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Sample records for subjects undergoing routine

  1. Safety evaluation of routine intracoronary acetylcholine infusion in patients undergoing a first diagnostic coronary angiogram

    NARCIS (Netherlands)

    Tio, RA; Monnink, SHJ; Amoroso, G; Jessurun, GAJ; Veeger, N; Volkers, C; Hautvast, R; Tan, ES; van Gilst, WH; van Boven, AJ

    Background: Recent findings imply prognostic significance of intracoronary acetylcholine infusion for endothelial function testing. We evaluated whether routine use of this test in coronary angiography patients is safe. Methods: Patients undergoing a first diagnostic coronary angiography were

  2. Micronutrient deficiency in obese subjects undergoing low calorie diet

    National Research Council Canada - National Science Library

    Damms-Machado, Antje; Weser, Gesine; Bischoff, Stephan C

    2012-01-01

    .... Furthermore, we determined the micronutrient status in obese subjects undergoing a standardized DRI-covering low-calorie formula diet to analyze if the DRI meet the micronutrient requirements of obese individuals...

  3. [Analysis of correlative factors of sterility in males undergoing routine sperm inspection by masturbation].

    Science.gov (United States)

    Zhou, Liyuan; Shi, Xiaobo; Wang, Xin; Liu, Dan

    2012-07-01

    To investigate the factors influencing sterility in males undergoing routine sperm inspection by masturbation. Scales for demographic data, self-compiled infertility questionnaire, Symptom Checklist-90 (SCL-90) , and sexual life subscale of Olson Marital Quality Questionnaire (ENRICH) were assessed in 220 cases of sterility in males who had undergone sperm examination after ejaculation. The total SCL-90 scores and the factor scores of anxiety, phobia, somatization, obsessive compulsive behavior, interpersonal-sensitivity, hostility, and depression were significantly higher than the norm (Pmasturbation have negative emotions such as anxiety, phobia, somatization, and interpersonal sensitivities. The defective ejaculation may be the influential factor at the stage.

  4. Analgesic effects of butorphanol tartrate and phenylbutazone administered alone and in combination in young horses undergoing routine castration.

    Science.gov (United States)

    Sanz, Macarena G; Sellon, Debra C; Cary, Julie A; Hines, Melissa T; Farnsworth, Kelly D

    2009-11-15

    To compare the analgesic efficacy of administration of butorphanol tartrate, phenylbutazone, or both drugs in combination in colts undergoing routine castration. Randomized controlled clinical trial. 36 client-owned colts. Horses received treatment with butorphanol alone (0.05 mg/kg [0.023 mg/lb], IM, prior to surgery and then q 4 h for 24 hours), phenylbutazone alone (4.4 mg/kg [2.0 mg/lb], IV, prior to surgery and then 2.2 mg/kg [1.0 mg/lb], PO, q 12 h for 3 days), or butorphanol and phenylbutazone at the aforementioned dosages (12 horses/group). For single-drug-treated horses, appropriate placebos were administered to balance treatment protocols among groups. All horses were anesthetized, and lidocaine hydrochloride was injected into each testis. Physical and physiological variables, plasma cortisol concentration, body weight, and water consumption were assessed before and at intervals after surgery, and induction of and recovery from anesthesia were subjectively characterized. Observers assessed signs of pain by use of a visual analogue scale and a numerical rating scale. Significant changes in gastrointestinal sounds, fecal output, and plasma cortisol concentrations were evident in each treatment group over time, compared with preoperative values. At any time point, assessed variables and signs of pain did not differ significantly among groups, although the duration of recumbency after surgery was longest for the butorphanol-phenylbutazone-treated horses. With intratesticular injections of lidocaine, administration of butorphanol to anesthetized young horses undergoing routine castration had the same apparent analgesic effect as phenylbutazone treatment. Combined butorphanolphenylbutazone treatment was not apparently superior to either drug used alone.

  5. Micronutrient deficiency in obese subjects undergoing low calorie diet

    Directory of Open Access Journals (Sweden)

    Damms-Machado Antje

    2012-06-01

    Full Text Available Abstract Background The prevalence of micronutrient deficiencies is higher in obese individuals compared to normal-weight people, probably because of inadequate eating habits but also due to increased demands among overweight persons, which are underestimated by dietary reference intakes (DRI intended for the general population. We therefore evaluated the dietary micronutrient intake in obese individuals compared to a reference population and DRI recommendations. Furthermore, we determined the micronutrient status in obese subjects undergoing a standardized DRI-covering low-calorie formula diet to analyze if the DRI meet the micronutrient requirements of obese individuals. Methods In 104 subjects baseline micronutrient intake was determined by dietary record collection. A randomly assigned subgroup of subjects (n = 32 underwent a standardized DRI-covering low-calorie formula diet over a period of three months. Pre- and post-interventional intracellular micronutrient status in buccal mucosa cells (BMC was analyzed, as well as additional micronutrient serum concentrations in 14 of the subjects. Results Prior to dietetic intervention, nutrition was calorie-rich and micronutrient-poor. Baseline deficiencies in serum concentrations were observed for 25-hydroxyvitamin-D, vitamin C, selenium, iron, as well as ß-carotene, vitamin C, and lycopene in BMC. After a three-month period of formula diet even more subjects had reduced micronutrient levels of vitamin C (serum, BMC, zinc, and lycopene. There was a significant negative correlation between lipophilic serum vitamin concentrations and body fat, as well as between iron and C-reactive protein. Conclusions The present pilot study shows that micronutrient deficiency occurring in obese individuals is not corrected by protein-rich formula diet containing vitamins and minerals according to DRI. In contrast, micronutrient levels remain low or become even lower, which might be explained by insufficient

  6. Use of an antimicrobial skin sealant reduces surgical site infection in patients undergoing routine cardiac surgery.

    Science.gov (United States)

    Dohmen, Pascal M; Weymann, Alexander; Holinski, Sebastian; Linneweber, Jörg; Geyer, Torsten; Konertz, Wolfgang

    2011-12-01

    With high morbidity and potentially devastating consequences, surgical site infections (SSIs) after cardiac surgery add substantially to the healthcare burden. Inhibiting migration of skin microbes is likely to reduce contamination of the surgical incision by endogenous potential pathogens. We studied the effect of treatment with a cyanoacrylate-based antimicrobial skin sealant (INTEGUSEAL®) on the SSI rate in cardiac surgery patients. In a consecutive series of 910 prospective patients undergoing routine cardiac surgery, standard pre-operative preparation was performed on 721 patients of whom 189 also received antimicrobial skin sealant. A further 189 consecutive patients who received only standard pre-operative care were studied retrospectively. The primary study endpoint was occurrence of superficial or deep SSI according to the definitions of the U.S. Centers for Disease Control and Prevention. The mean (standard deviation) SSI risk score based on combined pre-operative and intra-operative factors according to the Society of Thoracic Surgeons risk scoring system was significantly higher for the skin sealant group (9.1±1.0) than for the prospective (7.1±3.2; pantimicrobial skin sealant decreased the incidence of SSI in cardiac surgery patients.

  7. THE OCCURRENCE OF HIGH-LEVELS OF ACUTE BEHAVIORAL DISTRESS IN CHILDREN AND ADOLESCENTS UNDERGOING ROUTINE VENIPUNCTURES

    NARCIS (Netherlands)

    HUMPHREY, GB; BOON, CMJ; VANDENHEUVELL, GFECV; VANDEWIEL, HBM

    While there is no question that children dislike needles, there are very little data available on the occurrence of high levels of distress experienced by children undergoing routine venipunctures. To provide some insight into this problem, trained observers evaluated distress in 223 different

  8. Usefulness of the hepatitis C virus core antigen assay for screening of a population undergoing routine medical checkup.

    Science.gov (United States)

    Gaudy, Catherine; Thevenas, Catherine; Tichet, Jean; Mariotte, Nicole; Goudeau, Alain; Dubois, Frédéric

    2005-04-01

    We studied the usefulness of the recently designed Trak-C assay for the detection and quantification of the hepatitis C virus (HCV) core antigen (Ag) for the screening of HCV infection in 4,201 subjects selected from 74,150 consecutive volunteers undergoing routine medical checkups. Subjects were selected for screening because they had risk factors (group II, n = 321) and/or elevated alanine transaminase activity (group I, n = 3847). Initially, the anti-HCV antibody assay and the Trak-C assay were performed on each patient. Subsequently, the Trak-C assay was performed only when the anti-HCV enzyme immune assay (EIA) was positive. Positive samples were further evaluated for anti-HCV antibodies by a third-generation strip immunoblot assay and for HCV RNA. Four samples (1.2%) from group II and 113 (2.9%) from group I were anti-HCV EIA positive. We also tested 33 subjects who previously tested positive for anti-HCV in our medical center. Among the 150 anti-HCV EIA-positive samples, the HCV core Ag result was in accord with the HCV RNA result in 146 cases (97.3%). When the EIA result was positive, the HCV core Ag concentration and the HCV RNA load were correlated (r(2) = 0.78; P < 0.001). Four samples with low viral loads were Trak-C negative but HCV RNA positive. Among the 2,395 anti-HCV EIA-negative serum samples collected during the first part of the study, 17 (0.7%) were found to contain very low levels of HCV core Ag (<8.5 pg/ml, the cutoff value being 1.5 pg/ml). All these samples were HCV RNA negative and considered to be false positives. This was confirmed by HCV core Ag neutralization analysis. The HCV core Ag assay is a useful method in the screening strategy of HCV infection and provides a reliable means of distinguishing between current and cleared HCV infections that is well correlated with HCV RNA testing.

  9. Influences of Affect Associated with Routine Out-of-Home Activities on Subjective Well-Being

    NARCIS (Netherlands)

    Jacobson Bergstad, C.J.; Gamble, A.; Hagman, O.; Polk, M.; Gärling, T.; Ettema, D.F.; Friman, M.; Olsson, L.E.

    2012-01-01

    A survey of a random sample of 1,330 Swedish residents assessed the relationships between affect associated with performance of routine out-of-home activities, mood, and judgments of life satisfaction (cognitive subjective wellbeing, CSWB). Regression analyses showed that sociodemographic

  10. Value of routine transition zone biopsies in patients undergoing ultrasound-guided sextant biopsies for the first time.

    Science.gov (United States)

    Morote, J; López, M; Encabo, G; de Torres, I

    1999-04-01

    To analyze the efficacy of routine transition zone biopsies in patients undergoing ultrasound-guided sextant biopsies for the first time because of a suspicious digital rectal examination (DRE) or an elevated serum prostate-specific antigen (PSA) level. During sextant prostatic biopsy two additional transition zone biopsies were performed in 164 consecutive patients: in 98 because of a serum PSA of >4.0 ng/ml, and in 66 because of a suspicious DRE. The overall cancer detection rate was 46.9% (77/164). In 28 patients (36.4%) cancer was only detected in the peripheral zone, in 2 (2.6%) only in the transition zone and in 47 (61%) in both zones. Routine transition zone biopsies performed at the time of a first sextant biopsy seem to have low efficacy.

  11. Are routine pre-operative blood tests required in children undergoing primary cleft lip and/or palate repair?

    Science.gov (United States)

    Eley, Karen A; Goodacre, T E

    2010-06-01

    Primary surgical repair of cleft lip and/or palate is performed before 9 months of age, often representing the first surgical intervention these children encounter. Obtaining pre-operative blood tests in young children often produces much anxiety for all involved. We reviewed the electronic data of 282 children over a five-year period undergoing primary cleft repairs to determine the value of pre-operative full blood count, and transfusion requirements. Of these, three children required post-operative blood transfusion. In two cases concurrent illness contributed to transfusion requirement. To determine if our findings were consistent with those at other Cleft Centres, the views of primary cleft surgeons in the UK and Ireland were obtained using a questionnaire. A 96% response rate was achieved. The majority of cleft surgeons stated they no longer request routine pre-operative blood tests. Few could recall any of their patients requiring transfusion, and in those that did there was an underlying medical condition contributing to transfusion requirement, and an equal number whom could not have been predicted pre-operatively. The benefit of obtaining routine full blood count and group and save in children undergoing cleft repair is small in comparison to the stress caused from obtaining these bloods, and has significant cost implications to the Health Service. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Routine pre-operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures

    DEFF Research Database (Denmark)

    Bøtker, M T; Vang, M L; Grøfte, T

    2014-01-01

    was recorded, and subsequent changes in the anesthesia technique or supportive actions were registered. Results A total of 112 patients scheduled for urgent surgical procedures were included. Their mean age (standard deviation) was 62 (21) years. Of these patients, 24% were American Society...... of Anesthesiologists (ASA) class 1, 39% were ASA class 2, 32% were ASA class 3, and 4% were ASA class 4. Unexpected cardiopulmonary pathology was disclosed in 27% [95% confidence interval (CI) 19–36] of the patients and led to a change in anesthesia technique or supportive actions in 43% (95% CI 25–63) of these....... Unexpected pathology leading to changes in anesthesia technique or supportive actions was only disclosed in a group of patients above the age of 60 years and/or in ASA class ≥ 3. Conclusion Focused cardiopulmonary ultrasonography disclosed unexpected pathology in patients undergoing urgent surgical...

  13. Does routine symptom screening with ESAS decrease ED visits in breast cancer patients undergoing adjuvant chemotherapy?

    Science.gov (United States)

    Barbera, L; Sutradhar, R; Howell, D; Sussman, J; Seow, H; Dudgeon, D; Atzema, C; Earle, C; Husain, A; Liu, Y; Krzyzanowska, M K

    2015-10-01

    In 2007, the provincial cancer agency in Ontario, Canada initiated a wide-scale program to screen for symptoms in the cancer population using the Edmonton Symptom Assessment Scale (ESAS). The purpose of this study is to evaluate the impact of screening with ESAS on emergency department (ED) visit rates in women with breast cancer receiving adjuvant chemotherapy. This retrospective cohort study used linked administrative health care data from across the province of Ontario, Canada. The cohort included all women aged ≥18 who were diagnosed with stage I-III breast cancer between January 2007 and December 2009 and received adjuvant chemotherapy within 6 months of diagnosis. Using an adjusted recurrent event model, we examined the association of screening with ESAS at a clinic visit on the ED visit rate. The relative rate of ED visits was 0.57 when prior ESAS screening occurred compared to when it did not. The relative rate of ED visits was 0.83 when the prior number of ESAS screens was modeled as a continuous variable. Alternatively stated, the rate of ED visits was 43 % lower among patients previously screened with ESAS compared to those not previously screened. For each additional prior ESAS assessment, there was a 17 % decreased rate of ED visits. Our results demonstrate that screening with ESAS is associated with decreased ED visits. To our knowledge, this is the first report on the effectiveness of routinely documenting a patient reported outcome on ED visits, in a real-world setting.

  14. Development of the Horse Grimace Scale (HGS) as a Pain Assessment Tool in Horses Undergoing Routine Castration

    Science.gov (United States)

    Dalla Costa, Emanuela; Minero, Michela; Lebelt, Dirk; Stucke, Diana; Canali, Elisabetta; Leach, Matthew C.

    2014-01-01

    Background The assessment of pain is critical for the welfare of horses, in particular when pain is induced by common management procedures such as castration. Existing pain assessment methods have several limitations, which reduce the applicability in everyday life. Assessment of facial expression changes, as a novel means of pain scoring, may offer numerous advantages and overcome some of these limitations. The objective of this study was to develop and validate a standardised pain scale based on facial expressions in horses (Horse Grimace Scale [HGS]). Methodology/Principal Findings Forty stallions were assigned to one of two treatments and all animals underwent routine surgical castration under general anaesthesia. Group A (n = 19) received a single injection of Flunixin immediately before anaesthesia. Group B (n = 21) received Flunixin immediately before anaesthesia and then again, as an oral administration, six hours after the surgery. In addition, six horses were used as anaesthesia controls (C). These animals underwent non-invasive, indolent procedures, received the same treatment as group A, but did not undergo surgical procedures that could be accompanied with surgical pain. Changes in behaviour, composite pain scale (CPS) scores and horse grimace scale (HGS) scores were assessed before and 8-hours post-procedure. Only horses undergoing castration (Groups A and B) showed significantly greater HGS and CPS scores at 8-hours post compared to pre operatively. Further, maintenance behaviours such as explorative behaviour and alertness were also reduced. No difference was observed between the two analgesic treatment groups. Conclusions The Horse Grimace Scale potentially offers an effective and reliable method of assessing pain following routine castration in horses. However, auxiliary studies are required to evaluate different painful conditions and analgesic schedules. PMID:24647606

  15. Development of the Horse Grimace Scale (HGS as a pain assessment tool in horses undergoing routine castration.

    Directory of Open Access Journals (Sweden)

    Emanuela Dalla Costa

    Full Text Available BACKGROUND: The assessment of pain is critical for the welfare of horses, in particular when pain is induced by common management procedures such as castration. Existing pain assessment methods have several limitations, which reduce the applicability in everyday life. Assessment of facial expression changes, as a novel means of pain scoring, may offer numerous advantages and overcome some of these limitations. The objective of this study was to develop and validate a standardised pain scale based on facial expressions in horses (Horse Grimace Scale [HGS]. METHODOLOGY/PRINCIPAL FINDINGS: Forty stallions were assigned to one of two treatments and all animals underwent routine surgical castration under general anaesthesia. Group A (n = 19 received a single injection of Flunixin immediately before anaesthesia. Group B (n = 21 received Flunixin immediately before anaesthesia and then again, as an oral administration, six hours after the surgery. In addition, six horses were used as anaesthesia controls (C. These animals underwent non-invasive, indolent procedures, received the same treatment as group A, but did not undergo surgical procedures that could be accompanied with surgical pain. Changes in behaviour, composite pain scale (CPS scores and horse grimace scale (HGS scores were assessed before and 8-hours post-procedure. Only horses undergoing castration (Groups A and B showed significantly greater HGS and CPS scores at 8-hours post compared to pre operatively. Further, maintenance behaviours such as explorative behaviour and alertness were also reduced. No difference was observed between the two analgesic treatment groups. CONCLUSIONS: The Horse Grimace Scale potentially offers an effective and reliable method of assessing pain following routine castration in horses. However, auxiliary studies are required to evaluate different painful conditions and analgesic schedules.

  16. Role of routine pre-operative screening venous duplex ultrasound in morbidly obese patients undergoing bariatric surgery

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    P Praveen Raj

    2017-01-01

    Full Text Available Background/Aims: It is well established that obesity is a strongly associated risk factor for post-operative deep vein thrombosis (DVT. Physical effects and pro-thrombotic, pro-inflammatory and hypofibrinolytic effects of severe obesity may predispose to idiopathic DVT (pre-operatively because of which bariatric patients are routinely screened before surgery. The aim of this study was to audit the use of routine screening venous duplex ultrasound in morbidly obese patients before undergoing bariatric surgery. Methods: We retrospectively reviewed 180 patients who underwent bariatric surgery from August 2013 to August 2014 who had undergone pre-operative screening bilateral lower-extremity venous duplex ultrasound for DVT. Data were collected on patient's demographics, history of venous thromboembolism, prior surgeries and duplex ultrasound details of the status of the deep veins and superficial veins of the lower limbs. Results: No patients had symptoms or signs of DVT pre-operatively. No patient gave history of DVT. No patient was found to have iliac, femoral or popliteal vein thrombosis. Superficial venous disease was found in 17 (8%. One patient had a right lower limb venous ulcer. Conclusion: Thromboembolic problems in the morbidly obese before bariatric surgery are infrequent, and screening venous duplex ultrasound can be done in high-risk patients only.

  17. Esophageal polyps in pediatric patients undergoing routine diagnostic upper gastrointestinal endoscopy: a multicenter study.

    Science.gov (United States)

    Septer, S; Cuffari, C; Attard, T M

    2014-01-01

    Esophageal polyps are uncommon findings in pediatric patients, and reports have been limited to case reports. Esophageal polyps have been previously ascribed to esophagitis secondary to gastroesophageal reflux, medications, infections and recurrent vomiting. They have been associated with underlying conditions such as hiatal hernia, Barrett's esophagus, eosinophilic esophagitis and Crohn's disease. Presenting complaints of children with esophageal polyps have included vomiting, dysphagia, hematemesis and abdominal pain. The aim of this paper is to characterize the incidence, clinical presentation and progression, histologic subtypes and associated mucosal abnormalities in children with esophageal polyps. A retrospective multicenter study was performed at four institutions identifying diagnosis of esophageal polyps in pediatric patients (polyps were identified in 13 patients (9 M) from 9438 esophagogastroduodenoscopies (0.14%). Mean age of subjects was 9.2 years. Vomiting was the most common indication for endoscopy. Polyp location was at the gastroesophageal junction in 7 of the 13 cases. Most polyps were inflammatory (n = 7). Esophagitis was noted in 69% of those with esophageal polyps. Repeat endoscopies in six patients at a mean interval of 8 months noted persistence of polyps in all six patients. This paper is the first to characterize esophageal polyps in pediatrics. These polyps are rare in children and often are associated with esophagitis. Presenting complaints seem to vary by age. Polyps did not consistently change with either time or acid suppression. The optimal management strategy has yet to be defined and likely depends on the underlying pathophysiologic process. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  18. Evaluation of perioperative nutritional status with subjective global assessment method in patients undergoing gastrointestinal cancer surgery.

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    Erdim, Aylin; Aktan, Ahmet Özdemir

    2017-01-01

    This study was designed to evaluate the perioperative nutritional status of patients undergoing surgery for gastrointestinal cancer using Subjective Global Assessment and surgeon behavior on nutritional support. We recruited 100 patients undergoing surgery for gastrointestinal cancer in one university and two state teaching hospitals. Subjective Global Assessment was administered to evaluate preoperative and postoperative nutritional status. Fifty-two patients in the state hospitals (Group 1) and 48 in the university hospital were assessed. Anthropometric and biochemical measurements were performed. Changes in preoperative Subjective Global Assessment scores and scores at the time of discharge and types of nutritional support were compared. Subjective Global Assessment-B was regarded as moderate and Subjective Global Assessment-C as heavy malnutrition. Ten patients had Subjective Global Assessment-B and 29 had Subjective Global Assessment-C malnutrition in Group 1 and nine had Subjective Global Assessment-B and 31 had Subjective Global Assessment-C malnutrition in Group 2 during preoperative assessment. Respective numbers in postoperative assessment were 12 for Subjective Global Assessment-B and 30 for Subjective Global Assessment-C in Group 1 and 14 for Subjective Global Assessment-B and 26 for Subjective Global Assessment-C in Group 2. There was no difference between two groups. Nutritional methods according to Subjective Global Assessment evaluation in pre- and postoperative periods were not different between the groups. This study demonstrated that the malnutrition rate is high among patients scheduled for gastrointestinal cancer surgery and the number of surgeons were inadequate to provide perioperative nutritional support. Both university and state hospitals had similar shortcomings. Subjective Global Assessment is an easy and reliable test and if utilized will be helpful to detect patients requiring nutritional support.

  19. Physical after-effects in men undergoing prostate biopsy in routine clinical practice: Results from the PiCTure study.

    Science.gov (United States)

    Morgan, Eileen; Drummond, Frances J; Coyle, Catherine; Sharp, Linda; Gavin, Anna T

    2017-10-01

    As the incidence of prostate cancer has, until recently, increased in most developed countries, the rates of prostate biopsies, required for histological diagnosis, will also have increased. Little is known about the physical after-effects of prostate biopsy outside randomised control trials. We investigate reports on the physical effect of prostate biopsy undertaken in men in routine practice. A self-completed questionnaire was given to men living in the Republic of Ireland (RoI) or Northern Ireland 4 to 6 weeks after prostate biopsy. Men were asked about whether they experienced specific physical after-effects postbiopsy (raised temperature/pain/bleeding/erectile dysfunction/urinary retention) and, if so, their severity and duration, and any associated health care uses. Binomial and ordinal logistic regression was used to investigate factors associated with postbiopsy after-effects (presence/absence) and number of after-effects reported, respectively. Postbiopsy after-effects were common with 88.1% of 335 respondents reporting at least 1 after-effect; 21% reported at least 3. The odds of increasing number of after-effects was over 2-fold in men with both intermediate (odds ratio [OR] = 2.59, 95% CI: 1.52-4.42) and high (OR = 2.52, 95% CI: 1.28-4.94) levels of health anxiety and for men who had had multiple previous biopsies (adjusted OR = 2.02, 95% CI: 1.20-3.41). A total of 21.3% of men who experienced after-effects reported that they were worse than expected, 11.5% with after-effects reported contacting their doctor or local pharmacy, 14.6% contacted hospital services, and 3.1% of men with after-effects were admitted to hospital with an average stay of 5.4 nights (standard deviation = 6.3). Physical after-effects following prostate biopsy in routine practice are common, and in some men, serious enough to warrant contacting hospital or community services. Men with increased health anxiety or who undergo multiple biopsies might benefit from additional support

  20. Airway management in head and neck cancer patients undergoing microvascular free tissue transfer: delayed extubation as an alternative to routine tracheotomy.

    Science.gov (United States)

    Meerwein, Christian; Pézier, Thomas F; Beck-Schimmer, Beatrice; Schmid, Stephan; Huber, Gerhard F

    2014-03-07

    The aim of this study was to evaluate two practices of airway management in patients undergoing head and neck cancer (HNC) resection and microvascular free tissue transfer (MFTT), and to assess the advantages and disadvantages of the two approaches. Patients undergoing a delayed extubation approach (NO-TRACH group) and patients undergoing primary tracheotomy (PRIM-TRACH group) were retrospectively evaluated in terms of perioperative and postoperative outcome measures. Not performing routine tracheotomy was safe and no perioperative airway complications occurred. NO-TRACH patients were extubated after 1.1 ± 0.9 days (mean ± standard deviation) and secondary tracheotomy was necessary in three patients (13%). NO-TRACH patients revealed decreased duration of surgery (p tracheotomy.

  1. Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment

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    Fabricio Batistin Zanatta

    2014-06-01

    Full Text Available OBJECTIVE: The aim of this study was to investigate the association among gingival enlargement (GE, periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. METHODS: A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. RESULTS: The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01 and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03 were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. CONCLUSION: Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment.

  2. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study.

    Science.gov (United States)

    Zhang, Lin; Zhang, Wei; Zhang, Lingling; Tian, Danping; Li, Li; Deng, Xin; Deng, Jing; Ning, Peishan; Hu, Guoqing

    2016-06-23

    Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Data came from the first health service household interview of Hunan province, China, in 2013. A Rao-Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45-64 years, 46%; 18-44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1-3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7-6.5) for young adults aged 18-44 years. The associations were not statistically significant for age groups 45-64 years and 65 years or older. The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

  3. Usefulness of Routine Periodic Fasting to Lower Risk of Coronary Artery Disease among Patients Undergoing Coronary Angiography

    Science.gov (United States)

    Horne, Benjamin D.; May, Heidi T.; Anderson, Jeffrey L.; Kfoury, Abdallah G.; Bailey, Beau M.; McClure, Brian S.; Renlund, Dale G.; Lappé, Donald L.; Carlquist, John F.; Fisher, Patrick W.; Pearson, Robert R.; Bair, Tami L.; Adams, Ted D.; Muhlestein, Joseph B.

    2008-01-01

    Coronary artery disease (CAD) is common and multi-factorial. Members of the Church of Jesus Christ of Latter-day Saints (LDS, or Mormons) in Utah may have lower cardiac mortality than other Utahns and the US population. While the LDS proscription of smoking likely contributes to lower cardiac risk, it is unknown whether other shared behaviors also contribute. This study evaluated potential CAD-associated effects of fasting. Patients (N1=4,629) enrolled in the Intermountain Heart Collaborative Study registry (1994-2002) were evaluated for association of religious preference with CAD diagnosis (≥70% coronary stenosis on angiography) or no CAD (normal coronaries, <10% stenosis). Consequently, another set of patients (N2=448) were surveyed (2004-2006) for association of behavioral factors with CAD, with the primary variable being routine fasting (i.e., abstinence from food and drink). Secondary survey measures included proscription of alcohol, tea, and coffee, social support, and religious worship patterns. In population 1 (initial), 61% of LDS and 66% of all others had CAD (adjusted [including for smoking]: odds ratio [OR]=0.81; p=0.009). In population 2 (survey), fasting was associated with lower risk of CAD (64% vs. 76% CAD; OR=0.55, CI=0.35, 0.87; p=0.010) and this remained after adjustment for traditional risk factors (OR=0.46, CI=0.27, 0.81; p=0.007). Fasting was also associated with lower diabetes prevalence (p=0.048). In regression models entering other secondary behavioral measures, fasting remained significant with similar effect size. In conclusion, not only proscription of tobacco, but also routine periodic fasting was associated with lower risk of CAD. PMID:18805103

  4. Comparison of the Effect of the Routine Bowel Preparation and Use of Oral Sodium Phosphate on Acceptance and Bowel Cleansing in Patients Undergoing Colonoscopy: A Randomize Clinical Trial

    Directory of Open Access Journals (Sweden)

    Ghanbari A.

    2010-06-01

    Full Text Available Background and Objectives: Treatment team perform a variety of practices in the fields of treatment and caring. The main domain of nursing practice is to prepare patients for diagnostic tests. Colonoscopy is a method of endoscopy of lower gastrointestinal system which needs proper colon preparation that allows proper assessment, diagnosis and positive treatment. Currently, there are different methods of bowel preparation. Therefore more research by a clinical nurse on this can result in better care. This study was aimed at comparing the routine method (caster oil and bisacodyl tablet and oral sodium phosphate on the level of patients’ acceptance and bowel cleansing in patients undergoing colonoscopy.Methods: The study was a one-blind controlled randomized clinical trial done on 90 outpatient candidates for colonoscopy referring to Razi Training Center in Rasht city. Samples were randomly chosen on the visit day and divided to 2 groups of experiment and control. Data collection instrument included a demographic questionnaire and checklist to assess the level of patients’ acceptance and bowel preparation. Primarily demographic data form for each patient was filled, and then intervention was done for two groups with 45 samples. During the process the acceptance form was filled by the researcher by asking the patient and also the check list on the residual stool score and global preparation assessment left was marked by colonoscopist and the nurse.Results: The findings indicated that patients’ acceptance (p<0.000 and the level of bowel preparation (p<0.000 was better with oral sodium phosphate. Conclusion: According to the results result oral sodium phosphate has better acceptance and is more effective on colon cleansing prior to colonoscopy when compared with routine regime (caster oil and bisacodyl tablet.Keywords: Oral Sodium Phosphate; Colonoscopy; Bowel Preparation; Colonic Diseases; Intestines; A Randomize Clinical Trial.

  5. Clearance and synthesis rates of beta 2-microglobulin in patients undergoing hemodialysis and in normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Floege, J.; Bartsch, A.; Schulze, M.; Shaldon, S.; Koch, K.M.; Smeby, L.C. (Department of Nephrology, University Hospital of Hannover (Germany))

    1991-08-01

    Retention of {beta} 2-microglobulin in patients undergoing hemodialysis is associated with a {beta} 2-microglobulin-derived amyloidosis. Removal of {beta} 2-microglobulin by renal replacement therapy has been proposed for the prevention of this amyloidosis. Currently, however, data on the {beta} 2-microglobulin synthesis rate in patients undergoing hemodialysis are scarce, and consequently it remains speculative how much removal would be necessary to counterbalance synthesis. The plasma kinetics of iodine 131-labeled {beta} 2-microglobulin were therefore examined in 11 patients with anuria who were undergoing long-term hemodialysis. Five healthy persons served as controls. Kinetic modeling of the plasma curves showed that the data fitted a two-pool model (r2 greater than 0.96) consisting of a rapid 2 to 4 hour distribution phase followed by a less steep curve, described by the plasma (metabolic) clearance (Clp). Synthetic rates were calculated from Clp and the {beta} 2-microglobulin steady state plasma concentration (plus {beta} 2-microglobulin removal during hemodialysis in the case of high flux hemodialysis). The results showed a significantly higher Clp in normal controls as compared with patients undergoing hemodialysis (65.5 {plus minus} 12.8 ml/min (mean {plus minus} SD) versus 3.4 {plus minus} 0.7 ml/min). In contrast, the {beta} 2-microglobulin synthesis rate in the patient group (3.10 {plus minus} 0.79 mg/kg/day) was not significantly different from that of normal controls (2.40 {plus minus} 0.67 mg/kg/day), which was due to markedly elevated {beta} 2-microglobulin plasma concentrations in the patients (37.6 {plus minus} 14.1 mg/L vs 1.92 {plus minus} 0.27 mg/L). These findings suggest that the presence of end-stage renal disease does not have a significant impact on the beta 2-microglobulin generation rate.

  6. Subjective evaluation of uncorrected vision in patients undergoing cataract surgery with (diffractive multifocal lenses and monovision

    Directory of Open Access Journals (Sweden)

    Stock RA

    2017-07-01

    Full Text Available Ricardo Alexandre Stock, Thaís Thumé, Luan Gabriel Paese, Elcio Luiz Bonamigo Universidade do Oeste de Santa Catarina, Rua Getúlio Vargas, Joaçaba, Santa Catarina, Brazil Purpose: To analyze patient satisfaction and difficulties with bilateral multifocal intraocular lenses (IOLs implantation and aspheric monofocal IOLs implantation using monovision, after cataract surgery.Materials and methods: A total of 61 participants were included in the study, 29 with monovision and 32 with multifocal lenses. The inclusion criteria were patients undergoing phacoemulsification for bilateral visual impairment due to cataracts and presenting with postoperative visual acuity of 20/30 or better for distance and line J3 or better for near vision.Results: The 2 groups had similar results regarding difficulties with daily activities such as distance vision, near vision, watching television, reading, cooking, using a computer or cellphone, shaving/putting on makeup and shopping. There were differences in responses between the groups regarding difficulty with night vision (P=0.0565 and night driving (P=0.0291. Degree of satisfaction in terms of distance vision without glasses was statistically significantly better in monovision group (P=0.0332, but not for near (P=0.9101.Conclusion: Both techniques yielded satisfactory results regarding visual acuity for different activities without the need to use glasses. Multifocal lenses are a good option for patients with the exception of night driving, and who desire independence from glasses. Keywords: cataract extraction, aphakia, postcataract, patient satisfaction, night vision

  7. Attitudes, subjective norms, and intention to perform routine oral examination for oropharyngeal candidiasis as perceived by primary health-care providers in Nairobi Province

    NARCIS (Netherlands)

    Koyio, L.N.; Kikwilu, E.N.; Mulder, J.; Frencken, J.E.F.M.

