illustrates the significant degree of post-traumatic stress experienced with vicarious exposure and a wide spectrum of coping strategies used following the major terrorist attacks.

  19. Intelligence and Semen Quality Are Positively Correlated

    Science.gov (United States)

    Arden, Rosalind; Gottfredson, Linda S.; Miller, Geoffrey; Pierce, Arand

    2009-01-01

    Human cognitive abilities inter-correlate to form a positive matrix, from which a large first factor, called "Spearman's g" or general intelligence, can be extracted. General intelligence itself is correlated with many important health outcomes including cardio-vascular function and longevity. However, the important evolutionary question of…

  20. Prioritizing Positivity: An Effective Approach to Pursuing Happiness?

    Science.gov (United States)

    Catalino, Lahnna I.; Algoe, Sara B.; Fredrickson, Barbara L.

    2017-01-01

    A decade of research reveals the benefits of positive emotions for mental and physical health; however, recent empirical work suggests the explicit pursuit of happiness may backfire. The present study hypothesized that the pursuit of happiness is not inherently self-defeating; in particular, individuals who seek positivity, as exemplified by how they make decisions about how to organize their day-to-day lives, may be happier. This individual difference is labeled prioritizing positivity. In a community sample of young to older adults (N = 233), prioritizing positivity predicted a host of well-being outcomes (positive emotions, depressive symptomology). In addition, people high in prioritizing positivity have greater resources, and these links are explained by more frequent experiences of positive emotions. In sum, the present study suggests that seeking happiness, although a delicate art, may be a worthwhile pursuit. PMID:25401290

  1. Cumulative risk, cumulative outcome: a 20-year longitudinal study.

    Directory of Open Access Journals (Sweden)

    Leslie Atkinson

    Full Text Available Cumulative risk (CR models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO. We also predicted that early CR (assessed at age 5/6 explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20. The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a "mediated net of adversity" model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.

  2. Positivity in healthcare: relation of optimism to performance.

    Science.gov (United States)

    Luthans, Kyle W; Lebsack, Sandra A; Lebsack, Richard R

    2008-01-01

    The purpose of this paper is to explore the linkage between nurses' levels of optimism and performance outcomes. The study sample consisted of 78 nurses in all areas of a large healthcare facility (hospital) in the Midwestern United States. The participants completed surveys to determine their current state of optimism. Supervisory performance appraisal data were gathered in order to measure performance outcomes. Spearman correlations and a one-way ANOVA were used to analyze the data. The results indicated a highly significant positive relationship between the nurses' measured state of optimism and their supervisors' ratings of their commitment to the mission of the hospital, a measure of contribution to increasing customer satisfaction, and an overall measure of work performance. This was an exploratory study. Larger sample sizes and longitudinal data would be beneficial because it is probable that state optimism levels will vary and that it might be more accurate to measure state optimism at several points over time in order to better predict performance outcomes. Finally, the study design does not imply causation. Suggestions for effectively developing and managing nurses' optimism to positively impact their performance are provided. To date, there has been very little empirical evidence assessing the impact that positive psychological capacities such as optimism of key healthcare professionals may have on performance. This paper was designed to help begin to fill this void by examining the relationship between nurses' self-reported optimism and their supervisors' evaluations of their performance.

  3. Pharmacists' interventions on clinical asthma outcomes: a systematic review.

    Science.gov (United States)

    Garcia-Cardenas, Victoria; Armour, Carol; Benrimoj, Shalom I; Martinez-Martinez, Fernando; Rotta, Inajara; Fernandez-Llimos, Fernando

    2016-04-01

    The objective of this systematic review was to evaluate the impact of pharmacists' interventions on clinical asthma outcomes on adult patients and to identify the outcome indicators used.PubMed, Scopus, Web of Science and Scielo were searched. Studies addressing pharmacists' interventions on adult asthma patients reporting clinical asthma outcomes were incorporated.11 clinical outcomes were identified in 21 studies. 10 studies measured the impact of the intervention on asthma control. Randomised controlled trials (RCT) and non-RCTs found positive results in percentages of controlled patients and Asthma Control Questionnaire (ACQ) scores. Discordant results were found for Asthma Control Test results. Asthma severity was assessed in four studies. One RCT found a significant decrease in the percentage of severe patients; two non-RCTs found significant improvements in severity scores. 11 studies reported pulmonary function indicators, showing inconsistent results. Eight studies measured asthma symptoms; three RCTs and four non-RCTs showed significant improvements.RCTs and non-RCTs generated similar results for most outcomes. Based on the evidence generated by RCTs, pharmacists' have a positive impact on the percentage of controlled patients, ACQ scores, severity and symptoms. Future research should report using the core outcome set of indicators established for asthma (PROSPERO CRD42014007019). Copyright ©ERS 2016.

  4. Daily fluctuations in positive affect positively co-vary with working memory performance.

    Science.gov (United States)

    Brose, Annette; Lövdén, Martin; Schmiedek, Florian

    2014-02-01

    Positive affect is related to cognitive performance in multiple ways. It is associated with motivational aspects of performance, affective states capture attention, and information processing modes are a function of affect. In this study, we examined whether these links are relevant within individuals across time when they experience minor ups and downs of positive affect and work on cognitive tasks in the laboratory on a day-to-day basis. Using a microlongitudinal design, 101 younger adults (20-31 years of age) worked on 3 working memory tasks on about 100 occasions. Every day, they also reported on their momentary affect and their motivation to work on the tasks. In 2 of the 3 tasks, performance was enhanced on days when positive affect was above average. This performance enhancement was also associated with more motivation. Importantly, increases in task performance on days with above-average positive affect were mainly unrelated to variations in negative affect. This study's results are in line with between-person findings suggesting that high levels of well-being are associated with successful outcomes. They imply that success on cognitively demanding tasks is more likely on days when feeling happier. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  5. The Role of Theory-Specific Techniques and Therapeutic Alliance in Promoting Positive Outcomes: Integrative Psychotherapy for World Trade Center Responders.

    Science.gov (United States)

    Haugen, Peter Tejas; Werth, Aditi Sinha; Foster, Alyce Lauren; Owen, Jesse

    2016-12-01

    World Trade Center responders demonstrate high symptom burden, underscoring the importance of refining treatment approaches for this cohort. One method is examining the impact of therapy techniques on outcomes, and the interactions between technique and alliance on outcomes. This study a) examined the interaction of early treatment techniques on integrative psychotherapy outcomes and b) explored whether associations differed at varying levels of alliance. Twenty-nine adult responders diagnosed with partial or full posttraumatic stress disorder received outpatient psychotherapy and completed weekly measures of alliance, technique, and symptom distress. Analyses indicated significant interactions between 1) alliance and psychodynamic interventions on outcomes and 2) alliance and cognitive behavioral (CB) interventions on outcomes. Clients with high alliance had better outcomes when their therapist used fewer CB techniques. No meaningful differences were found between technique and outcomes for clients with lower alliance. These findings reiterate the critical roles technique and responsiveness to the alliance play in engendering successful outcomes.

  6. Thinking back about a positive event: The impact of processing style on positive affect

    Directory of Open Access Journals (Sweden)

    Sabine eNelis

    2015-03-01

    Full Text Available The manner in which individuals recall an autobiographical positive life event has affective consequences. Two studies addressed the processing styles during positive memory recall in a non-clinical sample. Participants retrieved a positive memory which was self-generated (Study 1, n = 70 or experimenter-chosen (i.e., academic achievement, Study 2, n = 159, followed by the induction of one of three processing styles (between-subjects: In Study 1, a ‘concrete/imagery’ vs. ‘abstract/verbal’ processing style was compared. In Study 2, a ‘concrete/imagery’, ‘abstract/verbal’, and ‘comparative/verbal’ processing style were compared. The processing of a personal memory in a concrete/imagery-based way led to a larger increase in positive affect compared to abstract/verbal processing in Study 1, as well as compared to comparative/verbal thinking in Study 2. Results of Study 2 further suggest that it is making unfavourable verbal comparisons that may hinder affective benefits to positive memories (rather then general abstract/verbal processing per se. The comparative/verbal thinking style failed to lead to improvements in positive affect, and with increasing levels of depressive symptoms it had a more negative impact on change in positive affect. We found no evidence that participant’s tendency to have dampening thoughts in response to positive affect in daily life contributed to the affective impact of positive memory recall. The results support the potential for current trainings in boosting positive memories and mental imagery, and underline the search for parameters that determine at times deleterious outcomes of abstract/verbal memory processing in the face of positive information.

  7. Infertility trial outcomes: healthy moms and babies.

    Science.gov (United States)

    Silver, Robert

    2014-05-01

    Traditionally, the primary outcome of infertility trials has been a positive pregnancy test or a clinically recognized pregnancy. However, parents desire a healthy baby that grows up to be a healthy adult, rather than a positive pregnancy test. Too often results of infertility trials are lacking in crucial obstetric details. This is problematic because treatments for infertility have the capacity to increase the risk for a variety of adverse obstetric outcomes. This review will outline important obstetric variables that should be included when reporting infertility research. The rationale for including these data, precise definitions of the variables, and cost-effective strategies for obtaining these obstetric details will be highlighted. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. HPV Positive Head and Neck Cancers: Molecular Pathogenesis and Evolving Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Rüveyda Dok

    2016-03-01

    Full Text Available Head and neck squamous cell carcinoma (HNSCC is a highly heterogeneous disease that is the result of tobacco and/or alcohol abuse or infection with high-risk Human papillomaviruses. Despite the fact that HPV positive HNSCC cancers form a distinct clinical entity with better treatment outcome, all HNSCC are currently treated uniformly with the same treatment modality. At present, biologic basis of these different outcomes and their therapeutic influence are areas of intense investigation. In this review, we will summarize the molecular basis for this different outcome, novel treatment opportunities and possible biomarkers for HPV positive HNSCC. In particular, the focus will be on several molecular targeted strategies that can improve the chemoradiation response by influencing DNA repair mechanisms.

  9. Outcomes management: incorporating and sustaining processes critical to using outcome data to guide practice improvement.

    Science.gov (United States)

    Hodges, Kay; Wotring, James R

    2012-04-01

    An outcomes management system (OMS) greatly facilitates an organization or state achieving requirements regarding accountability and use of empirically based interventions. A case example of the authors' experience with a successful and enduring OMS is presented, followed by a review of the literature and a proposed model delineating the key components and benefits of an OMS. Building capacity to measure performance requires embedding utilization of youth-specific, clinically meaningful outcome data into the organization's processes and structures. An OMS measures outcomes associated with services, facilitates implementation of evidence-based practices, informs case decision making, enables better and more efficient clinical management, and provides aggregated information used to improve services. A case-specific supervisory model based on instantaneously available information, including progress to date, helps maximize consumer outcomes. Continuous quality improvement activities, which are databased and goal-oriented, become a positive change management tool. This paper describes organizational processes that facilitate the development of a highly functional OMS.

  10. Stability Tests of Positive Fractional Continuous-time Linear Systems with Delays

    Directory of Open Access Journals (Sweden)

    Tadeusz Kaczorek

    2013-06-01

    Full Text Available Necessary and sufficient conditions for the asymptotic stability of positive fractional continuous-time linear systems with many delays are established. It is shown that: 1 the asymptotic stability of the positive fractional system is independent of their delays, 2 the checking of the asymptotic stability of the positive fractional systems with delays can be reduced to checking of the asymptotic stability of positive standard linear systems without delays.

  11. A Process and Outcome Evaluation of Police Working with Youth Programs

    Directory of Open Access Journals (Sweden)

    Stephen A. Anderson

    2008-09-01

    Full Text Available A process and outcome evaluation of 10 Police Working with Youth Programs was conducted. Process results indicated that the core components of the programs were consistent with those identified in previous literature as characteristic of quality youth development programs. Outcome results indicated that youth participants reported significantly improved attitudes toward police and social support received from significant, non-familial adults. Two subgroups of youth, most notably minority youth and younger participants in lower grade levels, reported positive changes in their capacity to resist peer pressures. Minority youth reported positive changes in their sense of mastery over stressful life situations. Relationships between core program components and youth outcomes also were examined. Implications of the findings and future process and outcome evaluations of youth programs are discussed.

  12. A Multicenter Retrospective Review of Prone Position Ventilation (PPV) in Treatment of Severe Human H7N9 Avian Flu.

    Science.gov (United States)

    Xu, Yuanda; Deng, Xilong; Han, Yun; Zhou, Lixin; He, Weiqun; Chen, Sibei; Nong, Lingbo; Huang, Huang; Zhang, Yan; Yu, Tieou; Li, Yimin; Liu, Xiaoqing

    2015-01-01

    Patients with H7N9 avian flu concurrent with severe acute respiratory distress syndrome (ARDS) usually have a poor clinical outcome. Prone position ventilation (PPV) has been shown to improve the prognosis of patients with severe ARDS. This study explored the effects of PPV on the respiratory and circulatory mechanics of H7N9-infected patients with severe ARDS. Individuals admitted to four hospitals designated for H7N9 patients in Guangdong province were treated with PPV, and their clinical data were recorded before and after receiving PPV. Six of 20 critically ill patients in the ICU received PPV. After treatment with 35 PPV sessions, the oxygenation index (OI) values of the six patients when measured post-PPV and post-supine position ventilation (SPV) were significantly higher than those measured pre-PPV (P protective ventilation strategy for use in patients with H7N9 avian flu concurrent with severe ARDS.

  13. Positive tertiary appraisals and posttraumatic stress disorder in U.S. male veterans of the war in Vietnam: the roles of positive affirmation, positive reformulation, and defensive denial.

    Science.gov (United States)

    Dohrenwend, Bruce P; Neria, Yuval; Turner, J Blake; Turse, Nicholas; Marshall, Randall; Lewis-Fernandez, Roberto; Koenen, Karestan C

    2004-06-01

    A 70.9% majority of the U.S. male veterans in a nationwide sample appraised the impact of their service in Vietnam on their present lives as mainly positive. A substantial minority, 41.7%, judged the effects to be highly salient. With controls on level of exposure to war-zone stressors measured with data from military records, the valence and salience of these appraisals are investigated in relation to posttraumatic stress disorder (PTSD) and other indicators of wartime and postwar functioning. The results are consistent with the hypothesis that mainly positive tertiary appraisals are affirmations of successful wartime and postwar adaptation rather than defensive denials related to maladaptive outcomes. The possibility that mainly positive tertiary appraisals also contribute to successful postwar adaptation is discussed. (c) 2004 APA, all rights reserved

  14. Effects of reviewing routine practices on learning outcomes in continuing education.

    Science.gov (United States)

    Mamede, Silvia; Loyens, Sofie; Ezequiel, Oscarina; Tibiriçá, Sandra; Penaforte, Júlio; Schmidt, Henk

    2013-07-01

    Conventional continuing medical education (CME) has been shown to have modest effects on doctor performance. New educational approaches based on the review of routine practices have brought better results. Little is known about factors that affect the outcomes of these approaches, especially in middle-income countries. This study aimed to investigate factors that influence the learning and quality of clinical performance in CME based on reflection upon experiences. A questionnaire and a clinical performance test were administered to 165 general practitioners engaged in a CME programme in Brazil. The questionnaire assessed behaviours related to four input variables (individual reflection on practices, peer review of experiences, self-regulated learning and learning skills) and two mediating variables (identification of learning needs and engagement in learning activities, the latter consisting of self-study of scientific literature, consultations about patient problems, and attendance at courses). Structural equation modelling was used to test a hypothesised model of relationships between these variables and the outcome variable of clinical performance, measured by the clinical performance test. After minor adjustments, the hypothesised model fit the empirical data well. Individual reflection fostered identification of learning needs, but also directly positively influenced the quality of clinical performance. Peer review did not affect identification of learning needs, but directly positively affected clinical performance. Learning skills and self-regulation did not help in identifying learning needs, but self-regulation enhanced study of the scientific literature, the learning activity that most positively influenced clinical performance. Consultation with colleagues, the activity most frequently triggered by the identification of learning needs, did not affect performance, and attendance of courses had only limited effect. This study shed light on the factors

  15. On the structural position of non-peripheral adjunct clauses

    Directory of Open Access Journals (Sweden)

    Maria Lobo

    2002-06-01

    Full Text Available This paper is concerned with the structural position occupied by a subset of adjunct clauses, namely those which can occur in final position without a special intonational break. After a definition of the structures to be considered, it will be shown that the classical assumption according to which they are generated as adjuncts is empirically superior to the adjunct-as-complement analysis (cf. Larson 1988; 1990, and to more recent analyses, which follow an antisymmetric framework (cf. Kayne 1994. It will also be shown that a base generation account of preverbal adverbial clauses is to be preferred over a movement analysis on the basis of empirical data, and in conformity with theoretical economy assumptions (Merge over Move.

  16. Reported positive and negative outcomes associated with a self-practice/self-reflection cognitive-behavioural therapy exercise for CBT trainees.

    Science.gov (United States)

    Spendelow, Jason S; Butler, Lisa J

    2016-09-01

    The aim of the current study was to identify outcomes of a self-practice/self-reflection (SP/SR) exercise for trainee clinical psychologists. Thirty-two trainees enrolled in their first year of a UK university doctoral clinical psychology training programme completed an online questionnaire following an eight-week exercise. Findings indicated an endorsement of many previously reported benefits of exercise participation, but also the identification of negative outcomes. Thematic analysis of qualitative data revealed that outcomes could be grouped into two main thematic domains (individual task outcomes and task organization issues) along with several subordinate themes. SP/SR is a useful tool in the development of trainee CBT therapist competences. There has been limited previous recognition of potential negative outcomes from this type of exercise. However, these can provide additional impetus for therapist skill development.