    2013-01-01

    Objectives: To assess attitudes, subjective norms, and intentions of primary health-care (PHC) providers in performing routine oral examination for oropharyngeal candidiasis (OPC) during outpatient consultations. Methods: A 47-item Theory of Planned Behaviour-based questionnaire was developed and

  8. Attitudes, subjective norms, and intention to perform routine oral examination for oropharyngeal candidiasis as perceived by primary health-care providers in Nairobi Province.

    Science.gov (United States)

    Koyio, Lucina N; Kikwilu, Emil; Mulder, Jan; Frencken, Jo E

    2013-01-01

    To assess attitudes, subjective norms, and intentions of primary health-care (PHC) providers in performing routine oral examination for oropharyngeal candidiasis (OPC) during outpatient consultations. A 47-item Theory of Planned Behaviour-based questionnaire was developed and administered, in a cross-sectional survey, to 216 PHC providers (clinical officers and nurses) working in 54 clinics, dispensaries, and health centers in Nairobi Province in January 2010. The constructs - attitudes, subjective norms, and perceived behavioral control (dependent variables) - and their individual indirect (direct) items were analyzed for scores, internal validity, independent variables (district, gender, years of service, profession, and age), and contribution to intentions. Perceived behavioral control had low construct validity and was therefore removed from subsequent analyses. The questionnaire was completed by 195 participants (90 percent response rate). PHC provider's attitudes, subjective norms, and intentions to perform an oral examination during outpatient consultations were highly positive, with mean scores of 6.30 (0.82), 6.06 (1.07), and 5.6 (1.33), respectively, regardless of sociodemographic characteristics. Indirect attitude and subjective norms were strongly correlated to their individual items (r=0.63-0.79, Psubjective norms (P<0.0001) were both predictive of intentions. PHC providers were willing to integrate patients' oral health care into their routine medical consultations. Emphasizing the importance of detecting other oral problems and of the fact that routine oral examination for OPC is likely to give patients' fulfillment will enhance PHC providers' morale in performing routine oral examinations. Winning support from policy makers, their supervisors, specialists, and colleagues is important for motivating PHC providers to perform routine oral examinations for OPC at their workplaces. © 2012 American Association of Public Health Dentistry.

  9. Subjective well-being, body image, and functional capacity in people candidate for or undergoing bariatric surgery

    Directory of Open Access Journals (Sweden)

    Mayra Juliana Galvis-Aparicio

    2017-07-01

    Full Text Available This paper presents two studies that aimed (1 at assessing and comparing the subjective well-being (SWB, and functional capacity and body image of people with morbid obesity, candidate for or undergoing bariatric surgery (BS, and (2 at identifying the relationship among the components of SWB, BMI, functional capacity, and body image. The sample was composed by 48 patients in pre-surgery period, and 29 in post-surgery. Instruments used were the Life Satisfaction Scale, the Positive and Negative Affect Scale, WHODAS 2.0, the Brazilian scale of figures and silhouettes, and thebateria fatorial da personalidade. Statistically significant differences were found between both groups in all the variables, except positive affect, comprehension and communication, and relationships with others. FC was correlated to all the components of SWB and contributed to explaining the variance of life satisfaction and negative affect. Personality traits turned out to be more important than other variables for explaining the variance of positive affect.

  10. Citation analysis with medical subject Headings (MeSH) using the Web of Knowledge: A new routine

    NARCIS (Netherlands)

    Leydesdorff, L.; Opthof, T.

    2013-01-01

    Citation analysis of documents retrieved from the Medline database (at the Web of Knowledge) has been possible only on a case-by-case basis. A technique is presented here for citation analysis in batch mode using both Medical Subject Headings (MeSH) at the Web of Knowledge and the Science Citation

  11. Preliminary experience comparing routine cytology results with the composite results of digital image analysis and fluorescence in situ hybridization in patients undergoing EUS-guided FNA.

    Science.gov (United States)

    Levy, Michael J; Clain, Jonathan E; Clayton, Amy; Halling, Kevin C; Kipp, Benjamin R; Rajan, Elizabeth; Roberts, Lewis R; Root, Renee M; Sebo, Thomas J; Topazian, Mark D; Wang, Kenneth K; Wiersema, Maurits J; Gores, Gregory J

    2007-09-01

    Studies indicate enhanced diagnostic accuracy for digital image analysis (DIA) and fluorescence in situ hybridization (FISH) versus routine cytology examination (RC) when biliary strictures are evaluated. These tumor markers have not been applied to EUS-guided FNA. Our purpose was to determine the accuracy of RC versus the composite results of DIA/FISH. Patients enrolled with known or suspected malignancy. The final diagnosis was based on strict cytopathologic and imaging criteria and 12-month follow-up. Tertiary referral center. A total of 39 patients were enrolled in whom each diagnostic test was performed on samples from 42 sites to evaluate lymphadenopathy (n=19), pancreatic mass (n=19), esophageal or gastric wall mass (n=3), and thyroid mass (n=1). EUS-guided FNA with RC, DIA, and FISH. Diagnostic accuracy of RC, DIA, and FISH. Malignancy was diagnosed in 30 of 42 patients, including esophageal squamous cell carcinoma, esophageal adenocarcinoma, gastric adenocarcinoma, pancreatic adenocarcinoma, pancreatic mucinous cystic neoplasia, intraductal papillary mucinous neoplasia, metastatic forearm sarcoma, small cell and non-small cell lung cancer, thyroid carcinoma, malignant GI stromal tumor, melanoma, adenocarcinoma of unknown primary, and lymphoma. The sensitivity, specificity, and accuracy of DIA/FISH versus RC for detecting malignancy were 97%, 100%, and 98% versus 87%, 100%, and 90%, respectively. Single-center pilot study. Our findings suggest that DIA and FISH processing of EUS-guided FNA specimens provides higher diagnostic accuracy than RC does. These data suggest that these tumor markers incorporate generic targets as suggested by the high diagnostic sensitivity in this patient cohort with diverse pathologic conditions.

  12. Intelligent Routines

    CERN Document Server

    Anastassiou, George A

    “Intelligent Routines II: Solving Linear Algebra and Differential Geometry with Sage” contains numerous of examples and problems as well as many unsolved problems. This book extensively applies the successful software Sage, which can be found free online http://www.sagemath.org/. Sage is a recent and popular software for mathematical computation, available freely and simple to use. This book is useful to all applied scientists in mathematics, statistics and engineering, as well for late undergraduate and graduate students of above subjects. It is the first such book in solving symbolically with Sage problems in Linear Algebra and Differential Geometry. Plenty of SAGE applications are given at each step of the exposition.

  13. Weight loss approach during routine follow-up is effective for obstructive sleep apnea hypopnea syndrome subjects receiving nasal continuous positive airway pressure treatment.

    Science.gov (United States)

    Fujii, Hiroko; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Muto, Takashi

    2010-01-01

    The present study investigated the effectiveness of a weight loss program during routine medical follow-up with regularity on promoting weight reduction in obese obstructive sleep apnea hypopnea syndrome (OSAHS) subjects receiving continuous positive airway pressure treatment (CPAP). A total of 10 male obese OSAHS subjects treated with CPAP were enrolled in the present study that was an intervention study without a control and had a pre-post test study design. The age was 50.7 (7.8) (mean (SD)) years, and body mass index was 30.7 (2.5) kg/m(2). A 4-month weight loss program was developed, using a combined approach of diet and physical activity based on individual counseling with behavioral approach. At 4 months, weight was significantly decreased compared with the baseline value (88.4 (8.9) kg to 86.9 (8.8) kg, p=0.005), and the mean weight loss was a 1.7% decrease from the baseline. There was significantly higher percent weight loss in the group with a CPAP duration or = 30 months (2.7 (1.6) % vs. 0.6 (0.5) %, p=0.032). The present study shows that a weight loss program may be useful in reducing weight for male obese OSAHS subjects treated with CPAP.

  14. Study of dosimetric quantities applied to patient undergoing routine chest examinations by computed tomography; Estudo de grandezas dosimetricas aplicadas em pacientes submetidos a exames de torax rotina em tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Gonzaga, Natalia Barbosa

    2012-07-01

    The radiological protection system has established a standard to protect persons against the harmful effects caused by ionizing radiation that is based on the justification, optimization and dose limitation principles. The increasing use of radiation in medicine and the related risks have stressed the discussion on patient radiation protection. The computed tomography (CT) is the diagnostic radiology technique that most contributes to patient doses and it requires optimization efforts. Diagnostic reference levels (DRL) has been established in many countries in terms of CT dosimetric quantities; in Brazil, the DRLs are still under investigation since the culture of patient protection is not very strong yet. The objective of this work was to investigate the dosimetric and protection quantities related to patients undergoing CT routine chest examinations. The ImPACT CT, CT Expo and ImpactDose softwares were used for calculations of the weight and volumetric air-kerma indexes (CW and CVOL), the air kerma - length product (P{sub K,L}), organ equivalent dose (H{sub T}) and the effective dose (E) for CT routine chest protocols in 19 tomographs in Belo Horizonte city. The CT Expo was selected to be validated against experimental measurements in three hospitals with thermoluminescent dosimeters and CT pencil ionization chamber in anthropomorphic and standard CT body phantoms. Experimental and calculated results indicated differences up to 97% for H{sub T} and E and acceptable agreement for C{sub W} ,C{sub VOL} and P{sub K,L}. All data from 19 tomographs showed that local DRLs for CT routine chest examinations may be chosen smaller than DRLs adopted in other countries; this would contribute to increase the radiological protection of patients. (author)

  15. Lung cancer risk and cancer-specific mortality in subjects undergoing routine imaging test when stratified with and without identified lung nodule on imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Saez, Noemi [Miguel Hernandez University, Public Health, History of Science and Ginecology Department, Alicante (Spain); Hernandez-Aguado, Ildefonso; Pastor Valero, Maria; Parker, Lucy Anne; Lumbreras, Blanca [Miguel Hernandez University, Public Health, History of Science and Ginecology Department, Alicante (Spain); CIBER en Epidemiologia y Salud Publica, Madrid (Spain); Vilar, Jose; Domingo, Maria Luisa [Peset Hospital, Radiodiagnostic Department, Valencia (Spain); Gonzalez-Alvarez, Isabel; Lorente, Maria Fermina [San Juan Hospital, Radiodiagnostic Department, San Juan de Alicante (Spain)

    2015-12-15

    To assess the risk of lung cancer and specific mortality rate in patients with and without solitary pulmonary nodules (SPN) on chest radiograph and CT. This prospective study included 16,078 patients ≥35 years old (893 of them had an SPN detected with either chest radiograph or CT) and 15,185 without SPN. Patients were followed up for 18 months or until being diagnosed with lung cancer. Risk and mortality lung cancer were calculated in both groups with Poisson regression. In patients with SPN, incidence of lung cancer was 8.3 % (95 % CI 6.0-11.2) on radiograph and 12.4 % (95 % CI 9.3-15.9) on CT. A chronic obstructive pulmonary disease in patients with radiographs (odds ratio 2.62; 95 % CI 1.03, 6.67) and smoking habit (odds ratio 20.63; 95 % CI 3.84, 110.77) in patients with CT were associated with a higher probability of lung cancer. Large nodule size and spiculated edge were associated with lung cancer on both CT and radiograph. Lung cancer-specific mortality was lower in patients with SPN than in those without SPN (1.73/1000 person-years, 95 % CI 1.08-2.88 vs. 2.15/1000 person-years, 95 % CI 1.25-3.96). The risk of lung cancer for patients with SPN is higher in clinical populations than in screening studies. Moreover, patients with SPN showed lower mortality than those without SPN. (orig.)

  16. [Comparative analysis of the glycemic response and glycemic index of instant mashed potatoes in subjects undergoing laparoscopic sleeve gastrectomy and control subjects].

    Science.gov (United States)

    Fuentes Valdes, Gabriel; del Valle Flores, Miguel; Vega Soto, Claudia

    2014-12-01

    The laparoscopic sleeve gastrectomy (LSG) is a successful surgical procedure for morbid obesity. However, post surgery weight regain is usual, thus applying the glycemic index could promote good weight control. To compare the glycemic index (GI) and glycemic response (GR) obtained of instant mashed potatoes in individuals subjected to LSG versus control subjects. GI and GR were assessed in 10 LSG subjects and compared with 10 controls. GI methodology proposed by FAO/WHO was used; instant mashed potatoes as test food and white bread as standard food (50g available CHO). Capillary blood sample 0 (fasting), 30, 60, 90 and 120 minutes. The GI was determined by trapezoidal method. ANOVA was used to compare a factor between RG and IG groups; t-student to compare RG between foods. Statistical significance pglycemic responses in LSG group, and its consumption possibly favoring weight regain. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  17. Communication subjective assessments of patients undergoing compulsory treatment with the severity of negative symptoms and cognitive functioning level

    Directory of Open Access Journals (Sweden)

    Kabanov T.N.

    2015-04-01

    Full Text Available The article presents the results of studies on the relationship of subjective assessments of the mentally ill with the severity of negative symptoms and cognitive functioning level. The features of patients perception of various aspects of compulsory treatment and subjective satisfaction with treatment. In a study of 94 male patients with a diagnosis of organic mental disorder and schizophrenia was used diagnostic system, consisting of patopsihologicheskogo study, formal survey map, the scale of assessment of negative symptoms SANS, questionnaire symptom levels SCL-90, self-existing problems, as well as - in Test authoring tool sheet to treatment and hospital stay (VG Bulygin, Kabanov, TN, 2011. The differences in subjective assessments of aspects of compulsory treatment and social functioning of patients with varying degrees of severity of negative symptoms and dependence of subjective assessments of the level of cognitive functioning.

  18. Subjectivity

    Directory of Open Access Journals (Sweden)

    Jesús Vega Encabo

    2015-11-01

    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  19. Prevalence of airflow limitation in subjects undergoing comprehensive health examination in Japan: Survey of Chronic Obstructive pulmonary disease Patients Epidemiology in Japan

    Directory of Open Access Journals (Sweden)

    Omori H

    2016-04-01

    Full Text Available Hisamitsu Omori,1 Toshihiko Kaise,2 Takeo Suzuki,2 Gerry Hagan3 1Department of Biomedical Laboratory Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, 2Development and Medical Affairs Division, GlaxoSmithKline, Tokyo, Japan; 3Independent Consultant, Marbella, Spain Purpose: There are still evidence gaps on the prevalence of airflow limitation in Japan. The purpose of this survey was to estimate the prevalence of airflow limitation among healthy subjects in Japan and to show what proportion of subjects with airflow limitation had been diagnosed with chronic obstructive pulmonary disease (COPD.Subjects and methods: This was an observational, cross-sectional survey targeting multiple regions of Japan. Subjects aged 40 years or above who were undergoing comprehensive health examination were recruited from 14 centers in Japan. Airflow limitation was defined as having forced expiratory volume in 1 second/forced vital capacity less than 70%.Results: In a total of 22,293 subjects, airflow limitation was most prevalent in subjects aged over 60 years (8.7%, but was also observed in subjects aged 50–59 years (3.1% and 40–49 years (1.7%. Overall prevalence was 4.3%. Among subjects with smoking history (n=10,981, the prevalence of airflow limitation in each age group (12.8% in those aged over 60 years, 4.4% in those aged 50–59 years, and 2.2% in those aged 40–49 years and overall prevalence (6.1% were higher than that of total subjects. Of the smokers with airflow limitation, 9.4% had been diagnosed with COPD/emphysema and 27.3% with other respiratory diseases.Conclusion: Among smokers undergoing comprehensive health examination, prevalence of airflow limitation reached 12.8% in those aged over 60 years and airflow limitation was observed in subjects aged 40–59 years as well, though their prevalence was lower than that in subjects aged over 60 years. We demonstrated that a significant proportion of smokers with airflow limitation

  20. Prevalence of airflow limitation in subjects undergoing comprehensive health examination in Japan: Survey of Chronic Obstructive pulmonary disease Patients Epidemiology in Japan.

    Science.gov (United States)

    Omori, Hisamitsu; Kaise, Toshihiko; Suzuki, Takeo; Hagan, Gerry

    2016-01-01

    There are still evidence gaps on the prevalence of airflow limitation in Japan. The purpose of this survey was to estimate the prevalence of airflow limitation among healthy subjects in Japan and to show what proportion of subjects with airflow limitation had been diagnosed with chronic obstructive pulmonary disease (COPD). This was an observational, cross-sectional survey targeting multiple regions of Japan. Subjects aged 40 years or above who were undergoing comprehensive health examination were recruited from 14 centers in Japan. Airflow limitation was defined as having forced expiratory volume in 1 second/forced vital capacity less than 70%. In a total of 22,293 subjects, airflow limitation was most prevalent in subjects aged over 60 years (8.7%), but was also observed in subjects aged 50-59 years (3.1%) and 40-49 years (1.7%). Overall prevalence was 4.3%. Among subjects with smoking history (n=10,981), the prevalence of airflow limitation in each age group (12.8% in those aged over 60 years, 4.4% in those aged 50-59 years, and 2.2% in those aged 40-49 years) and overall prevalence (6.1%) were higher than that of total subjects. Of the smokers with airflow limitation, 9.4% had been diagnosed with COPD/emphysema and 27.3% with other respiratory diseases. Among smokers undergoing comprehensive health examination, prevalence of airflow limitation reached 12.8% in those aged over 60 years and airflow limitation was observed in subjects aged 40-59 years as well, though their prevalence was lower than that in subjects aged over 60 years. We demonstrated that a significant proportion of smokers with airflow limitation had not been diagnosed with COPD/emphysema, suggesting that some of them can be diagnosed with COPD or other respiratory diseases by a detailed examination after comprehensive health examination. Screening for subjects at risk of COPD by spirometry in comprehensive health examination starting at 40 years of age, followed by a detailed examination, may be

  1. Enteral Nutrition Is a Risk Factor for Airway Complications in Subjects Undergoing Noninvasive Ventilation for Acute Respiratory Failure.

    Science.gov (United States)

    Kogo, Mariko; Nagata, Kazuma; Morimoto, Takeshi; Ito, Jiro; Sato, Yuki; Teraoka, Shunsuke; Fujimoto, Daichi; Nakagawa, Atsushi; Otsuka, Kojiro; Tomii, Keisuke

    2017-04-01

    Early enteral nutrition is recommended for mechanically ventilated patients in several studies and guidelines. In contrast, the effects of early enteral nutrition on noninvasive ventilation (NIV) have not been investigated extensively. The lack of an established method of airway protection suggests that enteral nutrition administration to these patients could increase airway complications and worsen outcomes. Between January 2007 and January 2015, 150 patients were admitted to our respiratory department for acute respiratory failure and received NIV for >48 h. Of these, 107 subjects incapable of oral intake were retrospectively analyzed. Clinical background and complications were compared in subjects who did and did not receive enteral nutrition. Sixty of the 107 subjects (56%) incapable of oral intake who received NIV also received enteral nutrition. Serum albumin concentration was significantly lower in subjects who received enteral nutrition than in those who did not (mean 2.7 ± 0.68 mg/dL vs 3.0 ± 0.75 mg/dL, P = .048). The rate of airway complications was significantly higher (53% [32/60] vs 32% [15/47], P = .03), and median NIV duration was significantly longer (16 [interquartile range 7-43] d vs 8 [5-20] d, P = .02) in subjects who received enteral nutrition than in those who did not. Multivariate analysis showed that enteral nutrition was unrelated to in-hospital mortality. Among subjects receiving NIV, enteral nutrition was associated with increased risk of airway complications but did not affect mortality. Enteral nutrition should be carefully considered in these patients. Copyright © 2017 by Daedalus Enterprises.

  2. Normal controlled attenuation parameter values: a prospective study of healthy subjects undergoing health checkups and liver donors in Korea.

    Science.gov (United States)

    Chon, Young Eun; Jung, Kyu Sik; Kim, Kwang Joon; Joo, Dong Jin; Kim, Beom Kyung; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang-Hyub; Kim, Seung Up

    2015-01-01

    The controlled attenuation parameter (CAP) is a noninvasive method of assessing hepatic steatosis. We defined the normal range of CAP values in healthy subjects and evaluated the associated factors. CAP values were measured in a cohort of healthy subjects who were screened as living liver transplantation donors and those who underwent health checkups. Subjects with current or a history of chronic liver disease, abnormalities on liver-related laboratory tests, or fatty liver on ultrasonography or biopsy were excluded. The mean age of the 264 recruited subjects (131 males and 133 females; 76 potential liver donors and 188 subjects who had undergone health checkups) was 49.2 years. The mean CAP value was 224.8 ± 38.7 dB/m (range 100.0-308.0 dB/m), and the range of normal CAP values (5th-95th percentiles) was 156.0-287.8 dB/m. The mean CAP value was significantly higher in the health checkup than in the potential liver donor group (227.5 ± 42.0 vs. 218.2 ± 28.3 dB/m, P = 0.040). CAP values did not differ significantly according to gender or age in either group (all P > 0.05). In a multivariate linear regression analysis, body mass index (β = 0.271, P = 0.024) and triglyceride levels (β = 0.348, P = 0.008) were found to be independently associated with CAP values. We determined the normal range of CAP values and found that body mass index and triglyceride levels were associated with the CAP values of healthy subjects.

  3. A mobile application of breast cancer e-support program versus routine Care in the treatment of Chinese women with breast cancer undergoing chemotherapy: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Zhu, Jiemin; Ebert, Lyn; Liu, Xiangyu; Chan, Sally Wai-Chi

    2017-04-26

    Women with breast cancer undergoing chemotherapy suffer from a number of symptoms and report receiving inadequate support from health care professionals. Innovative and easily accessible interventions are lacking. Breast Cancer e-Support is a mobile Application program (App) that provides patients with individually tailored information and a support group of peers and health care professionals. Breast Cancer e-Support aims to promote women's self-efficacy, social support and symptom management, thus improving their quality of life and psychological well-being. A single-blinded, multi-centre, randomised, 6-month, parallel-group superiority design will be used. Based on Bandura's self-efficacy theory and the social exchange theory, Breast Cancer e-Support has four modules: 1) a Learning forum; 2) a Discussion forum; 3) an Ask-the-Expert forum; and 4) a Personal Stories forum. Women with breast cancer (n = 108) who are commencing chemotherapy will be recruited from two university-affiliated hospitals in China. They will be randomly assigned to either control group that receives routine care or intervention group that receives routine care plus access to Breast Cancer e-Support program during their four cycles of chemotherapy. Self-efficacy, social support, symptom distress, quality of life, and anxiety and depression will be measured at baseline, then one week and 12 weeks post-intervention. This is the first study of its kind in China to evaluate the use of a mobile application intervention with a rigorous research design and theoretical framework. This study will contribute to evidence regarding the effectiveness of a theory-based mobile application to support women with breast cancer undergoing chemotherapy. The results should provide a better understanding of the role of self-efficacy and social support in reducing symptom distress and of the credibility of using a theoretical framework to develop internet-based interventions. The results will provide evidence

  4. Self-esteem and personality in subjects with and without body dysmorphic disorder traits undergoing cosmetic rhinoplasty: preliminary data.

    Science.gov (United States)

    Pecorari, G; Gramaglia, C; Garzaro, M; Abbate-Daga, G; Cavallo, G P; Giordano, C; Fassino, S

    2010-03-01

    Many individuals with body dysmorphic disorder (BDD) seek non-psychiatric treatment. BDD occurs in about 5% of patients who seek cosmetic surgery, and rhinoplasty is the most frequently sought treatment. A correlation exists between individuals' self-esteem and demand for cosmetic surgery. To investigate whether those subjects with BDD traits requesting cosmetic rhinoplasty differ from those without BDD traits in self-esteem, personality and quality of life. This study included 54 patients applying to the 1st ENT Division of Turin University. Assessment of the patients before cosmetic rhinoplasty includes: nasal obstruction symptom evaluation, health-related quality of life, Rosenberg self-esteem scale, body dysmorphic disorder questionnaire (BDDQ) and temperament and character inventory (TCI). Based on their responses to BDDQ questions 1, 3 and 4, patients were subdivided into subgroups and then compared. No difference emerged in the objective data. Lower self-esteem, higher harm avoidance (HA) and lower self-directedness (SD) are found in subjects who are worried about how they look, in those with interference in their social life due to this worry and in those who spend more than 3h per day thinking about the way they look. Novelty seeking (NS) is significantly higher in subjects who think about their looks for up to 3h than in those who spend less than 1h. Different subgroups of patients are identified. The first group includes pessimistic, shy, insecure subjects; people with fragile and immature personality and poor self-esteem; individuals concerned about the way they look and those who spend more time thinking about it. The second group includes more confident subjects with stronger personality and greater self-esteem. A third, less differentiated group, includes more impulsive (high NS) subjects who spend an intermediate amount of time thinking about the way they look. Patients should be carefully screened and assessed before cosmetic surgery interventions

  5. Physical activity after surgically obtained weight loss: study with a SenseWear armband in subjects undergoing biliopancreatic diversion.

    Science.gov (United States)

    Gradaschi, Raffaella; Camerini, Giovanni; Carlini, Flavia; Sukkar, Samyr; Sopinaro, Nicola; Adami, Gian Franco

    2014-02-01

    This study aimed to understand the role of the extra load of body mass in limiting physical activity and in preventing an active lifestyle in severely obese patients. The study was carried out in a University Hospital setting, and investigates severely obese patients, having undergone biliopancreatic diversion (BPD) for obesity and control subjects with a body weight closely similar to that of the BPD subjects; energy intake was evaluated by alimentary interview and energy expenditure was assessed with the Body Media SenseWear® Pro armband (SWA). SWA metabolic efficiency (MET) was negatively associated with body mass index values (ρ = -0.464, p active persons (27% vs. 0 and 7%, respectively) and a lower number of sedentary persons (27% vs. 70 and 43%, respectively) was found (p physical activity and leading to a sedentary lifestyle.

  6. Responsiveness of the Tampa Scale of Kinesiophobia in Italian subjects with chronic low back pain undergoing motor and cognitive rehabilitation.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Foti, Calogero; Ferrante, Simona

    2016-09-01

    The Tampa Scale of Kinesiophobia (TSK) is a commonly used measure for the assessment of kinesiophobia related to spinal diseases. The Italian version showed satisfactory psychometric properties, but its responsiveness has not yet been evaluated. This observational study is aimed at evaluating the responsiveness and minimal important changes (MICs) for the TSK in subjects with chronic low back pain. At the beginning and end of an 8-week multidisciplinary rehabilitation programme, 205 patients completed the TSK. After the programme, patients also completed the global perceived effect (GPE) scale, which was divided to produce a dichotomous outcome. Responsiveness was calculated by distribution [effect size (ES); standardised response mean (SRM)] and anchor-based methods [receiver-operating characteristics (ROC) curves; correlations between change scores of the TSK and GPE]. ROC curves were also used to compute the best cut-off levels between subjects with a "good" or "poor" outcome (MICs). The ES and the SRM were 1.49 and 1.36, respectively. The ROC analyses revealed a MIC value (AUC; sensitivity; specificity) of 5.5 (0.996; 95; 97). To avoid any dependence on the baseline scores, the MIC value [area under the curve (AUC); sensitivity; and specificity] was computed also based on the percentage of change from the baseline and a value of 18 % (0.998; 97; 98 %) was obtained. The correlation between change scores of the TSK and GPE was high (0.871). The TSK was sensitive in detecting clinical changes in subjects with chronic low back pain. We recommend taking the MICs provided into account when assessing patients' improvement or planning studies in this clinical context.

  7. A Comparison of the Nutritional Risk Screening 2002 Tool With the Subjective Global Assessment Tool to Detect Nutritional Status in Chinese Patients Undergoing Surgery With Gastrointestinal Cancer.

    Science.gov (United States)

    Chi, Juntao; Yin, Shaohua; Zhu, Yongjian; Gao, Fengli; Song, Xinna; Song, Zhenlan; Lv, Junying; Li, Miaomiao

    The objectives of this study were to describe the nutritional status of Chinese patients with gastrointestinal cancer undergoing surgery and to compare the ease of use, diversity, and concordance of the Nutritional Risk Screening 2002 with the Subjective Global Assessment in the same patients. A total of 280 gastrointestinal cancer patients admitted for elective surgery were evaluated by the Nutritional Risk Screening 2002 (NRS 2002) and Subjective Global Assessment (SGA) tools within 48 hours of admission from April to October 2012. Related opinions about ease of using the tools were obtained from 10 nurses. The prevalence of patients at nutritional risk with the SGA and NRS 2002 was 33.9% and 53.2% on admission. In the total group, ≤70 age group, and >70 age group, respectively, consistency was observed in 214 (76.4%), 175 (91.1%), and 39 (44.3%); and kappa values were 0.54 (p 70 age group (p nutritional status of patients with gastrointestinal cancer undergoing surgery, but it appeared to detect more patients at nutritional risk in the >70 age group.

  8. DNA Damage Response and Radiosensitivity of Immune Cells from Subjects Undergoing Confinement in the NASA Human Exploration Research Analog

    Science.gov (United States)

    Moreno-Villanueva, Maria

    2017-01-01

    The Human Exploration Research Analog (HERA) represents an analog for simulation of isolation, confinement and remote conditions of mission exploration scenarios. HERA aims at investigating team performance and cooperation, reaction to stress, signs of early depression, anxiety and anger and their impact on human health. HERA is a collaborative project involving experts in different fields. Not only psychological but also clinical biomarkers of stress, e.g. adrenaline has been measured. It is known that stress hormones induce DNA strand breaks thus, within this project, my tasks was to determine the level of DNA strand breaks as well as expression of genes involved in DNA damage response in immune cells obtained from HERA subjects. Furthermore, the sensitivity of the cells to ex vivo radiation was also assessed.

  9. Abdominal adiposity is the main determinant of the C-reactive response to injury in subjects undergoing inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Irkulla Sashidhar

    2013-02-01

    Full Text Available Abstract Background Obesity and serum C-reactive protein (CRP (a sensitive marker of inflammatory activity are associated with most chronic diseases. Abdominal adiposity along with age is the strongest determinant of baseline CRP levels in healthy subjects. The mechanism of the association of serum CRP with disease is uncertain. We hypothesized that baseline serum CRP is a marker of inflammatory responsiveness to injury and that abdominal adiposity is the main determinant of this responsiveness. We studied the effect of abdominal adiposity, age and other environmental risk factors for chronic disease on the CRP response to a standardised surgical insult, unilateral hernia repair to not only test this hypothesis but to inform the factors which must be taken into account when assessing systemic inflammatory responses to surgery. Methods 102 male subjects aged 24-94 underwent unilateral hernia repair by a single operator. CRP was measured at 0, 6, 24 and 48 hrs. Response was defined as the peak CRP adjusted for baseline CRP. Results Age and waist:hip ratio (WHR were associated both with basal CRP and CRP response with similar effect sizes after adjustment for a wide-range of covariates. The adjusted proportional difference in CRP response per 10% increase in WHR was 1.50 (1.17-1.91 p = 0.0014 and 1.15(1.00-1.31 p = 0.05 per decade increase in age. There was no evidence of important effects of other environmental cardiovascular risk factors on CRP response. Conclusion Waist:hip ratio and age need to be considered when studying the inflammatory response to surgery. The finding that age and waist:hip ratio influence baseline and post-operative CRP levels to a similar extent suggests that baseline CRP is a measure of inflammatory responsiveness to casual stimuli and that higher age and obesity modulate the generic excitability of the inflammatory system leading to both higher baseline CRP and higher CRP response to surgery. The mechanism for

  10. Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design.

    Science.gov (United States)

    Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J

    2013-04-01

    This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child's distress and cooperative behavior. Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures.

  11. Responsiveness and Minimal Important Changes of the Western Ontario and McMaster Universities Osteoarthritis Index in Subjects Undergoing Rehabilitation Following Hip Fracture.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Secci, Claudio; Rocca, Barbara; Ferrante, Simona; Capone, Antonio

    2017-05-01

    To evaluate the responsiveness and minimal important changes (MICs) for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and its subscales in subjects with hip fractures. At the beginning and end of a 2-month rehabilitation program, 106 patients completed the WOMAC. After the program, the global perceived effect (GPE) was analyzed to produce a dichotomous outcome (improved vs. stable). Responsiveness for the WOMAC and its subscales were calculated by distribution (effect size; standardized response mean) and anchor-based methods (receiver operating characteristic curves; correlations between change scores of the WOMAC and its subscales and GPE). Receiver operating characteristic curves were also used in order to compute the best cutoff levels between improved and stable subjects (MICs). The effect size ranged from 0.64 to 11.10 and the standardized response mean from 0.79 to 2.65. The receiver operating characteristic analyses revealed an MIC value (area under the curve, sensitivity, specificity) for the WOMAC of 29 (0.817, 92, 78); values of 35 (0.820, 77, 76) 44 (0.625, 25, 95), and 24 (0.707, 100, 76) were found for pain, stiffness, and physical function subscales, respectively. Correlations between change scores of the WOMAC and its subscales and GPE were low (0.240, for stiffness subscale) to moderate (0.438-0.570 for the other subscales and the WOMAC). The WOMAC and its subscales (all but stiffness) were sensitive in detecting clinical changes in subjects with hip fracture undergoing rehabilitation. We recommend taking the MICs provided into account when assessing patients' improvement or planning studies in this clinical context.