  17. Routes to positive interracial interactions: approaching egalitarianism or avoiding prejudice.

    Science.gov (United States)

    Plant, E Ashby; Devine, Patricia G; Peruche, Michelle B

    2010-09-01

    The current work examined factors that contribute to positive interracial interactions. It argues that the source of people's motivation to respond without prejudice and the goals and strategies they pursue in interracial interactions influence the quality of these interactions. Three studies show that non-Black participants who are highly internally motivated to respond without prejudice tend to focus on strategies and behaviors in interactions with Black people that approach a positive (i.e., egalitarian) outcome. As a result of engaging in these approach behaviors, their interracial interactions go more smoothly for both themselves and their interaction partners as compared to people less internally motivated. In contrast, externally motivated people tend to focus on avoiding negative (i.e., prejudiced) outcomes, which ironically results in their coming across to their partners as prejudiced. The implications of the findings for smoothing out the rocky road to positive intergroup interactions are discussed.

  18. Using the prone position for ventilated patients with respiratory failure: a review.

    Science.gov (United States)

    Wright, Angie D; Flynn, Maria

    2011-01-01

    this review explored the evidence relating to prone positioning in ventilated patients diagnosed with respiratory failure, including acute lung injury (ALI) or adult respiratory distress syndrome (ARDS). mortality rates for ventilated patients with ALI or ARDS are high, and there is a growing body of evidence suggesting that the position these patients are nursed in may influence clinical outcomes. However, there are no guidelines to inform nursing practice in positioning these patients. Medline, Scopus, Cinahl and the Cochrane Library databases were searched for original research reports or systematic reviews of evidence between 2000 and 2009. Reference lists of retrieved papers were hand searched and included studies were analysed using the Critical Appraisal and Skills Programme framework. A narrative data synthesis considered the strengths and limitations of studies, and findings were collated and interpreted. Application of the search strategy identified a systematic review, currently underway, which has not yet reported and 14 relevant studies eligible for inclusion in this review. Analysis showed considerable variation in study design, but suggests that PaO(2) /FiO(2) ratio, incidence of VAP and mortality may be positively affected by prone positioning. evidence of the clinical benefits associated with prone positioning is inconclusive and provides little guidance for nursing practice. There is a need for further research into the clinical outcomes of prone positioning, and greater understanding of the practicalities of prone positioning critically ill patients is required. nurses have a central role to play in the continual assessment and management of this patient group, including the position they are nursed in, not only to ensure the best clinical outcomes but also to provide care and comfort to the patient and their family. It is therefore important that their nursing practice and interventions are informed by the best available evidence.

  19. Caregiver outcomes and interventions: a systematic scoping review of the traumatic brain injury and spinal cord injury literature.

    Science.gov (United States)

    Baker, Anne; Barker, Samantha; Sampson, Amanda; Martin, Clarissa

    2017-01-01

    To identify factors reported with negative and positive outcomes for caregivers of the traumatic brain injury and spinal cord injury cohorts, to investigate what interventions have been studied to support carers and to report what effectiveness has been found. Scoping systematic review. Electronic databases and websites were searched from 1990 to December 2015. Studies were agreed for inclusion using pre-defined criteria. Relevant information from included studies was extracted and quality assessment was completed. Data were synthesised using qualitative methods. A total of 62 studies reported caregiver outcomes for the traumatic brain injury cohort; 51 reported negative outcomes and 11 reported positive outcomes. For the spinal cord injury cohort, 18 studies reported caregiver outcomes; 15 reported negative outcomes and three reported positive outcomes. Burden of care was over-represented in the literature for both cohorts, with few studies looking at factors associated with positive outcomes. Good family functioning, coping skills and social support were reported to mediate caregiver burden and promote positive outcomes. A total of 21 studies further described interventions to support traumatic brain injury caregivers and four described interventions to support spinal cord injury caregivers, with emerging evidence for the effectiveness of problem-solving training. Further research is required to explore the effects of injury severity of the care recipient, as well as caregiver age, on the outcome of the interventions. Most studies reported negative outcomes, suggesting that barriers to caregiving have been established, but not facilitators. The interventions described to support carers are limited and require further testing to confirm their effectiveness.

  20. 38 CFR 3.370 - Pulmonary tuberculosis shown by X-ray in active service.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Pulmonary tuberculosis... Rating Considerations Relative to Specific Diseases § 3.370 Pulmonary tuberculosis shown by X-ray in... connection for pulmonary tuberculosis. When under consideration, all available service department films and...

  1. Frequency of hepatitis C in pregnancy and pregnancy outcome

    International Nuclear Information System (INIS)

    Jaffery, T.; Tariq, N.; Ayub, R.; Yawar, A.

    2005-01-01

    Objective: To determine the frequency of HCV infections in pregnant women, to find out the risk factors of HCV infection in pregnant women and to compare pregnancy outcome of the sero-positive women with sero-negative women. Design: Case-control study. Place and Duration of Study: Shifa International Hospital, Islamabad, from June 2001 to May 2002. Patients and Methods: Study was conducted on 947 booked pregnant women who were screened for HCV antibodies during antenatal consultation and were admitted for delivery in labor room. At the time of admission in labor ward, medical records of all patients were reviewed for anti HCV antibody testing and the presence of risk factors for HCV infection. Previous vaginal deliveries with episiotomy, previous surgeries, blood transfusions, and D and C for abortion or dysfunctional uterine bleeding were taken as independent variables. The obstetric outcome variables studied were: completed weeks of gestation by mother, birth weight and apgar score of newborns. The risk factors under study and the outcome variables were compared among HCV positive and negative women through a case-control study and measures of association calculated. Results: The proportion of HCV sero-positively among pregnant woman in our study was 3.27%. Among all the risk factors under study, previous surgery was found to have a significant association with HCV positive status of women (p=0.001). Other variables did not have significant association with HCV positive status in our study. There was no statistical difference in the mean birth weight of newborns (p=0.94), mean Apgar score of newborns (p=0.73) and mean gestational period among HCV positive cases and controls (p=0.47). Conclusion: Prevalence of hepatitis C in pregnant women was 3.27%. Past history of surgical procedures was the most important factor for transmission of hepatitis C virus infection. No adverse effect on pregnancy outcome was observed in terms of gestational age, Apgar score and baby

  2. Adverse pregnancy outcomes following syphilis treatment in pregnancy in the UK.

    Science.gov (United States)

    Wallace, Harriet E; Isitt, Catherine E; Broomhall, Harriet M; Perry, Alison E; Wilson, Janet D

    2016-10-01

    Syphilis infection in pregnancy is known to cause a number of severe adverse pregnancy outcomes, including second-trimester miscarriage, stillbirth, very pre-term delivery and neonatal death, in addition to congenital syphilis. A retrospective review of women with positive syphilis serology and a pregnancy outcome between 2005 and 2012 in Leeds, UK, was performed. In all, 57 cases of positive syphilis serology in pregnancy were identified: 24 with untreated syphilis treated in the current pregnancy (Group 1); seven with reported but unconfirmed prior treatment who were retreated (Group 2); and 26 adequately treated prior to pregnancy (Group 3). The rate of severe adverse pregnancy outcomes in Group 1 at 21% was significantly higher than the 0% outcome of Group 3 (p = 0.02). The severe adverse pregnancy outcomes were two second-trimester miscarriages, two pre-term births at 25 and 28 weeks and one stillbirth at 32 weeks. There were no cases of term congenital syphilis or term neonatal death, but we observed high rates of other adverse pregnancy outcomes despite treatment during pregnancy. Rapid referral for treatment is needed before 18 weeks in order to minimise adverse pregnancy outcomes. © The Author(s) 2016.

  3. Influence of preoperative life satisfaction on recovery and outcomes after colorectal cancer surgery - a prospective pilot study.

    Science.gov (United States)

    Romain, B; Rohmer, O; Schimchowitsch, S; Hübner, M; Delhorme, J B; Brigand, C; Rohr, S; Guenot, D

    2018-01-17

    Colorectal surgery has an important impact on a patient's quality of life, and postoperative rehabilitation shows large variations. To enhance the understanding of recovery after colorectal cancer, health-related quality of life has become a standard outcome measurement for clinical care and research. Therefore, we aimed to correlate the influence of preoperative global life satisfaction on subjective feelings of well-being with clinical outcomes after colorectal surgery. In this pilot study of consecutive colorectal surgery patients, various dimensions of feelings of preoperative life satisfaction were assessed using a self-rated scale, which was validated in French. Both objective (length of stay and complications) and subjective (pain, subjective well-being and quality of sleep) indicators of recovery were evaluated daily during each patient's hospital stay. A total of 112 patients were included. The results showed a negative relationship between life satisfaction and postoperative complications and a significant negative correlation with the length of stay. Moreover, a significant positive correlation between life satisfaction and the combined subjective indicators of recovery was observed. We have shown the importance of positive preoperative mental states and global life satisfaction as characteristics that are associated with an improved recovery after colorectal surgery. Therefore, patients with a good level of life satisfaction may be better able to face the consequences of colorectal surgery, which is a relevant parameter in supportive cancer care.

  4. Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America

    Science.gov (United States)

    Cesar, Carina; Koethe, John R; Giganti, Mark J; Rebeiro, Peter; Althoff, Keri N; Napravnik, Sonia; Mayor, Angel; Grinsztejn, Beatriz; Wolff, Marcelo; Padgett, Denis; Sierra-Madero, Juan; Gotuzzo, Eduardo; Sterling, Timothy R; Willig, James; Levison, Julie; Kitahata, Mari; Rodriguez-Barradas, Maria C; Moore, Richard D; McGowan, Catherine; Shepherd, Bryan E; Cahn, Pedro

    2016-01-01

    Introduction Latinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America. Methods HIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts. Results The study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27% vs. 20%) and had lower nadir CD4 count (median 148 vs. 195 cells/µL, p<0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95% confidence interval (CI): 1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95% CI: 0.48 to 0.57). Conclusions HIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation. PMID:26996992

  5. Predictors of positive health in disability pensioners: a population-based questionnaire study using Positive Odds Ratio

    Directory of Open Access Journals (Sweden)

    Edén Lena

    2002-09-01

    Full Text Available Abstract Background Determinants of ill-health have been studied far more than determinants of good and improving health. Health promotion measures are important even among individuals with chronic diseases. The aim of this study was to find predictors of positive subjective health among disability pensioners (DPs with musculoskeletal disorders. Methods Two questionnaire surveys were performed among 352 DPs with musculoskeletal disorders. Two groups were defined: DPs with positive health and negative health, respectively. In consequence with the health perspective in this study the conception Positive Odds Ratio was defined and used in the logistic regression analyses instead of the commonly used odds ratio. Results Positive health was associated with age ≥ 55 years, not being an immigrant, not having fibromyalgia as the main diagnosis for granting an early retirement, no regular use of analgesics, a high ADL capacity, a positive subjective health preceding the study period, and good quality of life. Conclusion Positive odds ratio is a concept well adapted to theories of health promotion. It can be used in relation to positive outcomes instead of risks. Suggested health promotion and secondary prevention efforts among individuals with musculoskeletal disorders are 1 to avoid a disability pension for individuals

  6. A Context-Aware Model to Provide Positioning in Disaster Relief Scenarios

    Directory of Open Access Journals (Sweden)

    Daniel Moreno

    2015-09-01

    Full Text Available The effectiveness of the work performed during disaster relief efforts is highly dependent on the coordination of activities conducted by the first responders deployed in the affected area. Such coordination, in turn, depends on an appropriate management of geo-referenced information. Therefore, enabling first responders to count on positioning capabilities during these activities is vital to increase the effectiveness of the response process. The positioning methods used in this scenario must assume a lack of infrastructure-based communication and electrical energy, which usually characterizes affected areas. Although positioning systems such as the Global Positioning System (GPS have been shown to be useful, we cannot assume that all devices deployed in the area (or most of them will have positioning capabilities by themselves. Typically, many first responders carry devices that are not capable of performing positioning on their own, but that require such a service. In order to help increase the positioning capability of first responders in disaster-affected areas, this paper presents a context-aware positioning model that allows mobile devices to estimate their position based on information gathered from their surroundings. The performance of the proposed model was evaluated using simulations, and the obtained results show that mobile devices without positioning capabilities were able to use the model to estimate their position. Moreover, the accuracy of the positioning model has been shown to be suitable for conducting most first response activities.

  7. Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare.

    Science.gov (United States)

    Williams, Nathaniel J; Glisson, Charles

    2013-11-01

    High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures. The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2,346 youth aged 1.5- to 18-years-old and 1,544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18 month follow-up. The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency. To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.

  8. Relationship of family history and outcome after breast conservation therapy in women with ductal carcinoma in situ of the breast

    International Nuclear Information System (INIS)

    Harris, Eleanor E.R.; Schultz, Delray J.; Peters, Christopher A.; Solin, Lawrence J.

    2000-01-01

    Purpose: The purpose of this study was to evaluate the relationship between a family history of breast or ovarian cancer and outcome after breast-conserving surgery and radiation in women presenting with an initial diagnosis of ductal carcinoma in situ (DCIS) of the breast. Methods and Materials: A total of 146 consecutive women with a pathologic diagnosis of ductal carcinoma in situ as their first diagnosis of any breast cancer were identified; 28 (19%) had a positive family history of breast or ovarian cancer in a first-degree relative, 27 (19%) had a positive family history in a second-degree relative, and 91 (62%) had no family history. Pathologic, clinical, and treatment factors, and clinical outcomes for each family history group were compared. Cosmesis and complications were recorded at each follow-up. Patients were treated between 1978 and 1995, and the median follow-up was 7.1 years. Results: Patients with a positive family history in a first- or second-degree relative each had an 8% incidence of local failure at 10 years, while the negative family history group demonstrated a 16% local failure rate (p = 0.33). Overall survival at 10 years for patients with a positive family history in a first- or second-degree relative was 100% and for those with a negative family history was 91% (p = 0.08). The negative family history group had a higher median age that may account for the difference in overall survival. Cause-specific survival (CSS) was 97%, 100%, and 99%, respectively, at 10 years (p = 0.25). There were no differences in the cosmetic results or complication rates between women with a positive or negative family history. Conclusion: We have shown that a family history of breast and/or ovarian cancer is not associated with an adverse outcome for women treated with breast conservation therapy for DCIS. Local recurrence, cause-specific survival, overall survival, cosmesis, and complication rates were comparable to that of similarly treated women with

  9. Avoiding negative vs. achieving positive outcomes in hard and prosperous economic times

    NARCIS (Netherlands)

    Millet, K.; Lamey, L.; Van den Bergh, B.

    2012-01-01

    Three studies suggest that business cycle fluctuations trigger distinct motivational orientations that selectively affect economic judgment and decision making. Economic contractions induce avoidance motivation and affect negative economic sentiment, but leave approach motivation and positive

  10. Factors contributing to outcome following traumatic brain injury.

    Science.gov (United States)

    Ponsford, Jennie

    2013-01-01

    Traumatic brain injury results in some distinctive patterns of cognitive, behavioural and physical impairment which impact significantly on independent living skills and participation in work or study, social and leisure activities and interpersonal relationships. There is, however, still considerable variability in outcome across individuals in each of the reported domains. This has led to a significant body of research examining factors associated with outcome. A range of injury-related, personal and social factors have been shown to influence survival, as well as cognitive, functional and employment outcome. This paper reviews the factors associated with each of these aspects of outcome specifically injury-related factors, including neuroimaging findings, GCS and PTA, other injuries, and cognitive and behavioural impairments; demographic factors, including age, gender, genetic status, education, pre-injury IQ and employment status; and social factors including family and other social support, cultural factors, pre-injury psychiatric history and coping style. The paper identifies contributions and complex interrelationships of all of these factors to outcome following TBI. It concludes with a brief discussion of the implications of these factors for the rehabilitation process.

  11. FOXP3 positive regulatory T-cells in cutaneous and systemic CD30 positive T-cell lymphoproliferations

    DEFF Research Database (Denmark)

    Gjerdrum, Lise Mette; Woetmann, Anders; Ødum, Niels

    2008-01-01

    for FOXP3 expression in tumour cells and tumour infiltrating Tregs. Labelling of a majority of the neoplastic cells was seen in one case of C-ALCL. Another three cases (one LyP and two C-ALCL) displayed weak labelling of very occasional atypical T-cells. In the remaining 38 cases the atypical lymphoid...... infiltrate was FOXP3 negative. By contrast, all biopsies contained tumour infiltrating FOXP3-positive Tregs. Significant higher numbers were recorded in ALK negative S-ALCL and LyP than in C-ALCL and S-ALCL positive for ALK. In conclusion, it is shown that FOXP3 expression in cutaneous and systemic CD30...

  12. Head Position in Stroke Trial (HeadPoST)--sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for a cluster randomised controlled trial.

    Science.gov (United States)

    Muñoz-Venturelli, Paula; Arima, Hisatomi; Lavados, Pablo; Brunser, Alejandro; Peng, Bin; Cui, Liying; Song, Lily; Billot, Laurent; Boaden, Elizabeth; Hackett, Maree L; Heritier, Stephane; Jan, Stephen; Middleton, Sandy; Olavarría, Verónica V; Lim, Joyce Y; Lindley, Richard I; Heeley, Emma; Robinson, Thompson; Pontes-Neto, Octavio; Natsagdorj, Lkhamtsoo; Lin, Ruey-Tay; Watkins, Caroline; Anderson, Craig S

    2015-06-05

    Positioning a patient lying-flat in the acute phase of ischaemic stroke may improve recovery and reduce disability, but such a possibility has not been formally tested in a randomised trial. We therefore initiated the Head Position in Stroke Trial (HeadPoST) to determine the effects of lying-flat (0°) compared with sitting-up (≥ 30°) head positioning in the first 24 hours of hospital admission for patients with acute stroke. We plan to conduct an international, cluster randomised, crossover, open, blinded outcome-assessed clinical trial involving 140 study hospitals (clusters) with established acute stroke care programs. Each hospital will be randomly assigned to sequential policies of lying-flat (0°) or sitting-up (≥ 30°) head position as a 'business as usual' stroke care policy during the first 24 hours of admittance. Each hospital is required to recruit 60 consecutive patients with acute ischaemic stroke (AIS), and all patients with acute intracerebral haemorrhage (ICH) (an estimated average of 10), in the first randomised head position policy before crossing over to the second head position policy with a similar recruitment target. After collection of in-hospital clinical and management data and 7-day outcomes, central trained blinded assessors will conduct a telephone disability assessment with the modified Rankin Scale at 90 days. The primary outcome for analysis is a shift (defined as improvement) in death or disability on this scale. For a cluster size of 60 patients with AIS per intervention and with various assumptions including an intracluster correlation coefficient of 0.03, a sample size of 16,800 patients at 140 centres will provide 90 % power (α 0.05) to detect at least a 16 % relative improvement (shift) in an ordinal logistic regression analysis of the primary outcome. The treatment effect will also be assessed in all patients with ICH who are recruited during each treatment study period. HeadPoST is a large international clinical trial in

  13. Community attitudes toward childbearing and abortion among HIV-positive women in Nigeria and Zambia

    OpenAIRE

    Kavanaugh, Megan L.; Moore, Ann M.; Akinyemi, Odunayo; Adewole, Isaac; Dzekedzeke, Kumbutso; Awolude, Olutosin; Arulogun, Oyedunni

    2012-01-01

    Although stigma towards HIV-positive women for both continuing and terminating a pregnancy has been documented, to date few studies have examined relative stigma towards one outcome versus the other. This study seeks to describe community attitudes towards each of two possible elective outcome of an HIV-positive woman’s pregnancy – induced abortion or birth – to determine which garners more stigma and document characteristics of community members associated with stigmatising attitudes towards...

  14. The effect of positive and negative feedback on risk-taking across different contexts

    OpenAIRE

    Losecaat Vermeer, A.B.; Sanfey, A.G.

    2015-01-01

    Preferences for risky choices have often been shown to be unstable and context-dependent. Though people generally avoid gambles with mixed outcomes, a phenomenon often attributed to loss aversion, contextual factors can impact this dramatically. For example, people typically prefer risky options after a financial loss, while generally choosing safer options after a monetary gain. However, it is unclear what exactly contributes to these preference shifts as a function of prior outcomes, as the...

  15. Positive outcomes of office ergonomics in terms of higher productivity

    Directory of Open Access Journals (Sweden)

    Terek Edit

    2014-01-01

    Full Text Available One of the sciences which considers to human health, human performance and body activities is Ergonomics. Ergonomics is one of the modern sciences, drawing as much from the field as from the laboratory, and including elements of art and craft as well. Before designing the workplace it is necessary to determine its requirements, i.e., which it is intended for, what are the characteristics of the existing work equipment and the additional tools needed. However, there are some standards and with their application people will prevent the occurrence of modern office diseases. This paper is focused on the positive aspects of ergonomics in improvement of the working environment.

  16. Macaques can predict social outcomes from facial expressions.

    Science.gov (United States)

    Waller, Bridget M; Whitehouse, Jamie; Micheletta, Jérôme

    2016-09-01

    There is widespread acceptance that facial expressions are useful in social interactions, but empirical demonstration of their adaptive function has remained elusive. Here, we investigated whether macaques can use the facial expressions of others to predict the future outcomes of social interaction. Crested macaques (Macaca nigra) were shown an approach between two unknown individuals on a touchscreen and were required to choose between one of two potential social outcomes. The facial expressions of the actors were manipulated in the last frame of the video. One subject reached the experimental stage and accurately predicted different social outcomes depending on which facial expressions the actors displayed. The bared-teeth display (homologue of the human smile) was most strongly associated with predicted friendly outcomes. Contrary to our predictions, screams and threat faces were not associated more with conflict outcomes. Overall, therefore, the presence of any facial expression (compared to neutral) caused the subject to choose friendly outcomes more than negative outcomes. Facial expression in general, therefore, indicated a reduced likelihood of social conflict. The findings dispute traditional theories that view expressions only as indicators of present emotion and instead suggest that expressions form part of complex social interactions where individuals think beyond the present.

  17. Point processes and the position distribution of infinite boson systems

    International Nuclear Information System (INIS)

    Fichtner, K.H.; Freudenberg, W.

    1987-01-01

    It is shown that to each locally normal state of a boson system one can associate a point process that can be interpreted as the position distribution of the state. The point process contains all information one can get by position measurements and is determined by the latter. On the other hand, to each so-called Σ/sup c/-point process Q they relate a locally normal state with position distribution Q

  18. The Ambivalence of Challenge Stressors: Time Pressure Associated with Both Negative and Positive Well-Being

    Science.gov (United States)

    Widmer, Pascale S.; Semmer, Norbert K.; Kalin, Wolfgang; Jacobshagen, Nicola; Meier, Laurenz L.

    2012-01-01

    According to the challenge-hindrance model, challenge stressors contain both stressful and challenging aspects, hindrance stressors only stressful aspects. Typically, negative outcomes of challenge stressors refer to well-being (strain), positive outcomes to so-called work outcomes (e.g., productivity, intention to quit). As both effects occur…

  19. A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study

    NARCIS (Netherlands)

    Guérin, C.; Beuret, P.; Constantin, J. M.; Bellani, G.; Garcia-Olivares, P.; Roca, O.; Meertens, J. H.; Maia, P. Azevedo; Becher, T.; Peterson, J.; Larsson, A.; Gurjar, M.; Hajjej, Z.; Kovari, F.; Assiri, A. H.; Mainas, E.; Hasan, M. S.; Morocho-Tutillo, D. R.; Baboi, L.; Chrétien, J. M.; François, G.; Ayzac, L.; Chen, L.; Brochard, L.; Mercat, A.; Hajjej, Zied; Sellami, Walid; Ferjani, M.; Gurjar, Mohan; Assiri, Amer; Al Bshabshe, Ali; Almekhlafi, Ghaleb; Mandourah, Yasser; Hasan, Mohd Shahnaz; Rai, Vineya; Marzida, M.; Corcoles Gonzalez, Virgilio; Sanchez Iniesta, Rafael; Garcia, Pablo; Garcia-Montesinos de La Peña, Manuel; Garcia Herrera, Adriana; Roca, Oriol; Garcia-de-Acilu, Marina; Masclans Enviz, Joan Ramon; Mancebo, Jordi; Heili, Sarah; Artigas Raventos, Antonio; Blanch Torra, Lluís; Roche-Campo, Ferran; Schultz, Marcus

    2018-01-01

    While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low. This study aimed to determine the prevalence of use of PP in ARDS patients (primary

  20. ISO 9000 IMPLEMENTATION AND PERCEIVED ORGANISATIONAL OUTCOME: THE CASE OF A SERVICE ORGANISATION

    Directory of Open Access Journals (Sweden)

    Jasni Abdul Latif

    2003-01-01

    Full Text Available The study examines the relationship between the perceptions of the employees about ISO 9000 implementation and perceived organisational outcomes. A conceptual framework linking the level of employee influence and involvement, their perception of ISO 9000 and the perceived impact on their work and the organisational outcomes is posited. Data was collected from a random sample of 64 employees of a service organisation. Contrary to expectations, the work impact of ISO 9000 was not correlated with the efficiency and market outcomes of ISO 9000 certification but the employee involvement, influence and perception of ISO 9000 were. The conceptualization of the influence path of ISO 9000 implementation on the organisational outcomes may require rethinking as perception may have a direct effect on the outcomes without the mediation of the impact on work. In short, employees may report benefits or positive outcomes even though no change is reported in their work.

  1. Classification of positive blood cultures

    DEFF Research Database (Denmark)

    Gradel, Kim Oren; Knudsen, Jenny Dahl; Arpi, Magnus

    2012-01-01

    . For each classification, we tabulated episodes derived by the physicians assessment and the computer algorithm and compared 30-day mortality between concordant and discrepant groups with adjustment for age, gender, and comorbidity. RESULTS: Physicians derived 9,482 reference episodes from 21,705 positive......- vs. hospitalonset, whereas there were no material differences within the other comparison groups. CONCLUSIONS: Using data from health administrative registries, we found high agreement between the computer algorithms and the physicians assessments as regards contamination vs. bloodstream infection......ABSTRACT: BACKGROUND: Information from blood cultures is utilized for infection control, public health surveillance, and clinical outcome research. This information can be enriched by physicians assessments of positive blood cultures, which are, however, often available from selected patient groups...

  2. Anterior semicircular canal benign paroxysmal positional vertigo and positional downbeating nystagmus.

    Science.gov (United States)

    Lopez-Escamez, Jose A; Molina, Maria I; Gamiz, Maria J

    2006-01-01

    The aim of this study was to describe the clinical features and video-oculographic findings in patients with anterior semicircular canal benign paroxysmal positional vertigo (BPPV). This is a prospective case series. The study was set at an outpatient clinic in a general hospital. Fourteen individuals with symptoms of BPPV and positional downbeating nystagmus (pDBN) were included in the study. The diagnosis was based on a history of brief episodes of vertigo and the presence of pDBN confirmed in the video-oculographic examination during Dix-Hallpike test (DH) or head-hanging maneuver. Patients were treated by particle repositioning maneuver and the effectiveness was evaluated at 7, 30, and 180 days posttreatment. The treatment was repeated up to 4 times if pDBN was persistent. The main outcome measure is the number of patients without pDBN at 30 and 180 days. Video-oculography showed a predominant pDBN in response to DH. Of the 14 patients, 7 had arterial hypertension, and 5 of 14 cases presented abnormalities on the caloric test. Horizontal spontaneous nystagmus was found in 3 of 14 individuals. Positional nystagmus at different positional test was observed in 5 of 14 individuals, suggesting the involvement of several canals. Of the 14 patients, 10 (71%) did not present vertigo, and the positional tests were negative at 30 days. However, 3 cases presented a positive DH with persistence of BPPV episodes and pDBN at 30 days, and another developed a contralateral posterior canal affectation. One of the patients maintained a persistent pDBN at 180 days despite the repeated maneuvers. Video-oculography demonstrates that anterior canal BPPV is characterized by a predominant downbeating nystagmus in response to DH. These individuals may show alterations in the vestibular caloric, and they can have multicanal affectation.

  3. Do Video Games Promote Positive Youth Development?

    Science.gov (United States)

    Adachi, Paul J. C.; Willoughby, Teena

    2013-01-01

    We argue that video game play may meet Larson's (2000) criteria for fostering initiative in youth, and thus, may be related to positive outcomes such as flow, cooperation, problem solving, and reduced in-group bias. However, developmental and social psychologists examining adolescent video game use have focused heavily on how video games are…

  4. Neighborhood Quality and Labor Market Outcomes

    DEFF Research Database (Denmark)

    Damm, Anna Piil

    of men living in the neighborhood, but positively affected by the employment rate of non-Western immigrant men and co-national men living in the neighborhood. This is strong evidence that immigrants find jobs in part through their employed immigrant and co-ethnic contacts in the neighborhood of residence...... successfully addresses the methodological problem of endogenous neighborhood selection. Taking account of location sorting, living in a socially deprived neighborhood does not affect labor market outcomes of refugee men. Furthermore, their labor market outcomes are not affected by the overall employment rate...

  5. Expression of Vascular Endothelial Growth Factor in Odontogenic Cysts: Is There Any Impression on Clinical Outcome?

    Science.gov (United States)

    Sadri, Donia; Farhadi, Sareh; Shahabi, Zahra; Sarshar, Samaneh

    2016-01-01

    The recent scientific reports have shown that angiogenesis can affect biological behavior of pathologic lesions. Regarding unique clinical outcome of Odontogenic keratocyst (OKC), the present study was aimed to compare angiogenesis in Odontogenic keratocyst and Dentigerous cyst (DC). In this experimental study, tissue sections of 46 samples of OKC and DC were stained through immunohistochemical method using Vascular Endothelial Growth Factor (VEGF) antibody. VEGF expression was evaluated in epithelial cells, fibroblasts and endothelial cells. The average percentage of stained cells in any samples was categorized to 3 groups as follows: SCORE 0: 10% of cells or less are positive. SCORE 1: 10 to 50% of cells are positive. SCORE 2: more than 50% of cells are positive. Mann-U-Whitney, T-test and chi-square was used for statistical analysis. The average of VEGF expression in 24 samples of DC was 20.2% and in 22 samples of OKC was 52.6%, respectively. The average of VEGF expression in these two cysts had statistical significant differences. (PV= 0.045). There was significant statistical differences between two cysts in the terms of VEGF SCORE (PV= 0.000). OKC samples had significantly higher SCORE for the purpose of VEGF incidence than DC. Also, there were no differences between VEGF expression in epithelial cells of two cysts (PV= 0.268) there were significant statistical differences between two cysts in terms of endothelial cell staining. The endothelial cell staining was significantly higher in OKC than DC (PV= 0.037%). Regarding higher expression of Vascular Endothelial Growth factor in OKC than DC, it seems that angiogenesis may have great impression on clinical outcome of OKC.

  6. Nursing Practice Environment and Outcomes for Oncology Nursing

    Science.gov (United States)

    Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

    2012-01-01

    Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

  7. Position-momentum uncertainty relations in the presence of quantum memory

    Energy Technology Data Exchange (ETDEWEB)

    Furrer, Fabian, E-mail: furrer@eve.phys.s.u-tokyo.ac.jp [Department of Physics, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Berta, Mario [Institute for Quantum Information and Matter, Caltech, Pasadena, California 91125 (United States); Institute for Theoretical Physics, ETH Zurich, Wolfgang-Pauli-Str. 27, 8093 Zürich (Switzerland); Tomamichel, Marco [School of Physics, The University of Sydney, Sydney 2006 (Australia); Centre for Quantum Technologies, National University of Singapore, Singapore 117543 (Singapore); Scholz, Volkher B. [Institute for Theoretical Physics, ETH Zurich, Wolfgang-Pauli-Str. 27, 8093 Zürich (Switzerland); Christandl, Matthias [Institute for Theoretical Physics, ETH Zurich, Wolfgang-Pauli-Str. 27, 8093 Zürich (Switzerland); Department of Mathematical Sciences, University of Copenhagen, Universitetsparken 5, 2100 Copenhagen (Denmark)

    2014-12-15

    A prominent formulation of the uncertainty principle identifies the fundamental quantum feature that no particle may be prepared with certain outcomes for both position and momentum measurements. Often the statistical uncertainties are thereby measured in terms of entropies providing a clear operational interpretation in information theory and cryptography. Recently, entropic uncertainty relations have been used to show that the uncertainty can be reduced in the presence of entanglement and to prove security of quantum cryptographic tasks. However, much of this recent progress has been focused on observables with only a finite number of outcomes not including Heisenberg’s original setting of position and momentum observables. Here, we show entropic uncertainty relations for general observables with discrete but infinite or continuous spectrum that take into account the power of an entangled observer. As an illustration, we evaluate the uncertainty relations for position and momentum measurements, which is operationally significant in that it implies security of a quantum key distribution scheme based on homodyne detection of squeezed Gaussian states.

  8. Quantitative Assessment of Orbital Implant Position--A Proof of Concept.

    Directory of Open Access Journals (Sweden)

    Ruud Schreurs

    Full Text Available In orbital reconstruction, the optimal location of a predefined implant can be planned preoperatively. Surgical results can be assessed intraoperatively or postoperatively. A novel method for quantifying orbital implant position is introduced. The method measures predictability of implant placement: transformation parameters between planned and resulting implant position are quantified.The method was tested on 3 human specimen heads. Computed Tomography scans were acquired at baseline with intact orbits (t0, after creation of the defect (t1 and postoperatively after reconstruction of the defect using a preformed implant (t2. Prior to reconstruction, the optimal implant position was planned on the t0 and t1 scans. Postoperatively, the planned and realized implant position were compared. The t0 and t2 scans were fused using iPlan software and the resulting implant was segmented in the fused t2 scan. An implant reference frame was created (Orbital Implant Positioning Frame; the planned implant was transformed to the reference position using an Iterative Closest Point approach. The segmentation of the resulting implant was also registered on the reference position, yielding rotational (pitch, yaw, roll as well as translational parameters of implant position.Measurement with the Orbital Implant Positioning Frame proved feasible on all three specimen. The positional outcome provided more thorough and accurate insight in resulting implant position than could be gathered from distance measurements alone. Observer-related errors were abolished from the process, since the method is largely automatic.A novel method of quantifying surgical outcome in orbital reconstructive surgery was presented. The presented Orbital Implant Positioning Frame assessed all parameters involved in implant displacement. The method proved to be viable on three human specimen heads. Clinically, the method could provide direct feedback intraoperatively and could improve

  9. Positive stereotypes, negative outcomes: Reminders of the positive components of complementary gender stereotypes impair performance in counter-stereotypical tasks.

    Science.gov (United States)

    Kahalon, Rotem; Shnabel, Nurit; Becker, Julia C

    2018-04-01

    Gender stereotypes are complementary: Women are perceived to be communal but not agentic, whereas men are perceived to be agentic but not communal. The present research tested whether exposure to reminders of the positive components of these gender stereotypes can lead to stereotype threat and subsequent performance deficits on the complementary dimension. Study 1 (N = 116 female participants) revealed that compared to a control/no-stereotype condition, exposure to reminders of the stereotype about women's communality (but not to reminders of the stereotype about women's beauty) impaired women's math performance. In Study 2 (N = 86 male participants), reminders of the stereotype about men's agency (vs. a control/no-stereotype condition) impaired men's performance in a test of socio-emotional abilities. Consistent with previous research on stereotype threat, in both studies the effect was evident among participants with high domain identification. These findings extend our understanding of the potentially adverse implications of seemingly positive gender stereotypes. © 2018 The British Psychological Society.