  12. Soluble FcγRIIIaMφ Levels in Plasma Correlate with Carotid Maximum Intima-Media Thickness (IMT) in Subjects Undergoing an Annual Medical Checkup

    Science.gov (United States)

    Masuda, Midori; Amano, Katsuya; Hong, Shi Yan; Nishimura, Noriko; Fukui, Masayoshi; Yoshika, Masamichi; Komiyama, Yutaka; Masaki, Hiroya; Iwasaka, Toshiji; Takahashi, Hakuo

    2008-01-01

    Macrophages play a major role in the development of vascular lesions in atherogenesis. The cells express FcγRIIIa (CD16) identical to that in NK cells, but with a cell type-specific glycosylation, and these soluble forms (sFcγRIIIa) are present in plasma. We measured sFcγRIIIaMφ derived from macrophages in plasma from subjects undergoing an annual medical checkup. The levels of sFcγRIIIaMφ increased with age, and correlated positively with body mass index, blood pressure, LDL cholesterol to HDL cholesterol ratio, triglycerides, hemoglobin A1c, and creatinine, but negatively with HDL-cholesterol levels. The sFcγRIIIaMφ levels were related to the number of risk factors for atherosclerosis: such as aging, current smoking, diabetes, hypertension, hyper-LDL-cholesterolemia, hypo-HDL-cholesterolemia, and family history of atherosclerotic diseases. In addition, the sFcγRIIIaMφ levels were correlated with carotid maximum intima-media thickness (IMT). These findings indicate the macrophages are activated during the incipient stage of atherosclerosis, and suggest sFcγRIIIaMφ may be used as a predictive marker for atherosclerosis. PMID:18475309

  13. Soluble FcgammaRIIIa(Mphi) levels in plasma correlate with carotid maximum intima-media thickness (IMT) in subjects undergoing an annual medical checkup.

    Science.gov (United States)

    Masuda, Midori; Amano, Katsuya; Hong, Shi Yan; Nishimura, Noriko; Fukui, Masayoshi; Yoshika, Masamichi; Komiyama, Yutaka; Masaki, Hiroya; Iwasaka, Toshiji; Takahashi, Hakuo

    2008-01-01

    Macrophages play a major role in the development of vascular lesions in atherogenesis. The cells express FcgammaRIIIa (CD16) identical to that in NK cells, but with a cell type-specific glycosylation, and these soluble forms (sFcgammaRIIIa) are present in plasma. We measured sFcgammaRIIIa(Mphi) derived from macrophages in plasma from subjects undergoing an annual medical checkup. The levels of sFcgammaRIIIa(Mphi) increased with age, and correlated positively with body mass index, blood pressure, LDL cholesterol to HDL cholesterol ratio, triglycerides, hemoglobin A1c, and creatinine, but negatively with HDL-cholesterol levels. The sFcgammaRIIIa(Mphi) levels were related to the number of risk factors for atherosclerosis: such as aging, current smoking, diabetes, hypertension, hyper-LDL-cholesterolemia, hypo-HDL-cholesterolemia, and family history of atherosclerotic diseases. In addition, the sFcgammaRIIIa(Mphi) levels were correlated with carotid maximum intima-media thickness (IMT). These findings indicate the macrophages are activated during the incipient stage of atherosclerosis, and suggest sFcgammaRIIIa(Mphi) may be used as a predictive marker for atherosclerosis.

  14. Quality of life as subjective experience: Reframing of perception in patients with colon cancer undergoing radical resection with or without adjuvant chemotherapy

    National Research Council Canada - National Science Library

    Bernhard, J; Hürny, C; Maibach, R; Herrmann, R; Laffer, U

    1999-01-01

    Purpose and background: We examined whether patients with colon cancer undergoing surgery with or without adjuvant chemotherapy change the internal standards on which they base their quality-of-life (QL...

  15. The Relationship Between Body Image, Gender, Subjective Norms, and the Decision to Undergo Preventive Mastectomy Among Arab and Jewish BRCA Carriers.

    Science.gov (United States)

    Kardosh, Majeda; Bar-Tal, Yoram; Barnoy, Sivia

    2017-05-05

    Carriers for a mutation in BRCA1/2 genes have a high, lifelong risk for developing breast cancer. Preventive mastectomy is considered an effective risk reduction surgery. Many factors might affect the decision to undergo preventive mastectomy, including culture, perceived body image after mastectomy and important others opinion. The aim of this study is to evaluate BRCA mutation carriers' decision to undergo preventive mastectomy and the relationship between culture, gender, body image, and the decision. The study was a cross-sectional design where Arab and Jewish men and women were requested to imagine that they were/their spouse was a BRCA mutation carrier. The sample consisted of 200 participants, 101 Arab and 99 Jews, included 101 women and 99 men. The results show a high intention to undergo preventive mastectomy. Being Arab and having a more positive perception of body image after the surgery were connected to more intention to undergo the surgery. Also, those who intended to choose the surgery considered more the opinions of important others. The results point to the importance of partners' involvement in the decision to undergo preventive mastectomy. Also, important others (relatives, friends, and health caregivers) have an impact on the decision. Nurses need to consider cultural aspects of patients considering a decision about whether to undergo preventive mastectomy. Understanding the important others who might influence the decision and including them in the decision process are both essential.

  16. An investigation of the relationship between subjective sleep quality, loneliness and mood in an Australian sample: can daily routine explain the links?

    Science.gov (United States)

    Smith, Simon Squire; Kozak, Nahum; Sullivan, Karen Anne

    2012-03-01

    Loneliness and low mood are associated with significant negative health outcomes including poor sleep, but the strength of the evidence underlying these associations varies. There is strong evidence that poor sleep quality and low mood are linked, but only emerging evidence that loneliness and poor sleep are associated. To independently replicate the finding that loneliness and poor subjective sleep quality are associated and to extend past research by investigating lifestyle regularity as a possible mediator of relationships, since lifestyle regularity has been linked to loneliness and poor sleep. Using a cross-sectional design, 97 adults completed standardized measures of loneliness, lifestyle regularity, subjective sleep quality and mood. Loneliness was a significant predictor of sleep quality. Lifestyle regularity was not a predictor of, nor associated with, mood, sleep quality or loneliness. This study provides an important independent replication of the association between poor sleep and loneliness. However, the mechanism underlying this link remains unclear. A theoretically plausible mechanism for this link, lifestyle regularity, does not explain the relationship between loneliness and poor sleep. The nexus between loneliness and poor sleep is unlikely to be broken by altering the social rhythm of patients who present with poor sleep and loneliness.

  17. Routine versus selective postoperative nasogastric suction in ...

    African Journals Online (AJOL)

    Background: Nasogastric suction is a common routine postoperative procedure in abdominal surgery. Yet there is little scientific justification for it. This paper reports a comparision of routine with selective postoperative nasogastric tube suction in evaluating patients undergoing laparotomy. Methods: This was a prospective ...

  18. Routine versus Selective Postoperative Nasogastric Suction In ...

    African Journals Online (AJOL)

    user

    2005-12-02

    Dec 2, 2005 ... Background: Nasogastric suction is a common routine postoperative procedure in abdominal surgery. Yet there is little scientific justification for it. This paper reports a comparision of routine with selective postoperative nasogastric tube suction in evaluating patients undergoing laparotomy. Methods: This ...

  19. Fragmento 1+2 da protrombina em indivíduos submetidos à angiografia coronariana Prothrombin fragment 1+2 in subjects undergoing coronary angiography

    Directory of Open Access Journals (Sweden)

    Luciana M. Lima

    2005-09-01

    transforms the prothrombin into thrombin and breaks up prothrombin fragment 1+2 (F1+2. F1+2 plasma levels reflect the thrombin generation and can be used as in vivo markers of hypercoagulability since the thrombin is an unstable and easily degraded substance that cannot be directly measured in the plasma. The present study aims at determining the F1+2 plasma levels of a group of subjects undergoing coronary angiography, attempting to establish a possible correlation between this parameter and the severity of the coronary artery disease. F1+2 plasma levels were determined in blood samples of 17 subjects with absence of atheromatosis in coronary arteries (controls, 12 subjects presenting mild/moderate atheromatosis and 28 subjects presenting severe atheromatosis, using the Enzignost F1+2 (Behring® Diagnostics GmbH, Marburg, Germany diagnostic Kit. Significant differences between the averages for the three groups in respect to the evaluated parameters were not found. Therefore, F1+2 plasma level averages for the three groups did not point to a state of hypercoagulability in the studied population. However, 73.7% of the individuals were taking acetylsalicylic acid, which may have influenced the F1+2 plasma levels, considering that this medicine promotes the inhibition of the enzyme cyclo-oxygenase, diminishing the release of thromboxane A2 and the platelet aggregation. Therefore, it is presumed that platelet activation reduction could be contributing to a lower formation of thrombin and, consequently, diminishing the hypercoagulability potential.

  20. Selective endothelin-1 receptor type A inhibition in subjects undergoing cardiac surgery with preexisting left ventricular dysfunction: Influence on early postoperative hemodynamics.

    Science.gov (United States)

    Toole, John M; Ikonomidis, John S; Szeto, Wilson Y; Zellner, James L; Mulcahy, John; Deardorff, Rachael L; Spinale, Francis G

    2010-03-01

    A robust release of endothelin-1 with subsequent endothelin-A subtype receptor activation occurs in patients after cardiac surgery requiring cardiopulmonary bypass. Increased endothelin-A subtype receptor activation has been identified in patients with poor left ventricular function (reduced ejection fraction). Accordingly, this study tested the hypothesis that a selective endothelin-A subtype receptor antagonist administered perioperatively would favorably affect post-cardiopulmonary bypass hemodynamic profiles in patients with a preexisting poor left ventricular ejection fraction. Patients (n = 29; 66 +/- 2 years) with a reduced left ventricular ejection fraction (37% +/- 2%) were prospectively randomized in a blinded fashion, at the time of elective coronary revascularization or valve replacement requiring cardiopulmonary bypass, to infusion of the highly selective and potent endothelin-A subtype receptor antagonist sitaxsentan at 1 or 2 mg/kg (intravenous bolus; n = 9, 10 respectively) or vehicle (saline; n = 10). Infusion of the endothelin-A subtype receptor antagonist/vehicle was performed immediately before separation from cardiopulmonary bypass and again at 12 hours after cardiopulmonary bypass. Endothelin and hemodynamic measurements were performed at baseline, at separation from cardiopulmonary bypass (time 0), and at 0.5, 6, 12, and 24 hours after cardiopulmonary bypass. Baseline plasma endothelin (4.0 +/- 0.3 fmol/mL) was identical across all 3 groups, but when compared with preoperative values, baseline values obtained from age-matched subjects with a normal left ventricular ejection fraction (n = 37; left ventricular ejection fraction > 50%) were significantly increased (2.9 +/- 0.2 fmol/mL, P time 0, systemic vascular resistance changed in an equivalent fashion in the post-cardiopulmonary bypass period, but a significant endothelin-A subtype receptor antagonist effect was observed for pulmonary vascular resistance (analysis of variance; P < .05). For

  1. A Randomized Comparison between Everolimus-Eluting Stent and Cobalt Chromium Stent in Patients with Acute ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention Using Routine Intravenous Eptifibatide: The X-MAN (Xience vs. Multi-Link Stent in Acute Myocardial Infarction) Trial, A Pilot Study.

    Science.gov (United States)

    Dharma, Surya; Wardeh, Alexander J; Soerianata, Sunarya; Firdaus, Isman; Jukema, J Wouter

    2014-06-01

    The objective of this study is to determine the efficacy and safety of an everolimus-eluting stent (EES/Xience; Abbott Vascular, Santa Clara, CA) compared with a cobalt chromium stent (CoCr/Multi-Link Vision; Abbott Vascular) in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with routine administration of eptifibatide infusion. This is a prospective, single center, randomized trial comparing EES (n = 75) and CoCr stent (n = 75) implantation in patients with acute STEMI undergoing primary PCI. Intravenous eptifibatide administration was mandatory by protocol in this pilot study. The primary efficacy endpoint was major adverse cardiac events (MACE) at 30 days, defined as the composite of death, reinfarction, and target vessel revascularization. Secondary safety endpoints were stent thrombosis at 30 days and in-hospital bleeding event. Acute reperfusion parameters were also assessed. One-month MACE rate did not differ between EES and CoCr group (1.3 vs. 1.3%, p = 1.0). No stent thrombosis cases were observed in the EES group. The groups did not differ with respect to in-hospital bleeding events (5 vs. 9%, p = 0.37), achievement of final thrombolysis in myocardial infarction flow 2 or 3 (p = 0.21), achievement of myocardial blush grade 2 or 3 (p = 0.45), creatine kinase-MB level at 8 to 12 hours after stenting (p = 0.29), and left ventricular ejection fraction (p = 0.21). This pilot study demonstrates that after one-month follow-up, the use of EES is as safe and effective as the use of CoCr stents in patients with acute STEMI undergoing primary PCI with routine administration of intravenous eptifibatide.

  2. Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design

    National Research Council Canada - National Science Library

    Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J

    2013-01-01

    This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes...

  3. Prevalence of airflow limitation in subjects undergoing comprehensive health examination in Japan: Survey of Chronic Obstructive pulmonary disease Patients Epidemiology in Japan

    OpenAIRE

    Omori, Hisamitsu; Kaise, Toshihiko; Suzuki, Takeo; Hagan, Gerry

    2016-01-01

    Hisamitsu Omori,1 Toshihiko Kaise,2 Takeo Suzuki,2 Gerry Hagan3 1Department of Biomedical Laboratory Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, 2Development and Medical Affairs Division, GlaxoSmithKline, Tokyo, Japan; 3Independent Consultant, Marbella, Spain Purpose: There are still evidence gaps on the prevalence of airflow limitation in Japan. The purpose of this survey was to estimate the prevalence of airflow limitation among healthy subjects in Japan and to show...

  4. An LC-MS Assay with Isocratic Separation and On-Line Solid Phase Extraction to Improve the Routine Therapeutic Drug Monitoring of Busulfan in Plasma

    Directory of Open Access Journals (Sweden)

    Ialongo Cristiano

    2017-04-01

    Full Text Available Background: Busulfan (Bu requires therapeutic drug monitoring (TDM in subjects undergoing a conditioning regimen for hematopoietic stem cell transplantation (HSCT. To speed up the procedure and increase reproducibility, we improved our routine LC-MS/MS assay using the on-line solid-phase extraction (SPE of samples.

  5. Analysis by NASA's VESGEN Software of Retinal Blood Vessels in Human Subjects Undergoing Head-Down Tilt During 70-Day Bed Rest

    Science.gov (United States)

    Vyas, Ruchi J.; Murray, Matthew C.; Predovic, Marina; Lim, Shiyin; Askin, Kayleigh N.; Vizzeri, Gianmarco; Taibbi, Giovanni; Mason, Sara Stroble; Zanello, Susana B.; Young, Millenia; hide

    2017-01-01

    Significant risks for visual impairment associated with increased intracranial pressure (VIIP) are incurred by microgravity spaceflight, especially long-duration missions [1]. We hypothesize that microgravity-induced fluid shifts result in pathological changes within blood vessels of the retina that precede development of visual and other ocular impairments. Potential contributions of retinal vascular remodeling to VIIP etiology are therefore being investigated for two studies in 30deg infrared (IR) Heidelberg Spectralis(Registered Trademark) images with NASA's innovative VESsel GENeration Analysis (VESGEN) software [2,3]. The retrospective studies include: (1) before, during and after (pre, mid and post) 6º head-down tilt (HDT) in human subjects during 70 days of bed rest, and (2) before and after missions to the International Space Station (ISS) by U.S. crew members. Results for both studies are almost complete. A preliminary example for HDT is described below.

  6. Reflexivity of Routines

    DEFF Research Database (Denmark)

    Yamauchi, Yutaka; Hiramoto, Takeshi

    2016-01-01

    This study reconsiders the meaning and implications of reflexivity for the theory of routines. Due to their mundane nature, routines tend to be considered unambiguous phenomena that everyone can readily understand. The performative theory of routines has challenged this view by suggesting there i...

  7. Routines and Organizational Change

    DEFF Research Database (Denmark)

    Yi, Sangyoon; Becker, Markus; Knudsen, Thorbjørn

    2014-01-01

    Routines have been perceived as a source of inertia in the process of organizational change. In this study, we suggest an overlooked, but prevalent, mechanism by which the inertial nature of routines helps, rather than hinders, organizational adaptation. Routine-level inertia plays a hidden role...

  8. Comparison of Predicted Exercise Capacity Equations and the Effect of Actual versus Ideal Body Weight among Subjects Undergoing Cardiopulmonary Exercise Testing

    Directory of Open Access Journals (Sweden)

    H. Reza Ahmadian

    2013-01-01

    Full Text Available Background. Oxygen uptake at maximal exercise (VO2 max is considered the best available index for assessment of exercise capacity. The purpose of this study is to determine if the use of actual versus ideal body weight in standard regression equations for predicted VO2 max results in differences in predicted VO2 max. Methods. This is a retrospective chart review of patients who were predominantly in active military duty with complaints of dyspnea or exercise tolerance and who underwent cardiopulmonary exercise testing (CPET from 2007 to 2009. Results. A total of 230 subjects completed CPET on a bicycle ergometer with a male predominance (62% and an average age of 37 ± 15 years. There was significant discordance between the measured VO2 max and predicted VO2 max when measured by the Hansen and Wasserman reference equations (P<0.001. Specifically, there was less overestimation when predicted VO2 max was based on ideal body weight as opposed to actual body weight. Conclusion. Our retrospective analysis confirmed the wide variations in predicted versus measured VO2 max based on varying prediction equations and showed the potential advantage of using ideal body weight as opposed to actual body weight in order to further standardize reference norms.

  9. Assessment of subjective and hemodynamic tolerance of different high- and low-flux dialysis membranes in patients undergoing chronic intermittent hemodialysis: a randomized controlled trial.

    Science.gov (United States)

    Bianchi, Giorgia; Salvadé, Vanja; Lucchini, Barbara; Schätti-Stählin, Sibylle; Salvadé, Igor; Burnier, Michel; Gabutti, Luca

    2014-10-01

    Clinical experience and experimental data suggest that intradialytic hemodynamic profiles could be influenced by the characteristics of the dialysis membranes. Even within the worldwide used polysulfone family, intolerance to specific membranes was occasionally evoked. The aim of this study was to compare hemodynamically some of the commonly used polysulfone dialyzers in Switzerland. We performed an open-label, randomized, cross-over trial, including 25 hemodialysis patients. Four polysulfone dialyzers, A (Revaclear high-flux, Gambro, Stockholm, Sweden), B (Helixone high-flux, Fresenius), C (Xevonta high-flux, BBraun, Melsungen, Germany), and D (Helixone low-flux, Fresenius, Bad Homburg vor der Höhe, Germany), were compared. The hemodynamic profile was assessed and patients were asked to provide tolerance feedback. The mean score (±SD) subjectively assigned to dialysis quality on a 1-10 scale was A 8.4 ± 1.3, B 8.6 ± 1.3, C 8.5 ± 1.6, D 8.5 ± 1.5. Kt/V was A 1.58 ± 0.30, B 1.67 ± 0.33, C 1.62 ± 0.32, D 1.45 ± 0.31. The low- compared with the high-flux membranes, correlated to higher systolic (128.1 ± 13.1 vs. 125.6 ± 12.1 mmHg, P 20 mmHg) were 70 with A, 87 with B, 73 with C, and 75 with D (P Hemodialysis.

  10. Routine sputum culture

    Science.gov (United States)

    Sputum culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria ... Chernecky CC, Berger BJ. Culture, routine. In: Chernecky CC, Berger BJ, ... . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:409- ...

  11. Outdoor fitness routine

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000891.htm Outdoor fitness routine To use the sharing features on this ... you and is right for your level of fitness. Here are some ideas: Warm up first. Get ...

  12. Consuming technologies - developing routines

    DEFF Research Database (Denmark)

    Gram-Hanssen, Kirsten

    2008-01-01

    technologies and in this article these processes will be investigated from three different perspectives: an historical perspective of how new technologies have entered homes, a consumer perspective of how both houses and new technologies are purchased and finally, as the primary part of the article, a user...... perspective of how routines develop while these technologies are being used. In the conclusion these insights are discussed in relation to possible ways of influencing routines....

  13. Motivation through Routine Documentation

    Science.gov (United States)

    Koth, Laurie J.

    2016-01-01

    This informed commentary article offers a simple, effective classroom management strategy in which the teacher uses routine documentation to motivate students both to perform academically and to behave in a manner consistent with established classroom rules and procedures. The pragmatic strategy is grounded in literature, free to implement,…

  14. When Denial Becomes Routine.

    Science.gov (United States)

    Kuper, Leo

    1991-01-01

    Claims denial of genocide has become a routine defense as a result of the United Nations definition of international crimes. Describes grounds for denial by various governments and list arguments they have made to justify genocidal policies. Argues some academics assist in the process of denial by using revisionist strategies. (NL)

  15. Importance of Family Routines

    Science.gov (United States)

    ... although family time is essential, it is equally important for parents to set aside some time just for themselves, too. Additional Information from HealthyChildren.org: Turning Family Time into Active Time Bedtime Routines for School-Aged Children The Benefits & Tricks to Having a Family Dinner ​ ...

  16. Learning from Homeschooling Routines

    Science.gov (United States)

    Thomas, Jesse

    2016-01-01

    This study provides a rare opportunity to look inside the homeschool and to observe the routines of homeschooling families from across the United States. With more than 1000 survey participants, and nine parents selected for interviews, the compiled data were analyzed through open coding techniques. Meaningful aspects that arose from the routines…

  17. #4: No Routine Interventions

    OpenAIRE

    Lothian, Judith; Amis, Debby; Crenshaw, Jeannette; Goer, Henci

    2004-01-01

    In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the benefit of no routine interventions during birth is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. It presents evidence related to restrictions on eating and drinking, use of intravenous fluids, continuous electronic fetal monitoring, artifici...

  18. Relevância de exames de rotina em pacientes de baixo risco submetidos a cirurgias de pequeno e médio porte Relevancia de los exámenes de rutina en pacientes de bajo riesgo sometidos a cirugías menores Relevance of routine testing in low-risk patients undergoing minor and medium surgical procedures

    Directory of Open Access Journals (Sweden)

    Danielle de Sousa Soares

    2013-04-01

    .BACKGROUND AND OBJECTIVES: Preoperative tests aim to reduce morbidity and mortality of surgical patients, cost of perioperative care, and preoperative anxiety. Clinical evaluation allows defining the need for additional tests and strategies to reduce the surgical-anesthetic risk. The aim of this study was to evaluate the benefit of routine preoperative testing of low-risk patients undergoing minor and medium surgical procedures. METHODS: A descriptive cross-sectional study of 800 patients seen at the preanesthetic assessment department of Hospital Santo Antonio, Salvador, BA. Patients with physical status ASA I, aged 1-45 years and scheduled to undergo elective minor and medium surgeries were include in the study. We evaluated changes in blood count, coagulation profile, electrocardiogram, chest X-ray, blood sugar, kidney function, sodium and potassium levels, and eventual change in clinical approach occurring due to these changes. RESULTS: Of 800 patients evaluated, a blood count was performed in 97.5%, coagulation in 89%t, electrocardiogram in 74.1%, chest X-ray in 62%, fasting glucose in 68%, serum urea and creatinine in 55.7%, and plasma levels of sodium and potassium in 10.1%. Of these 700 patients, 68 (9.71% showed changes in preoperative routine tests and only 10 (14.7% of the patients with abnormal tests had a preoperative modified approach (i.e., new tests ordered, referral to a specialist or surgery postponement. No surgery was suspended. CONCLUSION: We found that preoperative additional tests are excessively ordered, even for young patients with low surgical risk, with little or no interference in perioperative management. Laboratory tests, besides generating high and unnecessary costs, are not good standardized screening instruments for diseases.

  19. Uso rutinario del balón de contra-pulsación aórtica preoperatorio en pacientes con enfermedad del tronco común izquierdo sometidos a cirugía de revascularización coronaria Routine use of preoperative intra-aortic balloon pump counterpulsation (IABP implantation in patients with left main coronary artery disease undergoing coronary revascularization surgery

    Directory of Open Access Journals (Sweden)

    Andrés Fernández

    2008-08-01

    : describe mortality, length of stay and percentage of infections and sepsis in the intensive care unit, as well as the mechanical ventilation duration in patients undergoing an elective coronary revascularization surgery with or without the use of preoperative intra-aortic balloon counterpulsation. Methods: descriptive retrospective study performed in the Santa María Cardiovascular Clinic in patients undergoing elective coronary revascularization surgery with or without the use of preoperative intra-aortic balloon counterpulsation between 1999 and 2003. Postoperative behaviour in patients with severe left main disease (stenosis > 50% submitted to this surgery was observed. Results: a total of 79 patients submitted to elective surgical revascularization were analyzed. 46 underwent preoperative balloon implantation and 33 underwent surgery without previous balloon implantation. Mean age was 62 years. 67.4% of patients were 60 years or older. Main pathologies previous to surgery were arterial hypertension in 67% of the patients, and ancient acute myocardial infarction in 59%. 87% of the patients with balloon and 45.5% of those without it had severe angina (class III before surgery. In the intensive care unit 6.5% patients with balloon were infected as well as 3% of the group without balloon (p=0,49 and sepsis was found in 4,3% of the balloon group and none in the non-balloon group (p=0,23. Mortality in the intensive care unit was 2.2% in the balloon group and 3% in the non-balloon group (p=0,06. No intrahospital mortality out of the intensive care unit was reported, nor mortality at 30 days after discharge. Main length of stay in the intensive care unit was 4,13 days in the balloon group and 2,7 in the non-balloon group, with no significant statistical difference (p=0,288. The mean IABP time was 1,32 days and no vascular complications related to its use were found. Conclusions: this study suggests that with routine use of intra-aortic balloon counterpulsation previous to

  20. Routine jejunostomy tube feeding following esophagectomy

    Science.gov (United States)

    van Eden, Hanneke W. J.; Ruurda, Jelle P.; Luyer, Misha D. P.; Steenhagen, Elles; Nieuwenhuijzen, Grard A. P.; van Hillegersberg, Richard

    2017-01-01

    Background Malnutrition is an important problem following esophagectomy. A surgically placed jejunostomy secures an enteral feeding route, facilitating discharge with home-tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine jejunostomy tube feeding and discharge with home-tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions. Methods Consecutive patients undergoing esophagectomy for cancer, with gastric tube reconstruction and jejunostomy creation, were analyzed. Two different regimens were compared. Before January 07, 2011 patients were discharged when oral intake was sufficient, without tube feeding. After that discharge with home-tube feeding was routinely performed. Logistic regression analysis corrected for confounders. Results Some 236 patients were included. The median duration of tube feeding was 35 days. Reoperation for a jejunostomy-related complication was needed in 2%. The median body mass index (BMI) remained stable during tube feeding. The BMI decreased significantly after stopping tube feeding: from 25.6 (1st–3rd quartile 23.0–28.6) kg/m2 to 24.4 (22.0–27.1) kg/m2 at 30 days later [median weight loss: 3.0 (1.0–5.3) kg; 3.9% (1.5–6.3%)]. Weight loss was not affected by the duration of tube feeding duration. Routine home-tube feeding did not affect weight loss, admission time or the readmission rate. Conclusions Weight loss following esophagectomy occurs once that tube feeding is stopped, independently from the time interval after esophagectomy. Moreover routine discharge with home-tube feeding does not reduce length of stay or readmissions. These findings question the value of routine jejunostomy placement and emphasize the need for further research. PMID:28815083

  1. Effect of routine preoperative fasting on residual gastric volume and ...

    African Journals Online (AJOL)

    2016-02-10

    Feb 10, 2016 ... Effect of routine preoperative fasting on residual gastric volume and acid in patients undergoing myomectomy. ... mouth into the stomach, approximately about 60 cm from the upper incisor. Accurate placement of the ... The patients were slightly tilted to both sides to maximize the emptying of the stomach.

  2. Fluid prescription practices of anesthesiologists managing patients undergoing elective colonoscopy: an observational study

    OpenAIRE

    Weinberg, Laurence; Faulkner, Matthew; Tan, Chong O; Liu, Daniel H; Tay, Stanley; Nikfarjam, Mehrdad; Peyton, Philip; Story, David

    2014-01-01

    Background Routine fluid prescription is common practice amongst anesthesiologists caring for patients undergoing colonoscopy. However there is limited information about routine procedural fluid prescription practices of anesthesiologists in this setting. Routine fluid administration may also have important pharmaco-economic implications for the health care budget. Therefore we performed a prospective observational study assessing the fluid prescription practices of anesthesiologists caring f...

  3. Is Routine Preoperative Chest X-ray Indicated in Elderly Patients ...

    African Journals Online (AJOL)

    Background: In our hospital pre-operative chest x-ray (CXR) are routinely requested without prior establishment of any medical indication for patients of 70 or more years of age who are undergoing elective surgery. The aim of this study was to determine if routine preoperative chest x-rays are justifiably indicated for elderly ...

  4. The institutionalization of a routine

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian

    2008-01-01

    -which has before largely been treated in overview by institutionalism-plays an important role in the making of a routine. In my empirical study, I demonstrate that the concept and practice of the valve changes, and that it is identified in a number of ways, as it passes through the testing phase...... of production. I argue that the negotiation of these changes during test production is the fulcrum in the routinization of the production procedure. It is through these identity shifts that the valve is both reified, and rendered producible and applicable in the customer world.......The theoretical ambition in this paper is to contribute to institutionalism, and the literature on organizational routines, by allotting a precise role to the context and the material. Through a theoretical discussion of several perspectives on organizational routines, I argue that materiality...

  5. Cost-utility of routine cataract surgery

    Directory of Open Access Journals (Sweden)

    Ryynänen Olli-Pekka

    2006-09-01

    Full Text Available Abstract Background If decisions on health care spending are to be as rational and objective as possible, knowledge on cost-effectiveness of routine care is essential. Our aim, therefore, was to evaluate the cost-utility of routine cataract surgery in a real-world setting. Methods Prospective assessment of health-related quality of life (HRQoL of patients undergoing cataract surgery. 219 patients (mean (SD age 71 (11 years entering cataract surgery (in 87 only first eye operated, in 73 both eyes operated, in 59 first eye had been operated earlier filled in the 15D HRQoL questionnaire before and six months after operation. Direct hospital costs were obtained from a clinical patient administration database and cost-utility analysis performed from the perspective of the secondary care provider extrapolating benefits of surgery to the remaining statistical life-expectancy of the patients. Results Mean (SD utility score (on a 0–1 scale increased statistically insignificantly from 0.82 (0.13 to 0.83 (0.14. Of the 15 dimensions of the HRQoL instrument, only seeing improved significantly after operation. Mean utility score improved statistically significantly only in patients reporting significant or major preoperative seeing problems. Of the subgroups, only those whose both eyes were operated during follow-up showed a statistically significant (p Conclusion Mean utility gain after routine cataract surgery in a real-world setting was relatively small and confined mostly to patients whose both eyes were operated. The cost of cataract surgery per quality-adjusted life year gained was much higher than previously reported and associated with considerable uncertainty.

  6. Routines.

    Science.gov (United States)

    1985-05-01

    Melser and Michie (1970), 135-151. Sacerdoti, Earl D, [1977], A structure for plans and behavior, Elsevier. * Sartre , Jean - Paul , [1976], Critique of...theorem proving to problem solving," Artificial Intelligence, 2 (3) 189-208. Fitts, Paul M and Michael I Posner, [1967], Human performance, Brooks/Cole...Laing, R D and A Esterson, [1964], Sanity, Madness, and the Family, Tavistock. Laird, John E, Paul Rosenbloom, and Allen Newell, [1984], Towards

  7. Routine outcome measures in Germany.

    Science.gov (United States)

    Puschner, Bernd; Becker, Thomas; Bauer, Stephanie

    2015-01-01

    The German healthcare system offers comprehensive coverage for people with mental illness including inpatient, day hospital and outpatient services. These services are primarily financed through the statutory health and pension insurances. According to legal regulations, providers are required to base their services on current scientific evidence and to continuously assure the quality of their services. This paper gives an overview of recent initiatives to develop, evaluate and disseminate routine outcome measurement (ROM) in service settings in Germany. A large number of projects have shown outcome monitoring to be feasible, and that feedback of outcome may enhance routine care through an improved allocation of treatment resources. However, none of these initiatives have been integrated into routine care on a nationwide or trans-sectoral level, and their sustainability has been limited. This is due to various barriers in a fragmented mental health service system and to the lack of coordinated national or state-level service planning. The time is ripe for a concerted effort including policy-makers to pick up on these initiatives and move them towards wide-spread implementation in routine care accompanied by practice-oriented research including service user involvement.

  8. Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Tippo; Foss, Nicolai Juul; Heimericks, Koen H.

    2012-01-01

    This article introduces the Special Issue and discusses the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories...