  10. Invasive micropapillary carcinoma of the breast overexpresses MUC4 and is associated with poor outcome to adjuvant trastuzumab in HER2-positive breast cancer.

    Science.gov (United States)

    Mercogliano, María F; Inurrigarro, Gloria; De Martino, Mara; Venturutti, Leandro; Rivas, Martín A; Cordo-Russo, Rosalía; Proietti, Cecilia J; Fernández, Elmer A; Frahm, Isabel; Barchuk, Sabrina; Allemand, Daniel H; Figurelli, Silvina; Deza, Ernesto Gil; Ares, Sandra; Gercovich, Felipe G; Cortese, Eduardo; Amasino, Matías; Guzmán, Pablo; Roa, Juan C; Elizalde, Patricia V; Schillaci, Roxana

    2017-12-28

    Invasive micropapillary carcinoma of the breast (IMPC) is a histological tumor variant that occurs with low frequency characterized by an inside-out formation of tumor clusters with a pseudopapillary arrangement. IMPC is an aggressive tumor with poor clinical outcome. In addition, this histological subtype usually expresses human epidermal growth factor receptor 2 (HER2) which also correlates with a more aggressive tumor. In this work we studied the clinical significance of IMPC in HER2-positive breast cancer patients treated with adjuvant trastuzumab. We also analyzed mucin 4 (MUC4) expression as a novel biomarker to identify IMPC. We retrospectively studied 86 HER2-positive breast cancer patients treated with trastuzumab and chemotherapy in the adjuvant setting. We explored the association of the IMPC component with clinicopathological parameters at diagnosis and its prognostic value. We compared MUC4 expression in IMPC with respect to other histological breast cancer subtypes by immunohistochemistry. IMPC, either as a pure entity or associated with invasive ductal carcinoma (IDC), was present in 18.6% of HER2-positive cases. It was positively correlated with estrogen receptor expression and tumor size and inversely correlated with patient's age. Disease-free survival was significantly lower in patients with IMPC (hazard ratio = 2.6; 95%, confidence interval 1.1-6.1, P = 0.0340). MUC4, a glycoprotein associated with metastasis, was strongly expressed in all IMPC cases tested. IMPC appeared as the histological breast cancer subtype with the highest MUC4 expression compared to IDC, lobular and mucinous carcinoma. In HER2-positive breast cancer, the presence of IMPC should be carefully examined. As it is often not informed, because it is relatively difficult to identify or altogether overlooked, we propose MUC4 expression as a useful biomarker to highlight IMPC presence. Patients with MUC4-positive tumors with IMPC component should be more frequently

  11. Legal drug content in music video programs shown on Australian television on saturday mornings.

    Science.gov (United States)

    Johnson, Rebecca; Croager, Emma; Pratt, Iain S; Khoo, Natalie

    2013-01-01

    To examine the extent to which legal drug references (alcohol and tobacco) are present in the music video clips shown on two music video programs broadcast in Australia on Saturday mornings. Further, to examine the music genres in which the references appeared and the dominant messages associated with the references. Music video clips shown on the music video programs 'Rage' (ABC TV) and [V] 'Music Video Chart' (Channel [V]) were viewed over 8 weeks from August 2011 to October 2011 and the number of clips containing verbal and/or visual drug references in each program was counted. The songs were classified by genre and the dominant messages associated with drug references were also classified and analysed. A considerable proportion of music videos (approximately one-third) contained drug references. Alcohol featured in 95% of the music videos that contained drug references. References to alcohol generally associated it with fun and humour, and alcohol and tobacco were both overwhelmingly presented in contexts that encouraged, rather than discouraged, their use. In Australia, Saturday morning is generally considered a children's television viewing timeslot, and several broadcaster Codes of Practice dictate that programs shown on Saturday mornings must be appropriate for viewing by audiences of all ages. Despite this, our findings show that music video programs aired on Saturday mornings contain a considerable level of drug-related content.

  12. Partner Accommodation Moderates Treatment Outcomes for Couple Therapy for Posttraumatic Stress Disorder

    Science.gov (United States)

    Fredman, Steffany J.; Pukay-Martin, Nicole D.; Macdonald, Alexandra; Wagner, Anne C.; Vorstenbosch, Valerie; Monson, Candice M.

    2015-01-01

    Objective Partner accommodation of posttraumatic stress disorder (PTSD) symptoms (i.e., altering one’s own behaviors to minimize patient distress and/or relationship conflict due to patients’ PTSD symptoms) has been shown to be positively associated with patient and partner psychopathology and negatively associated with patient and partner relationship satisfaction cross-sectionally. However, the prognostic value of partner accommodation in treatment outcomes is unknown. The goals of the present study were to determine if partner accommodation decreases as a function of couple therapy for PTSD and if pretreatment partner accommodation moderates the efficacy of couple therapy for PTSD. Method Thirty-nine patients with PTSD and their intimate partners (n = 39) were enrolled in a randomized controlled trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012) and received CBCT for PTSD immediately or after three months of waiting. Blinded assessors determined clinician-rated PTSD symptoms and patient-rated PTSD and depressive symptoms and relationship satisfaction at baseline, mid-treatment/4 weeks of waiting, and posttreatment/12 weeks of waiting. Results Contrary to expectation, partner accommodation levels did not change over time for either treatment condition. However, baseline partner accommodation significantly moderated treatment outcomes. Higher levels of partner accommodation were associated with greater improvements in PTSD, depressive symptoms, and relationship satisfaction among patients receiving CBCT for PTSD compared with waiting list. At lower levels of partner accommodation, patients in both groups improved or remained at low levels of these outcomes. Conclusions Individuals with PTSD who have more accommodating partners may be particularly well-suited for couple therapy for PTSD. PMID:26501498

  13. Positive psychiatry: its time has come.

    Science.gov (United States)

    Jeste, Dilip V; Palmer, Barton W; Rettew, David C; Boardman, Samantha

    2015-06-01

    Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article, we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit nonclinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (eg, well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom-including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall health care of the population. © Copyright 2015 Physicians Postgraduate Press, Inc.

  14. Positive Psychiatry: Its Time Has Come

    Science.gov (United States)

    Jeste, Dilip V.; Palmer, Barton W.; Rettew, David C.; Boardman, Samantha

    2017-01-01

    Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit non-clinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (e.g., well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom - including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry Interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine, rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall healthcare of the population. PMID:26132670

  15. Augmenting one-session treatment of children's specific phobias with attention training to positive stimuli.

    Science.gov (United States)

    Waters, Allison M; Farrell, Lara J; Zimmer-Gembeck, Melanie J; Milliner, Ella; Tiralongo, Evelin; Donovan, Caroline L; McConnell, Harry; Bradley, Brendan P; Mogg, Karin; Ollendick, Thomas H

    2014-11-01

    This study examined the efficacy of combining two promising approaches to treating children's specific phobias, namely attention training and one 3-h session of exposure therapy ('one-session treatment', OST). Attention training towards positive stimuli (ATP) and OST (ATP+OST) was expected to have more positive effects on implicit and explicit cognitive mechanisms and clinical outcome measures than an attention training control (ATC) condition plus OST (ATC+OST). Thirty-seven children (6-17 years) with a specific phobia were randomly assigned to ATP+OST or ATC+OST. In ATP+OST, children completed 160 trials of attention training responding to a probe that always followed the happy face in happy-angry face pairs. In ATC+OST, the probe appeared equally often after angry and happy faces. In the same session, children completed OST targeting their phobic situation/object. Clinical outcomes included clinician, parent and child report measures. Cognitive outcomes were assessed in terms of change in attention bias to happy and angry faces and in danger and coping expectancies. Assessments were completed before and after treatment and three-months later. Compared to ATC+OST, the ATP+OST condition produced (a) significantly greater reductions in children's danger expectancies about their feared situations/object during the OST and at three-month follow-up, and (b) significantly improved attention bias towards positive stimuli at post-treatment, which in turn, predicted a lower level of clinician-rated phobia diagnostic severity three-months after treatment. There were no significant differences between ATP+OST and ATC+OST conditions in clinician, parent, or child-rated clinical outcomes. Training children with phobias to focus on positive stimuli is effective in increasing attention towards positive stimuli and reducing danger expectancy biases. Studies with larger sample sizes and a stronger 'dose' of ATP prior to the OST may reveal promising outcomes on clinical measures

  16. Psychiatric symptoms among an HIV positive Urban Population in ...

    African Journals Online (AJOL)

    RICHY

    frequently psychiatric symptoms in an HIV positive adult ... affect the outcome of HIV disease. Firstly ... ignoring the serious consequences and impact the have on ... separated. 10. 5.4 divorced. 19. 10.3 widowed. 48. 26.0. Educational level.

  17. Systematic review of positive youth development programs for adolescents with chronic illness.

    Science.gov (United States)

    Maslow, Gary R; Chung, Richard J

    2013-05-01

    The Positive Youth Development (PYD) framework has been successfully used to support at-risk youth. However, its effectiveness in fostering positive outcomes for adolescents with chronic illness has not been established. We performed a systematic review of PYD-consistent programs for adolescents with chronic illness. Data sources included PubMed, CINAHL, and PsychINFO. Guided by an analytic framework, we searched for studies of PYD-consistent programs serving adolescents and young adults aged 13 through 24 with chronic illness. References were screened iteratively with increasing depth until a focused cohort was obtained and reviewed in full. The authors separately reviewed the studies using structured analysis forms. Relevant study details were abstracted during the review process. Fifteen studies describing 14 programs were included in the analysis. Three comprehensive programs included all 3 core components of a PYD program, including opportunities for youth leadership, skill building, and sustained connections between youth and adults. Four programs were primarily mentoring programs, and 7 others focused on youth leadership. Programs served youth with a variety of chronic illnesses. The quality and type of evaluation varied considerably, with most reporting psychosocial outcomes but only a few including medical outcomes. The PYD-consistent programs identified in this review can serve as models for the development of youth development programs for adolescents with chronic illness. Additional study is needed to evaluate such programs rigorously with respect to both psychosocial and health-related outcomes. PYD-consistent programs have the potential to reach youth with chronic illness and promote positive adult outcomes broadly.

  18. Illness beliefs and psychological outcome in people with Parkinson's disease.

    Science.gov (United States)

    Simpson, Jane; Lekwuwa, Godwin; Crawford, Trevor

    2013-06-01

    Illness beliefs are important predictors of psychological outcome in people with chronic illness and evidence suggests these could also be significant in furthering our understanding of psychological functioning in people with Parkinson's disease. Illness beliefs are specific, dynamic representations of an illness and cover dimensions such as cause, identity, consequences and controllability. Eighty-one people with Parkinson's disease completed a series of questionnaires to provide demographic, clinical and psychosocial data, which were then used to assess the relative impact of illness beliefs on their psychological functioning. Psychological functioning was assessed by measuring levels of depression, anxiety, stress, positive affect and emotional well-being. Hierarchical block regression indicated that illness beliefs were important independent predictors across some but not all outcomes and the results emphasised the importance of testing new predictors against more established predictors of outcome such as physical functioning and self-esteem. The illness beliefs most important in psychological outcome in people with PD were causal beliefs (particularly in psychosocial causes) and illness coherence (the level of understanding of the illness). The therapeutic potential of psychosocial variables was discussed given that these can be modified during therapy and this change can positively influence psychological outcome.

  19. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  20. Treatment deintensification in human papillomavirus-positive oropharynx cancer: Outcomes from the National Cancer Data Base.

    Science.gov (United States)

    Cheraghlou, Shayan; Yu, Phoebe K; Otremba, Michael D; Park, Henry S; Bhatia, Aarti; Zogg, Cheryl K; Mehra, Saral; Yarbrough, Wendell G; Judson, Benjamin L

    2018-02-15

    The growing epidemic of human papillomavirus-positive (HPV+) oropharyngeal cancer and the favorable prognosis of this disease etiology have led to a call for deintensified treatment for some patients with HPV+ cancers. One of the proposed methods of treatment deintensification is the avoidance of chemotherapy concurrent with definitive/adjuvant radiotherapy. To the authors' knowledge, the safety of this form of treatment de-escalation is unknown and the current literature in this area is sparse. The authors investigated outcomes after various treatment combinations stratified by American Joint Committee on Cancer (AJCC) eighth edition disease stage using patients from the National Cancer Data Base. A retrospective study of 4443 patients with HPV+ oropharyngeal cancer in the National Cancer Data Base was conducted. Patients were stratified into AJCC eighth edition disease stage groups. Multivariate Cox regressions as well as univariate Kaplan-Meier analyses were conducted. For patients with stage I disease, treatment with definitive radiotherapy was associated with diminished survival compared with chemoradiotherapy (hazard ratio [HR], 1.798; P = .029), surgery with adjuvant radiotherapy (HR, 2.563; P = .002), or surgery with adjuvant chemoradiotherapy (HR, 2.427; P = .001). For patients with stage II disease, compared with treatment with chemoradiotherapy, patients treated with a single-modality (either surgery [HR, 2.539; P = .009] or radiotherapy [HR, 2.200; P = .030]) were found to have poorer survival. Among patients with stage III disease, triple-modality therapy was associated with improved survival (HR, 0.518; P = .024) compared with treatment with chemoradiotherapy. Deintensification of treatment from chemoradiotherapy to radiotherapy or surgery alone in cases of HPV+ AJCC eighth edition stage I or stage II disease may compromise patient safety. Treatment intensification to triple-modality therapy for patients with stage III disease may improve survival in

  1. On Hamiltonians with position-dependent mass from Kaluza–Klein compactifications

    Energy Technology Data Exchange (ETDEWEB)

    Ballesteros, Ángel, E-mail: angelb@ubu.es; Gutiérrez-Sagredo, Iván, E-mail: igsagredo@ubu.es; Naranjo, Pedro, E-mail: pnaranjo@ubu.es

    2017-02-19

    In a recent paper (Morris (2015) ), an inhomogeneous compactification of the extra dimension of a five-dimensional Kaluza–Klein metric has been shown to generate a position-dependent mass (PDM) in the corresponding four-dimensional system. As an application of this dimensional reduction mechanism, a specific static dilatonic scalar field has been connected with a PDM Lagrangian describing a well-known nonlinear PDM oscillator. Here we present more instances of this construction that lead to PDM systems with radial symmetry, and the properties of their corresponding inhomogeneous extra dimensions are compared with the ones in the nonlinear oscillator model. Moreover, it is also shown how the compactification introduced in this type of models can alternatively be interpreted as a novel mechanism for the dynamical generation of curvature. - Highlights: • New position-dependent mass systems arising from inhomogeneous Kaluza–Klein compactifications are presented. • Connections with known integrable position-dependent mass systems are established. • A novel mechanism for the dynamical generation of curvature is proposed.

  2. Galectin-7 Expression Potentiates HER-2-Positive Phenotype in Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Andrée-Anne Grosset

    Full Text Available HER-2 positive tumors are among the most aggressive subtypes of breast cancer and are frequently associated with metastasis and poor outcome. As with other aggressive subtypes of breast cancer, these tumors are associated with abnormally high expression of galectin-7 (gal-7, which confers metastatic breast tumor cells with increased invasive behavior. Although previous studies in the rat model of breast tumorigenesis have shown that gal-7 is also increased in primary breast tumor, its contribution to the development of the primary breast tumors remains unclear. In the present work, we have used genetically-engineered gal-7-deficient mice to examine the role of gal-7 in the development of the mammary gland and of breast cancer. Using histological and immunohistological analysis of whole mammary glands at different stages of development, we detected no significant changes between normal and gal-7-deficient mice. To test the involvement of gal-7 in breast cancer, we next examined the effects of loss of gal-7 on mammary tumor development by crossing gal-7-deficient mice with the mammary tumor transgenic mouse strain FVB-Tg(MMTV-Erbb2NK1Mul/J. Finally, assessment of mice survival and tumor volume showed a delay of mammary tumor growth in the absence of systemic gal-7. These data suggest that gal-7 could potentiate the phenotype of HER-2 positive primary breast cancer.

  3. A randomized controlled trial of Internet-Based Cognitive Behavior Therapy for perfectionism including an investigation of outcome predictors.

    Science.gov (United States)

    Rozental, Alexander; Shafran, Roz; Wade, Tracey; Egan, Sarah; Nordgren, Lise Bergman; Carlbring, Per; Landström, Andreas; Roos, Stina; Skoglund, Malin; Thelander, Elisabet; Trosell, Linnéa; Örtenholm, Alexander; Andersson, Gerhard

    2017-08-01

    Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen's d = 0.68-1.00, 95% Confidence Interval (CI) [0.36-1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. A proposed set of metrics for standardized outcome reporting in the management of low back pain

    DEFF Research Database (Denmark)

    Clement, R Carter; Welander, Adina; Stowell, Caleb

    2015-01-01

    BACKGROUND AND PURPOSE: Outcome measurement has been shown to improve performance in several fields of healthcare. This understanding has driven a growing interest in value-based healthcare, where value is defined as outcomes achieved per money spent. While low back pain (LBP) constitutes an enor...

  5. Gas position sensitive x-ray detectors

    International Nuclear Information System (INIS)

    Barbosa, A.F.

    1994-12-01

    The construction of gas x-ray detectors used to count and localize x-ray photons in one and two dimensions is reported. The principles of operation of the detectors are described, as well as the electronic modules comprised in the data acquisition system. Results obtained with detectors built at CBPF are shown, illustrating the performance of the Linear Position Sensitive Detectors. (author). 6 refs, 14 figs

  6. Looking Forward: The Potential of Creativity for Social Justice and Equity (And Other Exciting Outcomes)

    Science.gov (United States)

    Kaufman, James C.

    2017-01-01

    This brief essay argues for the importance for more work on how creativity predicts positive outcomes, with a particular emphasis on expanding our definitions of these positive outcomes. The way that creativity may lead to increased equity and social justice is used as an example of these type of potential research questions.