  9. HIV Seroprevalence in Patients Undergoing Ophthalmic Surgery in ...

    African Journals Online (AJOL)

    Aim: The aim of this study was to determine the number of HIV positive cases undergoing ophthalmic surgery at two centres in Nigeria and to assess if routine testing is clinically or economically effective. Methods: All patients listed for ophthalmic surgery in two eye units in southern Nigeria during a six-month period in 2005,

  10. Value of routine polysomnography in bariatric surgery.

    Science.gov (United States)

    de Raaff, Christel A L; Pierik, Annouk S; Coblijn, Usha K; de Vries, Nico; Bonjer, H Jaap; van Wagensveld, Bart A

    2017-01-01

    Obstructive sleep apnea (OSA), present in 60-70 % of bariatric surgery patients, is a potentially life-threatening condition when not detected and managed appropriately. The best available method to identify the severity of OSA is polysomnography. However, routine polysomnography measurements have not been accepted as standard modality in bariatric surgery. We report our experience with routine polysomnography in a cohort of patients undergoing bariatric surgery to determine the true prevalence of OSA with respect to the different severity levels as determined by the apnea-hypopnea index (AHI). AHI data were retrospectively collected from all patients who underwent bariatric surgery from 2012 onward, when the performance of preoperative polysomnography became mandatory. Mild, moderate and severe OSA were defined as an AHI ≥5, ≥15 and ≥30/h, respectively. Prevalence and number needed to screen (NNS) were calculated for all OSA severity levels. A total of 1358 patients were included. OSA was detected in 813 (59.9 %; NNS: 2) patients. Moreover, 405 (29.8 %; NNS: 4) patients were diagnosed with an AHI ≥15/h and 213 (15.7 %; NNS: 7) with severe OSA (AHI ≥30/h). Extreme AHI thresholds of ≥60 and ≥90/h were detected in 79 (5.8 %; NNS: 18) and 17 (1.3 %; NNS: 77) patients, respectively. One-third of the bariatric surgery patients have an AHI ≥15/h and would benefit from continuous positive airway pressure therapy. In order to increase perioperative safety and avoid the preventable risk of perioperative complications, we recommend mandatory P(S)G prior to bariatric surgery.

  11. The utility of routine polyp histopathology after endoscopic sinus surgery.

    Science.gov (United States)

    Yeh, David H; Wong, Jay; Hoffbauer, Stephanie; Wehrli, Bret; Sommer, Doron; Rotenberg, Brian W

    2014-11-01

    Routine histopathological assessment is standard practice for nasal polyp specimens obtained during endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Retrospective studies suggest that routine histopathology of nasal polyps shows few unexpected diagnoses that alter patient management. Our objective was to study the use of routine pathological analysis, and its cost to the healthcare system, in a prospective manner. A multicenter prospective assessment was performed from data collected between 2007 and 2013. Only cases of patients undergoing ESS for bilateral CRS were included. We excluded unilateral disease cases, and cases in which diagnoses other than polyps were suspected either preoperatively or intraoperatively. We then compared the preoperative diagnosis with the final histopathology and identified the rate of unexpected pathologies. A cost analysis was performed. Only 4 of 866 pathological specimens were identified as having a clinically significant unexpected diagnosis. All unexpected pathologies in this series were benign. These 4 cases account for 0.46% of all specimens reviewed. This translates to a number needed to screen of 217 cases of bilateral CRS to discover 1 unexpected pathology. The associated cost for making an unexpected diagnosis was $19,192.73. Routine histopathology of nasal polyps in ESS for bilateral CRS with polyps yields few unexpected and management-altering diagnoses. It carries a significant cost to the healthcare system. In cases of bilateral CRS with no other concerning clinical features, clinicians should exercise judgment in submitting polyp specimens for pathology rather than routinely sending polyps for histopathologic analysis. © 2014 ARS-AAOA, LLC.

  12. Mycoplasma in urine and blood following catheterisation of patients undergoing vascular surgery

    DEFF Research Database (Denmark)

    Levi, N; Eiberg, J; Skov Jensen, J

    1997-01-01

    The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment.......The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment....

  13. Routines, rigidity and real estate

    OpenAIRE

    Dooley, Kenneth

    2017-01-01

    Finding ways to reduce the environmental impact of the existing building stock is an important element in climate change mitigation. This article examines environmentally focused organisational innovations in the corporate real estate industry. Organisational innovations are often overlooked as they cause considerable disruption to the daily routines of employees. In this article, the focal organisational innovation is the adoption of activity-based working. The study aims to uncover the barr...

  14. Victimization, Urbanicity, and the Relevance of Context: School Routines, Race and Ethnicity, and Adolescent Violence

    Directory of Open Access Journals (Sweden)

    Anthony A. Peguero

    2013-01-01

    Full Text Available The United States is undergoing a historical racial and ethnic demographic shift. There is limited criminological research exploring if and how these changes influence variation in the relationship between routine activity theory and adolescent violence. Although the link between routine activities and victimization has been tested and well established, criminologists have questioned if routine activities can explain adolescent violence across different social contexts. Prior research demonstrates that there are potential nuances in the theoretical connections between routine activities and victimization, particularly when considering race and ethnicity. This study builds on previous research by questioning if the elements of routine activities predict victimization across predominately urban, rural, and suburban schools. The implications of the relevance of school context in the relationships between routine activities and adolescent victimization will also be discussed more generally.

  15. Randomized Controlled Trial Assessing the Feasibility of Shortened Fasts in Intubated ICU Patients Undergoing Tracheotomy.

    Science.gov (United States)

    Gonik, Nathan; Tassler, Andrew; Ow, Thomas J; Smith, Richard V; Shuaib, Stefan; Cohen, Hillel W; Sarta, Catherine; Schiff, Bradley A

    2016-01-01

    American Society of Anesthesiology guidelines recommend preoperative fasts of 6 hours after light snacks and 8 hours after large meals. These guidelines were designed for healthy patients undergoing elective procedures but are often applied to intubated intensive care unit (ICU) patients. ICU patients undergoing routine procedures may be subjected to unnecessary prolonged fasts. This study tests whether shorter fasts allow for better nutrition delivery and patient outcomes without increasing the risk. Randomized blinded controlled trial. Tertiary academic medical center. ICU patients undergoing bedside tracheotomy. Intubated ICU patients who were receiving enteral feeding and for whom bedside tracheotomy was indicated were enrolled prospectively and randomly allocated to 2 parallel preoperative fasting regimens: a 6-hour fast (control) and a 45-minute fast (intervention). Patients were assessed for aspiration, caloric delivery, metabolic markers, and infectious and noninfectious complications. Twenty-four patients were enrolled and randomized. There were no complications related to the procedure. There were no cases of intraoperative aspiration identified. There was a single postoperative pneumonia in the control group. Median (interquartile range) length of fast and caloric delivery were significantly different between the control group and the shortened fast group: 22 hours (18, 34) vs 14 hours (5, 25; P < .001) and 429 kcal (57, 1125) vs 1050 kcal (825, 1410; P = .01), respectively. Shortening preoperative fasts in intubated ICU patients allowed for better caloric delivery in the preoperative period. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  16. Is routine histopathology of tonsil specimen necessary? | Adoga ...

    African Journals Online (AJOL)

    Background: Tonsillar diseases are common in paediatric and adult otolaryngological practice. These diseases require tonsillectomy. Specimens are subjected to histopathology routinely in my institution for fear of infections and tumour without consideration for risk factors. The financial burden is on the patients and waste ...

  17. Evaluation of Routine Preoperative Electrocardiogram-A Lagos ...

    African Journals Online (AJOL)

    Introduction: Patients who are 40yrs and above are required to have routine preoperative electrocardiogram (ECG) prior to major elective surgery in our practice. This is aimed at detecting cardiac abnormalities that may contribute to peri- and post-operative morbidity and mortality. There is paucity of literature on this subject ...

  18. Routine High Dose Excretory Urography

    Science.gov (United States)

    Gronner, Arthur T.; Arkoff, Robert S.; Burhenne, H. Joachim

    1967-01-01

    Radiologic evaluation of 316 excretory urograms utilizing a single 50 ml injection of a 50 to 60 per cent tri-iodinated contrast medium indicated that these studies are of better quality than those previously obtained with the injection of 30 ml. The low incidence of side effects coincides with recent reports in the literature that this dosage level is safe. High dose intravenous drip infusion pyelography was necessary only in selected cases. High dose excretory urography is recommended for routine use. ImagesFigure 1A, 1BFigure 2. PMID:6045483

  19. Jejunostomy tube feeding in patients undergoing esophagectomy.

    Science.gov (United States)

    Srinathan, Sadeesh K; Hamin, Tamara; Walter, Stephen; Tan, A Lawrence; Unruh, Helmut W; Guyatt, Gordon

    2013-12-01

    Surgical jejunostomy tubes are a routine part of elective esophagectomies in patients with carcinomas and provide a route for nutritional support in those who experience complications. We wished to determine how frequently oral intake is delayed and the amount of nutrition delivered via the jejunostomy tube. We reviewed the charts of all adults undergoing esophagectomy for carcinoma between January 2000 and June 2008. We determined the proportion of patients unable to resume oral nutrition after 8 days and the amount of nutrition delivered in each of the 8 days. In all, 111 patients underwent elective esophagectomy for carcinoma, and 103 had a jejunostomy tube placed. The mean age was 67 ± 10.8 years. The median time to oral intake was 7 (interquartile range 7-11) days. Seventy-four (67%) patients resumed oral intake within 8 days. The mean nutrition delivered by jejunostomy within the first 8 days as a percentage of the target was 45.6% (95% confidence interval 41.2%-49.9%). Six (5.4%) patients experienced complications attributable solely to the jejunostomy tube; 3 (2.9%) required surgery. Forty (38.8%) patients had abdominal issues serious enough to warrant delaying the progression of feeding. Two-thirds of patients undergoing elective esophagectomy were tolerating oral intake by the end of the eighth postoperative day, and less than half of the target nutrition was delivered over the first 8 days. We now selectively place surgical jejunostomy tubes in patients undergoing elective esophagectomies.

  20. Rotavirus vaccines in routine use.

    Science.gov (United States)

    Tate, Jacqueline E; Parashar, Umesh D

    2014-11-01

    Vaccines are now available to combat rotavirus, the most common cause of severe diarrhea among children worldwide. We review clinical trial data for available rotavirus vaccines and summarize postlicensure data on effectiveness, impact, and safety from countries routinely using these vaccines in national programs. In these countries, rotavirus vaccines have reduced all-cause diarrhea and rotavirus hospitalizations by 17%-55% and 49%-92%, respectively, and all-cause diarrhea deaths by 22%-50% in some settings. Indirect protection of children who are age-ineligible for rotavirus vaccine has also been observed in some high and upper middle income countries. Experience with routine use of rotavirus vaccines in lower middle income countries has been limited to date, but vaccine introductions in such countries have been increasing in recent years. The risk-benefit analysis of rotavirus vaccines is extremely favorable but other strategies to improve the effectiveness of the vaccine, particularly in lower middle income settings, should be considered. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  1. Body dysmorphic disorder in patients undergoing septorhinoplasty surgery: should we be performing routine screening?

    Science.gov (United States)

    Joseph, J; Randhawa, P; Hannan, S A; Long, J; Goh, S; O'Shea, N; Saleh, H; Hansen, E; Veale, D; Andrews, P

    2017-06-01

    Body dysmorphic disorder (BDD) is defined as having a preoccupation with a perceived flaw in one's appearance, which appears slight to others and significantly interferes with a person's functioning. When undetected in septorhinoplasty patients, it will often lead to poor outcomes. We performed a prospective cohort study to determine the prevalence of BDD in our patients and whether surgical correction could be considered. We recruited 34 patients being considered for septorhinoplasty in a tertiary referral rhinology clinic and a control group of 50 from the otology clinic giving a total of 84. Participants completed the Body Dysmorphic Disorder Questionnaire (BDDQ), the sino-nasal outcome test-23 (SNOT-23) and underwent nasal inspiratory peak flow (NIPF). Those found to be at high risk for BDD were referred to a clinical psychologist. Of the septorhinoplasty patients, 11 (32%) were high risk for BDD. Following psychological assessment, 7 (63%) patients were felt to be unsuitable for surgery and were offered psychological therapy. SNOT-23 scores were significantly higher in the BDD group indicating a negative impact on quality of life. NIPF readings were not significantly different in the BDD group compared to the control group. The BDDQ is a valid tool for identifying patients at risk of BDD. A close working relationship with clinical psychology has been advantageous to help the selection process of candidates for surgery when there is a high risk of BDD. © 2016 John Wiley & Sons Ltd.

  2. Should occlusal splints be a routine prescription for diagnosed bruxers undergoing implant therapy?

    Science.gov (United States)

    Mesko, Mauro Elias; Almeida, Rita Cássia Costa Ribeiro; Porto, Jose Augusto Sedrez; Koller, Clarissa Dias; da Rosa, Wellington Luiz de Oliveira; Boscato, Noéli

    2014-01-01

    Despite the documented excellent clinical performance of dental implants, concerns linger regarding the best way to protect the restored dentition in patients with bruxism. This is because of the risk of occlusal overload that is reported to cause biological and biomechanical failures in the implant-prosthesis system. To better distribute occlusal loads to the rigid components of the prosthesis and to the interface between bone and implant during parafunctional movements, several dentists prescribe acrylic resin occlusal splints for nocturnal use by patients considered at risk. However, it is unclear whether this recommendation is based on scientific evidence or expert clinical opinion. This report reflects our effort to employ the systematic review protocol to assess whether there is scientific evidence to recommend an occlusal splint in bruxers after implant therapy.

  3. Variability in non-nucleoside reverse transcriptase and protease inhibitor concentrations among HIV-infected adults in routine clinical practice

    Science.gov (United States)

    Moltó, José; Blanco, Asunción; Miranda, Cristina; Miranda, José; Puig, Jordi; Valle, Marta; DelaVarga, Meritxell; Fumaz, Carmina R; Barbanoj, Manuel José; Clotet, Bonaventura

    2006-01-01

    What is already known about this subject The concentration of protease and non-nucleoside reverse transcriptase inhibtors in plasma has been related to both efficacy and toxicity. Most antiretroviral concentration data come from selected populations of patients undergoing therapeutic drug monitoring programmes, which may overestimate interindividual variability. What this study adds Our study has demonstrated the large interindividual variability in antiretroviral drug concentrations in an unselected population of patients during routine clinical practice. These results may provide interesting information to clinicians for the management of antiretroviral therapy in HIV-infected patients. Aims The objective of this study was to assess interindividual variability in trough concentrations of plasma of non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors (PI) among HIV-infected adults in a routine outpatient setting. Methods One hundred and seventeen patients who attended our clinic for routine blood tests, and who were receiving antiretroviral therapy which included NNRTI or PI were studied. Patients were not informed that drug concentrations were going to be measured until blood sampling. The times of the last antiretroviral dose and of blood sampling were recorded. Drug concentrations were considered optimal if they were above the proposed minimum effective value. In addition, efavirenz, nevirapine and atazanavir concentrations were considered potentially toxic if they were >4.0 mg l−1, >6.0 mg l−1 and >0.85 mg l−1, respectively. Results Overall, interindividual variability of NNRTI and PI concentrations in plasma was approximately 50%, and only 68.4% of the patients had drug concentrations within the proposed therapeutic range. Poor adherence explained only 35% of subtherapeutic drug concentrations. Conclusion Interindividual variability in trough concentrations of NNRTI and PI among HIV-infected adults is large in routine clinical

  4. 42 CFR 493.931 - Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  5. Children's Daily Routines during Kindergarten Transition

    Science.gov (United States)

    Wildenger, Leah K.; McIntyre, Laura Lee; Fiese, Barbara H.; Eckert, Tanya L.

    2008-01-01

    Routines are an important feature of family life and functioning in families with young children. Common daily routines such as dinnertime, bedtime, and waking activities are powerful organizers of family behavior and may be instrumental to children and families during times of transition, such as elementary school entry. Daily routines were…

  6. Routines Are the Foundation of Classroom Management

    Science.gov (United States)

    Lester, Robin Rawlings; Allanson, Patricia Bolton; Notar, Charles E.

    2017-01-01

    Classroom management is the key to learning. Routines are the foundation of classroom management. Students require structure in their lives. Routines provide that in all of their life from the time they awake until the time they go to bed. Routines in a school and in the classroom provide the environment for learning to take place. The paper is…

  7. Program sustainability: focus on organizational routines.

    Science.gov (United States)

    Pluye, P; Potvin, L; Denis, J L; Pelletier, J

    2004-12-01

    Program sustainability is an ongoing concern for most people in health promotion. However, the current notion of sustainability in organizations, namely routinization, needs refinement. This article examines organizational routines. In so doing, it refines the notion of sustainability and the assessment of routines. Drawing on the organizational literature, a routinized program is defined by the presence of routinized activities, meaning that these activities exhibit four characteristics of organizational routines: memory, adaptation, values and rules. To answer the question of how these characteristics are useful, we conducted an empirical study of the routinization of the Quebec Heart Health Demonstration Project in five community health centers. Our method consisted of a multiple-case study. We observed project activities in each center in 2000. The data came from documents and interviews with project actors. Our results show that, in one of the centers, no resources had been officially committed to project activities. Even so, the actors continued some activities on an informal basis. In another center, the activities satisfied three of the four routine characteristics. In the three others, activities satisfied all of the characteristics. These results suggest focusing the study of program sustainability on the routinization of activities resulting from it. They indicate four distinct degrees of sustainability: (1) the absence of sustainability; no program activity is continued; (2) precarious sustainability; some residual activities are pursued, at least unofficially; (3) weak sustainability; the program produces some official activities that are not routinized; and (4) sustainability through routinization; routinized activities result from the program.

  8. Master schedule for CY-1982 Hanford environmental surveillance routine program

    Energy Technology Data Exchange (ETDEWEB)

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1981-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. The environmental surveillance program objectives are to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5484.1. The routine sampling schedule provided does not include samples which are planned to be collected during FY-1982 in support of special studies or for quality control purposes. In addition, the routine program outlined in this schedule is subject to modification during the year in response to changes in Site operations, program requirements, or unusual sample results. Sampling schedules are presented for the following: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurements; portable instrument surveys; and surveillance of waste disposal sites. (ATT)

  9. Safety and efficacy of xenon in routine use as an inhalational anaesthetic

    NARCIS (Netherlands)

    B.F. Lachmann (Burkhard); S. Armbruster (S.); W. Schairer (W.); A.M. Landstra (A. M.); A. Trouwborst (Adrianus); G.J. van Daal; A. Kusuma (Ari); W. Erdmann (Wilhelm)

    1990-01-01

    markdownabstractAbstract 40 patients (24 male, 16 female, aged 21-59 years) of American Society of Anesthesiologists class I or II who were undergoing routine surgery took part in a randomised, double-blind comparison of the anaesthetic efficacy and potency of xenon and nitrous oxide and their

  10. Impact of preoperative information on anxiety and disease-related knowledge in women undergoing mastectomy for breast cancer: a randomized clinical trial.

    Science.gov (United States)

    Wysocki, W M; Mituś, J; Komorowski, A L; Karolewski, K

    2012-01-01

    Despite the large number of clinical trials on breast cancer, patient-related factors such as perioperative anxiety and level of knowledge about the disease and treatment have not been included in mainstream research efforts. This randomized trial was performed to evaluate the impact of information, provided preoperatively, on anxiety and knowledge of women undergoing mastectomy for breast cancer. Sixty consecutive patients with breast cancer, admitted for a mastectomy, as primary treatment for breast cancer, with no previous cancer history, were randomized to receive structured information (short video about practical aspects of the hospital stay, surgical and adjuvant treatment) in addition to the routine informed consent procedure for surgery or the routine informed consent only. Anxiety and subjective knowledge levels were measured with the visual analogue scales; in addition, knowledge was assessed with a questionnaire. There was no significant effect of the additional information on perioperative anxiety or knowledge (subjective). Significantly more patients in the additional information group correctly listed all major available treatment options compared to the patients that received routine information (preoperatively 54% vs. 19%; p = 0.0101; 7 days postoperatively 50% vs.19%; p = 0.0367). Use of an informational video, preoperatively, did not significantly affect perioperative anxiety or subjective knowledge. Additional research is needed on effective delivery of disease- and treatment-specific information perioperatively.

  11. ASTRONAUT ALDRIN UNDERGOES SPACESUIT CHECKS

    Science.gov (United States)

    1969-01-01

    ASTRONAUT ALDRIN UNDERGOES SPACESUIT CHECKS KSC-69PC-0374 69-HC-742,S-266,ARCHIVE-00337 White undergoing spacesuit checks, Apollo 11 lunar module pilot Edwin E. Aldrin, Jr., watches Astronauts Neil A. Armstrong and Michael Collins suit up for launch.

  12. The value of routine biopsy during percutaneous kyphoplasty for vertebral compression fractures.

    Directory of Open Access Journals (Sweden)

    Qiang Li

    Full Text Available Percutaneous kyphoplasty (PKP is now widely performed to treat VCF, which is usually caused by osteoporosis. Previous researches have reported unsuspected malignancies found by biopsy. However, the safety and cost-effective profiles of routine biopsy during PKP are unclear. The purpose of this study was to evaluate the feasibility of routine biopsy during PKP in treatment of VCF.Ninety-three patients (September 2007-November 2010 undergoing PKP without biopsy were reviewed as the control group. One hundred and three consecutive patients (November 2010-September 2013 undergoing PKP with biopsy of every operated vertebral level were prospectively enrolled as the biopsy group. The rate of unsuspected lesions was reported, and the severe adverse events, surgical duration, cement leakage rate and pain control were compared between the two groups.No statistically significant differences were found between the two groups, regarding the severe adverse events, surgical duration, cement leakage rate and pain control. Four unsuspected lesions were found in the biopsy group, three of which were malignancies with a 2.9% (3/103 unsuspected malignancy rate. The economic analysis showed that routine biopsy was cost-effective in finding new malignancies comparing with a routine cancer screening campaign.Routine biopsy during PKP was safe and cost-effective in finding unsuspected malignancies. We advocate routine biopsy in every operated vertebral level during PKP for VCF patients.

  13. Parental employment, family routines and childhood obesity.

    Science.gov (United States)

    Anderson, Patricia M

    2012-12-01

    Using the Early Childhood Longitudinal Survey-Kindergarten Class of 1998-1999 (ECLS-K) data from kindergarten through eighth grade, this paper investigate the relationships among maternal employment, family routines and obesity. More hours worked by the mother tend to be negatively related to positive routines like eating meals as a family or at regular times, or having family rules about hours of television watched. Many of these same routines are significantly related to the probability of being obese, implying that family routines may be a mechanism by which maternal employment intensity affects children's obesity. However, inclusion of family routines in the obesity regression does not appreciably change the estimated effect of maternal employment hours. Thus, the commonly estimated deleterious effect of maternal employment on children's obesity cannot be explained by family routines, leaving the exact mechanisms an open question for further exploration. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Routine Liver Biopsy During Bariatric Surgery: an Analysis of Evidence Base.

    Science.gov (United States)

    Mahawar, Kamal K; Parmar, Chetan; Graham, Yitka; Abouleid, Ayman; Carr, William R J; Jennings, Neil; Schroeder, Norbert; Small, Peter K

    2016-01-01

    Non-alcoholic fatty liver disease and non-alcoholic steato-hepatitis are common in patients undergoing bariatric surgery. Non-alcoholic steato-hepatitis can progress to cirrhosis of the liver and hepatocellular carcinoma. Non-invasive methods of diagnosing non-alcoholic steato-hepatitis are not as accurate as liver biopsy, and bariatric surgery presents a unique opportunity to carry out a simultaneous liver biopsy. Routine liver biopsy can help early and accurate diagnosis of obesity-associated liver conditions. This has led some surgeons to argue for routine liver biopsy at the time of bariatric surgery. However, most bariatric surgeons remain unconvinced and liver biopsy is currently not routine practice with bariatric surgery. This review examines published scientific literature to ascertain the usefulness of routine liver biopsy at the time of bariatric surgery.

  15. Routine Chest Computed Tomography and Patient Outcome in Blunt Trauma

    Science.gov (United States)

    Moussavi, Nushin; Davoodabadi, Abdol Hossein; Atoof, Fatemeh; Razi, Seyed Ebrahim; Behnampour, Mehdi; Talari, Hamid Reza

    2015-01-01

    Background: Computerized Tomography (CT) scan is gaining more importance in the initial evaluation of patients with multiple trauma, but its effect on the outcome is still unclear. Until now, no prospective randomized trial has been performed to define the role of routine chest CT in patients with blunt trauma. Objectives: In view of the considerable radiation exposure and the high costs of CT scan, the aim of this study was to assess the effects of performing the routine chest CT on the outcome as well as complications in patients with blunt trauma. Patients and Methods: After approval by the ethics board committee, 100 hemodynamically stable patients with high-energy blunt trauma were randomly divided into two groups. For group one (control group), only chest X-ray was requested and further diagnostic work-up was performed by the decision of the trauma team. For group two, a chest X-ray was ordered followed by a chest CT, even if the chest X-ray was normal. Injury severity, total hospitalization time, Intensive Care Unit (ICU) admission time, duration of mechanical ventilation and complications were recorded. Data were evaluated using t-test, Man-Whitney and chi-squared test. Results: No significant differences were found regarding the demographic data such as age, injury severity and Glasgow Coma Scale (GCS). Thirty-eight percent additional findings were seen in chest CT in 26% of the patients of the group undergoing routine chest CT, leading to 8% change in management. The mean of in-hospital stay showed no significant difference in both groups with a P value of 0.098. In addition, the mean ICU stay and ventilation time revealed no significant differences (P values = 0.102 and 0.576, respectively). Mortality rate and complications were similar in both groups. Conclusions: Performing the routine chest CT in high-energy blunt trauma patients (with a mean injury severity of 9), although leading to the diagnosis of some occult injuries, has no impact on the outcome

  16. Expanding subjectivities

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda; Soldz, Stephen

    2012-01-01

    A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool to understa...

  17. External Agents' Effect on Routine Dynamics

    DEFF Research Database (Denmark)

    Busse Hansen, Nicolai

    analyses of naturally occurring interactional routine data in the form of recordings of job interviews in an international oil contractor company. The term interactional routine is used to describe recurrent and recognizable patterns of interaction. The findings suggest that the aspects of alignment...

  18. Routinizing Lexical Phrases on Spoken Discourse

    Science.gov (United States)

    Osman, Nazira Binti; Jusoff, Kamaruzaman

    2009-01-01

    This paper examines the effectiveness of routinizing lexical phrases to a group of second language learners. A group of proficiency class students were drilled or routinized with semi-fixed and fixed phrases which are commonly used in problem-solving group discussion. Basic frequency counts and interview were carried out to see improvement in…

  19. The embeddedness of selfish routines: How routines are replicated in business networks

    DEFF Research Database (Denmark)

    Andersen, Poul Houman

    2003-01-01

    Organisational routines may be viewed as replicators of business organisation and lead to the formation of new ventures. This paper discuss this idea, and ilustrates it using two case studies of routine replication in a Danish context......Organisational routines may be viewed as replicators of business organisation and lead to the formation of new ventures. This paper discuss this idea, and ilustrates it using two case studies of routine replication in a Danish context...

  20. Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study

    Directory of Open Access Journals (Sweden)

    Nurudeen Amusat

    2014-12-01

    Full Text Available Question: In the 6 months after total knee arthroplasty (TKA, what is the pattern of pain resolution and functional recovery in people without diabetes, with diabetes that does not impact on routine activities, and with diabetes that does impact on routine activities? Is diabetes that impacts on routine activities an independent predictor of slower resolution of pain and functional recovery after TKA? Design: Community-based prospective observational study. Participants: A consecutive cohort of 405 people undergoing primary TKA, of whom 60 (15% had diabetes. Participants with diabetes were also asked preoperatively whether diabetes impacted on their routine activities. Participants were categorised into three groups: no diabetes (n = 345, diabetes with no impact on activities (n = 41, and diabetes that impacted activities (n = 19. Outcome measures: Pain and function were measured using the Western Ontario and McMaster Universities (WOMAC Osteoarthritis Index within the month before surgery and 1, 3 and 6 months after surgery. Demographic, medical and surgical factors were also measured, along with depression, social support and health-related quality of life. Results: No baseline differences in pain and function were seen among the three groups (p > 0.05. Adjusting for age, gender and contralateral joint involvement across the 6 postoperative months, participants with diabetes that impacted on routine activities had pain scores that were 8.3 points higher (indicating greater pain and function scores that were 5.4 points higher (indicating lower function than participants without diabetes. Participants with diabetes that doesn’t impact on routine activities had similar recovery to those without diabetes. Conclusion: People undergoing TKA who report preoperatively that diabetes impacts on their routine activities have less recovery over 6 months than those without diabetes or those with diabetes that does not impact on routine activities

  1. Increased Exposure to Rigid Routines Can Lead to Increased Challenging Behavior Following Changes to Those Routines

    Science.gov (United States)

    Bull, Leah E.; Oliver, Chris; Callaghan, Eleanor; Woodcock, Kate A.

    2015-01-01

    Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to…

  2. Routine X-ray of the chest is not justified in staging of cutaneous melanoma patients

    DEFF Research Database (Denmark)

    Gjorup, Caroline Asirvatham; Hendel, Helle Westergren; Pilegaard, Rita Kaae

    2016-01-01

    INTRODUCTION: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma...... patients and hypothesised that routine CXR is not justified. METHODS: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014. RESULTS: A total of 603 patients were included. The mean time of follow...

  3. Daily medication routine of adolescents with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Cristiane Cardoso de Paula

    2013-12-01

    Full Text Available The objective of this study was to describe the sociodemographic, clinical, and behavioral characteristics of the daily medication routine of adolescents with HIV/AIDS of ages 13 to 19 years, followed at a reference service. This descriptive cross-sectional study was performed with 23 adolescents, using a quantitative approach. Data were collected using a form during appointments at the outpatient clinic. Univariate analysis revealed: females, in the initial phase of adolescence, and vertical transmission. The highlights were: lack of assiduity to appointments; unprotected sex; and consumption of alcohol. Regarding the daily medication routine, subjects depend on their parents or guardians, use strategies to remember to take the medications, and are unaware about the laboratory test for disease management and treatment. There is a need for educative intervention using information and communication technology, such as the Internet, to promote health and autonomy among adolescents. Descriptors: Acquired Immunodeficiency Syndrome; Adolescent Health; Antiretroviral Therapy, Highly Active; Nursing.

  4. Master schedule for CY-1981 Hanford environmental surveillance routine program

    Energy Technology Data Exchange (ETDEWEB)

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1980-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is provided. Questions about specific entries should be referred to the authors since modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Air quality data obtained in a separate program are also reported. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Schedules are presented for the following subjects: air, Columbia River, sanitary water, surface water, ground water, foodstuffs, wildlife, soil and vegetation, external radiation measurement, portable instrument surveys, and surveillance of waste disposal sites. (JGB)

  5. Total Laboratory Automation of Routine Hemostasis Testing

    National Research Council Canada - National Science Library

    Da Rin, Giorgio; Lippi, Giuseppe

    2014-01-01

    The aim of this study was to assess whether preanalytical management of coagulation samples through an open total laboratory automation system may impair the reliability of routine hemostasis tests...

  6. Taking medicine at home - create a routine

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000613.htm Taking medicine at home - create a routine To use the ... teeth. Find Ways to Help You Remember Your Medicines You can: Set the alarm on your clock, ...

  7. Unsedated flexible upper gastrointestinal endoscopy: need for routine oxygen monitoring?

    Science.gov (United States)

    Embu, H Y; Misauno, M J; Isamade, E S; Yilkudi, M G

    2008-01-01

    To determine the incidence of oxygen desaturation and whether routine oxygen monitoring is necessary during unsedated diagnostic flexible upper gastrointestinalendoscopy. A prospective study involving 54 consecutive in and out patients who had diagnostic upper gastrointestinal endoscopy at the endoscopy suit of the Jos University Teaching Hospital, Jos, Nigeria between March 2007 and October 2007. The patients were reviewed before the procedure and classified according to the American Society of Anesthesiologists' (ASA) classification into classes I, II, III and IV Endoscopy was carried out after topical pharyngeal anaesthesia using 10% lidocaine spray and oxygen saturation was monitored throughout the procedure. There were 30 males and 24 females, with a male, female ratio of 1.25:1. The mean age was 46.7 with a range of 17 to 81 years. Mild to moderate desaturation occurred in 10 (18.5%) of the patients while severe desaturation occurred in 7 (12.9%) of the patients. All cases of severe desaturation lasted less than 30 seconds and no supplementary oxygen was needed. There were no significant statistical correlations between desaturation and gender, age, duration of procedure or ASA status of the patients. Routine oxygen monitoring may not be necessary in patients undergoing unsedated diagnostic upper gastrointestinal endoscopy and who do not have respiratory disease.

  8. Continuous and routine eeg in intensive care

    OpenAIRE

    Ney, JP; Van Der Goes, DN; Nuwer, MR; Nelson, L; Eccher, MA

    2013-01-01

    Objectives: To evaluate the effect of intensive care unit continuous EEG (cEEG) monitoring on inpatient mortality, hospital charges, and length of stay. Methods: A retrospective cross-sectional study was conducted using the Nationwide Inpatient Sample, a dataset representing 20% of inpatient discharges in nonfederal US hospitals. Adult discharge records reporting mechanical ventilation and EEG (routine EEG or cEEG) were included. cEEG was compared with routine EEG alone in association with th...

  9. Effectiveness of routine psychotherapy: Method matters.

    Science.gov (United States)

    McAleavey, Andrew A; Youn, Soo Jeong; Xiao, Henry; Castonguay, Louis G; Hayes, Jeffrey A; Locke, Benjamin D

    2017-11-02

    Though many studies have shown that psychotherapy can be effective, psychotherapy available in routine practice may not be adequate. Several methods have been proposed to evaluate routine psychological treatments. The aim of this paper is to demonstrate the combined utility of complementary methods, change-based benchmarking, and end-state normative comparisons, across a range of self-reported psychological symptoms. Benchmarks derived from randomized controlled trials (RCTs) and normative comparisons were used to evaluate the effectiveness of psychotherapy in a large (N = 9895) sample of clients in university counseling centers (UCCs). Overall, routine psychotherapy was associated with significant improvement across all symptoms examined. For clients whose initial severity was similar to RCT participants, the observed pre-post effect sizes were equivalent to those in RCTs. However, treatment tended to lead to normative end-state functioning only for those clients who were moderately, but not severely, distressed at the start of psychotherapy. This suggests that although psychotherapy is associated with an effective magnitude of symptom improvement in routine practice, additional services for highly distressed individuals may be necessary. The methods described here comprise a comprehensive analysis of the quality of routine care, and we recommend using both methods in concert. Clinical or methodological significance of this article: This study examines the effectiveness of routine psychotherapy provided in a large network of counseling centers. By comparing multiple established methods to define outcomes in this sample we provide a detailed understanding of typical outcomes. The findings show that, across several different problem areas, routine psychotherapy provided substantial benefit, particularly to clients in the most distress. However, there is room to improve, especially by increasing the number of clients who return to normal functioning by the end of

  10. SUBJECT INDEX

    Indian Academy of Sciences (India)

    Subject Index. Variation of surface electric field during geomagnetic disturbed period at Maitri, Antarctica. 1721. Geomorphology. A simple depression-filling method for raster and irregular elevation datasets. 1653. Decision Support System integrated with Geographic. Information System to target restoration actions in water-.