  7. Reporting bias inflates the reputation of medical treatments: A comparison of outcomes in clinical trials and online product reviews.

    Science.gov (United States)

    de Barra, Mícheál

    2017-03-01

    People often hold unduly positive expectations about the outcomes of medicines and other healthcare products. Here the following explanation is tested: people who have a positive outcome tend to tell more people about their disease/treatment than people with poor or average outcomes. Akin to the file drawer problem in science, this systematically and positively distorts the information available to others. If people with good treatment outcomes are more inclined to tell others, then they should also be more inclined to write online medical product reviews. Therefore, average treatment outcomes in these reviews should be more positive than those found in randomised controlled trials (RCTs). Data on duration of treatment and outcome (i.e., weight/cholesterol change) were extracted from user-generated health product reviews on Amazon.com and compared to RCT data for the same treatments using ANOVA. The sample included 1675 reviews of cholesterol reduction (Benecol, CholestOff) and weight loss (Orlistat) treatments and the primary outcome was cholesterol change (Bencol and CholestOff) or weight change (Orlistat). In three independent tests, average outcomes reported in the reviews were substantially more positive than the outcomes reported in the medical literature (η 2  = 0.01 to 0.06; p = 0.04 to 0.001). For example, average cholesterol change following use of Benecol is -14 mg/dl in RCTs and -45 mg/dl in online reviews. People with good treatment outcomes are more inclined to share information about their treatment, which distorts the information available to others. People who rely on word of mouth reputation, electronic or real life, are likely to develop unduly positive expectations. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  8. Strategic positioning in banking industry: Evidence from banking industry

    Directory of Open Access Journals (Sweden)

    Hedieh Mashoof

    2014-08-01

    Full Text Available Strategic positioning has always been a key tool for managers to analyze the position of the firm in different attributes in comparison with competitors. With regard to fierce competition in banking industry, the aim of this study is to analyze the position of Bank Melli Iran with 5 public and private rivals in 6 attributes. The sample of this study was 387 Bank Melli Iran customers. The results of this study were in 14 perceptual maps in which the positions of Bank Melli Iran attributes have been shown compared with bank’s key competitors. The results showed that Bank Melli Iran had strong position and came to the first place in attributes like price, physical equipment and location and security. Moreover, Bank Melli Iran has to improve its position in attributes with no better position.

  9. Complex Relationships Among Masculine Norms and Health/Well-Being Outcomes: Correlation Patterns of the Conformity to Masculine Norms Inventory Subscales.

    Science.gov (United States)

    Gerdes, Zachary T; Levant, Ronald F

    2018-03-01

    The Conformity to Masculine Norms Inventory (CMNI) is a widely used multidimensional scale. Studies using the CMNI most often report only total scale scores, which are predominantly associated with negative outcomes. Various studies since the CMNI's inception in 2003 using subscales have reported both positive and negative outcomes. The current content analysis examined studies ( N = 17) correlating the 11 subscales with 63 criterion variables across 7 categories. Most findings were consistent with past research using total scale scores that reported negative outcomes. For example, conformity to masculine norms has been inversely related to help-seeking and positively correlated with concerning health variables, such as substance use. Nonetheless, past reliance on total scores has obscured the complexity of associations with the CMNI in that 30% of the findings in the present study reflected positive outcomes, particularly for health promotion. Subscales differed in their relationships with various outcomes: for one subscale they were predominantly positive, but six others were mostly negative. The situational and contextual implications of conformity to masculine norms and their relationships to positive and negative outcomes are discussed.

  10. Nonendemic HPV-Positive Nasopharyngeal Carcinoma: Association With Poor Prognosis

    International Nuclear Information System (INIS)

    Stenmark, Matthew H.; McHugh, Jonathan B.; Schipper, Matthew; Walline, Heather M.; Komarck, Christine; Feng, Felix Y.; Worden, Francis P.; Wolf, Gregory T.; Chepeha, Douglas B.; Prince, Mark E.; Bradford, Carol R.; Mukherji, Suresh K.; Eisbruch, Avraham; Carey, Thomas E.

    2014-01-01

    Purpose: To investigate the relationship between human papillomavirus (HPV) and Epstein-Barr virus (EBV) in nonendemic nasopharyngeal carcinoma (NPC) and assess the prognostic implications of viral status. Methods and Materials: Paraffin-embedded tumor specimens from 62 patients with primary NPC diagnosed between 1985 and 2011 were analyzed for EBV and high-risk HPV. EBV status was determined by the use of in situ hybridization for EBV encoded RNA. HPV status was assessed with p16 immunohistochemistry and multiplex polymerase chain reaction MassArray for determination of HPV type. Proportional hazards models were used to compare the risk of death among patients as stratified by viral status. Results: Of 61 evaluable tumors, 26 (43%) were EBV-positive/HPV-negative, 18 (30%) were HPV-positive/EBV-negative, and 17 (28%) were EBV/HPV-negative. EBV and HPV infection was mutually exclusive. HPV positivity was significantly correlated with World Health Organization grade 2 tumors, older age, and smoking (all P<.001). The racial distribution of the study population was 74% white, 15% African American, and 11% Asian/Middle Eastern. Among HPV-positive patients, 94% were white. At a median follow-up time of 7 years, HPV-positive and EBV/HPV-negative tumors exhibited worse outcomes than did EBV-positive tumors, including decreased overall survival (hazard ratio [HR] 2.98, P=.01; and HR 3.89, P=.002), progression-free survival (HR 2.55, P=.02; and HR 4.04, P<.001), and locoregional control (HR 4.01, P=.03; and HR 6.87, P=.001). Conclusion: In our Midwestern population, high-risk HPV infection may play an etiologic role in the development of nonendemic, EBV-negative NPC. Compared with EBV-positive NPC, HPV-positive and EBV/HPV-negative NPC are associated with worse outcomes. A larger confirmatory study is needed to validate these findings

  11. Nonendemic HPV-Positive Nasopharyngeal Carcinoma: Association With Poor Prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Stenmark, Matthew H., E-mail: stenmark@med.umich.edu [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); McHugh, Jonathan B. [Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Schipper, Matthew [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Department of Biostatistics, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Walline, Heather M.; Komarck, Christine [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Worden, Francis P. [Department of Medical Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Wolf, Gregory T.; Chepeha, Douglas B.; Prince, Mark E.; Bradford, Carol R. [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Mukherji, Suresh K. [Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Eisbruch, Avraham [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Carey, Thomas E. [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States)

    2014-03-01

    Purpose: To investigate the relationship between human papillomavirus (HPV) and Epstein-Barr virus (EBV) in nonendemic nasopharyngeal carcinoma (NPC) and assess the prognostic implications of viral status. Methods and Materials: Paraffin-embedded tumor specimens from 62 patients with primary NPC diagnosed between 1985 and 2011 were analyzed for EBV and high-risk HPV. EBV status was determined by the use of in situ hybridization for EBV encoded RNA. HPV status was assessed with p16 immunohistochemistry and multiplex polymerase chain reaction MassArray for determination of HPV type. Proportional hazards models were used to compare the risk of death among patients as stratified by viral status. Results: Of 61 evaluable tumors, 26 (43%) were EBV-positive/HPV-negative, 18 (30%) were HPV-positive/EBV-negative, and 17 (28%) were EBV/HPV-negative. EBV and HPV infection was mutually exclusive. HPV positivity was significantly correlated with World Health Organization grade 2 tumors, older age, and smoking (all P<.001). The racial distribution of the study population was 74% white, 15% African American, and 11% Asian/Middle Eastern. Among HPV-positive patients, 94% were white. At a median follow-up time of 7 years, HPV-positive and EBV/HPV-negative tumors exhibited worse outcomes than did EBV-positive tumors, including decreased overall survival (hazard ratio [HR] 2.98, P=.01; and HR 3.89, P=.002), progression-free survival (HR 2.55, P=.02; and HR 4.04, P<.001), and locoregional control (HR 4.01, P=.03; and HR 6.87, P=.001). Conclusion: In our Midwestern population, high-risk HPV infection may play an etiologic role in the development of nonendemic, EBV-negative NPC. Compared with EBV-positive NPC, HPV-positive and EBV/HPV-negative NPC are associated with worse outcomes. A larger confirmatory study is needed to validate these findings.

  12. The Glasgow Benefit Inventory: a systematic review of the use and value of an otorhinolaryngological generic patient-recorded outcome measure

    Science.gov (United States)

    Hendry, J.; Chin, A.; Swan, I.R.C.; Akeroyd, M.A.; Browning, G.G.

    2018-01-01

    Background The Glasgow Benefit Inventory (GBI) is a validated, generic patient-recorded outcome measure widely used in otolaryngology to report change in quality of life post-intervention. Objectives of review To date, no systematic review has made (i) a quality assessment of reporting of Glasgow Benefit Inventory outcomes; (ii) a comparison between Glasgow Benefit Inventory outcomes for different interventions and objectives; (iii) an evaluation of subscales in describing the area of benefit; (iv) commented on its value in clinical practice and research. Type of review Systematic review. Search strategy ‘Glasgow Benefit Inventory’ and ‘GBI’ were used as keywords to search for published, unpublished and ongoing trials in PubMed, EMBASE, CINAHL and Google in addition to an ISI citation search for the original validating Glasgow Benefit Inventory paper between 1996 and January 2015. Evaluation method Papers were assessed for study type and quality graded by a predesigned scale, by two authors independently. Papers with sufficient quality Glasgow Benefit Inventory data were identified for statistical comparisons. Papers with 50% and gave sufficient Glasgow Benefit Inventory total and subscales for meta-analysis. For five of the 11 operation categories (vestibular schwannoma, tonsillectomy, cochlear implant, middle ear implant and stapes surgery) that were most likely to have a single clear clinical objective, score data had low-to-moderate heterogeneity. The value in the Glasgow Benefit Inventory having both positive and negative scores was shown by an overall negative score for the management of vestibular schwannoma. The other six operations gave considerable heterogeneity with rhinoplasty and septoplasty giving the greatest percentages (98% and 99%) most likely because of the considerable variations in patient selection. The data from these operations should not be used for comparative purposes. Five papers also reported the number of patients that had no

  13. Stimulation site within the MRI-defined STN predicts postoperative motor outcome.

    Science.gov (United States)

    Wodarg, Fritz; Herzog, Jan; Reese, René; Falk, Daniela; Pinsker, Markus O; Steigerwald, Frank; Jansen, Olav; Deuschl, Günther; Mehdorn, H Maximillian; Volkmann, Jens

    2012-06-01

    High-frequency stimulation of the subthalamic nucleus (STN-HFS) is highly effective in treating motor symptoms in Parkinson's disease (PD) and medication side effects as well as in improving quality of life. Despite preoperative screening for patients as eligible candidates for this treatment, electrode position may furthermore influence treatment quality. Here, we investigated the relationship between the anatomical site of stimulation within the MRI-defined STN and the outcome of PD patients after STN-HFS. In 30 PD patients with bilateral STN stimulation, we retrospectively defined the boundaries of the STN within the axial target plane of the stereotactic T2-weighted MRI and determined the position of the active electrode contact in relation to the border of the STN. The position of the active contact within the STN was the only variable to predict the outcome of STN stimulation. In contrast, covariates such as age, disease duration, symptom severity, and response to levodopa had no effect. The lateral position of the stimulation contact within the STN led to significantly better clinical improvement, lower stimulation parameters, and less need for postoperative dopaminergic medication. The outcome of patients with stimulation contacts within the medial region of the STN was significantly worse. Precise targeting of the lateral region of the STN is essential for achieving sufficient stimulation efficacy. Preoperative T2-weighted MRI might be a useful component of the targeting procedure to improve the outcome of PD patients. Copyright © 2012 Movement Disorder Society.

  14. Sociotropic personality traits positively correlate with the severity of ...

    African Journals Online (AJOL)

    psychology. ... concepts of sociotropy-autonomy, depression and anxiety. ... may have a positive impact on treatment outcome. ... Beck Depression Inventory (BDI) rates somatic, emotional, .... and may prospectively provide a contribution to the literature. ... Individual differences in ego depletion: The role of sociotropy-.

  15. Quantum incompatibility of channels with general outcome operator algebras

    Science.gov (United States)

    Kuramochi, Yui

    2018-04-01

    A pair of quantum channels is said to be incompatible if they cannot be realized as marginals of a single channel. This paper addresses the general structure of the incompatibility of completely positive channels with a fixed quantum input space and with general outcome operator algebras. We define a compatibility relation for such channels by identifying the composite outcome space as the maximal (projective) C*-tensor product of outcome algebras. We show theorems that characterize this compatibility relation in terms of the concatenation and conjugation of channels, generalizing the recent result for channels with quantum outcome spaces. These results are applied to the positive operator valued measures (POVMs) by identifying each of them with the corresponding quantum-classical (QC) channel. We also give a characterization of the maximality of a POVM with respect to the post-processing preorder in terms of the conjugate channel of the QC channel. We consider another definition of compatibility of normal channels by identifying the composite outcome space with the normal tensor product of the outcome von Neumann algebras. We prove that for a given normal channel, the class of normally compatible channels is upper bounded by a special class of channels called tensor conjugate channels. We show the inequivalence of the C*- and normal compatibility relations for QC channels, which originates from the possibility and impossibility of copying operations for commutative von Neumann algebras in C*- and normal compatibility relations, respectively.

  16. Widespread signatures of positive selection in common risk alleles associated to autism spectrum disorder.

    Directory of Open Access Journals (Sweden)

    Renato Polimanti

    2017-02-01

    Full Text Available The human brain is the outcome of innumerable evolutionary processes; the systems genetics of psychiatric disorders could bear their signatures. On this basis, we analyzed five psychiatric disorders, attention deficit hyperactivity disorder, autism spectrum disorder (ASD, bipolar disorder, major depressive disorder, and schizophrenia (SCZ, using GWAS summary statistics from the Psychiatric Genomics Consortium. Machine learning-derived scores were used to investigate two natural-selection scenarios: complete selection (loci where a selected allele reached fixation and incomplete selection (loci where a selected allele has not yet reached fixation. ASD GWAS results positively correlated with incomplete-selection (p = 3.53*10-4. Variants with ASD GWAS p<0.1 were shown to have a 19%-increased probability to be in the top-5% for incomplete-selection score (OR = 1.19, 95%CI = 1.11-1.8, p = 9.56*10-7. Investigating the effect directions of minor alleles, we observed an enrichment for positive associations in SNPs with ASD GWAS p<0.1 and top-5% incomplete-selection score (permutation p<10-4. Considering the set of these ASD-positive-associated variants, we observed gene-expression enrichments for brain and pituitary tissues (p = 2.3*10-5 and p = 3*10-5, respectively and 53 gene ontology (GO enrichments, such as nervous system development (GO:0007399, p = 7.57*10-12, synapse organization (GO:0050808, p = 8.29*10-7, and axon guidance (GO:0007411, p = 1.81*10-7. Previous genetic studies demonstrated that ASD positively correlates with childhood intelligence, college completion, and years of schooling. Accordingly, we hypothesize that certain ASD risk alleles were under positive selection during human evolution due to their involvement in neurogenesis and cognitive ability.

  17. Religion, Spirituality, and HIV Clinical Outcomes: A Systematic Review of the Literature.

    Science.gov (United States)

    Doolittle, B R; Justice, A C; Fiellin, D A

    2018-06-01

    This systematic review evaluates the association between religion, spirituality and clinical outcomes in HIV-infected individuals. A systematic literature review was conducted for all English language articles published between 1980 and 2016 in relevant databases. Six hundred fourteen studies were evaluated. 15 met inclusion criteria. Ten (67%) studies reported a positive association between religion or spirituality and a clinical HIV outcome. Two (13%) studies failed to detect such an association; and two (13%) demonstrated a negative association. One study (7%) identified features of religiosity and spirituality that had both negative and positive associations with HIV clinical outcomes. Recognizing the religious or spiritual commitments of patients may serve as an important component of patient care. Further longitudinal studies and interventions might be required to further clarify the potential impact of religion and spirituality on HIV clinical outcomes.

  18. Spoken language outcomes after hemispherectomy: factoring in etiology.

    Science.gov (United States)

    Curtiss, S; de Bode, S; Mathern, G W

    2001-12-01

    We analyzed postsurgery linguistic outcomes of 43 hemispherectomy patients operated on at UCLA. We rated spoken language (Spoken Language Rank, SLR) on a scale from 0 (no language) to 6 (mature grammar) and examined the effects of side of resection/damage, age at surgery/seizure onset, seizure control postsurgery, and etiology on language development. Etiology was defined as developmental (cortical dysplasia and prenatal stroke) and acquired pathology (Rasmussen's encephalitis and postnatal stroke). We found that clinical variables were predictive of language outcomes only when they were considered within distinct etiology groups. Specifically, children with developmental etiologies had lower SLRs than those with acquired pathologies (p =.0006); age factors correlated positively with higher SLRs only for children with acquired etiologies (p =.0006); right-sided resections led to higher SLRs only for the acquired group (p =.0008); and postsurgery seizure control correlated positively with SLR only for those with developmental etiologies (p =.0047). We argue that the variables considered are not independent predictors of spoken language outcome posthemispherectomy but should be viewed instead as characteristics of etiology. Copyright 2001 Elsevier Science.

  19. Global positioning method based on polarized light compass system

    Science.gov (United States)

    Liu, Jun; Yang, Jiangtao; Wang, Yubo; Tang, Jun; Shen, Chong

    2018-05-01

    This paper presents a global positioning method based on a polarized light compass system. A main limitation of polarization positioning is the environment such as weak and locally destroyed polarization environments, and the solution to the positioning problem is given in this paper which is polarization image de-noising and segmentation. Therefore, the pulse coupled neural network is employed for enhancing positioning performance. The prominent advantages of the present positioning technique are as follows: (i) compared to the existing position method based on polarized light, better sun tracking accuracy can be achieved and (ii) the robustness and accuracy of positioning under weak and locally destroyed polarization environments, such as cloudy or building shielding, are improved significantly. Finally, some field experiments are given to demonstrate the effectiveness and applicability of the proposed global positioning technique. The experiments have shown that our proposed method outperforms the conventional polarization positioning method, the real time longitude and latitude with accuracy up to 0.0461° and 0.0911°, respectively.