  11. Factors affecting patients undergoing cosmetic surgery in bushehr, southern iran.

    Science.gov (United States)

    Salehahmadi, Zeinab; Rafie, Seyyed Reza

    2012-07-01

    Although, there have been extensive research on the motivations driving patient to undergo cosmetic procedures, there is still a big question mark on the persuasive factors which may lead individuals to undergo cosmetic surgery. The present study evaluated various factors affecting patients undergoing cosmetic surgery in Bushehr, Southern Iran. From 24th March 2011 to 24th March 2012, eighty-one women and 20 men who wished to be operated in Fatemeh Zahra Hospital in Bushehr, Southern Iran and Pars Clinic, Iran were enrolled by a simple random sampling method. They all completed a questionnaire to consider reasons for cosmetic procedures. The collected data were statistically analyzed. Demographical, sociological and psychological factors such as age, gender, educational level, marital status, media, perceived risks, output quality, depression and self-improvement were determined as factors affecting tendency of individuals to undergo cosmetic surgery in this region. Trend to undergo cosmetic surgery was more prevalent in educational below bachelor degree, married subjects, women population of 30-45 years age group. Education level, age, marital status and gender were respectively the influential factors in deciding to undergo cosmetic surgery. Among the socio-psychological factors, self-improvement, finding a better job opportunity, rivalry, media, health status as well as depression were the most persuasive factors to encourage people to undergo cosmetic surgery too. Cost risk was not important for our samples in decision making to undergo cosmetic surgery. We need to fully understand the way in which the combination of demographic, social and psychological factors influence decision-making to undergo cosmetic surgery.

  12. Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery : an observational study

    NARCIS (Netherlands)

    Hamouda, Khaled; Oezkur, Mehmet; Sinha, Bhanu; Hain, Johannes; Menkel, Hannah; Leistner, Marcus; Leyh, Rainer; Schimmer, Christoph

    2015-01-01

    Background: All international guidelines recommend perioperative antibiotic prophylaxis (PAB) should be routinely administered to patients undergoing cardiac surgery. However, the duration of PAB is heterogeneous and controversial. Methods: Between 01.01.2011 and 31.12.2011, 1096 consecutive cardiac

  13. Are Routine Interventions Necessary in Normal Birth?

    Directory of Open Access Journals (Sweden)

    Chen-Yu Chen

    2006-12-01

    Full Text Available Routine interventions during labor and birth, such as perineal shaving and enemas before vaginal delivery, continuous intrapartum electronic fetal monitoring (EFM, and episiotomy are prevalent in Taiwan, but they may not always be necessary. Numerous studies investigating these interventions have failed to find absolute benefits for women with uncomplicated and low-risk pregnancies. No evidence-based benefits support routine perineal shaving or enemas during labor for reducing the risk of perineal wound infection or neonatal infection. The use of EFM is associated with an increased rate of operative interventions (vacuum, forceps, cesarean delivery but does not result in a significant decrease in the incidence of perinatal death or cerebral palsy. Routine episiotomy does not have demonstrable advantages over restrictive episiotomy in the frequency or severity of perineal damage or pelvic relaxation.

  14. Routine Radiological Environmental Monitoring Plan. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Bechtel Nevada

    1999-12-31

    The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs.

  15. Integrated medicines management - can routine implementation improve quality?

    Science.gov (United States)

    Scullin, Claire; Hogg, Anita; Luo, Ruoyin; Scott, Michael G; McElnay, James C

    2012-08-01

    Previous service development work in the area of integrated medicines management (IMM) has demonstrated clear quality improvements in a targeted group of patients within a hospital in Northern Ireland. In order to determine whether this programme could be transferable to routine practice and thereby assess its generalizability, research has been carried out to quantify the health care benefits of incorporating the concept of IMM as routine clinical practice. The IMM programme of care was delivered to all eligible patients (subject to inclusion criteria) across two hospital sites in Northern Ireland during normal pharmacy opening hours. All patients were followed up for a period of 12 months from their time of hospital admission. All patient data were collected using the custom-designed Electronic Pharmacist Intervention Clinical System at each stage of their hospital journey, that is, admission, inpatient stay and discharge. Patients who received the IMM service benefited from a reduced length of hospital stay on their reference admission (1.42 days; P = 0.020) as well as a reduced length of stay during the first rehospitalization (5.86 days; P = 0.013). There was also a trend of a reduced number of readmissions and a longer time to readmission during the 12-month follow-up period. Potential significant opportunity cost savings were demonstrated as well as a significant improvement in medication appropriateness (discharge vs. reference admission). The IMM programme of care has proven to be transferable to routine hospital care within two hospitals in Northern Ireland. It is anticipated that this current research will further inform the development of IMM as routine clinical practice across Northern Ireland and beyond. © 2011 Blackwell Publishing Ltd.

  16. The (Proper) Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Teppo; Foss, Nicolai Juul

    2012-01-01

    Sidney Winter (2011), Brian Pentland (2011), and Geoffrey Hodgson and Thorbjørn Knudsen (2011) take issue with the arguments in Teppo Felin and Nicolai J. Foss (2011), along with more generally critiquing the ‘microfoundations project’ related to routines and capabilities. In this rejoinder we...... argue that the responses of our critics reinforce a number of the points stated in our writings on the routines and capabilities literature. In response to their many points we address the following key issues in the debate: (1) lack of construct clarity; (2) universal mechanisms or comparative...

  17. Absorptive routines and international patent performance

    Directory of Open Access Journals (Sweden)

    Fernando E. García-Muiña

    2017-04-01

    We enrich the treatment of the absorptive capacity phases including the moderating effects between routines associated to the traditional potential-realized absorptive capacities. Taking into account external knowledge search strategies, the deeper external relationships, the better transference and appropriation of specific external knowledge. Nevertheless, when the moderating role of assimilation is included, cooperation agreements appear as the most efficient source of external knowledge. Finally, we show that technological tools let firms store and structure the information making easier its use for international patenting. This positive effect is reinforced in the presence of exploitation routines, since technological knowledge will better fit to the industry's key factors of success.

  18. Conversational routines in English convention and creativity

    CERN Document Server

    Aijmer, Karin

    2014-01-01

    It is surprising how much of everyday conversation consists of repetitive expressions such as 'thank you', 'sorry', would you mind?' and their many variants. However commonplace they may be, they do have important functions in communication.This thorough study draws upon original data from the London-Lund Corpus of Spoken English to provide a discoursal and pragmatic account of the more common expressions found in conversational routines, such as apologising, thanking, requesting and offering.The routines studied in this book range from conventionalized or idiomatized phrases t

  19. ANSYS duplicate finite-element checker routine

    Science.gov (United States)

    Ortega, R.

    1995-01-01

    An ANSYS finite-element code routine to check for duplicated elements within the volume of a three-dimensional (3D) finite-element mesh was developed. The routine developed is used for checking floating elements within a mesh, identically duplicated elements, and intersecting elements with a common face. A space shuttle main engine alternate turbopump development high pressure oxidizer turbopump finite-element model check using the developed subroutine is discussed. Finally, recommendations are provided for duplicate element checking of 3D finite-element models.

  20. Postoperative care for Samter's triad patients undergoing endoscopic sinus surgery: a double-blinded, randomized controlled trial.

    Science.gov (United States)

    Rotenberg, Brian W; Zhang, Irene; Arra, Ian; Payton, Keith B

    2011-12-01

    Evidence is lacking to guide the postoperative management of Samter's triad patients with chronic rhinosinusitis with polyposis (CRSwP) undergoing endoscopic sinus surgery (ESS). The purpose of this study was to compare three different standardized medication regimens prescribed to these patients after ESS. Three-arm, randomized, double-blinded, controlled trial. Patients with Samter's triad undergoing ESS were postoperatively randomized into three medication regimens, those being saline irrigation alone (control group A), saline irrigation plus separate budesonide nasal spray (group B), and saline irrigation mixed with budesonide nasal spray (group C). Outcome measures were Sino-Nasal Outcome Test scores, Lund-Mackay computed tomography scores, and Lund-Kennedy endoscopic scores taken at preoperative baseline, and then at 6 months and 1 year postoperatively. Side effect profiles were also measured (adrenocorticotropic hormone blood level ranges and intraocular pressure at the same interval points). Analysis of variance and χ(2) analyses were conducted using a Bonferroni correction method and routine descriptive statistics. Inter- and intragroup comparisons were made. Sixty subjects were recruited. All groups were equivalent at baseline in all outcomes. All intragroup analyses showed statistically and clinically significant improvement in disease status as compared to baseline (P .05). There was no treatment effect noted. In this study, nasal steroids did not confer any additional benefit over saline alone as post-ESS care for the Samter's triad CRSwP patient population. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  1. Effectiveness of Self-Care Education on the Enhancement of the Self-Esteem of Patients Undergoing Hemodialysis.

    Science.gov (United States)

    Poorgholami, Farzad; Javadpour, Shohreh; Saadatmand, Vahid; Jahromi, Marzieh Kargar

    2015-06-12

    The assessment of self-esteem in hemodialysis people is becoming increasingly important and necessary. Low self-esteem as a problem in patients undergoing hemodialysis decreases adherence to treatment. The researcher intends to carry out a study in order to investigate the effect of self-care education on enhancement of the self-esteem of patients undergoing hemodialysis in Iran. This is a quasi-experimental study. The subjects of the study who were selected based on purposive sampling method consisted of 50 patients with advanced chronic renal disease treated with hemodialysis. Before the intervention, two questionnaires were completed by patients. There was no intervention in the control group and the patients received only routine care in the hospital. In the experimental group, the hemodialysis patients received 5 consecutive one-hour training sessions by the researcher. Then the Rosenberg scale was filled out by the patients 2 month later. According to the results, Paired t-test showed a significant difference between the mean self-esteem score in both groups before and after intervention. Increasing the knowledge and awareness of hemodialysis patients must constitute a cornerstone of therapy and an integral part of nursing responsibilities. Nurses should educate the patients about self-care behaviors and remind them of the dangerous complications of abandoning these.

  2. Impact of routine follow-up examinations on life expectancy in ovarian cancer patients: a simulation study.

    NARCIS (Netherlands)

    Geurts, S.M.E.; Vegt, F. de; Altena, A.M. van; Tjan-Heijnen, V.C.; Massuger, L.F.A.G.; Adang, E.M.M.; Dijck, J.A.A.M. van; Verbeek, A.L.M.

    2012-01-01

    OBJECTIVE: The clinical benefit of routine follow-up in patients treated for ovarian cancer is subject to debate. In this study, the magnitude of the potential survival benefit of routine examinations was evaluated by Markov modeling. METHODS: The clinical course of ovarian cancer was simulated

  3. An Examination of Latino Students' Homework Routines

    Science.gov (United States)

    Martinez, Sylvia

    2011-01-01

    Homework appears to be positively associated with better student outcomes. Although some researchers have explored the connection between time spent on homework and minority student achievement, few have examined the homework routines of Latino youth. Interviews with Latino high school students show that they have some difficulty completing daily…

  4. Improving care coordination using organisational routines

    DEFF Research Database (Denmark)

    Prætorius, Thim

    2016-01-01

    be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Design/methodology/approach: Theory of routines is systematically applied to the concept of care pathways in order to develop theoretically derived propositions. Findings: Care pathways mirror...

  5. libvaxdata: VAX data format conversion routines

    Science.gov (United States)

    Baker, Lawrence M.

    2005-01-01

    libvaxdata provides a collection of routines for converting numeric data-integer and floating-point-to and from the formats used on a Digital Equipment Corporation1 (DEC) VAX 32-bit minicomputer (Brunner, 1991). Since the VAX numeric data formats are inherited from those used on a DEC PDP-11 16-bit minicomputer, these routines can be used to convert PDP-11 data as well. VAX numeric data formats are also the default data formats used on DEC Alpha 64-bit minicomputers running OpenVMS The libvaxdata routines are callable from Fortran or C. They require that the caller use two's-complement format for integer data and IEEE 754 format (ANSI/IEEE, 1985) for floating-point data. They also require that the 'natural' size of a C int type (integer) is 32 bits. That is the case for most modern 32-bit and 64-bit computer systems. Nevertheless, you may wish to consult the Fortran or C compiler documentation on your system to be sure. Some Fortran compilers support conversion of VAX numeric data on-the-fly when reading or writing unformatted files, either as a compiler option or a run-time I/O option. This feature may be easier to use than the libvaxdata routines. Consult the Fortran compiler documentation on your system to determine if this alternative is available to you. 1Later Compaq Computer Corporation, now Hewlett-Packard Company

  6. Community Pharmacies As Possible Centres For Routine ...

    African Journals Online (AJOL)

    Community Pharmacies As Possible Centres For Routine Immunization. R I Aderemi-Williams, C I Igwilo. Abstract. Background: Nigeria has embraced the primary healthcare movement and has committed its resources to the provision of cost effective community based primary healthcare strategy which recognizes the need ...

  7. Individual Values, Learning Routines and Academic Procrastination

    Science.gov (United States)

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-01-01

    Background: Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. Aims: The…

  8. Individual values, learning routines and academic procrastination.

    Science.gov (United States)

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-12-01

    Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. The model tested in this study posits that postmodern value orientations are positively related to procrastination and to a lack of daily routines concerning the performance of academic activities. In contrast, modern values are negatively related to procrastination and positively to learning routines. Academic procrastination, in-turn, should be associated with the tendency to prefer leisure activities to schoolwork in case of conflicts between these two life domains. Seven hundred and four students from 6th and 8th grade with a mean age of 13.5 years participated in the study. The sample included students from all tracks of the German educational system. Students completed a questionnaire containing two value prototypes as well as scales on learning routines and procrastination. Decisions in motivational conflicts were measured using two vignettes. Results from structural equation modelling supported the proposed model for the whole sample as well as for each school track. A planned course of the day can prevent procrastination and foster decisions for academic tasks in case of conflicts. Students' learning takes place within a societal context and reflects the values held in the respective culture.

  9. Value of routine polysomnography in bariatric surgery

    NARCIS (Netherlands)

    de Raaff, C.A.L.; Pierik, A.S.; Coblijn, U.K.; de Vries, N.; Bonjer, H.J.; van Wagensveld, B.A.

    2017-01-01

    Background: Obstructive sleep apnea (OSA), present in 60–70 % of bariatric surgery patients, is a potentially life-threatening condition when not detected and managed appropriately. The best available method to identify the severity of OSA is polysomnography. However, routine polysomnography

  10. ROUTINE ANTENATAL SYPHILIS SCREENING IN SOUTH WEST ...

    African Journals Online (AJOL)

    years (± 5.34) and the mean gestational age 26.4 weeks. (±6.36). The modal parity was 0. Only three patients were found to be reactive for syphilis giving a prevalence of 0.13%. Conclusion: The sero- prevalence value in this study is quite low and may justify the call to discontinue routine antena- tal syphilis screening.

  11. Routinely available cotrimoxazole prophylaxis and occurrence of ...

    African Journals Online (AJOL)

    Objectives. To examine the influence of cotrimoxazole (CTM) prophylaxis on incidence of lower respiratory tract infections (LRTis) and diarrhoea. Design. A prospective observational cohort study. Morbidity and feeding data on infants born to HN-infected mothers were collected routinely at. clink visits at 1 week, 6 weeks ...

  12. The effect of music on anxiety and pain in patients undergoing cholecystectomy

    Directory of Open Access Journals (Sweden)

    Zamanzadeh V

    2015-02-01

    Full Text Available Background and Objective: Today, the control or reduction of pain and anxiety is considered to be of great importance. Thus, the use of complementary medicine therapies has gained much attention. The present study was performed with the aim to investigate the effect of music on anxiety and pain in patients undergoing cholecystectomy. Materials and Method: This single-blind randomized clinical trial was performed on 60 patients undergoing cholecystectomy in Sina Hospital of Tabriz, Iran, in 2013. Subjects were selected through simple random sampling method and divided into intervention (n = 30 and control groups (n = 30 using a random number table. For the intervention group, 8 and 16 hours after surgery, the music was played for 15-30 minutes. For the control group, routine care was performed. Data collection tools included demographic information form and a visual analogue scales (VAS for anxiety and pain. Data analysis was performed using SPSS software version 13, and chi-square, Students’ independent t-test, and repeated measures ANOVA. Results: Comparison of changes in anxiety and pain in the two groups showed a significant decrease in anxiety 8 hours (6/27 ± 3.23 and 16 hours (5.33 ± 3.03 after surgery (P = 0.001. Moreover, the reduction in pain 8 hours (7.51 ± 1.83 and 16 hours (6.61 ± 1.86 after surgery was greater in the intervention group than the control group (P = 0.001. Conclusion: The results illustrated the positive impact of music on anxiety and pain reduction 8 and 16 hours after cholecystectomy. Therefore, this method can be used as an inexpensive and non-invasive nursing care technique.

  13. Routine repeat head CT may not be indicated in patients on anticoagulant/antiplatelet therapy following mild traumatic brain injury.

    Science.gov (United States)

    McCammack, Kevin C; Sadler, Charlotte; Guo, Yueyang; Ramaswamy, Raja S; Farid, Nikdokht

    2015-01-01

    Evaluation recommendations for patients on anticoagulant and antiplatelet (ACAP) therapy that present after mild traumatic brain injury (TBI) are controversial. At our institution, an initial noncontrast head computed tomography (HCT) is performed, with a subsequent HCT performed six hours later to exclude delayed intracranial hemorrhage (ICH). This study was performed to evaluate the yield and advisability of this approach. We performed a retrospective review of subjects undergoing evaluation for ICH after mild TBI in patients on ACAP therapy between January of 2012 and April of 2013. We assessed for the frequency of ICH on both the initial noncontrast HCT and on the routine six-hour follow-up HCT. Additionally, chart review was performed to evaluate the clinical implications of ICH, when present, and to interrogate whether pertinent clinical and laboratory data may predict the presence of ICH prior to imaging. We used multivariate generalized linear models to assess whether presenting Glasgow Coma Score (GCS), loss of consciousness (LOC), neurological or physical examination findings, international normalized ratio, prothrombin time, partial thromboplastin time, platelet count, or specific ACAP regimen predicted ICH. 144 patients satisfied inclusion criteria. Ten patients demonstrated initial HCT positive for ICH, with only one demonstrating delayed ICH on the six-hour follow-up HCT. This patient was discharged without any intervention required or functional impairment. Presenting GCS deviation (pclopidogrel (p=0.003), aspirin (p=0.03) or combination regimen (p=0.004) use were more commonly seen in patients with ICH. Routine six-hour follow-up HCT is likely not indicated in patients on ACAP therapy, as our study suggests clinically significant delayed ICH does not occur. Additionally, presenting GCS deviation, LOC, neurological examination findings, clopidogrel, aspirin or combination regimen use may predict ICH, and, in the absence of these findings, HCT may

  14. [Routine screening of splenic or portal vein thrombosis after splenectomy].

    Science.gov (United States)

    Bouvier, A; Gout, M; Audia, S; Chalumeau, C; Rat, P; Deballon, O

    2017-01-01

    Portal and/or splenic vein thrombosis (PSVT) is common after splenectomy. It can be a life-threatening complication, with a risk of bowel ischemia and portal hypertension. An early diagnosis allows an effective medical treatment and prevents life-threatening complications. There is no consensus regarding the benefit of systematic screening of patients after splenectomy for PSVT. We started in January 2012 a routine screening of PSVT after elective splenectomy. The aim of this study was to assess this policy. Since January 2012, all patients undergoing an elective splenectomy had an abdominal CT-scan on postoperative-day 7. Demographic data, pathology, type of surgery, platelet counts before and after surgery, outcome, results of medical imaging, and management of PSVT and its results were recorded. Over 3 years, 52 patients underwent an elective splenectomy. All of them had a CT-scan at postoperative-day 7. A PSVT was found in 11 patients (21.2 %). They were all asymptomatic. Lymphoma and splenomegaly were the main factors associated with PSVT in the univariate analysis. All patients with PSVT were treated with anticoagulation and no complication of PSVT occurred. The follow-up CT confirmed the efficacy of anticoagulation therapy in all patients. Routine screening of PSVT after elective splenectomy is warranted because it allows to start anticoagulant therapy and avoid further life-threatening complications. The incidence of PSVT is particularly high among patients operated on for lymphoma or with splenomegaly. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  15. Reference values for generic instruments used in routine outcome monitoring: the leiden routine outcome monitoring study

    Directory of Open Access Journals (Sweden)

    Schulte-van Maaren Yvonne WM

    2012-11-01

    Full Text Available Abstract Introduction The Brief Symptom Inventory (BSI, Mood & Anxiety Symptom Questionnaire −30 (MASQ-D30, Short Form Health Survey 36 (SF-36, and Dimensional Assessment of Personality Pathology-Short Form (DAPP-SF are generic instruments that can be used in Routine Outcome Monitoring (ROM of patients with common mental disorders. We aimed to generate reference values usually encountered in 'healthy' and ‘psychiatrically ill’ populations to facilitate correct interpretation of ROM results. Methods We included the following specific reference populations: 1294 subjects from the general population (ROM reference group recruited through general practitioners, and 5269 psychiatric outpatients diagnosed with mood, anxiety, or somatoform (MAS disorders (ROM patient group. The outermost 5% of observations were used to define limits for one-sided reference intervals (95th percentiles for BSI, MASQ-D30 and DAPP-SF, and 5th percentiles for SF-36 subscales. Internal consistency and Receiver Operating Characteristics (ROC analyses were performed. Results Mean age for the ROM reference group was 40.3 years (SD=12.6 and 37.7 years (SD=12.0 for the ROM patient group. The proportion of females was 62.8% and 64.6%, respectively. The mean for cut-off values of healthy individuals was 0.82 for the BSI subscales, 23 for the three MASQ-D30 subscales, 45 for the SF-36 subscales, and 3.1 for the DAPP-SF subscales. Discriminative power of the BSI, MASQ-D30 and SF-36 was good, but it was poor for the DAPP-SF. For all instruments, the internal consistency of the subscales ranged from adequate to excellent. Discussion and conclusion Reference values for the clinical interpretation were provided for the BSI, MASQ-D30, SF-36, and DAPP-SF. Clinical information aided by ROM data may represent the best means to appraise the clinical state of psychiatric outpatients.

  16. Self-management support in routine primary care by nurses.

    Science.gov (United States)

    Westland, Heleen; Schröder, Carin D; de Wit, Jessica; Frings, Judith; Trappenburg, Jaap C A; Schuurmans, Marieke J

    2017-09-27

    To examine how and to what extent self-management support, including behaviour change support, is provided by primary care nurses in routine consultations with chronically ill patients. Observational study design. Routine consultations of primary care nurses in the Netherlands with chronically ill patients were audio-taped and analysed. The analysis identified health topics addressed according to health care standards, self-management topics addressed using a validated set of topics, and behaviour change techniques (BCTs) using the Behaviour Change Techniques Taxonomy v1. Seventy-eight routine consultations of 17 primary care nurses with chronically ill patients were included in the analysis. Nurses addressed both health topics and self-management topics in brief, fragmented, and often inconsistent manners. Dietary intake and physical activity were the most frequently addressed topics. Nurses applied 21 BCTs to target behaviour change, but the use of these techniques was mainly inconsistent and implicit. The most consistently used BCTs were review behaviour goal(s) (56.4%) and feedback on behaviour (51.3%). Nurses addressed both health topics and self-management topics in their routine consultations. The duration, frequency, and number of addressed topics differed throughout the consultations. Nurses tended to prioritize the monitoring and optimization of patients' medical treatment and provided limited self-management support. Nurses seldom deepened their focus on behaviour change and infrequently used effective techniques to support this change. Adoption of self-management in primary care, including behaviour change, might be enhanced if nurses consistently and explicitly use effective BCTs in their consultations. Statement of contribution What is already known on this subject? Primary care nurses play a pivotal role in self-management support for patients with a chronic condition. Adequate self-management support requires nurses to activate patients and enhance

  17. Association of adipokines and adhesion molecules with indicators of obesity in women undergoing mammography screening

    Directory of Open Access Journals (Sweden)

    Isoppo de Souza Caroline

    2012-10-01

    Full Text Available Abstract Background The soluble cell adhesion molecules and adipokines are elevated in patients with obesity, hypertension, type 2 diabetes mellitus, breast cancer and atherosclerosis. Objective To investigate the relationship between anthropometric profile, dietary intake, lipid profile and fasting glycemia with serum levels of adipokines (adiponectin and PAI-1 and adhesion molecules (ICAM-1 and VCAM-1 in women without breast cancer undergoing routine mammographic screening. Design Transversal study. Subjects One hundred and forty-five women over 40-years old participated in this study. Results In 39.3% of cases the BMI was above 30 kg/m2; 46.9% had hypertension, 14.5% had type 2 Diabetes Mellitus, 31.7% had dyslipidemia and 88.3% presented a waist-to-hip ratio ≥ 0.8. A linear correlation was found between serum levels of PAI-1 and triglycerides, between serum levels of PAI-1 and WHR and between serum levels of VCAM-1 and BMI. Conclusion We found a high prevalence of obesity and metabolic syndrome. PAI-1 and VCAM-1 levels were correlated with clinical indicators of obesity and overweight.

  18. Probability and statistics with integrated software routines

    CERN Document Server

    Deep, Ronald

    2005-01-01

    Probability & Statistics with Integrated Software Routines is a calculus-based treatment of probability concurrent with and integrated with statistics through interactive, tailored software applications designed to enhance the phenomena of probability and statistics. The software programs make the book unique.The book comes with a CD containing the interactive software leading to the Statistical Genie. The student can issue commands repeatedly while making parameter changes to observe the effects. Computer programming is an excellent skill for problem solvers, involving design, prototyping, data gathering, testing, redesign, validating, etc, all wrapped up in the scientific method.See also: CD to accompany Probability and Stats with Integrated Software Routines (0123694698)* Incorporates more than 1,000 engaging problems with answers* Includes more than 300 solved examples* Uses varied problem solving methods

  19. Family-Related Opinions and Stressful Situations Associated with Psychological Distress in Women Undergoing Infertility Treatment

    OpenAIRE

    Jiro Takaki; Yuri Hibino

    2014-01-01

    The purpose of this study is to investigate how family-related opinions and stressful situations are related to psychological distress in women undergoing infertility treatment. The subjects in this cross-sectional study were recruited from female patients undergoing infertility treatment (n = 2540) at 70 infertility treatment institutions in Japan. Because of non-participation or missing data, the number of subjects included in the analysis was 635 (response rate, 25.0%). The family-related ...

  20. Primary culture media for routine urine processing.

    OpenAIRE

    Fung, J C; Lucia, B; Clark, E.; Berman, M.; Goldstein, J.; D'Amato, R F

    1982-01-01

    It has been recommended that routine microbiological processing of urine specimens include quantitative plating onto blood agar medium along with a selective and differential agar such as MacConkey agar for gram-negative organisms. Few data have been published to justify this combination. To evaluate the validity of this recommendation 2,553 midstream, clean-voided urine samples were quantitatively plated onto blood agar, MacConkey agar, and colistin-nalidixic acid agar, which is a selective ...

  1. Preoperative medical testing in Medicare patients undergoing cataract surgery.

    Science.gov (United States)

    Chen, Catherine L; Lin, Grace A; Bardach, Naomi S; Clay, Theodore H; Boscardin, W John; Gelb, Adrian W; Maze, Mervyn; Gropper, Michael A; Dudley, R Adams

    2015-04-16

    Routine preoperative testing is not recommended for patients undergoing cataract surgery, because testing neither decreases adverse events nor improves outcomes. We sought to assess adherence to this guideline, estimate expenditures from potentially unnecessary testing, and identify patient and health care system characteristics associated with potentially unnecessary testing. Using an observational cohort of Medicare beneficiaries undergoing cataract surgery in 2011, we determined the prevalence and cost of preoperative testing in the month before surgery. We compared the prevalence of preoperative testing and office visits with the mean percentage of beneficiaries who underwent tests and had office visits during the preceding 11 months. Using multivariate hierarchical analyses, we examined the relationship between preoperative testing and characteristics of patients, health system characteristics, surgical setting, care team, and occurrence of a preoperative office visit. Of 440,857 patients, 53% had at least one preoperative test in the month before surgery. Expenditures on testing during that month were $4.8 million higher and expenditures on office visits $12.4 million higher (42% and 78% higher, respectively) than the mean monthly expenditures during the preceding 11 months. Testing varied widely among ophthalmologists; 36% of ophthalmologists ordered preoperative tests for more than 75% of their patients. A patient's probability of undergoing testing was associated mainly with the ophthalmologist who managed the preoperative evaluation. Preoperative testing before cataract surgery occurred frequently and was more strongly associated with provider practice patterns than with patient characteristics. (Funded by the Foundation for Anesthesia Education and Research and the Grove Foundation.).

  2. Parent routines for managing cystic fibrosis in children.

    Science.gov (United States)

    Grossoehme, Daniel H; Filigno, Stephanie Spear; Bishop, Meredith

    2014-06-01

    Management of cystic fibrosis (CF) is burdensome and adherence is often suboptimal. Family routines are associated with adherence and health outcomes in other disease populations. Few studies have examined routines in CF. The study's aim was to describe parent experiences developing and utilizing CF care routines. Semi-structured interviews with a convenience sample of 25 parents of children under 13 years of age with CF were analyzed using phenomenological analysis. Three domains emerged: parent experiences developing a routine, support systems facilitating maintenance of routines, and challenges with maintaining care routines. Parents found routines difficult to establish, used trial and error, encountered barriers, and found support helpful to manage care demands. Some parents chose to deviate from their routine. Providing anticipatory guidance to promote the use of care routines and strategies to manage potential challenges may facilitate use of routines and improve CF management.

  3. Postural balance in Alzheimer's disease patients undergoing sensory pitfalls

    Directory of Open Access Journals (Sweden)

    Brunna Berton

    Full Text Available Abstract Despite consensus regarding the interference of cognitive processes on the human balance, the impact that different sensory stimuli have on the stabilometric measures remains unclear. Here, we investigated changes in the postural balance of individuals with Alzheimer's disease (AD and in healthy controls undergoing different proprioceptive and somesthetic pitfalls. We included 17 subjects submitted to eight sensorimotor dynamics with differences in the support bases, contact surfaces, and visual clues. The measurements used to assess participants balance were as follows: position of the body in space, range of instability, area of the support base, and velocity of postural control. From a total of 56 cross-sectional analyses, 21.42% pointed out differences between groups. Longitudinal analyses showed that tasks with proprioceptive and somesthetic pitfalls similarly impact imbalance in both groups. The current results suggest that AD subjects and healthy controls had different patterns submitted to balance, but suffered similar interference when undergoing proprioceptive and somesthetic challenges.

  4. Routine colonic endoscopic evaluation following resolution of acute diverticulitis: Is it necessary?

    Science.gov (United States)

    Agarwal, Amit K; Karanjawala, Burzeen E; Maykel, Justin A; Johnson, Eric K; Steele, Scott R

    2014-01-01

    Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations, low fiber diets, and in younger and obese patients. Twenty-five percent of patients with diverticulosis will develop acute diverticulitis. This imposes a significant burden on healthcare systems, resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion USD. Abdominal computed tomography (CT) is the diagnostic study of choice, with a sensitivity and specificity greater than 95%. Unfortunately, similar CT findings can be present in colonic neoplasia, especially when perforated or inflamed. This prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out malignancy. Yet, the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated technology. While any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation, in the era of widespread use of high-resolution computed tomography, routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs, comes with inherent risks, and may require further study. In this manuscript, we review the current data related to this recommendation. PMID:25253951

  5. The Use of Routine Postoperative Microscopy and Culture Screening Following Elective Hip and Knee Arthroplasty: An Unnecessary Cost With No Effect on Clinical Management?

    Science.gov (United States)

    Kemp, Mark A; Martina, Ka; Collins, Claire L; Salmon, Lucy J; Gooden, Benjamin R; Lyons, Matthew C

    2017-04-01

    The use of microscopy and culture screening to detect pathogenic microorganisms followed by a decolonization protocol is a widely performed practice prior to elective hip and knee arthroplasty. In our center, the routine care of hip and knee arthroplasty also involves postoperative screening including direct culture of the surgical site. The aim of this study was to assess the frequency of pathogen detection following these tests and to determine whether routine postoperative screening, with particular reference to postoperative surgical site culture, led to any change in clinical management of these patients. A series of 1000 patients undergoing hip or knee arthroplasty at The Mater Hospital between January 2014 and December 2015 were identified from our arthroplasty database. Results of preoperative and postoperative microscopy and culture screening were reviewed by 2 independent researchers. Of the 1000 subjects, positive microscopy and culture results were identified in 88 patients (8.8%) preoperatively and 5 patients (0.5%) postoperatively. None of the 1000 postoperative surgical site swabs had a positive microscopy and culture screen. All the 5 positive postoperative microscopy and culture screen results were in patients who had positive cultures preoperatively. There were no positive postoperative microscopy and culture screen results in patients who had had negative preoperative results. Postoperative screening was performed at a cost of AUS$213 per patient. Routine postoperative surgical site culture following hip and knee arthroplasty does not alter clinical management, has a significant associated financial cost, and has the potential to expose the patient to a risk of surgical site infection and is therefore not supported. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Validity of subjective smoking status in orthopedic patients

    Directory of Open Access Journals (Sweden)

    Bender D

    2015-08-01

    Full Text Available Daniel Bender,* Patrick Haubruck,* Sonja Boxriker, Sebastian Korff, Gerhard Schmidmaier, Arash Moghaddam Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany *These authors contributed equally to this work Purpose: In this level 1 diagnostic study, we analyzed the validity of subjective smoking status and, as secondary research question, the smoking cessation adherence in orthopedic patients during a routine hospital stay of nonunion patients by measuring serum cotinine.  Methods: We included patients undergoing revision surgery due to nonunion of long bones. Patients were interviewed about their smoking status. Blood samples were taken from all the patients prior to surgery and for an additional 6 weeks following surgery. Serum levels of cotinine were measured, and coherence between subjective smoking status and objective cotinine analysis was evaluated.  Results: Between March 2012 and August 2014, we enrolled 136 patients. Six of the 26 “previous smokers” (23% and four of the 65 “nonsmokers” (6% had serum cotinine above cutoff levels. In self-labeled smokers, serum cotinine levels averaged at 2,367.4±14,885.9 ng/mL (with a median of 100 ng/mL, whereas in previous smokers the levels averaged at 4,270±19,619.4 ng/mL (with a median of 0 ng/mL and in the nonsmokers group the levels averaged at 12±53.9 ng/mL (with a median of 0.03 ng/mL. Overall, the subjective smoking status matched serum cotinine testing in 88% of the cases. Sensitivity was 79.6% and specificity was 93.1%. Ninety-one percent of the patients with preoperative positive serum values were still positive at follow-up.  Conclusion: In this study, we could show that subjective smoking status in orthopedic patients is predominantly reliable as validated by objective cotinine measurements; however, patients who declare themselves as “previous smokers” are at elevated risk

  7. Humour and the Unacceptable in Neil Hamburger’s Routine

    Directory of Open Access Journals (Sweden)

    Daniel Derrin

    2014-08-01

    Full Text Available This paper addresses the comic routine of Australian born U.S. comedian Gregg Turkington’s alter-ego, ‘Neil Hamburger’, from the perspective of Aristotle’s ancient conception of the risible as a species of the unacceptable, or the unseemly. In doing so, it explores two thresholds of acceptability, subjective and social, which are relevant to an understanding of Hamburger’s comic style. The paper argues that Hamburger’s style willfully violates those thresholds, risking the audience’s laughter, and yet working towards the visualization of a less normative kind of ‘unseemliness’ that underlies Hamburger’s politics: reverence for celebrity and the sacred.

  8. Matching Medline/PubMed data with Web of Science: a routine in R language

    NARCIS (Netherlands)

    Rotolo, D.; Leydesdorff, L.

    2015-01-01

    We present a novel routine, namely medlineR, based on the R language, that allows the user to match data from Medline/PubMed with records indexed in the ISI Web of Science (WoS) database. The matching allows exploiting the rich and controlled vocabulary of medical subject headings (MeSH) of

  9. Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy.

    LENUS (Irish Health Repository)

    Manning, B J

    2012-02-03

    BACKGROUND: The routine use of nasogastric tubes in patients undergoing elective abdominal operation is associated with an increased incidence of postoperative fever, atelectasis, and pneumonia. Previous studies have shown that nasogastric tubes have no significant effect on the incidence of gastroesophageal reflux or on lower esophageal sphincter pressure in healthy volunteers. We hypothesized that nasogastric intubation in patients undergoing laparotomy reduces lower esophageal sphincter pressure and promotes gastroesophageal reflux in the perioperative period. METHODS: A prospective randomized case-control study was undertaken in which 15 consenting patients, admitted electively for bowel surgery, were randomized into 2 groups. Group 1 underwent nasogastric intubation after induction of anesthesia, and Group 2 did not. All patients had manometry and pH probes placed with the aid of endoscopic vision at the lower esophageal sphincter and distal esophagus, respectively. Nasogastric tubes, where present, were left on free drainage, and sphincter pressures and pH were recorded continuously during a 24-hour period. Data were analyzed with 1-way analysis of variance. RESULTS: The mean number of reflux episodes (defined as pH < 4) in the nasogastric tube group was 137 compared with a median of 8 episodes in the group managed without nasogastric tubes (P =.006). The median duration of the longest episode of reflux was 132 minutes in Group 1 and 1 minute in Group 2 (P =.001). A mean of 13.3 episodes of reflux lasted longer than 5 minutes in Group 1, with pH less than 4 for 37.4% of the 24 hours. This was in contrast to Group 2 where a mean of 0.13 episodes lasted longer than 5 minutes (P =.001) and pH less than 4 for 0.2% of total time (P =.001). The mean lower esophageal sphincter pressures were lower in Group 1. CONCLUSIONS. These findings demonstrate that patients undergoing elective laparotomy with routine nasogastric tube placement have significant gastroesophageal

  10. Should nylon corneal sutures be routinely removed?

    Science.gov (United States)

    Jackson, H.; Bosanquet, R.

    1991-01-01

    Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery. Images PMID:1751460

  11. How can we screen voice problems effectively in patients undergoing thyroid surgery?

    Science.gov (United States)

    Park, Jun-Ook; Bae, Ja-Sung; Chae, Byung-Joo; Kim, Choung Soo; Nam, Inn-Chul; Chun, Byung-Joon; Shim, Mi-Ran; Hwang, Yeon-Shin; Kim, Min-Sik; Sun, Dong-Il

    2013-11-01

    Voice problems following thyroid surgery are well known, and perioperative voice analysis in patients undergoing thyroidectomy no longer seems optional. However, multiple means of assessing vocal function are time-consuming, require specific instruments and specialists, and increase costs. Therefore, we designed this study to develop an efficient and cost-effective screening tool for detecting voice disorders following thyroidectomy. We developed the Perioperative Voice-Screening Protocol for Thyroid Surgery (PVST) using the Thyroidectomy-Related Voice Questionnaire (TVQ) to provide a cost-effective diagnostic flow chart for patients following thyroidectomy. The TVQ is a simple questionnaire that was developed at our institution and has already demonstrated its effectiveness in detecting pre- and postthyroidectomy voice-related disorders in our previous studies. To investigate the PVST, we enrolled 242 subjects who underwent thyroidectomy and let them follow the PVST. All subjects underwent a voice work-up by a voice specialist to verify the predictive value of the protocol. Using PVST, we could effectively screen for abnormal preoperative laryngeal findings with sensitivity and specificity of 82.1% and 50.5%, respectively, especially laryngeal benign mucosal disease with sensitivity and specificity of 100% and 45.6%, respectively. We could also screen for postoperative voice-related problems with sensitivity and specificity of 100% and 50.4% for detecting vocal-cord palsy, and 66.7% and 51.2% for detecting a low-pitched voice, respectively. If all 242 patients followed the protocol, US $42,768 would be saved, and the PVST was estimated to decrease costs by 43.5%. The PVST is a reliable and cost-effective perioperative screening tool that enables thyroid surgeons to detect patients with voice problems in their routine outpatient clinic for early and appropriate referral to voice specialists.

  12. CPU timing routines for a CONVEX C220 computer system

    Science.gov (United States)

    Bynum, Mary Ann

    1989-01-01

    The timing routines available on the CONVEX C220 computer system in the Structural Mechanics Division (SMD) at NASA Langley Research Center are examined. The function of the timing routines, the use of the timing routines in sequential, parallel, and vector code, and the interpretation of the results from the timing routines with respect to the CONVEX model of computing are described. The timing routines available on the SMD CONVEX fall into two groups. The first group includes standard timing routines generally available with UNIX 4.3 BSD operating systems, while the second group includes routines unique to the SMD CONVEX. The standard timing routines described in this report are /bin/csh time,/bin/time, etime, and ctime. The routines unique to the SMD CONVEX are getinfo, second, cputime, toc, and a parallel profiling package made up of palprof, palinit, and palsum.

  13. Scoring Rules for Subjective Probability Distributions

    DEFF Research Database (Denmark)

    Harrison, Glenn W.; Martínez-Correa, Jimmy; Swarthout, J. Todd

    2017-01-01

    Subjective beliefs are elicited routinely in economics experiments. However, such elicitation often suffers from two possible disadvantages. First, beliefs are recovered in the form of a summary statistic, usually the mean, of the underlying latent distribution. Second, recovered beliefs are bias...

  14. Radiation dose monitoring in the clinical routine

    Energy Technology Data Exchange (ETDEWEB)

    Guberina, Nika [UK Essen (Germany). Radiology

    2017-04-15

    Here we describe the first clinical experiences regarding the use of an automated radiation dose management software to monitor the radiation dose of patients during routine examinations. Many software solutions for monitoring radiation dose have emerged in the last decade. The continuous progress in radiological techniques, new scan features, scanner generations and protocols are the primary challenge for radiation dose monitoring software systems. To simulate valid dose calculations, radiation dose monitoring systems have to follow current trends and stay constantly up-to-date. The dose management software is connected to all devices at our institute and conducts automatic data acquisition and radiation dose calculation. The system incorporates 18 virtual phantoms based on the Cristy phantom family, estimating doses in newborns to adults. Dose calculation relies on a Monte Carlo simulation engine. Our first practical experiences demonstrate that the software is capable of dose estimation in the clinical routine. Its implementation and use have some limitations that can be overcome. The software is promising and allows assessment of radiation doses, like organ and effective doses according to ICRP 60 and ICRP 103, patient radiation dose history and cumulative radiation doses. Furthermore, we are able to determine local diagnostic reference doses. The radiation dose monitoring software systems can facilitate networking between hospitals and radiological departments, thus refining radiation doses and implementing reference doses at substantially lower levels.

  15. Routine intraoperative cholangiography is unnecessary in patients with mild gallstone pancreatitis and normalizing bilirubin levels.

    Science.gov (United States)

    Pham, Xuan-Binh D; de Virgilio, Christian; Al-Khouja, Lutfi; Bermudez, Michael C; Schwed, Alexander C; Kaji, Amy H; Plurad, David S; Lee, Steven L; Bennion, Robert S; Saltzman, Darin J; Kim, Dennis Y

    2016-12-01

    The benefit of intraoperative cholangiography (IOC) is controversial in patients with gallstone pancreatitis whose bilirubin levels are normalizing. IOC with subsequent endoscopic retrograde cholangiopancreatography may lengthen duration of surgery and length of stay, whereas failure to clear the common bile duct may result in recurrent pancreatitis. We performed a 6-year retrospective cohort analysis of consecutive adult patients with mild gallstone pancreatitis undergoing same-admission cholecystectomy at 2 university-affiliated medical centers. Institution A routinely performed IOC, whereas institution B did not. The primary outcome was readmission within 30 days for recurrent pancreatitis. Of 520 patients evaluated, 246 (47%) were managed at institution A (routine IOC) and 274 (53%) were managed at institution B (restricted IOC). Patients at institution B had a shorter duration of surgery (1.0 vs 1.6 hours, P pancreatitis with normalizing bilirubin values. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Evaluation of central venous pressure monitoring in children undergoing craniofacial reconstruction surgery.

    Science.gov (United States)

    Stricker, Paul A; Lin, Elaina E; Fiadjoe, John E; Sussman, Emily M; Pruitt, Eric Y; Zhao, Huaqing; Jobes, David R

    2013-02-01

    Massive hemorrhage during craniofacial surgery is common and often results in hypovolemia and hypotension. We conducted this study to assess the effect of the addition of routine central venous pressure (CVP) monitoring on the incidence of intraoperative hypotension and to evaluate the relationship between CVP and hypotension in this population. Data from our prospective craniofacial perioperative registry for children 6 to 24 months of age undergoing cranial vault reconstruction with CVP monitoring were compared with data from a historical cohort without CVP monitoring. The incidence and duration of hypotension in the 2 cohorts were compared. In the cohort of subjects with CVP monitoring who experienced hypotension, CVP at the onset of hypotension (T0) was compared with CVP 5 minutes before (T-5) and 5 minutes after (T+5) the onset of hypotension and with the baseline CVP. The amount of time spent at various CVP levels below the baseline, and the associated incidence of hypotension were also determined. Data from 57 registry subjects were compared with data from 115 historical cohort subjects. The median total duration of hypotension in subjects experiencing hypotension was 278 seconds in the CVP cohort versus 165 seconds in the historical cohort; the median difference was 98 seconds (95% confidence interval [CI], -45 to 345 seconds). The incidence of hypotension was 18% in the CVP cohort versus 21% in the historical cohort; the difference in the incidence of hypotension was -3% (95% CI, -10% to 15%). Analysis using a linear mixed effects model showed a significant decrease in CVP from T-5 to T0 (95% CI, -0.9 to -2.2 mm Hg), a significant increase in CVP from T0 to T+5 (95% CI, 1.0-2.4 mm Hg), no significant difference in CVP between T-5 and T+5 (95% CI, -0.9 to 0.9 mm Hg), and a significant decrease in CVP from baseline to T0 (95% CI, -3.4 to -2.1 mm Hg). CVP at T0 was less than the baseline CVP in 97% of hypotensive episodes. When all cases were examined, CVP

  17. Hearing Preservation Among Patients Undergoing Cochlear Implantation

    Science.gov (United States)

    Van Abel, Kathryn M.; Dunn, Camille C.; Sladen, Douglas P.; Oleson, Jacob J.; Beatty, Charles W.; Neff, Brian A.; Hansen, Marlan; Gantz, Bruce J.; Driscoll, Colin L. W.

    2015-01-01

    Introduction Despite successful preservation of low-frequency hearing in patients undergoing cochlear implantation (CI) with shorter electrode lengths, there is still controversy regarding which electrodes maximize hearing preservation (HP). The thin straight electrode array (TSEA) has been suggested as a full cochlear coverage option for HP. However, very little is known regarding its HP potential. Methods A retrospective review was performed at two tertiary academic medical centers, reviewing the electronic records for 52 patients (mean, 58.2 yr; range, 11–85 yr) implanted with the Cochlear Nucleus CI422 Slim Straight (Centennial, CO, USA) electrode array, referred to herein as the thin straight electrode array or TSEA. All patients had a preoperative low-frequency pure-tone average (LFPTA) of 85 dB HL or less. Hearing thresholds were measured at initial activation (t1) and 6 months after activation (t2). HP was assessed by evaluating functional HP using a cutoff level of 85 dB HL PTA. Results At t1, 54% of the subjects had functional hearing; 33% of these subjects had an LFPTA between 71 and 85 dB HL, and 17% had an LFPTA between 56 and 70 dB HL. At t2, 47% of the patients had functional hearing, with 31% having an LFPTA between 71 and 85 dB HL. Discussion Preliminary research suggests that the TSEA has the potential to preserve functional hearing in 54% of patients at t1. However, 22% (n = 6) of the patients who had functional hearing at t1 (n = 28) lost their hearing between t1 and t2. Further studies are needed to evaluate factors that influence HP with the TSEA electrode and determine the speech perception benefits using electric and acoustic hearing over electric alone. PMID:25575373

  18. Salivary Glucose Concentration and Excretion in Normal and Diabetic Subjects

    Directory of Open Access Journals (Sweden)

    Cedric Jurysta

    2009-01-01

    saliva glucose concentration was comparable, however, to that of blood glucose concentration. The relationship between these two variables was also documented in normal subjects and diabetic patients undergoing an oral glucose tolerance test.

  19. A prospective controlled trial of routine opt-out HIV testing in a men's jail.

    Directory of Open Access Journals (Sweden)

    Ravi Kavasery

    2009-11-01

    Full Text Available Approximately 10 million Americans enter jails annually. The Centers for Disease Control and Prevention now recommends routine opt-out HIV testing in these settings. The logistics for performing routine opt-out HIV testing within jails, however, remain controversial. The objective of this study was to evaluate the optimal time to routinely HIV test newly incarcerated jail detainees using an opt-out strategy.This prospective, controlled trial of routine opt-out HIV testing was conducted among 298 newly incarcerated male inmates in an urban men's jail in New Haven, Connecticut. 298 sequential entrants to the men's jail over a three week period in March and April 2008 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 103, early (next day, n = 98, or delayed (7 days, n = 97. The primary outcome was the proportion of men in each group consenting to testing.Routine opt-out HIV testing was significantly higher for the early (53%: AOR = 2.6; 95% CI = 1.5 to 4.7 and immediate (45%: AOR = 2.3; 95% CI = 1.3 to 4.0 testing groups compared to the delayed (33% testing group. The immediate and early testing groups, however, did not significantly differ (p = 0.67. In multivariate analyses, factors significantly associated with routine opt-out HIV testing were assignment to the 'early' testing group (p = 0.0003 and low (bond > or = $5,000, immigration or federal charges or pre-sentencing > 30 days likelihood of early release (p = 0.04. Two subjects received preliminary positive results and one of them was subsequently confirmed HIV seropositive.In this men's jail where attrition was high, routine opt-out HIV testing was not only feasible, but resulted in the highest rates of HIV testing when performed within 24 hours of incarceration.ClinicalTrials.gov NCT00624247.

  20. Set of FORTRAN routines for multitask timing analysis on shared memory machines

    Energy Technology Data Exchange (ETDEWEB)

    Montry, G.R.

    1986-03-31

    A set of FORTRAN-based timing routines has been written for shared memory parallel processors. These routines are designed to measure the performance of multitasking codes on machines with different hardware configurations. Complete run-time histories of all executing tasks are provided in a postmortem summary. The package is able to provide both processing time and elapsed time statistics for each task subject to functional hardware constraints. Source code for the ELXSI 6400 version of the package is included in an Appendix. 3 refs., 4 figs.

  1. ROUTINE IMMUNIZATION IN INDIA: A PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    G Taneja

    2013-08-01

    Full Text Available The Universal Immunization Programme is possibly the longest and one of the biggest public health intervention measures undertaken in India. To improve immunization coverage in the country various initiatives have been undertaken since the inception of the programme in 1985; key inputs being strengthening and expanding the cold chain system, establishing a network of outreach immunization sites, alternate vaccine delivery model, capacity building of health functionaries and medical officers and intensified polio control measures. Introduction of new and underutilized vaccines, drafting of the national vaccine policy, tracking of beneficiaries through the Maternal and Child Tracking system are some of the recent developments. However in spite of more than 25 years since inception the programme is still adversely impacted by challenges across key thematic areas of programme management, cold chain and vaccine management, recording and reporting and injection safety. To further strengthen and improve service delivery 2012-13 has been declared as the “Year of Intensification of Routine Immunization” with the objective of improving immunization coverage rates across poor performing districts and states so as to attain Global Immunization Vision and Strategy goals of 90% coverage at national and more than 80% coverage at district level. Key activities planned during the year include sustained advocacy at all levels, improved communication and social mobilization, robust and regular program reviews, comprehensive microplanning, strengthening cold chain and vaccine logistics system, special catch up rounds through immunization weeks, piloting the teeka express, improved surveillance systems, strengthened partnerships and operational research activities. The current review pertains to the existing scenario of Universal Immunization Program in the country with impetus on the existing challenges, progress achieved till date as a result of various

  2. ROM als tomtom: Als routine outcome monitoring echt routine zou zijn

    NARCIS (Netherlands)

    Tiemens, B.G.; Sonsbeek, A.M.S. van

    2017-01-01

    Achtergrond: Om het gebruik van rom in de behandeling te bevorderen is er meer aandacht voor implementatie-strategieën dan voor de daadwerkelijke functie van rom. Doel: De vraag beantwoorden wat rom de behandelaar en cliënt moet opleveren om routine te kunnen worden. Methode: De functie van rom

  3. Improvement of Constipation in Leukemia Patients Undergoing Chemotherapy Using Sweet Potato.

    Science.gov (United States)

    Zou, Jing-Ying; Xu, Yi; Wang, Xiao-Hua; Jiang, Qing; Zhu, Xia-Ming

    2016-01-01

    Leukemia patients undergoing chemotherapy commonly develop constipation, which is difficult to treat using routine methods. The aim of this study was to determine whether sweet potato can alleviate constipation in leukemia patients undergoing chemotherapy. Leukemia patients receiving their first chemotherapy were randomized to an intervention group (n = 57) or a control group (n = 63). The control and intervention groups were managed by using routine nursing methods and routine methods plus dietary sweet potato consumption (eating sweet potato 200 g/d, from admission to discharge), respectively. Related data regarding patients' defecation were collected on the second and fifth days after chemotherapy initiation, which included rates of constipation, frequency and duration of purgative usage, constipation status assessed by Rome III criteria, and scores on defecation satisfaction. On the second day, the rate of constipation and the rate of having first defecation within 24 hours after chemotherapy initiation were significantly improved in the intervention group, but the difference of the defecation satisfaction and "almost no loose stools without purgative use" in Rome III criteria were not significantly changed. On the fifth day, except for "the sensation of anorectal obstruction" and "requirement of manual assistance" in Rome III criteria, other items regarding defecation were significantly improved. This study demonstrates that sweet potato had a positive impact on the prevention of constipation and the defecation satisfaction in leukemia patients receiving their first chemotherapy. As sweet potato is inexpensive, abundant, tasty, and easy to prepare, it can be widely used in leukemia patients undergoing chemotherapy.

  4. Family Routines and School Readiness during the Transition to Kindergarten

    Science.gov (United States)

    Ferretti, Larissa K.; Bub, Kristen L.

    2017-01-01

    Research Findings: Using data from 3,250 participants in the Early Childhood Longitudinal Study, Birth Cohort, we used structural equation modeling to investigate whether family routines (e.g., bedtime routine, reading routine) established in preschool predict children's school readiness (i.e., academic skills, social-emotional skills, and…

  5. 42 CFR 493.1210 - Condition: Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  6. Correlates of Family Routines in Head Start Families

    Science.gov (United States)

    Churchill, Susan L.; Stoneman, Zolinda

    2004-01-01

    The popular parenting literature places great importance on the role of routines in children's lives. Empirical research on family routines, however, is limited. This study examined correlates of family routines in a Head Start population in order to better understand their significance in the lives of families. Weak correlations were found…

  7. Rituals and Routines: Supporting Infants and Toddlers and Their Families

    Science.gov (United States)

    Gillespie, Linda; Petersen, Sandra

    2012-01-01

    The words "routine" and "ritual" are sometimes used interchangeably. Yet there are some important differences. Routines are repeated, predictable events that provide a foundation for the daily tasks in a child's life. Teachers can create a predictable routine in early childhood settings for infants and toddlers, and they can individualize those…

  8. [The controversy of routine articulator mounting in orthodontics].

    Science.gov (United States)

    Wang, Li; Han, Xianglong; Bai, Ding

    2013-06-01

    Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

  9. 29 CFR 18.406 - Habit; routine practice.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Habit; routine practice. 18.406 Section 18.406 Labor Office... OFFICE OF ADMINISTRATIVE LAW JUDGES Rules of Evidence Relevancy and Its Limits § 18.406 Habit; routine practice. Evidence of the habit of a person or of the routine practice of an organization, whether...

  10. Impact of multimodal preoperative preparation program on children undergoing surgery

    Directory of Open Access Journals (Sweden)

    Priya Reshma Aranha

    2017-01-01

    Full Text Available Background: The advanced era of technological development in child health care has resulted in more pediatric procedures being performed in various settings. Millions of children undergo surgery every year which is a stressful event. Many nonpharmacological strategies are being used to manage the preoperative fear and anxiety in children. The current study aims to assess the effectiveness of multimodal preoperative preparation program (MPPP on children undergoing surgery in terms of its effect on the psychophysiological parameters. Objective: The aim of this study is to assess the effectiveness of MPPP on the psychophysiological parameters of children undergoing surgery. Materials and Methods: A quasi-experimental study was conducted in a selected multi-specialty hospital. Using the purposive sampling technique, a total of 110 children aged 8–12 years were assigned to nonintervention (n = 55 and intervention (n = 55 groups, respectively. The MPPP was administered to the intervention group. The children in the nonintervention group received the routine preoperative care. Child's fear and anxiety was assessed on admission, prior to shifting the child to operation theater (OT, 24 and 48 h after surgery, whereas child's pulse, respiration, blood pressure (BP, and oxygen saturation was assessed on admission, prior to shifting the child to OT, 6, 12, 24, and 48 h after surgery and pain was assessed at 24 and 48 h after surgery. Results: The mean fear and anxiety scores of children were significantly lower in the intervention group than that of nonintervention group (P 0.05. This study also found that there is a significant association between the psychophysiological parameters of children with the selected demographic variables (P < 0.05. A positive correlation was found between the psychological and physiological parameters of children undergoing surgery. Conclusion: The MPPP is effective on psychophysiological parameters of children undergoing

  11. Tuberculosis in children undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Gargah Tahar

    2010-04-01

    Full Text Available Gargah Tahar1, Goucha-Louzir Rim2, Lakhoua Mohamed Rachid11Department of Pediatric Nephrology, 2Department of Nephrology, Charles Nicolle Hospital, Tunis, TunisiaAbstract: Tuberculosis (TB remains a public health problem in Tunisia. Its incidence is higher in immunocompromised hosts than in the general population. In children and during hemodialysis, TB is characterized by the frequency of extrapulmonary localizations and diagnostic difficulties. The aim of this retrospective study is to evaluate the incidence of TB in Tunisian children undergoing hemodialysis and to determine its clinical features as well as the results of chemotherapy.Method: This retrospective study includes seven TB children among 112 children on hemodialysis at the pediatric nephrology department in Charles Nicolle Hospital from 2002 to 2008. The diagnosis of TB was established by a combination of clinical, radiological, biochemical, microbiological, and histological examinations. Treatment with anti-TB drugs, the results of therapy, and the outcome of patients were noted.Results: There were four girls and three boys aged 10 to 16 years (mean, 13 years. They had been on hemodialysis for 2 to 5 years (mean, 3 years. Noted clinical features were weight loss and fever in five cases, chest pain in one case, cervical lymph node in one case, and spinal pain in one case. The organ systems involved were pleural in two cases, pulmonary in one case, peritoneal in one case, cervical lymphatic in one case, and spinal in one case. One patient was treated empirically with a good response. Diagnosis was made by isolation of mycobacterium TB in three cases, by specific histological signs observed in a lymph node biopsy in one case, in peritoneal biopsy in one case, and in discovertebral biopsy in one case. In the remaining patient, the clinical and radiological presentations were compatible with pulmonary TB. All patients received four anti-TB drugs: isoniazid, rifampicin, pyrazinamide

  12. Massage for Children Undergoing Hematopoietic Cell Transplantation: A Qualitative Report

    Science.gov (United States)

    Ackerman, Sara L.; Lown, E. Anne; Dvorak, Christopher C.; Dunn, Elizabeth A.; Abrams, Donald I.; Horn, Biljana N.; Degelman, Marcia; Cowan, Morton J.; Mehling, Wolf E.

    2012-01-01

    Background. No in-depth qualitative research exists about the effects of therapeutic massage with children hospitalized to undergo hematopoietic cell transplantation (HCT). The objective of this study is to describe parent caregivers' experience of the effects of massage/acupressure for their children undergoing HCT. Methods. We conducted a qualitative analysis of open-ended interviews with 15 parents of children in the intervention arm of a massage/acupressure trial. Children received both practitioner and parent-provided massage/acupressure. Results. Parents reported that their child experienced relief from pain and nausea, relaxation, and greater ease falling asleep. They also reported increased caregiver competence and closeness with their child as a result of learning and performing massage/acupressure. Parents supported a semistandardized massage protocol. Conclusion. Massage/acupressure may support symptom relief and promote relaxation and sleep among pediatric HCT patients if administered with attention to individual patients' needs and hospital routines and may relieve stress among parents, improve caregiver competence, and enhance the sense of connection between parent and child. PMID:22474526

  13. Objective and subjective sleep quality

    DEFF Research Database (Denmark)

    Baandrup, Lone; Glenthøj, Birte Yding; Jennum, Poul Jørgen

    2016-01-01

    and subjective sleep quality during benzodiazepine discontinuation and whether sleep variables were associated with benzodiazepine withdrawal. Eligible patients included adults with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder and long-term use of benzodiazepines in combination...... with antipsychotics. All participants gradually tapered the use of benzodiazepines after randomization to add-on treatment with melatonin versus placebo. Here we report a subsample of 23 patients undergoing sleep recordings (one-night polysomnography) and 55 patients participating in subjective sleep quality ratings....... Melatonin had no effect on objective sleep efficiency, but significantly improved self-reported sleep quality. Reduced benzodiazepine dosage at the 24-week follow-up was associated with a significantly decreased proportion of stage 2 sleep. These results indicate that prolonged-release melatonin has some...

  14. Post-genomic behavioral genetics: From revolution to routine.

    Science.gov (United States)

    Ashbrook, David G; Mulligan, Megan K; Williams, Robert W

    2017-11-28

    What was once expensive and revolutionary-full genome sequence-is now affordable and routine. Costs will continue to drop, opening up new frontiers in behavioral genetics. This shift in costs from the genome to the phenome is most notable in large clinical studies of behavior and associated diseases in cohorts that exceed hundreds of thousands of subjects. Examples include the Women's Health Initiative (www.whi.org), the Million Veterans Program (www. va.gov/MVP), the 100,000 Genomes Project (genomicsengland.co.uk), and commercial efforts such as those by deCode (www.decode.com) and 23andme (www.23andme.com). The same transition is happening in experimental neuro- and behavioral genetics, and samples sizes of many hundreds of cases are becoming routine (www.genenetwork.org, www.mousephenotyping.org). There are two major consequence of this new affordability of massive omics data sets: (1) It is now far more practical to explore genetic modulation of behavioral differences and the key role of gene-by-environment interactions. Researchers are already doing the hard part-the quantitative analysis of behavior. Adding the omics component can provide powerful links to molecules, cells, circuits, and even better treatment. (2) There is an acute need to highlight and train behavioral scientists in how best to exploit new omics approaches. This review addresses this second issue and highlights several new trends and opportunities that will be of interest to experts in animal and human behaviors. This article is protected by copyright. All rights reserved.

  15. Organizational determinants of high-quality routine diabetes care

    Science.gov (United States)

    Braspenning, Jozé C. C.; Wolters, René J.; Bouma, Margriet; de Grauw, Wim J. C.; Wensing, Michel

    2014-01-01

    Abstract Objective. Randomized trials showed that changes in healthcare organization improved diabetes care. This study aimed to identify which organizational determinants were associated with patient outcomes in routine diabetes care. Design. Observational study, in which multilevel regression analyses were applied to examine the impact of 12 organizational determinants on diabetes care as separate measures and as a composite score. Setting. Primary care practices in the Netherlands. Subjects. 11,751 patients with diabetes in 354 practices. Main outcome measures. Patients’ recorded glycated hemoglobin (HbA1c), systolic blood pressure, and serum cholesterol levels. Results. A higher score on the composite measure of organizational determinants was associated with better control of systolic blood pressure (p = 0.017). No effects on HbA1C or cholesterol levels were found. Exploration of specific organizational factors found significant impact of use of an electronic patient registry on HbA1c (OR = 1.80, 95% CI 1.12–2.88), availability of patient leaflets on systolic blood pressure control (OR = 2.59, 95% CI 1.06–6.35), and number of hours’ nurse education on cholesterol control (OR = 2.51, 95% CI 1.02–6.15). Conclusion. In routine primary care, it was found that favorable healthcare organization was associated with a number of intermediate outcomes in diabetes care. This finding lends support to the findings of trials on organizational changes in diabetes care. Notably, the composite measure of organizational determinants had most impact. PMID:25264939

  16. Comparative evaluation of diffusion hypoxia and psychomotor skills with or without postsedation oxygenation following administration of nitrous oxide in children undergoing dental procedures: A clinical study.

    Science.gov (United States)

    Khinda, Vineet Inder Singh; Bhuria, Parvesh; Khinda, Paramjit; Kallar, Shiminder; Brar, Gurlal Singh

    2016-01-01

    Diffusion hypoxia is the most serious potential complication associated with nitrous oxide. It occurs during the recovery period. Hence, administration of 100% oxygen is mandatory as suggested by many authors. The aim of this study is to evaluate the occurrence/nonoccurrence of diffusion hypoxia in two groups of patients undergoing routine dental treatment under nitrous oxide sedation when one group is subjected to 7 min of postsedation oxygenation and the second group of the patients is made to breathe room air for the similar period. A total of sixty patients within the age group of 7-10 years requiring invasive dental procedures were randomly divided into two groups of 30 each using chit method. In the control group, patients were administered 100% oxygen postsedation, whereas, in the study group, patients were made to breathe room air postsedation. Various parameters (pulse rate, respiratory rate, blood pressure, and oxygen saturation [SpO2]) were recorded pre- and post-operatively. Data were collected and then sent for statistical analysis. The mean postoperative SpO2 at measurement times 1, 3, 5, and 7 min in both the groups was higher than the mean preoperative SpO2. This increase was statistically significant. No significant difference was found between the Trieger test scores. This study proves that clinical occurrence of diffusion hypoxia is not possible while following the routine procedure of nitrous oxide sedation.

  17. Comparative evaluation of diffusion hypoxia and psychomotor skills with or without postsedation oxygenation following administration of nitrous oxide in children undergoing dental procedures: A clinical study

    Directory of Open Access Journals (Sweden)

    Vineet Inder Singh Khinda

    2016-01-01

    Full Text Available Background: Diffusion hypoxia is the most serious potential complication associated with nitrous oxide. It occurs during the recovery period. Hence, administration of 100% oxygen is mandatory as suggested by many authors. Aim: The aim of this study is to evaluate the occurrence/nonoccurrence of diffusion hypoxia in two groups of patients undergoing routine dental treatment under nitrous oxide sedation when one group is subjected to 7 min of postsedation oxygenation and the second group of the patients is made to breathe room air for the similar period. Materials and Methods: A total of sixty patients within the age group of 7–10 years requiring invasive dental procedures were randomly divided into two groups of 30 each using chit method. In the control group, patients were administered 100% oxygen postsedation, whereas, in the study group, patients were made to breathe room air postsedation. Various parameters (pulse rate, respiratory rate, blood pressure, and oxygen saturation [SpO2] were recorded pre- and post-operatively. Data were collected and then sent for statistical analysis. Results: The mean postoperative SpO2 at measurement times 1, 3, 5, and 7 min in both the groups was higher than the mean preoperative SpO2. This increase was statistically significant. No significant difference was found between the Trieger test scores. Conclusion: This study proves that clinical occurrence of diffusion hypoxia is not possible while following the routine procedure of nitrous oxide sedation.