  20. Thyroid dysfunction and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Sima Nazarpour

    2015-07-01

    Full Text Available Background: Pregnancy has a huge impact on the thyroid function in both healthy women and those that have thyroid dysfunction. The prevalence of thyroid dysfunction in pregnant women is relatively high. Objective: The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction including hyperthyroidism, hypothyroidism and thyroid autoimmune positivity on pregnancy outcomes. Materials and Methods: In this review, Medline, Embase and the Cochrane Library were searched with appropriate keywords for relevant English manuscript. We used a variety of studies, including randomized clinical trials, cohort (prospective and retrospective, case-control and case reports. Those studies on thyroid disorders among non-pregnant women and articles without adequate quality were excluded. Results: Overt hyperthyroidism and hypothyroidism has several adverse effects on pregnancy outcomes. Overt hyperthyroidism was associated with miscarriage, stillbirth, preterm delivery, intrauterine growth retardation, low birth weight, preeclampsia and fetal thyroid dysfunction. Overt hypothyroidism was associated with abortion, anemia, pregnancy-induced hypertension, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, intrauterine fetal death, increased neonatal respiratory distress and infant neuro developmental dysfunction. However the adverse effect of subclinical hypothyroidism, and thyroid antibody positivity on pregnancy outcomes was not clear. While some studies demonstrated higher chance of placental abruption, preterm birth, miscarriage, gestational hypertension, fetal distress, severe preeclampsia and neonatal distress and diabetes in pregnant women with subclinical hypothyroidism or thyroid autoimmunity; the other ones have not reported these adverse effects. Conclusion: While the impacts of overt thyroid dysfunction on feto-maternal morbidities have been clearly

  1. Prediction of unfavorable outcomes in cryptococcal meningitis

    DEFF Research Database (Denmark)

    Hakyemez, I N; Erdem, H; Beraud, G

    2018-01-01

    Cryptococcal meningitis (CM) is mostly seen in immunocompromised patients, particularly human immunodeficiency virus (HIV)-positive patients, but CM may also occur in apparently immunocompetent individuals. Outcome analyses have been performed in such patients but, due to the high prevalence of HIV...

  2. Beam Position Monitor Engineering

    International Nuclear Information System (INIS)

    Smith, Stephen R.

    1996-07-01

    The design of beam position monitors often involves challenging system design choices. Position transducers must be robust, accurate, and generate adequate position signal without unduly disturbing the beam. Electronics must be reliable and affordable, usually while meeting tough requirements on precision. accuracy, and dynamic range. These requirements may be difficult to achieve simultaneously, leading the designer into interesting opportunities for optimization or compromise. Some useful techniques and tools are shown. Both finite element analysis and analytic techniques will be used to investigate quasi-static aspects of electromagnetic fields such as the impedance of and the coupling of beam to striplines or buttons. Finite-element tools will be used to understand dynamic aspects of the electromagnetic fields of beams, such as wake-fields and transmission-line and cavity effects in vacuum-to-air feed through. Mathematical modeling of electrical signals through a processing chain will be demonstrated, in particular to illuminate areas where neither a pure time-domain nor a pure frequency-domain analysis is obviously advantageous. Emphasis will be on calculational techniques, in particular on using both time-domain and frequency domain approaches to the applicable parts of interesting problems

  3. Reduced Bearing Excursion After Mobile-Bearing Unicompartmental Knee Arthroplasty is Associated With Poor Functional Outcomes.

    Science.gov (United States)

    Wahal, Naman; Gaba, Sahil; Malhotra, Rajesh; Kumar, Vijay; Pegg, Elise C; Pandit, Hemant

    2018-02-01

    A small proportion of patients with mobile unicompartmental knee arthroplasty (UKA) report poor functional outcomes in spite of optimal component alignment on postoperative radiographs. The purpose of this study is to assess whether there is a correlation between functional outcome and knee kinematics. From a cohort of consecutive cases of 150 Oxford medial UKA, patients with fair/poor functional outcome at 1-year postsurgery (Oxford Knee Score [OKS] bearing position with knee flexion angle. Mean OKS in the fair/poor group was 29.9 and the mean OKS in the good/excellent group was 41.1. The tibial slope, time taken to complete the exercises, and patellar tendon angle trend over the flexion range were similar in both the groups; however, bearing position and the extent of bearing excursion differed significantly. The total bearing excursion in the OKS bearing was positioned 1.7 mm more posterior on the tibia in the OKS bearing excursion and positioning, are associated with worse functional outcomes after mobile UKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Hui-yan Sun

    2015-01-01

    Full Text Available Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury.

  5. Associations between the peer support relationship, service satisfaction and recovery-oriented outcomes: a correlational study.

    Science.gov (United States)

    Thomas, Elizabeth C; Salzer, Mark S

    2017-12-18

    The working alliance between non-peer providers and mental health consumers is associated with positive outcomes. It is hypothesized that this factor, in addition to other active support elements, is also positively related to peer support service outcomes. This study evaluates correlates of the peer-to-peer relationship and its unique association with service satisfaction and recovery-oriented outcomes. Participants were 46 adults with serious mental illnesses taking part in a peer-brokered self-directed care intervention. Pearson correlation analyses examined associations among peer relationship factors, services-related variables and recovery-oriented outcomes (i.e. empowerment, recovery and quality of life). Hierarchical multiple regression analyses evaluated associations between relationship factors and outcomes over time, controlling for other possible intervention effects. The peer relationship was not related to number of contacts. There were robust associations between the peer relationship and service satisfaction and some recovery-oriented outcomes at 24-months, but not at 12-months. These associations were not explained by other possible intervention effects. This study contributes to a better understanding of the positive, unique association between the peer-to-peer relationship and outcomes, similar to what is found in non-peer-delivered interventions. Implications for program administrators and policymakers seeking to integrate peer specialists into mental health service systems are discussed.

  6. Parameters estimation for X-ray sources: positions

    International Nuclear Information System (INIS)

    Avni, Y.

    1977-01-01

    It is shown that the sizes of the positional error boxes for x-ray sources can be determined by using an estimation method which we have previously formulated generally and applied in spectral analyses. It is explained how this method can be used by scanning x-ray telescopes, by rotating modulation collimators, and by HEAO-A (author)

  7. Clinical outcomes with daptomycin: a post-marketing, real-world evaluation.

    Science.gov (United States)

    Sakoulas, G

    2009-12-01

    The Cubicin Outcomes Registry and Experience (CORE) is an ongoing, retrospective, post-marketing database of daptomycin use in the USA. Although non-comparative, CORE offers insight into real-life clinical experience with daptomycin in various Gram-positive infections and specific patient types. Analyses of daptomycin treatment outcomes using the CORE database revealed that treatment with daptomycin has resulted in high rates of clinical success for a variety of Gram-positive infections, including indicated infections such as complicated skin and soft tissue infections, Staphylococcus aureus bacteraemia and right-sided infective endocarditis, and non-indicated infections such as osteomyelitis. Treatment outcomes did not differ significantly according to the causative pathogen for any of the analyses performed and were not influenced by the vancomycin MIC. Patients frequently received therapy with alternative antibiotics prior to treatment with daptomycin, particularly those patients with more serious infections. However, similar treatment outcomes were observed when daptomycin was used as first-line therapy or as salvage therapy, demonstrating the effectiveness of daptomycin in the treatment of these patients.

  8. A deterministic - approach controller design for electrohydraulic position servo control system

    International Nuclear Information System (INIS)

    Johari Osman

    2000-01-01

    This paper is concerned with the design of a tracking controller for controlling electrohydraulic position servo system based on a deterministic approach. The system is treated as an uncertain system with bounded uncertainties where the bounds are assumed known. It will be shown that the electrohydraulic position servo systems with the proposed controller is practically stable and tracks the desired position in spite of the uncertainties and nonlinearities present in the system (author)

  9. Forum: Learning Outcomes in Communication. Upside Down/Side Up: Problematizing Teacher Communication Behaviors and Learning Outcomes in Communication

    Science.gov (United States)

    Dannels, Deanna P.; Toale, Mary C.; Backlund, Philip M.; Frederick, John G. M.; Love, Brad

    2016-01-01

    Could teacher communication behaviors generally assumed to be positive ever be detrimental to student realization of particular outcomes? This essay argues for increased scholarly attention to this question. The authors advocate a research agenda that explores the potential "downside" of teacher communication behaviors (TCBs);…

  10. The effect of positive and negative feedback on risk-taking across different contexts

    NARCIS (Netherlands)

    Losecaat Vermeer, A.B.; Sanfey, A.G.

    2015-01-01

    Preferences for risky choices have often been shown to be unstable and context-dependent. Though people generally avoid gambles with mixed outcomes, a phenomenon often attributed to loss aversion, contextual factors can impact this dramatically. For example, people typically prefer risky options

  11. The Effect of Positive and Negative Feedback on Risk-Taking across Different Contexts

    NARCIS (Netherlands)

    Losecaat Vermeer, A.B.; Sanfey, A.G.

    2015-01-01

    Preferences for risky choices have often been shown to be unstable and context-dependent. Though people generally avoid gambles with mixed outcomes, a phenomenon often attributed to loss aversion, contextual factors can impact this dramatically. For example, people typically prefer risky options

  12. Differences among nursing homes in outcomes of a safe resident handling program.

    Science.gov (United States)

    Kurowski, Alicia; Gore, Rebecca; Buchholz, Bryan; Punnett, Laura

    2012-01-01

    A large nursing home corporation implemented a safe resident handling program (SRHP) in 2004-2007. We evaluated its efficacy over a 2-year period by examining differences among 5 centers in program outcomes and potential predictors of those differences. We observed nursing assistants (NAs), recording activities and body postures at 60-second intervals on personal digital assistants at baseline and at 3-month, 12-month, and 24-month follow-ups. The two outcomes computed were change in equipment use during resident handling and change in a physical workload index that estimated spinal loading due to body postures and handled loads. Potential explanatory factors were extracted from post-observation interviews, investigator surveys of the workforce, from administrative data, and employee satisfaction surveys. The facility with the most positive outcome measures was associated with many positive changes in explanatory factors and the facility with the fewest positive outcome measures experienced negative changes in the same factors. These findings suggest greater SRHP benefits where there was lower NA turnover and agency staffing; less time pressure; and better teamwork, staff communication, and supervisory support. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

  13. The Impact of Parental Personality on Birth Outcomes: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Naho Morisaki

    Full Text Available To investigate the effect of parental personality on birth outcomes.Prospective cohort study.727 pregnant women and 579 spouses receiving antenatal care at a single-center in rural Tokyo, Japan during 2010-2013.We measured the association between maternal effect of parental personality traits assessed by the Cloninger's Temperament and Character Inventory on birth outcomes, using multiple regression and adjusting for demographics.Maternal self-transcendence personality was inversely associated with gestational age [-0.26 (95% confidence interval (CI: -0.51 to -0.01 weeks per unit] and positively associated with preterm birth [odds ratio (OR 2.60 (95% CI: 1.00 to 6.75 per unit], while paternal self-transcendence personality was positively associated with gestational age [0.31 (95% CI: 0.07 to 0.55 weeks per unit]. Maternal reward dependence was positively associated with fetal growth [0.30 (95% CI: 0.02 to 0.59 per unit]. Other maternal and paternal personality traits associated with adverse maternal behavior, such as novelty seeking, harm avoidance and self-directedness, were not associated with birth outcomes.We found that specific parental personality traits can be associated with birth outcomes.

  14. High positive computed tomography yields in the emergency ...

    African Journals Online (AJOL)

    when the diagnosis is uncertain.[1,2] It is therefore ... Methods. This was a retrospective record review of all patients who received CT ... period. Primary outcomes were to establish CT scan usage and positive yield rates. ... scans performed in the hospital. ... considered for surgical intervention may have a negative scan and.

  15. Impact of Diabetes on Long-Term Outcome After Primary Angioplasty

    DEFF Research Database (Denmark)

    De Luca, Giuseppe; Dirksen, Maurits T; Spaulding, Christian

    2012-01-01

    Diabetes has been shown to be associated with worse survival and repeat target vessel revascularization (TVR) after primary angioplasty. The aim of the current study was to evaluate the impact of diabetes on long-term outcome in patients undergoing primary angioplasty treated with bare metal sten...

  16. Antenatal Deworming and Materno-Perinatal Outcomes in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ubong Bassey Akpan

    2018-05-01

    CONCLUSION: Presumptive deworming during the antenatal period can significantly reduce the incidence of peripartum anaemia. However, more studies may be needed to prove any positive perinatal outcome.

  17. Turning the pink cloud grey: Dampening of positive affect predicts postpartum depressive symptoms.

    NARCIS (Netherlands)

    Raes, Filip; Smets, Jorien; Wessel, Ineke; Van Den Eede, Filip; Nelis, Sabine; Franck, Erik; Jacquemyn, Yves; Hanssens, Myriam

    OBJECTIVE: Maladaptive response styles to negative affect have been shown to be associated with prospective (postpartum) depression. Whether maladaptive styles to positive affect are also critically involved is understudied, even though anhedonia (a correlate of low positive affectivity) is a

  18. Positive Psychology Interventions for Patients With Heart Disease: A Preliminary Randomized Trial.

    Science.gov (United States)

    Nikrahan, Gholam Reza; Suarez, Laura; Asgari, Karim; Beach, Scott R; Celano, Christopher M; Kalantari, Mehrdad; Abedi, Mohammad Reza; Etesampour, Ali; Abbas, Rezaei; Huffman, Jeff C

    2016-01-01

    Positive psychologic characteristics have been linked to superior cardiac outcomes. Accordingly, in this exploratory study, we assessed positive psychology interventions in patients who had recently undergone a procedure to treat cardiovascular disease. Participants were randomly assigned to receive 1 of 3 different 6-week face-to-face interventions or a wait-list control condition. We assessed intervention feasibility and compared changes in psychologic outcome measures postintervention (7wk) and at follow-up (15wk) between intervention and control participants. Across the interventions, 74% of assigned sessions were completed. When comparing outcomes between interventions and control participants (N = 55 total), there were no between-group differences post-intervention, but at follow-up intervention participants had greater improvements in happiness (β = 14.43, 95% CI: 8.66-20.2, p psychology intervention for cardiac patients. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  19. Positive emotional change: mediating effects of forgiveness and spirituality.

    Science.gov (United States)

    Levenson, Michael R; Aldwin, Carolyn M; Yancura, Loriena

    2006-01-01

    We evaluated the efficacy of an emotional education program that seeks to reduce the intergenerational transmission of negative interaction patterns by increasing forgiveness and spirituality. We examined both reduction of psychological symptoms and increase in positive psychological outcomes over the course of a year, as well as the mediators of this change. At baseline, the sample consisted of 99 participants and 47 waiting list controls. Comparisons of scores from baseline (Time 1) to one week after the Hoffman Quadrinity Process (Time 2) showed large declines in negative affect (depressive symptoms) and increases in both positive outcomes (mastery, empathy, emotional intelligence, life satisfaction, forgiveness, and spiritual experience) and health and well-being. Over the course of a year, most of these gains were sustained, in comparison with the control group. Further, increases in forgiveness and spirituality mediated the effect of program participation on depressive symptoms.

  20. Pain relief and clinical outcome: from opioids to balanced analgesia

    DEFF Research Database (Denmark)

    Kehlet, H

    1996-01-01

    If it is generally accepted that adequate postoperative pain relief will improve outcome from surgery, several controlled trials demonstrated this only for lower body surgical procedures with epidural and spinal anesthetics. Important effects on outcome were not shown when postoperative opioids...... were administered with patient controlled (PCA) or epidural techniques. However, the most optimal pain relief seems to be best achieved with balanced analgesia techniques using combinations of epidural opioids and local anesthetics and systemic non-steroidal antiinflammatory drugs. Future efforts...... should aim at including physical rehabilitation programs in the pain treatment regimen....

  1. Application of TaiWan Ionosphere Model to Single-Frequency Ionospheric Delay Correction for GPS Static Position Positioning

    Science.gov (United States)

    Macalalad, E. P.; Tsai, L.; Wu, J.

    2011-12-01

    Ionospheric delay is one of the major sources of error in GPS positioning and navigation. This error in both pseudorange and phase ranges can vary depending on the location of observation, local time, season, solar cycle and geomagnetic activity. This effect can be practically removed using dual-frequency receivers. However, these types of receivers are very expensive and thus, impractical for most users. Therefore, for single-frequency receivers, ionosphere is usually modeled to attempt to remove this effect analytically. Numerous ionosphere models have been introduced in the past. Some of which are the Klobuchar (or broadcast) model and the global ionosphere map (GIM) provided by the International GNSS Service (IGS). In this paper, another model, called the TaiWan Ionosphere Model (TWIM) was used to correct this effect. TWIM is a three dimensional ionospheric electron (ne) density model derived from FormoSat3/COSMIC GPS Radio Occultation measurements, was used to calculate ionospheric delay for GPS single-frequency positioning. The ne profiles were used to calculate the slant TEC (STEC) between a receiver and each GPS satellite and correct the pseudorange single-frequency observations. The corrected pseudorange for every epoch was used to calculate the position of the receiver. Observations were made in a low-latitude location near one of the peaks of the equatorial anomaly. It was shown that TEC maps generated using TWIM exhibited detailed structure of the ionosphere, whereas Klobuchar and GIM only provided the basic diurnal and geographic features of the ionosphere. Also, it was shown that for static point positioning TWIM provides more accurate and more precise positioning than the Klobuchar and GIM models. That is, on the average, the horizontal accuracy, represented by the circular error probable (CEP), distance RMS (DRMS) and twice the DRMS (2DRMS), were better by 15-18% as compared with the CEP, DRMS and 2DRMS of uncorrected, Klobuchar and GIM. Moreover

  2. Wage, Work Environment, and Staffing: Effects on Nurse Outcomes

    Science.gov (United States)

    McHugh, Matthew D.; Ma, Chenjuan

    2015-01-01

    Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes—less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes. PMID:25121923

  3. Citation bias favoring positive clinical trials of thrombolytics for acute ischemic stroke: a cross-sectional analysis.