  18. In search for effective methods of routine formation

    Directory of Open Access Journals (Sweden)

    Kandora Marcin

    2017-05-01

    Full Text Available Organizational routines are a frequently researched phenomenon in contemporary management science. Although the available theoretical foundations of Routine Theory seem to have reached a significant degree of maturity over the last thirty years, the same could not be said about the availability of material advice for the management practice. This paper addresses this gap and proposes a framework for an effective routine shaping process. It builds on a brief analysis of available literature on routine formation, supported by case study findings. The approach proposed stresses the importance of the controlled learning process and underlines the importance of deliberate implementation, in contrast to the evolutionary and engineering views on routine emergence.

  19. [Difficulties in routine diagnostics of urothelium lesions].

    Science.gov (United States)

    Dusková, J; Babjuk, M; Soukup, V

    2008-04-01

    Facing the increasing frequency of urothelial neoplasms and stratified therapeutic strategy pathologists have to meet the demands of urologists for constantly increasing preciseness of the histopathology reports influencing the application of tailored therapeutic schemes. The WHO/ISUP consensus conference in 1998 resulted into adoption of a new classification of the urothelial lesions. Its employment requires considering of features that can be difficult to find in the material provided. parallel typing of more than 200 urothelial neoplasms from the daily routine biopsy samples provided by the faculty of medicine urology clinic according to the previous Mostofi 1973 and the new WHO/ISUP 1998 classification. Realizing the consultation demands we have identified some repetitive problems in the urothelium lesions diagnostics considering typing, grading, and staging of the lesions. Typing was a less frequent source of problems. It appeared in classifying lesions with inverted growth, and mucin producing urothelial neoplasms vs. adenocarcinomas. Less important typing problems are represented by uncommon rare diagnoses, as they manifest from the beginning as a specialty solvable mostly with the help of immunohistochemistry. Grading was experienced as troublesome in the following items: papillary hyperplasia vs. LG papillary ca, PUNLMP vs. LG papillary ca, HG papillary ca with a majority of LG material, monotonous types of HG flat lesions, and combined lesions. Staging difficulties applied mostly in identification of the initial unequivocal invasion and the substaging of pT1 into pT1a and pT1b with learning to find the decisive mucosa structures described in detail as late as 1983 (2). We have implemented reporting the presence/absence of the detrusor muscle in the material as a marker describing the representativness of the sample provided; we consider this approach less confusing than introduction of clinical staging terminology Ta, T1 instead of pTa, pT1. To help the

  20. The routine use of post-operative drains in thyroid surgery: an outdated concept.

    LENUS (Irish Health Repository)

    Prichard, R S

    2010-01-01

    The use of surgical drains in patients undergoing thyroid surgery is standard surgical teaching. Life-threatening complications, arising from post-operative haematomas, mandates their utilization. There is increasing evidence to suggest that this is an outdated practice. This paper determines whether thyroid surgery can be safely performed without the routine use of drains. A retrospective review of patients undergoing thyroid surgery, over a three year period was performed and post-operative complications documented. One hundred and four thyroidectomies were performed. 63 (60.6%) patients had a partial thyroidectomy, 27 (25.9%) had a total thyroidectomy and 14 (13.5%) had a sub-total thyroidectomy. Suction drains were not inserted in any patient. A cervical haematoma did not develop in any patient in this series and no patient required re-operation. There is no evidence to suggest the routine use of surgical drains following uncomplicated thyroid surgery reduces the rate of haematoma formation or re-operation rates and indeed is now unwarranted.

  1. Bleeding outcomes after routine transradial primary angioplasty for acute myocardial infarction using eptifibatide and unfractionated heparin: a single-center experience following the HORIZONS-AMI trial.

    Science.gov (United States)

    Moody, William E; Chue, Colin D; Ludman, Peter F; Chan, Yik-Ki C; Narayan, Gautam; Millington, Jenna M; Townend, Jonathan N; Doshi, Sagar N

    2013-09-01

    We sought to (1) determine the bleeding rates after primary percutaneous coronary intervention (PPCI) in our institution, where the default strategy has been transradial (TR) access in combination with unfractionated heparin (UFH) plus eptifibatide, and (2) compare these with the outcomes of patients treated with bivalirudin in HORIZONS-AMI. HORIZONS-AMI demonstrated that in PPCI undertaken via the transfemoral route, routine use of bivalirudin was associated with lower bleeding rates and improved mortality compared to routine use of UFH plus glycoprotein IIb/IIIa inhibitor (GPI). This was a single-center prospective registry of consecutive patients undergoing PPCI from January 2009 to August 2011 at the Queen Elizabeth Hospital Birmingham, UK. Thirty-day major bleeding was defined as per the HORIZONS-AMI criteria and also according to TIMI and GUSTO scales. Of the 432 consecutive patients, 350 fulfilled entry criteria for HORIZONS-AMI. In contrast with HORIZONS-AMI, these subjects were older (62.5 ± 13.7 yr vs. 59.8 ± 11.1 yr, P < 0.05) with a higher rate of cardiogenic shock (6.3% vs. 0.8%, P < 0.0001). Despite this higher risk population, the rate of major bleeding was favorable (3.7% [95% CI: 2.0-6.3%] vs. 4.9% [4.0-6.1%], P = 0.32). Similarly, TIMI major bleeding (2.0% [0.8-4.1%] vs. 3.1% [2.3-3.4%], P = 0.10) and GUSTO severe or life-threatening bleeding (0.6% [0.1-2.5%] vs. 0.4% [0.2-0.9%], P = 0.75) were comparable. Routine TR access for PPCI using UFH plus GPI is associated with a low 30-day rate of major bleeding equivalent to the bivalirudin arm of HORIZONS-AMI. Default transradial access for PPCI permits routine use of a GPI without the penalty of high bleeding rates. Copyright © 2013 Wiley Periodicals, Inc.

  2. Factors Related to Satisfaction with Body Image in Children Undergoing Chemotherapy

    OpenAIRE

    Wu, Li-Min; Chin, Chi-Chun

    2003-01-01

    This cross-sectional correlational study explored factors related to satisfaction with body image in children undergoing chemotherapy. We recruited 118 children with cancer undergoing chemotherapy at three medical centers. Subjects ranged from 6 to 18 years old (mean, 10.8 years). Most had leukemia, were in the first to third grade of elementary school, and had their mother as the primary caregiver. Two structured questionnaires were used, the Body Image Scale (part I, Cronbach's α = 0.82; pa...

  3. Adapting immunisation schedules for children undergoing chemotherapy.

    Science.gov (United States)

    Fernández-Prada, María; Rodríguez-Martínez, María; García-García, Rebeca; García-Corte, María Dolores; Martínez-Ortega, Carmen

    2018-02-01

    Children undergoing chemotherapy for cancer have special vaccination needs after completion of the treatment. The aim of this study was to evaluate the adaptation of post-chemotherapy vaccination schedules. An observational study was performed on a retrospective cohort that included all children aged from 0 to 14 years, who completed chemotherapy in a tertiary hospital between 2009 and 2015. Inclusion and exclusion criteria were applied. Immunisation was administered in accordance with the guidelines of the Vaccine Advisory Committee of the Spanish Association of Paediatrics. Primary Care immunisation and clinical records of the Preventive Medicine and Public Health Department were reviewed. Of the 99 children who had received chemotherapy, 51 (70.6% males) were included in the study. As regards the type of tumour, 54.9% had a solid organ tumour, and 45.1% had a haematological tumour. Post-chemotherapy immunisation was administered to 70.6%. The most common vaccines received were: diphtheria-tetanus-pertussis or diphtheria-tetanus (54.9%), meningococcus C (41.2%), and seasonal influenza (39.2%). The rate of adaptation of the immunisation schedule after chemotherapy was 9.8%. The pneumococcal conjugate vaccine against 7v or 13v was administered to 21.6% of study subjects. However, only 17.6% received polysaccharide 23v. None received vaccination against hepatitis A. No statistically significant differences were observed between adherence to immunisation schedules and type of tumour (P=.066), gender (P=.304), or age (P=.342). Post-chemotherapy immunisation of children with cancer is poor. The participation of health professionals in training programs and referral of paediatric cancer patients to Vaccine Units could improve the rate of schedule adaptation and proper immunisation of this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  4. The changing role of the subject specialist

    Directory of Open Access Journals (Sweden)

    Michael Cotta-Schønberg

    2007-11-01

    Full Text Available As we all know, libraries are these years rapidly undergoing change on unparalleled scale. Evidently, this applies to librarians, too, and not the least to that important category of library staff, the subject specialist. As recruiting and education of library workers differ from country to country it is difficult to give a detailed, generally valid description of the subject librarian in libraries, but I believe that you can describe an ideal model of subject librarianship as follows: Within each of the major subject disciplines covered by the library, the library should have a subject specialist preferably with a master degree or at least a bachelor degree in the particular subject discipline. The role of the subject specialist is to perform four basic functions where extensive subject knowledge is considered to be necessary: selecting and classifying books, assisting users with advanced subject inquiries, giving subject-specific courses in information retrieval, and maintaining liaison with relevant academic departments and centres. Personally, I know this system very well since I got employment in the Royal Library in Copenhagen as a subject specialist in psychology in the very month I finished my degree in psychology from the University of Copenhagen, back in 1973. The subject librarian system at the Royal Library in Copenhagen was patterned on the ideal model, as I just described it, and it was closely paralleled in the other academic libraries in Denmark, also the new university libraries which were founded in the seventies.

  5. Routine Processing and Evaluation of HST Observations

    Science.gov (United States)

    Parsons, S. B.; Wilson, I. R.; Crawford, J. R.; Dempsey, R. C.; Ewald, R. A.; Gillam, S. D.; Giovane, E. A.; Kochte, M. C.; Schultz, A. B.; Scott, J. F.; Swade, D. A.

    1993-05-01

    All WFPC, FOC, FOS, GHRS, HSP observations taken by the Hubble Space Telescope are automatically processed by the Routine Science Data Processing (RSDP) ``pipeline'' at STScI, under the Post Observation Data Processing System (PODPS) branch. Over 36,000 readouts have been processed since launch, 97% of these within two days of execution. Packetized science data enter the pipeline after telemetry bit-error correction at the Data Capture Facility, GSFC. Software sorts the data by observation, inserts fill packets as needed, and examines the data structure for errors. If none, the Edited Information Set is converted into a generic (waivered FITS) format. If repair is required (1-2% of observations), tested procedures are used to modify erroneous bits or keywords. The observation is then calibrated, and a film file or laser plot is generated. The HST instrument teams supply all information for calibration performed by RSDP. As calibration evolves, PODPS updates the flat fields and other files and tables for subsequent pipeline processing. Also, the observer may recalibrate the data with STSDAS tools. PODPS staff astronomers, using STSDAS IRAF tasks and SAOimage, evaluate the quality of each observation and provide keywords such as `OK' or `UNDEREXP' plus informative comments to the archive catalog. Comments often include information from the Observation Support Branch (OSS) regarding guide star acquisition success, centering slews, high jitter, etc. Observation data (in packetized, reformatted, and calibrated form) and their comments are placed in the HST science and ancillary optical disk archives (now by DMF, to be superseded by DADS). FITS tapes containing both uncalibrated and calibrated files are written for the GO by the Data Systems Operations Branch (DSOB), and prints or plots plus OSS and PODPS comments are mailed with the tapes. The authors are staff members of the Space Telescope Science Institute.

  6. Asbestos exposure during routine brake lining manufacture.

    Science.gov (United States)

    Kakooei, Hossein; Sameti, Mahmod; Kakooei, Ali Akbar

    2007-12-01

    Occupational exposure to asbestos fiber and total dust of workers of a major brake lining manufacture plant in a developing country were examined and compared with those in developed countries. Time weighted average of total dust and asbestos fiber concentration in the potential sources of exposure were monitored. All personal air sampling were collected on membrane filters and analyzed by phase contrast optical microscopy (PCM) for comparison with the occupational safety and health administration (OSHA) permissible exposure limit (PEL) of 0.1 f/cc, 8-h time--weighted average. This study demonstrates that routine mixing, polishing and beveling process in the brake lining production can result in elevated levels of airborne asbestos. Greater releases of airborne asbestos were observed during mixing process and mixer machine. The results also showed that the employees working in the process had the exposure to total dust concentrations ranging from 2.08 to 16.32 mg/m(3) that is higher than OSHA, recommendation. According to OSHA definition of fibers, it has been indicated that from 3,000 counted particles, 90% of particles are in the form of non-fiber and reaming have fiber-shaped. The particle analyze gives the geometric mean diameter as 6.02 mum, and also indicated that the arithmetic mean of the number distribution for the particle population was 8.4 mum. Approximately 60.4% of the counted fibers were lower than 10 mum in length, from which only 8% consists of fibers (>5 mum in length). In conclusion, the analysis showed a presence in the air of only chrysotile asbestos and an absence of other types of asbestos. During an 8-h shift, the average asbestos fiber exposure (0.78 f/cc) were 7.8 time in excess of OSHA PEL. Additional studies in occupational exposure to asbestos are needed.

  7. Theoretical description of methodology in PHASER (Probabilistic hybrid analytical system evaluation routine)

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, J.A.

    1996-01-01

    Probabilistic safety analyses (PSAs) frequently depend on fault tree and event tree models, using probabilities of `events` for inputs. Uncertainty or variability is sometimes included by assuming that the input probabilities vary independently and according to an assumed stochastic probability distribution modes. Evidence is accumulating that this methodology does not apply well to some situations, most significantly when the inputs contain a degree of subjectivity or are dependent. This report documents the current status of an investigation into methods for effectively incorporating subjectivity and dependence in PSAs and into the possibility of incorporating inputs that are partly subjective and partly stochastic. One important byproduct of this investigation was a computer routine that combines conventional PSA techniques with newly developed subjective techniques in a `hybrid` (subjective and conventional PSA) program. This program (PHASER) and a user`s manual are now available for beta use.

  8. Underdiagnosis of Vertebral Collapse on Routine Multidetector Computed Tomography Scan of the Abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Obaid, H.; Husamaldin, Z.; Bhatt, R. (Doncaster Royal Infirmary, Doncaster (United Kingdom))

    2008-09-15

    Background: Vertebral fractures are commonly associated with osteoporosis and have significant morbidity and mortality rates. Osteoporotic vertebral fractures are presently considered as a treatable and preventable condition, and early detection is vital for further management. The evaluation of vertebral compression on multidetector computed tomography (MDCT) scans of the abdomen has, to our knowledge, not been reported before. Purpose: To assess the prevalence of vertebral collapse on routine abdominal CT scans, and to evaluate the usefulness of the multiplanar reconstruction (MPR) capability of MDCT scans in accurately identifying vertebral abnormalities such as vertebral collapse, spondylolisthesis, and retrolisthesis. Material and Methods: A retrospective review of 307 MDCT scans of the abdomen was carried out at a university teaching hospital. Identifiable patient information was anonymized for data protection. All images were reviewed on a picture archiving and communications system (PACS) using sagittal MPR and bone window for the assessment of the vertebrae. Data were collected from the Computerized Radiology Information System (CRIS). Results: Vertebral collapse was seen in 42 (13.6%) of the 307 patients undergoing routine MDCT of the abdomen. Multilevel and single-level collapses were seen in 24 and 18 patients, respectively. Spondylolisthesis was identified in 5.5% (n=17), and retrolisthesis was seen in 0.6% (n=2). All patients with vertebral fracture were older than 50 years. Women were more commonly affected than men. Conclusion: A significant number of patients with vertebral collapse were diagnosed using MPR on MDCT routine scans of the abdomen

  9. Predicting Future Hip Fractures on Routine Abdominal CT Using Opportunistic Osteoporosis Screening Measures: A Matched Case-Control Study.

    Science.gov (United States)

    Lee, Scott J; Anderson, Paul A; Pickhardt, Perry J

    2017-08-01

    Hip fracture is a major consequence of low bone mineral density, which is treatable but underdiagnosed. The purpose of this case-control study is to determine whether lumbar vertebral trabecular attenuation, vertebral compression fractures, and femoral neck T scores readily derived from abdominopelvic CT scans obtained for various indications are associated with future hip fragility fracture. A cohort of 204 patients with hip fracture (130 women and 74 men; mean age, 74.3 years) who had undergone abdominopelvic CT before fracture occurred (mean interval, 24.8 months) was compared with an age- and sex-matched control cohort without hip fracture. L1 trabecular attenuation, vertebral compression fractures of grades 2 and 3, and femoral neck T scores derived from asynchronous quantitative CT were recorded. The presence of one or more clinical risk factor for fracture was also recorded. Multivariate logistic regression models were used to determine the association of each measurement with the occurrence of hip fracture. The mean L1 trabecular attenuation value, the presence of one or more vertebral compression fracture, and CT-derived femoral neck T scores were all significantly different in patients with hip fracture versus control subjects (p hip fracture outcome after adjustments were made for age, sex, and the presence of one or more clinical risk factor. L1 trabecular attenuation and CT-derived femoral neck T scores showed moderate accuracy in differentiating case and control patients (AUC, 0.70 and 0.78, respectively). L1 trabecular attenuation, CT-derived femoral neck T scores, and the presence of at least one vertebral compression fracture on CT are all associated with future hip fragility fracture in adults undergoing routine abdominopelvic CT for a variety of conditions.

  10. Additive value of amyloid-PET in routine cases of clinical dementia work-up after FDG-PET.

    Science.gov (United States)

    Brendel, Matthias; Schnabel, Jonas; Schönecker, Sonja; Wagner, Leonie; Brendel, Eva; Meyer-Wilmes, Johanna; Unterrainer, Marcus; Schildan, Andreas; Patt, Marianne; Prix, Catharina; Ackl, Nibal; Catak, Cihan; Pogarell, Oliver; Levin, Johannes; Danek, Adrian; Buerger, Katharina; Bartenstein, Peter; Barthel, Henryk; Sabri, Osama; Rominger, Axel

    2017-12-01

    In recent years, several [18F]-labeled amyloid-PET tracers have been developed and have obtained clinical approval. Despite their widespread scientific use, studies in routine clinical settings are limited. We therefore investigated the impact of [18F]-florbetaben (FBB)-PET on the diagnostic management of patients with suspected dementia that was still unclarified after [18F]-fluordeoxyglucose (FDG)-PET. All subjects were referred in-house with a suspected dementia syndrome due to neurodegenerative disease. After undergoing an FDG-PET exam, the cases were discussed by the interdisciplinary dementia board, where the most likely diagnosis as well as potential differential diagnoses were documented. Because of persistent diagnostic uncertainty, the patients received an additional FBB-PET exam. Results were interpreted visually and classified as amyloid-positive or amyloid-negative, and we then compared the individual clinical diagnoses before and after additional FBB-PET. A total of 107 patients (mean age 69.4 ± 9.7y) were included in the study. The FBB-PET was rated as amyloid-positive in 65/107. In 83% of the formerly unclear cases, a final diagnosis was reached through FBB-PET, and the most likely prior diagnosis was changed in 28% of cases. The highest impact was observed for distinguishing Alzheimer's dementia (AD) from fronto-temporal dementia (FTLD), where FBB-PET altered the most likely diagnosis in 41% of cases. FBB-PET has a high additive value in establishing a final diagnosis in suspected dementia cases when prior investigations such as FDG-PET are inconclusive. The differentiation between AD and FTLD was particularly facilitated by amyloid-PET, predicting a considerable impact on patient management, especially in the light of upcoming disease-modifying therapies.

  11. Routine Repeat Head CT may not be Indicated in Patients on Anticoagulant/Antiplatelet Therapy Following Mild Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    McCammack, Kevin C.

    2014-12-01

    Full Text Available Introduction: Evaluation recommendations for patients on anticoagulant and antiplatelet (ACAP therapy that present after mild traumatic brain injury (TBI are controversial. At our institution, an initial noncontrast head computed tomography (HCT is performed, with a subsequent HCT performed six hours later to exclude delayed intracranial hemorrhage (ICH. This study was performed to evaluate the yield and advisability of this approach. Methods: We performed a retrospective review of subjects undergoing evaluation for ICH after mild TBI in patients on ACAP therapy between January of 2012 and April of 2013. We assessed for the frequency of ICH on both the initial noncontrast HCT and on the routine six-hour follow-up HCT. Additionally, chart review was performed to evaluate the clinical implications of ICH, when present, and to interrogate whether pertinent clinical and laboratory data may predict the presence of ICH prior to imaging. We used multivariate generalized linear models to assess whether presenting Glasgow Coma Score (GCS, loss of consciousness (LOC, neurological or physical examination findings, international normalized ratio, prothrombin time, partial thromboplastin time, platelet count, or specific ACAP regimen predicted ICH. Results: 144 patients satisfied inclusion criteria. Ten patients demonstrated initial HCT positive for ICH, with only one demonstrating delayed ICH on the six-hour follow-up HCT. This patient was discharged without any intervention required or functional impairment. Presenting GCS deviation (p<0.001, LOC (p=0.04, neurological examination findings (p<0.001, clopidogrel (p=0.003, aspirin (p=0.03 or combination regimen (p=0.004 use were more commonly seen in patients with ICH. Conclusion: Routine six-hour follow-up HCT is likely not indicated in patients on ACAP therapy, as our study suggests clinically significant delayed ICH does not occur. Additionally, presenting GCS deviation, LOC, neurological examination

  12. The influence of the premedication consult and preparatory information about anesthesia on anxiety among patients undergoing cardiac surgery

    NARCIS (Netherlands)

    Van der Zee, K.I.; Gallandat Huet, R.CG; Cazemier, C; Evers, K

    The present study examines the impact of patients' subjective evaluation of the premedication consult and of preparatory information about anesthesia on preoperative anxiety among patients undergoing cardiac surgery (N=93). The preparatory information concerned a flyer that contained information

  13. Specialised care in patients undergoing pancreatoduodenectomy

    NARCIS (Netherlands)

    Tol, J.A.M.G.

    2014-01-01

    This thesis studies the controversies in the management of patients with pancreatic cancer undergoing pancreatoduodenectomy and determines different factors that will improve this management and thereby the postoperative outcomes. The studies were performed in both the pre-, peri- and postoperative

  14. The meaning of family routines in a homeless shelter.

    Science.gov (United States)

    Schultz-Krohn, Winifred

    2004-01-01

    This exploratory investigation sought to understand what meaning parents, living in a homeless shelter, attribute to family routines and the nature of those routines. In-depth interviews were conducted with 12 parents living in a homeless shelter. Thematic analysis was employed to develop descriptive codes and themes from transcribed data and field notes. Parents described family routines focused on three features: promoting intimacy, maintaining or developing a legacy, and connections with the community. These routines seemed to preserve family integrity while homeless and to provide hope for the family to continue into the future. Homeless parents, in this investigation, seemed to expend a substantial amount of energy to create or maintain family routines while living in a homeless shelter. Findings suggest that occupational therapy services may help support homeless parents as they exercise their role as the organizer of family routines.

  15. Assessing the role of eptifibatide in patients with diffuse coronary disease undergoing drug-eluting stenting: the INtegrilin plus STenting to Avoid myocardial Necrosis Trial.

    Science.gov (United States)

    Biondi-Zoccai, Giuseppe; Valgimigli, Marco; Margheri, Massimo; Marzocchi, Antonio; Lettieri, Corrado; Stabile, Amerigo; Petronio, A Sonia; Binetti, Giorgio; Bolognese, Leonardo; Bellone, Pietro; Sardella, Gennaro; Contarini, Marco; Sheiban, Imad; Marra, Sebastiano; Piscione, Federico; Romeo, Francesco; Colombo, Antonio; Sangiorgi, Giuseppe

    2012-05-01

    The optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions (PCIs) is uncertain. We aimed to assess the impact of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibition with eptifibatide in clinically stable subjects with diffuse coronary lesions. Patients with stable coronary artery disease undergoing PCI by means of implantation of >33 mm of drug-eluting stent were single-blindedly randomized to heparin plus eptifibatide versus heparin alone. The primary end point was the rate of abnormal post-PCI creatine kinase-MB mass values. Secondary end points were major adverse cardiovascular events (MACEs) (ie, cardiac death, myocardial infarction, or urgent revascularization) and MACE plus bailout GpIIb/IIIa inhibitor use. The study was stopped for slow enrollment and funding issues after including a total of 91 patients: 44 were randomized to heparin plus eptifibatide, and 47, to heparin alone. Analysis for the primary end point showed a trend toward lower rates of abnormal post-PCI creatine kinase-MB mass values in the heparin-plus-eptifibatide group (18 [41%]) versus the heparin-alone group (26 [55%], relative risk 0.74 [95% CI 0.48-1.15], P = .169). Similar nonstatistically significant trends were found for rates of MACE, their components, or MACE plus bailout GpIIb/IIIa inhibitors (all P > .05). Notably, heparin plus eptifibatide proved remarkably safe because major bleedings or minor bleeding was uncommon and nonsignificantly different in both groups (all P > .05). Given its lack of statistical power, the INSTANT study cannot definitively provide evidence against or in favor of routine eptifibatide administration in stable patients undergoing implantation of multiple drug-eluting stent for diffuse coronary disease. However, the favorable trend evident for the primary end point warrants further larger randomized studies. Copyright © 2012 Mosby, Inc. All rights reserved.

  16. Victimization, perception of insecurity, and changes in daily routines in Mexico

    OpenAIRE

    ?vila, Mar?a Elena; Mart?nez-Ferrer, Bel?n; Vera, Alejandro; Bahena, Alejandro; Musitu, Gonzalo

    2016-01-01

    OBJECTIVE: To analyze the relationships between victimization, perception of insecurity, and changes in routines. METHODS: The 8,170 subjects of both sexes (49.9% women and 50.1% men) aged between 12 and 60 years, selected from a proportional stratified sampling, participated in this study. The measuring instrument was an adaptation of the National Survey on Victimization and Perception of Public Security. Chi-square tests were performed. RESULTS: The results show significan...

  17. Psychosocial Factors Associated With Routine Health Examination Scheduling and Receipt Among African American Men

    Science.gov (United States)

    Hammond, Wizdom Powell; Matthews, Derrick; Corbie-Smith, Giselle

    2010-01-01

    Introduction African American men often fail to obtain routine health examinations, which increases the probability of disease detection, yet little is known about psychosocial factors that motivate scheduling and receipt among this group. Methods We used the Andersen model and theory of reasoned action as frameworks to evaluate the relative contribution of psychosocial factors to self-reported routine health examination scheduling and receipt in a cross-sectional sample of African American men (N = 386) recruited from barbershops (65.3%) and academic institutions/events (34.7%) in Michigan, Georgia, and North Carolina between 2003-2004 and 2007-2009. Participants completed measures assessing demographic factors, physical/mental health status, traditional male role norms, health-promoting male subjective norms, health value, and medical mistrust. Pearson's χ2, analysis of variance, and multivariate logistic regression analyses were used to investigate associations between these study factors and routine health examination scheduling and receipt in the past year. Results After final adjustment, the odds of scheduling a routine health examination were increased for men with a usual source of care (OR, 5.48; 95% CI, 3.06-9.78) and more health-promoting male subjective norms exposure (OR, 1.46; 95% CI, 1.02-2.04). Higher medical mistrust (OR, 0.26; 95% CI, 0.09-0.76) and traditional male role norms (OR, 0.71; 95% CI, 0.52-0.98) reduced the odds of routine health examination receipt. The odds of routine health examination receipt were increased among men who were older (OR=1.05; 95% CI, 1.01-1.10), had a usual source of care (OR, 2.91; 95% CI, 1.54-5.51) and reported more male subjective norms exposure (OR, 1.51; 95% CI, 1.02-2.22). Conclusions Improving African American men's uptake of routine health examinations will require addressing medical mistrust, mitigating traditional masculine concerns about disclosing vulnerability, and leveraging male social networks. PMID

  18. Psychosocial factors associated with routine health examination scheduling and receipt among African American men.

    Science.gov (United States)

    Hammond, Wizdom Powell; Matthews, Derrick; Corbie-Smith, Giselle

    2010-04-01

    African American men often fail to obtain routine health examinations, which increases the probability of disease detection, yet little is known about psychosocial factors that motivate scheduling and receipt among this group. We used the Andersen model and theory of reasoned action as frameworks to evaluate the relative contribution of psychosocial factors to self-reported routine health examination scheduling and receipt in a cross-sectional sample of African American men (N = 386) recruited from barbershops (65.3%) and academic institutions/events (34.7%) in Michigan, Georgia, and North Carolina between 2003-2004 and 2007-2009. Participants completed measures assessing demographic factors, physical/mental health status, traditional male role norms, health-promoting male subjective norms, health value, and medical mistrust. Pearson's chi(2), analysis of variance, and multivariate logistic regression analyses were used to investigate associations between these study factors and routine health examination scheduling and receipt in the past year. After final adjustment, the odds of scheduling a routine health examination were increased for men with a usual source of care (OR, 5.48; 95% CI, 3.06-9.78) and more health-promoting male subjective norms exposure (OR, 1.46; 95% CI, 1.02-2.04). Higher medical mistrust (OR, 0.26;; 95% CI, 0.09-0.76) and traditional male role norms (OR, 0.71; 95% CI, 0.52-0.98) reduced the odds of routine health examination receipt. The odds of routine health examination receipt were increased among men who were older (OR=1.05; 95% CI, 1.01-1.10), had a usual source of care (OR, 2.91; 95% CI, 1.54-5.51) and reported more male subjective norms exposure (OR, 1.51; 95% CI, 1.02-2.22). Improving African American men's uptake of routine health examinations will require addressing medical mistrust, mitigating traditional masculine concerns about disclosing vulnerability, and leveraging male social networks.

  19. Eating routines: Embedded, value based, modifiable, and reflective

    OpenAIRE

    Jastran, Margaret; Bisogni, Carole A.; Sobal, Jeffery; Blake, Christine; Devine, Carol M.

    2008-01-01

    Eating routines are a compelling issue because recurring eating behaviors influence nutrition and health. As non-traditional and individualized eating patterns have become more common, new ways of thinking about routine eating practices are needed. This study sought to gain conceptual understanding of working adults' eating routines. Forty-two purposively sampled US adults reported food intake and contextual details about eating episodes in qualitative 24-hour dietary recalls conducted over 7...

  20. Parent routines for managing cystic fibrosis in children

    OpenAIRE

    Grossoehme, Daniel H; Filigno, Stephanie Spear; Bishop, Meredith

    2014-01-01

    Management of cystic fibrosis (CF) is burdensome and adherence is often suboptimal. Family routines are associated with adherence and health outcomes in other disease populations. Few studies have examined routines in CF. The study's aim was to describe parent experiences developing and utilizing CF care routines. Semi-structured interviews with a convenience sample of 25 parents of children under 13 years of age with CF were analyzed using phenomenological analysis. Three domains emerged: pa...

  1. The Candy Smell Test in clinical routine.

    Science.gov (United States)

    Haxel, Boris R; Bertz-Duffy, Shannon; Faldum, Andreas; Trellakis, Sokrates; Stein, Bernhard; Renner, Bertold; Kobal, Gerd; Letzel, Stephan; Mann, Wolf J; Muttray, Axel

    2011-01-01

    The "Candy Smell Test" (CST) has been introduced as a new testing method for the evaluation of the human sense of smell. In contrast to other established orthonasal smell tests, the CST addresses the retronasal application of odors, typical for food aroma effects during mastication and swallowing. The aim of this study was to evaluate the CST in a clinical setting in patients with olfactory dysfunction and normal controls against the Sniffin' Sticks test. Furthermore, cutoff points for normal and pathological results in the CST should be determined. The olfactory performance of 96 patients presenting with olfactory disorders and 71 healthy controls was evaluated with the CST-comprised of 23 different aromatized smell candies and the extended Sniffin' Sticks test (threshold, discrimination, and identification). The control group was gender matched but included also younger persons. The tested subjects could easily understand the procedures and were motivated to participate. The CST correlated well with the Sniffin' Sticks for all tested subjects and for patients (n = 96) and controls (n = 71). The proposed cutoff value to differentiate normosmia from hyposmia in the CST was a score of <16 (i.e., 16 correctly identified odors) of 23. A score below 13 in the CST was the cutoff value for anosmia. The CST is an easy-to-handle reliable tool to investigate retronasal olfaction suited for clinical determination of normosmia, hyposmia, and ansomia. In addition, it can be used for investigation where self-application is necessary such as in large survey studies.

  2. Family routines and rituals: a context for occupational therapy interventions.

    Science.gov (United States)

    Segal, Ruth

    2004-01-01

    This paper explores the importance of family daily routines and rituals for the family's functioning and sense of identity. The findings of this paper are derived from an analysis of the morning routines of 40 families with children with disabilities in the United States and Canada. The participants lived in urban and rural areas. Forty of the 49 participants were mothers and the majority of the families were of European descent. Between one and four interviews were conducted with each participant. Topics included the family's story, daily routines, and particular occupations. Data on the morning routines of the families were analyzed for order and affective and symbolic meaning using a narrative approach. The findings are presented as narratives of morning activities in five families. These narratives are examples for rituals, routines, and the absence of a routine. Rituals are discussed in terms of their affective and symbolic qualities, routines are discussed in terms of the order they give to family life, whereas the lack of family routine is discussed in terms of lack of order in the family. Family routines and rituals are organizational and meaning systems that may affect family's ability to adapt them.