    Science.gov (United States)

    Misemer, Benjamin S; Platts-Mills, Timothy F; Jones, Christopher W

    2016-09-28

    Citation bias occurs when positive trials involving a medical intervention receive more citations than neutral or negative trials of similar quality. Several large clinical trials have studied the use of thrombolytic agents for the treatment of acute ischemic stroke with differing results, thereby presenting an opportunity to assess these trials for evidence of citation bias. We compared citation rates among positive, neutral, and negative trials of alteplase (tPA) and other thrombolytic agents for stroke. We used a 2014 Cochrane Review of thrombolytic therapy for the treatment of acute stroke to identify non-pilot, English-language stroke trials published in MEDLINE-indexed journals comparing thrombolytic therapy with control. We classified trials as positive if there was a statistically significant primary outcome difference favoring the intervention, neutral if there was no difference in primary outcome, or negative for a significant primary outcome difference favoring the control group. Trials were also considered negative if safety concerns supported stopping the trial early. Using Scopus, we collected citation counts through 2015 and compared citation rates according to trial outcomes. Eight tPA trials met inclusion criteria: two were positive, four were neutral, and two were negative. The two positive trials received 9080 total citations, the four neutral trials received 4847 citations, and the two negative trials received 1096 citations. The mean annual per-trial citation rates were 333 citations per year for positive trials, 96 citations per year for neutral trials, and 35 citations per year for negative trials. Trials involving other thrombolytic agents were not cited as often, though as with tPA, positive trials were cited more frequently than neutral or negative trials. Positive trials of tPA for ischemic stroke are cited approximately three times as often as neutral trials, and nearly 10 times as often as negative trials, indicating the presence of

  4. Outcomes of Node-positive Breast Cancer Patients Treated With Accelerated Partial Breast Irradiation Via Multicatheter Interstitial Brachytherapy: The Pooled Registry of Multicatheter Interstitial Sites (PROMIS) Experience.

    Science.gov (United States)

    Kamrava, Mitchell; Kuske, Robert R; Anderson, Bethany; Chen, Peter; Hayes, John; Quiet, Coral; Wang, Pin-Chieh; Veruttipong, Darlene; Snyder, Margaret; Demanes, David J

    2018-06-01

    To report outcomes for breast-conserving therapy using adjuvant accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy in node-positive compared with node-negative patients. From 1992 to 2013, 1351 patients (1369 breast cancers) were treated with breast-conserving surgery and adjuvant APBI using interstitial multicatheter brachytherapy. A total of 907 patients (835 node negative, 59 N1a, and 13 N1mic) had >1 year of data available and nodal status information and are the subject of this analysis. Median age (range) was 59 years old (22 to 90 y). T stage was 90% T1 and ER/PR/Her2 was positive in 87%, 71%, and 7%. Mean number of axillary nodes removed was 12 (SD, 6). Cox multivariate analysis for local/regional control was performed using age, nodal stage, ER/PR/Her2 receptor status, tumor size, grade, margin, and adjuvant chemotherapy/antiestrogen therapy. The mean (SD) follow-up was 7.5 years (4.6). The 5-year actuarial local control (95% confidence interval) in node-negative versus node-positive patients was 96.3% (94.5-97.5) versus 95.8% (87.6-98.6) (P=0.62). The 5-year actuarial regional control in node-negative versus node-positive patients was 98.5% (97.3-99.2) versus 96.7% (87.4-99.2) (P=0.33). The 5-year actuarial freedom from distant metastasis and cause-specific survival were significantly lower in node-positive versus node-negative patients at 92.3% (82.4-96.7) versus 97.8% (96.3-98.7) (P=0.006) and 91.3% (80.2-96.3) versus 98.7% (97.3-99.3) (P=0.0001). Overall survival was not significantly different. On multivariate analysis age 50 years and below, Her2 positive, positive margin status, and not receiving chemotherapy or antiestrogen therapy were associated with a higher risk of local/regional recurrence. Patients who have had an axillary lymph node dissection and limited node-positive disease may be candidates for treatment with APBI. Further research is ultimately needed to better define specific criteria for APBI

  5. A review of expectancy theory and alcohol consumption.

    Science.gov (United States)

    Jones, B T; Corbin, W; Fromme, K

    2001-01-01

    Research is reviewed on the association between alcohol outcome expectancies and consumption which has led many to argue that manipulating expectancies might be a route to manipulating consumption for problem prevention and treatment. Studies indirectly and directly evaluating this latter position are reviewed. Expectancies predicting treatment outcome: two studies have shown that the more positive expectancies held at treatment, the poorer is treatment outcome, but five other studies have failed to find this. Three related studies have shown that the more negative expectancies held at treatment, the better the treatment outcome. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited support for negative. Expectancy manipulations and ad libitum consumption: three studies in the laboratory have shown that increasing positive expectancies through word priming increases subsequent consumption and two studies have shown that increasing negative expectancies decreases it. A single study in the field showed a similar relationship. This evaluation provides evidence consistent with the main position but is limited by measuring consumption changes over only 1-2 hours. Prevention programmes with expectancy components: seven projects are reviewed in which positive expectancies were targeted, but only two report an expectancy change analysis and in both cases the expectancy change did not relate to subsequent consumption. This evaluation provides evidence inconsistent with the main position. Expectancy challenge: two related studies are reviewed in which positive expectancy challenges reduce subsequent consumption but changes in expectancy were not evaluated as predictors of consumption change. Two studies are reviewed which found a reduction in positive expectancy following expectancy challenge but no reduction in consumption. One study is reviewed in which when negative expectancy was increased in treatment there was a

  6. Information Geometry of Positive Measures and Positive-Definite Matrices: Decomposable Dually Flat Structure

    Directory of Open Access Journals (Sweden)

    Shun-ichi Amari

    2014-04-01

    Full Text Available Information geometry studies the dually flat structure of a manifold, highlighted by the generalized Pythagorean theorem. The present paper studies a class of Bregman divergences called the (ρ,τ-divergence. A (ρ,τ -divergence generates a dually flat structure in the manifold of positive measures, as well as in the manifold of positive-definite matrices. The class is composed of decomposable divergences, which are written as a sum of componentwise divergences. Conversely, a decomposable dually flat divergence is shown to be a (ρ,τ -divergence. A (ρ,τ -divergence is determined from two monotone scalar functions, ρ and τ. The class includes the KL-divergence, α-, β- and (α, β-divergences as special cases. The transformation between an affine parameter and its dual is easily calculated in the case of a decomposable divergence. Therefore, such a divergence is useful for obtaining the center for a cluster of points, which will be applied to classification and information retrieval in vision. For the manifold of positive-definite matrices, in addition to the dually flatness and decomposability, we require the invariance under linear transformations, in particular under orthogonal transformations. This opens a way to define a new class of divergences, called the (ρ,τ -structure in the manifold of positive-definite matrices.

  7. Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation.

    Science.gov (United States)

    Wang, Li; Li, Xiao; Yang, Zongxia; Tang, Xueli; Yuan, Qiang; Deng, Lijing; Sun, Xin

    2016-01-08

    Ventilator-associated pneumonia (VAP) is associated with increased mortality, prolonged length of hospital stay and increased healthcare costs in critically ill patients. Guidelines recommend a semi-recumbent position (30º to 45º) for preventing VAP among patients requiring mechanical ventilation. However, due to methodological limitations in existing systematic reviews, uncertainty remains regarding the benefits and harms of the semi-recumbent position for preventing VAP. To assess the effectiveness and safety of semi-recumbent positioning versus supine positioning to prevent ventilator-associated pneumonia (VAP) in adults requiring mechanical ventilation. We searched CENTRAL (2015, Issue 10), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1946 to October 2015), EMBASE (2010 to October 2015), CINAHL (1981 to October 2015) and the Chinese Biomedical Literature Database (CBM) (1978 to October 2015). We included randomised controlled trials (RCTs) comparing semi-recumbent versus supine positioning (0º to 10º), or RCTs comparing alternative degrees of positioning in mechanically ventilated patients. Our outcomes included clinically suspected VAP, microbiologically confirmed VAP, intensive care unit (ICU) mortality, hospital mortality, length of ICU stay, length of hospital stay, duration of ventilation, antibiotic use and any adverse events. Two review authors independently and in duplicate screened titles, abstracts and full texts, assessed risk of bias and extracted data using standardised forms. We calculated the mean difference (MD) and 95% confidence interval (95% CI) for continuous data and the risk ratio (RR) and 95% CI for binary data. We performed meta-analysis using the random-effects model. We used the grading of recommendations, assessment, development and evaluation (GRADE) approach to grade the quality of evidence. We included 10 trials involving 878 participants, among which 28 participants in two

  8. Six-Position, Frontal View Photography in Blepharoplasty: A Simple Method.

    Science.gov (United States)

    Zhang, Cheng; Guo, Xiaoshuang; Han, Xuefeng; Tian, Yi; Jin, Xiaolei

    2018-02-26

    Photography plays a pivotal role in patient education, photo-documentation, preoperative planning and postsurgical evaluation in plastic surgeries. It has long been serving as a bridge that facilitated communication not only between patients and doctors, but also among plastic surgeons from different countries. Although several basic principles and photographic methods have been proposed, there is no internationally accepted photography that could provide both static and dynamic information in blepharoplasty. In this article, we introduced a novel six-position, frontal view photography for thorough assessment in blepharoplasty. From October 2013 to January 2017, 1068 patients who underwent blepharoplasty were enrolled in our clinical research. All patients received six-position, frontal view photography. Pictures were taken of the patients looking up, looking down, squeezing, smiling, looking ahead and with closed eyes. Conventionally, frontal view photography only contained the last two positions. Then, both novel six-position photographs and conventional two-position photographs were used to appraise postsurgical outcomes. Compared to conventional two-position, frontal view photography, six-position, frontal view photography can provide more detailed, thorough information about the eyes. It is of clinical significance in indicating underlying adhesion of skin/muscle/fat according to individual's features and assessing preoperative and postoperative dynamic changes and aesthetic outcomes. Six-position, frontal view photography is technically uncomplicated while exhibiting static, dynamic and detailed information of the eyes. This innovative method is favorable in eye assessment, especially for revision blepharoplasty. We suggest using six-position, frontal view photography to obtain comprehensive photographs. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer

  9. Risk factors for unsuccessful tuberculosis treatment outcome (failure, default and death) in public health institutions, Eastern Ethiopia.

    Science.gov (United States)

    Amante, Tariku Dingeta; Ahemed, Tekabe Abdosh

    2015-01-01

    Unsuccessful TB treatment outcome is a serious public health concern. It is compelling to identify, and deal with factors determining unsuccessful treatment outcome. Therefore, study was aimed to determine pattern of unsuccessful TB treatment outcome and associated factors in eastern Ethiopia. A case control study was used. Cases were records of TB patients registered as defaulter, dead and/or treatment failure where as controls were those cured or treatment complete. Multivariate logistic regression models were used to derive adjusted odds ratios (OR) at 95% CI to examine the relationship between the unsuccessful TB treatment outcome and patients' characteristics. A total of 990 sample size (330 cases and 660 controls) were included. Among cases (n = 330), majority 212(64.2%) were because of death, 100(30.3%) defaulters and 18(5.5%) were treatment failure. Lack of contact person(OR = 1.37; 95% CI 1.14-2.9, P, .024), sputum smear negative treatment category at initiation of treatment (OR = 1.8; 95% CI 1.3-5.5,P, .028), smear positive sputum test result at 2(nd) month after initiation treatment (OR = 14; 95% CI 5.5-36, P,0.001) and HIV positive status (OR = 2.5; 95% CI 1.34-5.7, P, 0.01) were independently associated with increased risk of unsuccessful TB treatment outcome. Death was the major cause of unsuccessful TB treatment outcome. TB patients do not have contact person, sputum smear negative treatment category at initiation of treatment, smear positive on 2(nd) month after treatment initiation and HIV positive were factors significantly associated unsuccessful treatment outcome. TB patients with sputum smear negative treatment category, HIV positive and smear positive on 2(nd) nd month of treatment initiation need strict follow up throughout DOTs period.

  10. Direct and indirect effects of caregiver social support on adolescent psychological outcomes in two South African AIDS-affected communities

    Science.gov (United States)

    Casale, Marisa; Cluver, Lucie; Crankshaw, Tamaryn; Kuo, Caroline; Lachman, Jamie M.; Wild, Lauren G.

    2015-01-01

    Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV-endemic, resource-scarce Southern African communities. A cross-sectional household survey was conducted over 2009-2010 with 2477 South African adolescents aged 10-17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu-Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (psocial support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network. PMID:25623784

  11. The role of the laparoscopy on circumferential resection margin positivity in patients with rectal cancer: long-term outcomes at a single high-volume institution.

    Science.gov (United States)

    Dural, Ahmet C; Keskin, Metin; Balik, Emre; Akici, Murat; Kunduz, Enver; Yamaner, Sumer; Asoglu, Oktar; Gulluoglu, Mine; Bugra, Dursun

    2015-04-01

    The aim of this study was to evaluate the influence of laparoscopic rectal cancer surgery on circumferential resection margin (CRM) involvement. The data from 579 consecutive patients who underwent laparoscopic or open resection of rectal cancer from October 2002 to August 2008 were analyzed retrospectively. The primary endpoint was CRM status. The secondary endpoints were morbidity, local recurrence rate, overall survival, and disease-free survival. Laparoscopic resections were performed in 266 patients (46%), and the remainder of the patients underwent open resection. The rates of CRM involvement were similar between the laparoscopic and open groups (5.6% vs. 5.4%). The perioperative morbidity rates between the 2 groups were not significantly different (P=0.2). The incidence of local recurrence for the CRM-negative group was 8.4% (8.3% laparoscopic vs. 8.45% open; P=0.99), whereas the local recurrence rate was 34.3% for the CRM-positive group. The local recurrence rate was 20% for the CRM-positive patients in the laparoscopic group and 47% for the CRM-positive patients in the open group (PCRM status. CRM positivity was correlated with both 5-year survival and the 5-year disease-free survival rate (P=0.009 and P=0.001, respectively). We did not observe any significant differences in morbidity, local recurrence, or overall or disease-free survival rates between the overall laparoscopic and open resection groups. Laparoscopic surgery for rectal cancer is associated with similar complication rates, CRM involvement status, and long-term outcomes as those associated with open surgery but with the advantages of minimally invasive surgery. Although laparoscopic surgery might necessitate more advanced technical skills, similar long-term oncological results can be obtained with this technique.

  12. Drinking motives and alcohol outcome expectancies as mediators of the association between negative urgency and alcohol consumption.

    Science.gov (United States)

    Anthenien, Amber M; Lembo, Jordanna; Neighbors, Clayton

    2017-03-01

    To determine whether the effects of negative urgency, a unique facet of impulsivity marked by engaging in potentially unhealthy and rash behaviors in order to cope with anxiety or negative moods, on drinking behavior can be explained by positive and negative alcohol outcome expectancies and specific drinking motives (i.e., coping and enhancement). College students (N=194) completed web-based surveys in exchange for course credit. Students completed measures of negative urgency, comprehensive effects of alcohol, drinking motives, and alcohol use behaviors. Results of path analysis indicated significant indirect effects of negative urgency and alcohol use through both alcohol outcome expectancies and enhancement motives. The effects of enhancement motives on drinking were mediated by positive alcohol outcome expectancies. The effects of coping motives on drinking were not attributable to negative expectancies. Individuals high on negative urgency may consume alcohol in order to ameliorate their emotional distress due to strong desires to increase positive and decrease negative experiences associated with drinking. Emotion-focused impulsivity's influence on drinking outcomes can be ascribed to enhancement motives for drinking as well as positive and negative alcohol outcome expectancies. Prevention efforts should target drinking motives and alcohol outcome expectancies among those higher in negative urgency. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Hamiltonian Dynamics and Positive Energy in General Relativity

    Energy Technology Data Exchange (ETDEWEB)

    Deser, S. [Physics Department, Brandeis University, Waltham, MA (United States)

    1969-07-15

    A review is first given of the Hamiltonian formulation of general relativity; the gravitational field is a self-interacting massless spin-two system within the framework of ordinary Lorentz covariant field theory. The recently solved problem of positive-definiteness of the field energy is then discussed. The latter, a conserved functional of the dynamical variables, is shown to have only one extremum, a local minimum, which is the vacuum state (flat space). This implies positive energy for the field, with the vacuum as ground-state. Similar results hold when minimally coupled matter is present. (author)

  14. The burden of anaemia and associated factors in HIV positive Nigerian women.

    Science.gov (United States)

    Ezechi, O C; Kalejaiye, O O; Gab-Okafor, C V; Oladele, D A; Oke, B; Ekama, S O; Odunukwe, N N; Ujah, I A O

    2013-02-01

    Anaemia is the most common complication of pregnancy and a predictor of poor maternal and foetal outcomes. HIV infection is now recognized as one of the major contributors to anaemia in pregnancy. It is therefore important to determine the burden and risk factors of anaemia in maternal HIV infection in others to plan effective prevention strategies as well as optimize management outcomes. To determine the prevalence and risk factors of anaemia in pregnant HIV positive Nigerians. The prevalence and possible risk factors of anaemia were investigated in HIV positive pregnant Nigerian women at a large HIV treatment clinic in southwestern Nigeria using a cross-sectional design between January 2006 and December 2011. Nine hundred and eighty-five (42.5 %) women of 2,318 HIV positive pregnant women seen during the period were anaemic by WHO standard defined by haemoglobin anaemia in HIV positive pregnant women after controlling for confounding variables. Anaemia was found to be high at 42.5 % among the HIV positive women studied and was found to be independently associated with short inter birth interval, presence of OIs, advanced HIV disease and use of zidovudine containing HAART regimen.

  15. Investigating the effects of tea, water and a positive affect induction on mood and creativity

    NARCIS (Netherlands)

    Einöther, S.J.L.; Baas, M.; Rowson, M.; Giesbrecht, T.

    2015-01-01

    Positive affect has been shown to be predictive of improved creativity. This study investigated the immediate effect of the tea experience on positive affect and creativity, compared to both a neutral and positive control condition. Regular tea drinkers (N = 150) were allocated to three conditions:

  16. Effects of gemfibrozil on outcome after permanent middle cerebral artery occlusion in mice

    OpenAIRE

    Guo, Qingmin; Wang, Guangming; Liu, Xiaowei; Namura, Shobu

    2009-01-01

    Fibrates are lipid lowering drugs and found as ligands for peroxisome proliferator-activated receptors (PPARs). A clinical study has shown that one type of fibrate gemfibrozil reduces stroke incidence in men. However, it remains unknown whether gemfibrozil improves outcome after stroke. We hypothesized that prophylactic administration of gemfibrozil improves outcome after ischemic stroke. In this study, we measured the impact of gemfibrozil in two permanent middle cerebral artery occlusion (M...

  17. Magnitude of income-related disparities in adverse perinatal outcomes

    OpenAIRE

    Shankardass, Ketan; O’Campo, Patricia; Dodds, Linda; Fahey, John; Joseph, KS; Morinis, Julia; Allen, Victoria M

    2014-01-01

    Background To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. Methods A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 11...

  18. New and improved? A review of novel antibiotics for Gram-positive bacteria.

    Science.gov (United States)

    Abbas, M; Paul, M; Huttner, A

    2017-10-01

    The number of antibiotics in the pipeline targeting Gram-positive pathogens has increased in recent years. This narrative review aims to provide a summary of existing evidence on efficacy, microbiological spectrum and safety of novel systemic antibiotics that have either recently been licensed or completed phase III trials, and possess activity predominantly against Gram-positive organisms. A review of the published literature via the MEDLINE database was performed. In addition, ongoing trials were identified through a search of the clinical trial registration platform clinicaltrials.gov, and when necessary, pharmaceutical companies responsible for the development of the drug were contacted for further information. Data on development, microbiological spectrum, pharmacokinetic/pharmacodynamic properties, clinical efficacy, safety and cost are presented for the new cephalosporins ceftaroline and ceftobiprole; the lipoglycopeptides dalbavancin, oritavancin and telavancin; the fluoroquinolones delafloxacin, nemonoxacin and zabofloxacin; the dihydrofolate-reductase inhibitor iclaprim; the pleuromutilin lefamulin; and the tetracycline omadacycline. Although promising, these new antibiotics have so far been tested in non-severe infections whose treatment is generally uncomplicated and whose aetiologies were not predominantly multidrug-resistant pathogens. None of the new antibiotics have shown superiority to standard care, and none have been investigated for patient-relevant outcomes. Safety and pharmacokinetic data continue to be lacking. How these new drugs are to be integrated into the current armamentarium remains to be established. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Nitrous oxide and perioperative outcomes.

    Science.gov (United States)

    Ko, Hanjo; Kaye, Alan David; Urman, Richard D

    2014-06-01

    There is emerging evidence related to the effects of nitrous oxide on important perioperative patient outcomes. Proposed mechanisms include metabolic effects linked to elevated homocysteine levels and endothelial dysfunction, inhibition of deoxyribonucleic acid and protein formation, and depression of chemotactic migration by monocytes. Newer large studies point to possible risks associated with the use of nitrous oxide, although data are often equivocal and inconclusive. Cardiovascular outcomes such as stroke or myocardial infarction were shown to be unchanged in previous studies, but the more recent Evaluation of Nitrous Oxide in the Gas Mixture for Anesthesia I trial shows possible associations between nitrous oxide and increased cardiovascular and pulmonary complications. There are also possible effects on postoperative wound infections and neuropsychological function, although the multifactorial nature of these complications should be considered. Teratogenicity linked to nitrous oxide use has not been firmly established. The use of nitrous oxide for routine anesthetic care may be associated with significant costs if complications such as nausea, vomiting, and wound infections are taken into consideration. Overall, definitive data regarding the effect of nitrous oxide on major perioperative outcomes are lacking. There are ongoing prospective studies that may further elucidate its role. The use of nitrous oxide in daily practice should be individualized to each patient's medical conditions and risk factors.

  20. Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion

    NARCIS (Netherlands)

    van Houwelingen, Reinier C.; Luijckx, Gert-Jan; Mazuri, Aryan; Bokkers, Reinoud P. H.; Eshghi, Omid S.; Uyttenboogaart, Maarten

    2016-01-01

    IMPORTANCE After the many positive results in thrombectomy trials in ischemic stroke of the anterior circulation, the question arises whether these positive results also apply to the patient with basilar artery occlusion (BAO). OBJECTIVE To report up-to-date outcome data of intra-arterial (IA)

  1. The role of employee HR attributions in the relationship between high-performance work systems and employee outcomes

    NARCIS (Netherlands)

    van de Voorde, F.C.; Beijer, Susanne

    2015-01-01

    Although research has shown that the use of high-performance work systems (HPWS) is associated with employee outcomes, our knowledge of the meanings employees attach to HPWS systems and how these shape employee outcomes is still limited. This study examines the signalling impact of enacted HPWS on

  2. The Precautionary Principle Has Not Been Shown to Be Incoherent: A Reply to Peterson.

    Science.gov (United States)

    Boyer-Kassem, Thomas

    2017-11-01

    In this journal, I have objected to Peterson's 2006 claim that the precautionary principle is an incoherent decision rule. I defend my objections to Peterson's recent replies, and I still claim that the precautionary principle has not been shown to be incoherent. © 2017 Society for Risk Analysis.

  3. Conflict Elaboration and Cognitive Outcomes

    OpenAIRE

    Buchs, Céline; Butera, Fabrizio; Mugny, Gabriel; Darnon, Céline

    2004-01-01

    This article presents advice for teachers about using sociocognitive conflicts to promote academic learning. In doing so, the conditions under which sociocognitive conflicts are constructive or disruptive are examined and the relevant research is reviewed on social development, cooperative learning, and social influence. Two types of conflict elaboration—epistemic and relational—are identified. Epistemic elaborations focus students on task resolution leading to positive cognitive outcomes, an...

  4. Positive Psychology in Cancer Care: Bad Science, Exaggerated Claims, and Unproven Medicine

    OpenAIRE

    Coyne, James C.; Tennen, Howard

    2010-01-01

    Background Claims of positive psychology about people with cancer enjoy great popularity because they seem to offer scientific confirmation of strongly held cultural beliefs and values. Purpose Our goal is to examine critically four widely accepted claims in the positive psychology literature regarding adaptational outcomes among individuals living with cancer. Methods We examine: (1) the role of positive factors, such as a ?fighting spirit? in extending the life of persons with cancer; (2) e...

  5. Positive effect of social work-related values on work outcomes: the moderating role of age and work situation.

    Science.gov (United States)

    Yeung, Dannii Y; Fung, Helene H; Chan, Darius K-S

    2015-03-01

    This study investigated the effect of social work-related values on job performance through job satisfaction and tested whether age and work situation would moderate such associations. This study consists of two parts: Part 1 is a cross-sectional survey among 299 Chinese clerical employees aged 19-60 years and Part 2 is a 14-day experience sampling study in a subsample of Part 1 (N = 67). Part 1 revealed that age moderated the effect of social work-related values on job performance through job satisfaction, with a stronger positive effect in older workers than in younger workers. Part 2 demonstrated that the moderating effect of age shown in Part 1 also varied across work situations. In particular, holding momentary social work-related values was beneficial to the task performance of older workers, and the effect was significantly stronger when they were in social situations than in nonsocial situations, whereas the effect remained weak among younger workers regardless of work context. Moreover, the moderating effect of age could be accounted for by future time perspective. This study supports socioemotional selectivity theory that goal orientation shifts toward the emphasis of interpersonal closeness when one perceives future time as increasingly limited. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Tumor tissue levels of tissue inhibitor of metalloproteinases-I (TIMP-I) and outcome following adjuvant chemotherapy in premenopausal lymph node-positive breast cancer patients

    DEFF Research Database (Denmark)

    Schrohl, Anne-Sofie; Look, Maxime P.; Gelder, Marion E. Meijer-van

    2009-01-01

    BACKGROUND: We have previously demonstrated that high tumor tissue levels of TIMP-1 are associated with no or limited clinical benefit from chemotherapy with CMF and anthracyclines in metastatic breast cancer patients. Here, we extend our investigations to the adjuvant setting studying outcome...... an association between shorter survival after treatment in TIMP-1 high patients compared with TIMP-1 low patients, especially in patients receiving anthracycline-based therapy. This suggests that high tumor tissue levels of TIMP-1 might be associated with reduced benefit from classical adjuvant chemotherapy. Our...... after adjuvant chemotherapy in premenopausal lymph node-positive patients. We hypothesize that TIMP-1 high tumors are less sensitive to chemotherapy and accordingly that high tumor tissue levels are associated with shorter survival. METHODS: From our original retrospectively collected tumor samples we...

  7. It Hurts to Be Lonely! Loneliness and Positive Mental Wellbeing in Australian Rural and Urban Adolescents

    Science.gov (United States)

    Houghton, Stephen; Hattie, John; Carroll, Annemaree; Wood, Lisa; Baffour, Bernard

    2016-01-01

    This study examined associations between loneliness, a construct associated with serious adverse mental health outcomes, and positive mental wellbeing. Validated measures of loneliness (represented by friendship-related loneliness, isolation, positive attitude to solitude, and negative attitude to solitude) and positive mental wellbeing were…

  8. Antibiotic treatment delay and outcome in acute bacterial meningitis

    DEFF Research Database (Denmark)

    Køster-Rasmussen, Rasmus; Korshin, André; Meyer, Christian N

    2008-01-01

    OBJECTIVES: To identify to what degree in-hospital delay of antibiotic therapy correlated to outcome in community acquired bacterial meningitis. METHODS: All cases of culture-positive cerebrospinal fluids in east Denmark from 2002 to 2004 were included. Medical records were collected retrospectiv......OBJECTIVES: To identify to what degree in-hospital delay of antibiotic therapy correlated to outcome in community acquired bacterial meningitis. METHODS: All cases of culture-positive cerebrospinal fluids in east Denmark from 2002 to 2004 were included. Medical records were collected......=1.30/h, CI: 1.08-1.57). The median delay to the first dose of adequate antibiotics was 1h and 39min (1h and 14min in children vs. 2h in adults, pmeningitis. CONCLUSION: The delay in antibiotic therapy correlated...

  9. Endophthalmitis caused by Pantoea agglomerans: clinical features, antibiotic sensitivities, and outcomes

    Directory of Open Access Journals (Sweden)

    Venincasa VD

    2015-07-01

    Full Text Available Vincent D Venincasa, Ajay E Kuriyan, Harry W Flynn Jr, Jayanth Sridhar, Darlene Miller Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Purpose: To report the clinical findings, antibiotic sensitivities, and visual outcomes associated with endophthalmitis caused by Pantoea agglomerans.Methods: A consecutive case series of patients with vitreous culture-positive endophthalmitis caused by P. agglomerans from January 1, 1990 to December 31, 2012 at a large university referral center. Findings from the current study were compared to prior published studies.Results: Of the three study patients that were identified, clinical settings included trauma (n=2 and post-cataract surgery (n=1. Presenting visual acuity was hand motion or worse in all three cases. All isolates were sensitive to ceftazidime, gentamicin, imipenem, and fluoroquinolones. All isolates were resistant to ampicillin. Initial treatment strategies were vitreous tap and intravitreal antibiotic injection (n=1 and pars plana vitrectomy with intravitreal antibiotic injection (n=2. At last follow-up, one patient had no light perception vision, while the other two had best-corrected visual acuity of 20/200 and 20/400.Conclusion: All Pantoea isolates were sensitive to ceftazidime, gentamicin, imipenem, and fluoroquinolones. All patients in the current study received at least one intravitreal antibiotic to which P. agglomerans was shown to be sensitive in vitro. In spite of this, the visual outcomes were generally poor.Keywords: ocular infection, trauma, antibiotic resistance

  10. Rotation vectors for homeomorphisms of non-positively curved manifolds

    International Nuclear Information System (INIS)

    Lessa, Pablo

    2011-01-01

    Rotation vectors, as defined for homeomorphisms of the torus that are isotopic to the identity, are generalized to such homeomorphisms of any complete Riemannian manifold with non-positive sectional curvature. These generalized rotation vectors are shown to exist for almost every orbit of such a dynamical system with respect to any invariant measure with compact support. The concept is then extended to flows and, as an application, it is shown how non-null rotation vectors can be used to construct a measurable semi-conjugacy between a given flow and the geodesic flow of a manifold

  11. Family Perception and 6-Month Symptomatic and Functioning Outcomes in Young Adolescents at Clinical High Risk for Psychosis in a General Population in China.

    Directory of Open Access Journals (Sweden)

    Lu Wang

    Full Text Available Given the difficulty of treating schizophrenia and other forms of psychosis, researchers have shifted focus to early detection and intervention of individuals at clinical high risk (CHR for psychosis. Previous studies have shown that elements in family functioning could predict symptom outcome in CHR individuals. However, associations between self reported family functioning and symptom or functioning outcome of CHR individuals was rarely reported. Our study aimed to investigate the characteristics and the role of family functioning in the development of CHR individuals among young adolescents.A sample of 32 CHR individuals was recruited from 2800 university students. The characteristics of family perception were evaluated by both Family Assessment Device (FAD and Family cohesion and adaptability evaluation Scale II (FACES II. 6 month follow up data was available with 25 of the recruited CHR individuals. Baseline socio-demographic characteristics and family functioning were compared between CHR and control group. We also measured the associations between different dimensions of perceived family functioning and both severity of prodromal symptoms and global functioning at baseline and 6-month follow up.CHR individuals showed more maladaptive family functioning compared to control in nearly all of the dimensions of FAD and FACES II except for Affective Involvement. Better Problem Solving and Affective Responsiveness predicted less severe positive and negative symptoms respectively. Family cohesion and adaptability were not only correlated with the baseline severity of general symptoms, but also positively associated with the general and disorganized symptom outcome.This study contributed preliminary evidence towards the associations between family perception and symptom outcome of CHR individuals. It also provided evidence for the importance of family interventions on CHR individuals.

  12. DIDACTIC PRINCIPLES OF THE FORMATION OF STUDENTS’ SUBJECT POSITION

    Directory of Open Access Journals (Sweden)

    R. M. Garanina

    2017-01-01

    Full Text Available Introduction. Subject position of a personality is the phenomenon that determines self-activity, identity, sovereignty, and positive dynamics of selfdevelopment, self-education, self-training and self-realization, i.e. those qualities which are necessary for a modern expert. Therefore, the development of the concept of formation and development of a subject position of a future expert during his/her vocational training is an urgent scientific and practical task.The aim of the present research is to prove theoretically the following issues: regularities of a formation process of a subject position of a student of a higher education institution; principles reflecting features of functioning of subject space; and requirements shown to the organization of this pedagogical process.Methodology and research methods. The methods involve the analysis of philosophical and psychology and pedagogical sources on the research problem; transspective, phenomenological, psychological, comparative, system, and structure-functional types of the analysis; deductive and inductive methods; comparison, generalization, synthesis, and abstraction.Results and scientific novelty. The concept «student’s subject position» is redefined; the concept includes such features as polysystemacity, multidimensionality, and multi-functionality. The characteristics of a person with a subject position are summarized; special attention is paid to his/her personal characteristics. The regularities of formation and development of the subject position of the student caused by internal mechanisms of self-updating, self-organization, self-development and self-improvement are found out. It is testified that these regularities are shown in the system of various social relations; depend on external impact, integrity and unity of a teaching and educational process; those regularities are characterized by heterochronism, emergence, and evolving. The research enables to present an overall

  13. An outcome study of gestalt-oriented growth workshops.

    Science.gov (United States)

    Leung, Grace Suk Man; Leung, Timothy Yuk Ki; Ng, Monica Lai Tuen

    2013-01-01

    Compared to other intervention modalities, there are relatively few outcome studies of gestalt therapy. This study aimed to address this gap by evaluating the therapeutic effects of four gestalt-oriented group workshops designed to enhance well-being in professionals trained as social workers, counselors, and psychologists. The results of this preliminary, uncontrolled study indicated that the 55 participants had better emotional well-being and experienced a heightened sense of hope following the workshops. The factors leading to these positive outcomes are discussed.

  14. Obesity and Labour Market Outcomes

    DEFF Research Database (Denmark)

    Greve, Jane

    This paper analyzes the relationship between three body weight measures and employment status and wages, thereby broadening the perspective of the literature on obesity and labor market outcomes. The analysis uses a unique dataset from a Danish panel survey from 1995 and 2000, combined with admin......This paper analyzes the relationship between three body weight measures and employment status and wages, thereby broadening the perspective of the literature on obesity and labor market outcomes. The analysis uses a unique dataset from a Danish panel survey from 1995 and 2000, combined...... weight has a negative effect on wages for women but a positive effect for men, whereas in the public sector body weight has no influence on wages for either men or women....

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