  3. Modeling Routinization in Games: An Information Theory Approach

    DEFF Research Database (Denmark)

    Wallner, Simon; Pichlmair, Martin; Hecher, Michael

    2015-01-01

    -time, discrete-space Markov chains and information theory to measure the actual error between the dynamically trained models and the player interaction. Preliminary research supports the hypothesis that Markov chains can be effectively used to model routinization in games. A full study design is presented......Routinization is the result of practicing until an action stops being a goal-directed process. This paper formulates a definition of routinization in games based on prior research in the fields of activity theory and practice theory. Routinization is analyzed using the formal model of discrete...

  4. Routine intracranial pressure monitoring in acute coma.

    Science.gov (United States)

    Forsyth, Rob J; Raper, Joseph; Todhunter, Emma

    2015-11-02

    We know that the brain damage resulting from traumatic and other insults is not due solely to the direct consequences of the primary injury. A significant and potentially preventable contribution to the overall morbidity arises from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raised intracranial pressure (ICP) prevents adequate cerebral perfusion with well-oxygenated blood.Detection of raised ICP could be useful in alerting clinicians to the need to improve cerebral perfusion, with consequent reductions in brain injury. To determine whether routine ICP monitoring in severe coma of any cause reduces the risk of all-cause mortality or severe disability at final follow-up. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL Plus, ISI Web of Science (SCI-EXPANDED & CPCI-S), clinical trials registries and reference lists. We ran the most recent search on 22 May 2015. All randomised controlled studies of real-time ICP monitoring by invasive or semi-invasive means in acute coma (traumatic or non-traumatic aetiology) versus clinical care without ICP monitoring (that is, guided only by clinical or radiological inference of the presence of raised ICP). Two authors (ET and RF) worked independently to identify the one study that met inclusion criteria. JR and RF independently extracted data and assessed risk of bias. We contacted study authors for additional information, including details of methods and outcome data. One randomized controlled trial (RCT) meeting the selection criteria has been identified to date.The included study had 324 participants. We judged risk of bias to be low for all categories except blinding of participants and personnel, which is not feasible for this intervention. There were few missing data, and we analysed all on an intention-to-treat basis.Participants could be 13 years of age or older (mean age of sample 29

  5. Parent routines, child routines, and family demographics associated with obesity in parents and preschool-aged children

    OpenAIRE

    Blake Lee Jones; Fiese, Barbara H

    2014-01-01

    Many daily routines and behaviors are related to the prevalence of obesity. This study investigated the association between routines and behaviors that act as protective factors related to lower prevalence of obesity in parents (BMI ≥ 30 kg/m2) and overweight in preschool children (BMI ≥ 85th percentile). Socio-demographic characteristics were assessed in relation to protective routines (PRs), and prevalence of obesity/overweight data from 337 preschool children and their parents. The two PRs...

  6. Taking a new biomarker into routine use – A perspective from the routine clinical biochemistry laboratory

    Science.gov (United States)

    Sturgeon, Catharine; Hill, Robert; Hortin, Glen L; Thompson, Douglas

    2010-01-01

    There is increasing pressure to provide cost-effective healthcare based on “best practice.” Consequently, new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence base and if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test, ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefit studies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway. From the laboratory perspective, pre-analytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker in relevant physiological matrices is essential to avoid the need for special processing. Absence of specific timing requirements for sampling and knowledge of the effect of medications that might be used to treat the patients in whom the biomarker will be measured is also highly desirable. Analytically, automation is essential in modern high-throughput clinical laboratories. Assays must therefore be robust, fulfilling standard requirements for linearity on dilution, precision and reproducibility, both within- and between-run. Provision of measurements by a limited number of specialized reference laboratories may be most appropriate, especially when a new biomarker is first introduced into routine practice. PMID:21137030

  7. Support Routines for In Situ Image Processing

    Science.gov (United States)

    Deen, Robert G.; Pariser, Oleg; Yeates, Matthew C.; Lee, Hyun H.; Lorre, Jean

    2013-01-01

    This software consists of a set of application programs that support ground-based image processing for in situ missions. These programs represent a collection of utility routines that perform miscellaneous functions in the context of the ground data system. Each one fulfills some specific need as determined via operational experience. The most unique aspect to these programs is that they are integrated into the large, in situ image processing system via the PIG (Planetary Image Geometry) library. They work directly with space in situ data, understanding the appropriate image meta-data fields and updating them properly. The programs themselves are completely multimission; all mission dependencies are handled by PIG. This suite of programs consists of: (1)marscahv: Generates a linearized, epi-polar aligned image given a stereo pair of images. These images are optimized for 1-D stereo correlations, (2) marscheckcm: Compares the camera model in an image label with one derived via kinematics modeling on the ground, (3) marschkovl: Checks the overlaps between a list of images in order to determine which might be stereo pairs. This is useful for non-traditional stereo images like long-baseline or those from an articulating arm camera, (4) marscoordtrans: Translates mosaic coordinates from one form into another, (5) marsdispcompare: Checks a Left Right stereo disparity image against a Right Left disparity image to ensure they are consistent with each other, (6) marsdispwarp: Takes one image of a stereo pair and warps it through a disparity map to create a synthetic opposite- eye image. For example, a right eye image could be transformed to look like it was taken from the left eye via this program, (7) marsfidfinder: Finds fiducial markers in an image by projecting their approximate location and then using correlation to locate the markers to subpixel accuracy. These fiducial markets are small targets attached to the spacecraft surface. This helps verify, or improve, the

  8. Routine invasive management after fibrinolysis in patients with ST-elevation myocardial infarction: a systematic review of randomized clinical trials

    Science.gov (United States)

    2011-01-01

    Background Patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolysis are increasingly, and ever earlier, referred for routine coronary angiography and where feasible, undergo percutaneous coronary intervention (PCI). We sought to examine the randomized clinical trials (RCTs) on which this approach is based. Methods We systematically searched EMBASE, Medline, and references of relevant studies. All contemporary RCTs (published since 1995) that compared systematic invasive management of STEMI patients after fibrinolysis with standard care were included. Relevant study design and clinical outcome data were extracted. Results Nine RCTs that randomized a total of 3320 patients were identified. All suggested a benefit from routine early invasive management. They were individually reviewed but important design variations precluded a formal quantitative meta-analysis. Importantly, several trials did not compare a routine practice of invasive management after fibrinolysis with a more selective 'ischemia-guided' approach but rather compared an early versus later routine invasive strategy. In the other studies, recourse to subsequent invasive management in the usual care group varied widely. Comparison of the effectiveness of a routine invasive approach to usual care was also limited by asymmetric use of a second anti-platelet agent, differing enzyme definitions of reinfarction occurring spontaneously versus as a complication of PCI, a preponderance of the 'soft' outcome of recurrent ischemia in the combined primary endpoint, and an interpretative bias when invasive procedures on follow-up were tallied as an endpoint without considering initial invasive procedures performed in the routine invasive arm. Conclusions Due to important methodological limitations, definitive RCT evidence in favor of routine invasive management following fibrinolysis in patients with STEMI is presently lacking. PMID:21689449

  9. Maintaining periodontal health in patients undergoing orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Shobhana Misra

    2012-01-01

    Full Text Available Presence of fixed orthodontic appliances in the mouth leads to accumulation of food debris and an elevation in the amount of plaque. It also hinders plaque removal by tooth brushing alone. Chemical agents may be used during the active phase of orthodontic treatment to reduce the bacterial plaque accumulation and decrease the occurrence of periodontal disease in these patients. The present study was therefore done to compare the efficacy of chemical plaque control by chlorhexidiene in patients undergoing orthodontic treatment. Forty five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10 days after prophylaxis, and at the end of one month in all the three groups. The data obtained was subjected to stastical analysis. Anova test showed significant difference among all the three groups for bleeding index, modified gingival index and plaque index. Paired t test showed significant differences in bleeding index for pre and post treatment recordings for chlorhexidine group. Modified gingival index showed significant difference in the chlorhexidine group. For plaque index significant difference was found for chlorhexidine, and control groups. Chlorhexidine mouthrinse 0.12% was found to be the most effective in reducing the bleeding scores, modified gingival index scores and the plaque index scores. It can therefore be said that chlorhexidine mouthrinse 0.12% provides greater benefits to the patients undergoing fixed orthodontic treatment.

  10. Electrotactile feedback improves performance and facilitates learning in the routine grasping task

    Directory of Open Access Journals (Sweden)

    Milica Isaković

    2016-06-01

    Full Text Available Aim of this study was to investigate the feasibility of electrotactile feedback in closed loop training of force control during the routine grasping task. The feedback was provided using an array electrode and a simple six-level spatial coding, and the experiment was conducted in three amputee subjects. The psychometric tests confirmed that the subjects could perceive and interpret the electrotactile feedback with a high success rate. The subjects performed the routine grasping task comprising 4 blocks of 60 grasping trials. In each trial, the subjects employed feedforward control to close the hand and produce the desired grasping force (four levels. First (baseline and the last (validation session were performed in open loop, while the second and the third session (training included electrotactile feedback. The obtained results confirmed that using the feedback improved the accuracy and precision of the force control. In addition, the subjects performed significantly better in the validation vs. baseline session, therefore suggesting that electrotactile feedback can be used for learning and training of myoelectric control.

  11. Sensibility and Subjectivity: Levinas’ Traumatic Subject

    Directory of Open Access Journals (Sweden)

    Rashmika Pandya

    2011-02-01

    Full Text Available The importance of Levinas’ notions of sensibility and subjectivity are evident in the revision of phenomenological method by current phenomenologists such as Jean-Luc Marion and Michel Henry. The criticisms of key tenants of classical phenomenology, intentionality and reduction, are of a particular note. However, there are problems with Levinas’ characterization of subjectivity as essentially sensible. In “Totality and Infinity” and “Otherwise than Being”, Levinas criticizes and recasts a traditional notion of subjectivity, particularly the notion of the subject as the first and foremost rational subject. The subject in Levinas’ works is characterized more by its sensibility and affectedness than by its capacity to reason or affect its world. Levinas ties rationality to economy and suggests an alternative notion of reason that leads to his analysis of the ethical relation as the face-to-face encounter. The ‘origin’ of the social relation is located not in our capacity to know but rather in a sensibility that is diametrically opposed to the reason understood as economy. I argue that the opposition in Levinas’ thought between reason and sensibility is problematic and essentially leads to a self-conflicted subject. In fact, it would seem that violence characterizes the subject’s self-relation and, thus, is also inscribed at the base of the social relation. Rather than overcoming a problematic tendency to dualistic thought in philosophy Levinas merely reverses traditional hierarchies of reason/emotion, subject/object and self/other. 

  12. Use of perioperative dialogues with children undergoing day surgery.

    Science.gov (United States)

    Wennström, Berith; Hallberg, Lillemor R-M; Bergh, Ingrid

    2008-04-01

    This paper is a report of a study to explore what it means for children to attend hospital for day surgery. Hospitalization is a major stressor for children. Fear of separation, unfamiliar routines, anaesthetic/operation expectations/experiences and pain and needles are sources of children's negative reactions. A grounded theory study was carried out during 2005-2006 with 15 boys and five girls (aged 6-9 years) scheduled for elective day surgery. Data were collected using tape-recorded interviews that included a perioperative dialogue, participant observations and pre- and postoperative drawings. A conceptual model was generated on the basis of the core category 'enduring inflicted hospital distress', showing that the main problem for children having day surgery is that they are forced into an unpredictable and distressful situation. Pre-operatively, the children do not know what to expect, as described in the category 'facing an unknown reality'. Additional categories show that they perceive a 'breaking away from daily routines' and that they are 'trying to gain control' over the situation. During the perioperative period, the categories 'losing control' and 'co-operating despite fear and pain' are present and intertwined. Post-operatively, the categories 'breathing a sigh of relief' and 'regaining normality in life' emerged. The perioperative dialogue used in our study, if translated into clinical practice, might therefore minimize distress and prepare children for the 'unknown' stressor that hospital care often presents. Further research is needed to compare anxiety and stress levels in children undergoing day surgery involving the perioperative dialogue and those having 'traditional' anaesthetic care.

  13. Pharmaceutical care and the use of routine diagnostic tools by ...

    African Journals Online (AJOL)

    Purpose: To evaluate the use of routine diagnostic tools among community pharmacists in Ibadan,. Nigeria. Methods: ... measurements in this setting is recommended by ... Development. Majority of respondents used routine diagnostic tools in their pharmacies. These tools included blood pressure monitors (87.6%), glucose.

  14. The emergence and change of management accounting routines

    NARCIS (Netherlands)

    van der Steen, M.P.

    2011-01-01

    Purpose - The purpose of this paper is to explore the dynamics involved in the emergence and change of management accounting routines. It seeks to provide an understanding of the ways in which these complex routines foster stability and change in management accounting practices.

  15. 42 CFR 493.841 - Standard; Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  16. 42 CFR 493.1267 - Standard: Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  17. Utility of routine chest radiographs in Kenya | Ndii | East African ...

    African Journals Online (AJOL)

    Background: Many otherwise healthy Kenyans are required to obtain chest radiographs as part of routine medical examination to exclude pulmonary TB, a condition of significant public health concern. Many of these people are required to have these radiographs taken yearly as part of routine check-up. No local data is ...

  18. Eating routines. Embedded, value based, modifiable, and reflective.

    Science.gov (United States)

    Jastran, Margaret M; Bisogni, Carole A; Sobal, Jeffery; Blake, Christine; Devine, Carol M

    2009-02-01

    Eating routines are a compelling issue because recurring eating behaviors influence nutrition and health. As non-traditional and individualized eating patterns have become more common, new ways of thinking about routine eating practices are needed. This study sought to gain conceptual understanding of working adults' eating routines. Forty-two purposively sampled US adults reported food intake and contextual details about eating episodes in qualitative 24-h dietary recalls conducted over 7 consecutive days. Using the constant comparative method, researchers analyzed interview transcripts for recurrent ways of eating that were either explicitly reported by study participants as "routines" or emergent in the data. Participants' eating routines included repetition in food consumption as well as eating context, and also involved sequences of eating episodes. Eating routines were embedded in daily schedules for work, family, and recreation. Participants maintained purposeful routines that helped balance tension between demands and values, but they modified routines as circumstances changed. Participants monitored and reflected upon their eating practices and tended to assess their practices in light of their personal identities. These findings provide conceptual insights for food choice researchers and present a perspective from which practitioners who work with individuals seeking to adopt healthful eating practices might usefully approach their tasks.

  19. Recapturing Desired Family Routines: A Parent-Professional Behavioral Collaboration

    Science.gov (United States)

    Buschbacher, Pamelazita; Fox, Lise; Clarke, Shelley

    2004-01-01

    Children with complex disabilities such as autism spectrum disorders and Landau Kleffner syndrome often lack means to participate in everyday family routines. Serious problem behaviors may result from their challenges in responding to and initiating communicative interactions. These behaviors can change routine family activities such that the…

  20. Parental Involvement Routines and Former Head Start Children's Literacy Outcomes

    Science.gov (United States)

    Dove, Meghan Kicklighter; Neuharth-Pritchett, Stacey; Wright, David W.; Wallinga, Charlotte

    2015-01-01

    This study examined the relationship between parental involvement routines and former Head Start children's literacy outcomes. Former Head Start children (n = 3, 808) from the National Head Start/Public School Transition Demonstration Research Project comprised the sample. Family routines and literacy outcomes in kindergarten were examined,…

  1. 32 CFR 1701.31 - General routine uses.

    Science.gov (United States)

    2010-07-01

    ... program statute, regulation, rule or order issued pursuant thereto, may be disclosed as a routine use to..., local, tribal or other public authority, or to a legitimate agency of a foreign government or... maintained by the ODNI may be disclosed as a routine use to legitimate foreign, international or...

  2. Routines in School Organizations: Creating Stability and Change

    Science.gov (United States)

    Conley, Sharon; Enomoto, Ernestine K.

    2005-01-01

    Purpose: This paper presents routinized action theory as a way to examine the regular, habitual activities that occur in school organizations. Using this theoretical lens, school routines were analyzed in order to understand organizational stability and change. Design/methodology/approach: Using case study methods, three discrete cases are…

  3. Family routines and rituals following separation: continuity and change

    NARCIS (Netherlands)

    Bakker, W.; Karsten, L.; Mulder, C.H.

    2015-01-01

    Separation always changes family life. The aim of this study is to gain insight into the everyday practices of ‘doing family’ after separation. We focus on two central elements of family life: routines and rituals. While in most families both parents are involved in family routines and rituals, this

  4. Using Routines-Based Interventions in Early Childhood Special Education

    Science.gov (United States)

    Jennings, Danielle; Hanline, Mary Frances; Woods, Juliann

    2012-01-01

    Embedding early intervention activities into routines and activities of early care and education programs can result in increased skill development for young children with special needs or developmental delays. Routines-based interventions must be implemented through ongoing collaboration and communication among teachers, families, intervention…

  5. Routine contrast enema is not required for all infants prior to ostomy reversal: A 10-year single-center experience.

    Science.gov (United States)

    Grant, Christa N; Golden, Jamie M; Anselmo, Dean M

    2016-07-01

    The incidence of intestinal stricture is low for most conditions requiring a primary small bowel stoma in infants. Routine performance of contrast enemas (CE) prior to stoma closure adds cost and radiation exposure. We hypothesized that routine CE prior to ostomy reversal is not necessary in all infants, and sought to identify a subset of patients who may benefit from preoperative CE. Medical records of infants under age 1 (N=161) undergoing small bowel stoma reversal at a single institution between 2003 and 2013 were retrospectively reviewed. Student's T-test was used to compare groups. Contrast enemas were performed on 80% of all infants undergoing small bowel ostomy reversal during the study period. Infants with necrotizing enterocolitis (NEC) were more likely to have a CE than those with intestinal atresia (p=0.03) or those with all other diagnoses combined (p=0.03). Nine strictures were identified on CE. Of those, 8 (89%) were in patients with NEC, and only 4 were clinically significant and required operative resection. The overall relevant stricture rate was 2.5%. No patient that underwent ostomy takedown without CE had a stricture diagnosed intraoperatively or an unrecognized stricture that presented clinically after stoma takedown. Routine CE is not required prior to small bowel ostomy reversal in infants. We recommend judicious use of enema studies in patients with NEC and high likelihood of stricture. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Routine healthcare for families in transition after a natural disaster

    Directory of Open Access Journals (Sweden)

    Gisele Cristina Manfrini Fernandes

    2013-07-01

    Full Text Available OBJECTIVE: to present the healthcare routines of families in transition after natural disasters based on the Family Routines and Rituals theoretical framework. METHOD: this qualitative study of multiple cases was developed based on six rural families in southern Brazil, 2 years after a natural disaster. The data were collected through participant observation, interviews, narratives, genograms, ecomaps, and routine calendars, and a narrative analysis was conducted. RESULTS: families showed notable episodes of illness that required professional assistance during post-disaster care, daily routine care, and other routines associated with healthcare services. CONCLUSION: these results reinforce the need for nurses to attend to family experiences during transitions after natural disasters and to prepare for the changes and needs with regard to healthcare and its promotion.

  7. Household routines and obesity in US preschool-aged children.

    Science.gov (United States)

    Anderson, Sarah E; Whitaker, Robert C

    2010-03-01

    To determine the association between the prevalence of obesity in preschool-aged children and exposure to 3 household routines: regularly eating the evening meal as a family, obtaining adequate sleep, and limiting screen-viewing time. We conducted a cross-sectional analysis of a nationally representative sample of approximately 8550 four-year-old US children who were assessed in 2005 in the Early Childhood Longitudinal Study, Birth Cohort. Height and weight were measured. We assessed the association of childhood obesity (BMI > or = 95th percentile) with 3 household routines: regularly eating the evening meal as a family (>5 nights per week); obtaining adequate nighttime sleep on weekdays (> or =10.5 hours per night); and having limited screen-viewing (television, video, digital video disk) time on weekdays (routines, and 12.4% were exposed to none of the routines. The prevalence of obesity was 14.3% (95% confidence interval [CI]: 11.3%-17.2%) among children exposed to all 3 routines and 24.5% (95% CI: 20.1%-28.9%) among those exposed to none of the routines. After adjusting for covariates, the odds of obesity associated with exposure to all 3, any 2, or only 1 routine (compared with none) were 0.63 (95% CI: 0.46-0.87), 0.64 (95% CI: 0.47-0.85), and 0.84 (95% CI: 0.63-1.12), respectively. US preschool-aged children exposed to the 3 household routines of regularly eating the evening meal as a family, obtaining adequate nighttime sleep, and having limited screen-viewing time had an approximately 40% lower prevalence of obesity than those exposed to none of these routines. These household routines may be promising targets for obesity-prevention efforts in early childhood.

  8. Correlation between spirometry values and pulmonary artery pressure in young healthy subjects.

    Science.gov (United States)

    Grossman, Alon; Benderly, Michal; Prokupetz, Alex; Gordon, Barak; Kalter-Leibovici, Ofra

    2014-03-01

    Pulmonary hypertension is frequently associated with parenchymal lung disease. We evaluated the association between spirometry values and pulmonary artery systolic pressure (PASP) in young subjects without lung disease : We studied applicants to the Israeli Air Force, who undergo routine evaluation that includes resting spirometry and echocardiography. Applicants with overt lung disease were excluded. All echocardiographic studies performed in the years 1994 through 2010 (n = 6,598) were screened, and files that included PASP and spirometry values were analyzed for the association between PASP and FVC, FEV1, FEV1/FVC, peak expiratory flow, and forced expiratory flow during the middle half of the FVC maneuver. Of the 647 air force applicants who underwent echocardiography in which PASP was measurable and had spirometry data, 607 (94%) were male, and their average age was 18.16 ± 0.73 years. Mean PASP was 26.4 ± 5.2 mm Hg (range 10-41 mm Hg). None of the spirometry values significantly correlated with PASP. PASP in young healthy subjects is not significantly associated with spirometry values. Lung mechanics probably do not contribute significantly to PASP in this population.

  9. Systemic Assessment of Patients Undergoing Dental Implant ...

    African Journals Online (AJOL)

    These days, dental implants are becoming routinely used as a treatment option for rehabilitation of lost teeth. Conventionally, it is only after the completion of bone healing that the dental implants are loaded into the bone. Bone healing time is approximately 3 months and. 6 months for the mandible and maxilla, respectively.

  10. Multi-centre first-trimester screening for Down syndrome in the Netherlands in routine clinical practice.

    NARCIS (Netherlands)

    Schielen, P C J I; Leeuwen-Spruijt, M van; Belmouden, I; Elvers, L H; Jonker, M; Loeber, J G

    2006-01-01

    OBJECTIVES: This is the first report on the results of a first-trimester combined-test screening programme in the Netherlands in a multi-centre routine clinical setting. METHODS: Between July 2002 and May 2004, blood samples were taken from subjects in 44 centres in the Netherlands and sent to our

  11. Comparison of Shoulder Strength in Routinely Trained Badminton Players and Non-Badminton Players

    Directory of Open Access Journals (Sweden)

    Wong Zhen Feng

    2017-06-01

    Full Text Available Background: Shoulder pain is a common reason for patients to seek medical help in any healthcare center. Shoulder pain is influenced by a few factors such as gender, posture during daily activities, aging and psychological factors. Based on the study of Epidemiology of Injuries and Prevention Strategies in Competitive Swimmers, shoulder pain due to shoulder injuries can be reduced by strengthening the shoulder muscle. Badminton has become one of the most popular sports in Asia, especially in Indonesia. This study was conducted to determine if badmintonis able to strengthen the shoulder muscle group. Methods: A cross-sectional analytic experimental study was conducted on September 2015 at Lodaya Badminton Training Center and Bale Padjadjaran of Universitas Padjadjaran. Subjects were 30 healthy male routinely trained badminton players and 30 non-badminton players who voluntarily follow the rstudy procedures. Strength measurement procedures were provided to the subjects after getting informed consent.  Data analysis was performed using T-test. Results: The shoulder strength  in routinely trained badminton players was significantly different from  non-badminton players (P<0.05. Conclusions: Shoulder strength can be improved through routine training of badminton to reduce risk of shoulder injury.   DOI: 10.15850/amj.v4n2.1083

  12. Anesthetic Routines: The Anesthesiologist's Role in GI Recovery and Postoperative Ileus

    Directory of Open Access Journals (Sweden)

    John B. Leslie

    2011-01-01

    Full Text Available All patients undergoing bowel resection experience postoperative ileus, a transient cessation of bowel motility that prevents effective transit of intestinal contents or tolerance of oral intake, to varying degrees. An anesthesiologist plays a critical role, not only in the initiation of surgical anesthesia, but also with the selection and transition to effective postoperative analgesia regimens. Attempts to reduce the duration of postoperative ileus have prompted the study of various preoperative, perioperative, and postoperative regimens to facilitate gastrointestinal recovery. These include modifiable variables such as epidural anesthesia and analgesia, opioid-sparing anesthesia and analgesia, fluid restriction, colloid versus crystalloid combinations, prokinetic drugs, and use of the new peripherally acting mu-opioid receptor (PAM-OR antagonists. Review and appropriate adaptation of these multiple modifiable interventions by anesthesiologists and their surgical colleagues will facilitate implementation of a best-practice management routine for bowel resection procedures that will benefit the patient and the healthcare system.

  13. Studies on the LHC superconducting circuits and routine qualification of their functionalities

    CERN Document Server

    Pojer, M; Mompo, R; Schmidt, R; Solfaroli Camillocci, M

    2012-01-01

    The Large Hadron Collider (LHC) is systematically undergoing periods of maintenance stop (either 4-5 days stops or longer Christmas breaks), after which some or all superconducting circuits have to be re-commissioned to check the correct functionality of all powering and protection systems. Detailed procedures have been developed during the past few years and they have been optimized to increase powering tests efficiency, thus reducing beam downtime. The approach to the routine qualification of the LHC powering systems is described in this paper. During the technical stops in 2011 various studies on the superconducting circuits were performed, to assess the quality of the superconducting splices of individually powered magnets and to study the quench propagation in the main magnet bus-bars. The methodology of these tests and some results are presented.

  14. Eating routines: Embedded, value based, modifiable, and reflective

    Science.gov (United States)

    Jastran, Margaret; Bisogni, Carole A.; Sobal, Jeffery; Blake, Christine; Devine, Carol M.

    2009-01-01

    Eating routines are a compelling issue because recurring eating behaviors influence nutrition and health. As non-traditional and individualized eating patterns have become more common, new ways of thinking about routine eating practices are needed. This study sought to gain conceptual understanding of working adults' eating routines. Forty-two purposively sampled US adults reported food intake and contextual details about eating episodes in qualitative 24-hour dietary recalls conducted over 7 consecutive days. Using the constant comparative method, researchers analyzed interview transcripts for recurrent ways of eating that were either explicitly reported by study participants as “routines” or emergent in the data. Participants' eating routines included repetition in food consumption as well as eating context, and also involved sequences of eating episodes. Eating routines were embedded in daily schedules for work, family, and recreation. Participants maintained purposeful routines that helped balance tension between demands and values, but they modified routines as circumstances changed. Participants monitored and reflected upon their eating practices and tended to assess their practices in light of their personal identities. These findings provide conceptual insights for food choice researchers and present a perspective from which practitioners who work with individuals seeking to adopt healthful eating practices might usefully approach their tasks. PMID:18835305

  15. Patients undergoing dacryocystorhinostomy surgery in northern Iran ...

    African Journals Online (AJOL)

    Background: Dacryocystorhinostomy (DCR) is widely accepted as the procedure of choice for surgical correction of lacrimal drainage system obstruction distal to common canaliculus in adulthood. Although, there are only limited epidemiological data available in Iran about the patients undergoing DCR surgery. Aim: This ...

  16. Experiences of patients undergoing chemotherapy - a qualitative ...

    African Journals Online (AJOL)

    Background: Cancer is a global public health challenge and how patients in countries with poor healthcare infrastructure experience cancer treatment is largely unknown. Purpose: The objective of this study was to describe adult Ugandan cancer patients' experiences of undergoing chemotherapy treatment. Methodology: ...

  17. Patients Undergoing Dacryocystorhinostomy Surgery in Northern ...

    African Journals Online (AJOL)

    such as age, and gender, clinical findings, history of surgery, etc., extracted from archived files of the patients undergoing ... between gender and dacryocystitis rate, it was high among female (P = 0.02( Most of the patients complained of ... at 3 months after surgery and a healed patent neo-ostium with a free flow of tears from ...

  18. Experiences of patients undergoing chemotherapy - a qualitative ...

    African Journals Online (AJOL)

    Purpose: The objective of this study was to describe adult Ugandan cancer patients' experiences of undergoing chemotherapy treatment. Methodology: Using a qualitative descriptive design, seven in-patients with varying cancer diagnoses at the Uganda Cancer ... tance of focusing research on persons with cancer in.

  19. Effect of music on patients undergoing outpatient colonoscopy.

    Science.gov (United States)

    Bechtold, Matthew-L; Perez, Rodney-A; Puli, Srinivas-R; Marshall, John-B

    2006-12-07

    To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist. One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played. There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time, endoscopist assessment of scope insertion difficulty, endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure. The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales. While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.

  20. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  1. Allergy to kiwi: is component-resolved diagnosis in routine clinical practice really impossible?

    Science.gov (United States)

    Asero, R

    2012-04-01

    Kiwi allergy is frequent and can be the result of sensitization to a number of allergens showing different physicochemical characteristics. Component-resolved diagnosis of kiwi allergy is still unavailable in routine clinical practice. To investigate whether component resolved-diagnosis of kiwi allergy can be, at least in part, carried out by a proper combination of routinely available diagnostic tools. 63 adults with plant food allergy were studied 36 were kiwi-allergic while 27 were kiwi-tolerant and served as controls. Patients and controls underwent SPT with commercial peach and kiwi extracts, and with aprofilin-enriched date palm pollen extract (all by ALK-Abellò), and the measurement of IgE to birch, kiwi, and natural rubber latex. The in-vitro test showed poor sensitivity and specificity, as it scored positive in about 50% of patients and controls irrespective of clinical allergy to kiwi. The kiwi SPT showed overall poor sensitivity; however, it scored negative in all subjects with pollen food-allergy syndrome, was weakly positive in some lipid transfer protein-hypersensitive/kiwi tolerant subjects and in one latex-sensitized subject, and strongly positive in all subjects with primary kiwi sensitization. SPT with this commercial kiwi extract sensitively and specifically detects patients reacting to specific kiwi allergens. This can be useful to detect patients that are at risk of potentially severe reactions, particularly in case of co-sensitization to labile allergens, while we wait that the whole spectrum of kiwi allergens becomes available for routine in-vitro testing.

  2. Application of acute phase protein measurements in meat extract collected during routine veterinary inspection at abattoirs.

    Science.gov (United States)

    Gutiérrez, A M; Villa, M I; Marsilla, B A; Martinez-Subiela, S; Montes, A M; Cerón, J J

    2015-08-01

    The possible application of acute phase protein measurements of meat extract in porcine carcass inspection at abattoir, under routine conditions, was studied. Concentrations of two acute phase proteins, C-reactive protein and haptoglobin, were quantified in 357 samples from carcasses subjected to official veterinary inspection at slaughterhouses. Carcasses were classified according to their sanitary status in five groups of animals ranging from healthy animals, without any organ alteration (group 1), to completely condemned carcasses with gross alteration in several organic systems (group 5). The concentration of both acute phase proteins appeared significantly higher in groups 2 to 5 in comparison to group 1. Sensitivity of these proteins to detect animals with organ alterations was 86% when the values of both proteins were taken into account. The quantification of the levels of acute phase proteins could be of help during routine veterinary meat inspection by offering an objective tool for active disease detection. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. IT Infrastructure to support the secondary use of routinely acquired clinical imaging data for research.

    Science.gov (United States)

    Leung, Kai Yan Eugene; van der Lijn, Fedde; Vrooman, Henri A; Sturkenboom, Miriam C J M; Niessen, Wiro J

    2015-01-01

    We propose an infrastructure for the automated anonymization, extraction and processing of image data stored in clinical data repositories to make routinely acquired imaging data available for research purposes. The automated system, which was tested in the context of analyzing routinely acquired MR brain imaging data, consists of four modules: subject selection using PACS query, anonymization of privacy sensitive information and removal of facial features, quality assurance on DICOM header and image information, and quantitative imaging biomarker extraction. In total, 1,616 examinations were selected based on the following MRI scanning protocols: dementia protocol (246), multiple sclerosis protocol (446) and open question protocol (924). We evaluated the effectiveness of the infrastructure in accessing and successfully extracting biomarkers from routinely acquired clinical imaging data. To examine the validity, we compared brain volumes between patient groups with positive and negative diagnosis, according to the patient reports. Overall, success rates of image data retrieval and automatic processing were 82.5 %, 82.3 % and 66.2 % for the three protocol groups respectively, indicating that a large percentage of routinely acquired clinical imaging data can be used for brain volumetry research, despite image heterogeneity. In line with the literature, brain volumes were found to be significantly smaller (p-value <0.001) in patients with a positive diagnosis of dementia (915 ml) compared to patients with a negative diagnosis (939 ml). This study demonstrates that quantitative image biomarkers such as intracranial and brain volume can be extracted from routinely acquired clinical imaging data. This enables secondary use of clinical images for research into quantitative biomarkers at a hitherto unprecedented scale.

  4. Widely applicable MATLAB routines for automated analysis of saccadic reaction times.

    Science.gov (United States)

    Leppänen, Jukka M; Forssman, Linda; Kaatiala, Jussi; Yrttiaho, Santeri; Wass, Sam

    2015-06-01

    Saccadic reaction time (SRT) is a widely used dependent variable in eye-tracking studies of human cognition and its disorders. SRTs are also frequently measured in studies with special populations, such as infants and young children, who are limited in their ability to follow verbal instructions and remain in a stable position over time. In this article, we describe a library of MATLAB routines (Mathworks, Natick, MA) that are designed to (1) enable completely automated implementation of SRT analysis for multiple data sets and (2) cope with the unique challenges of analyzing SRTs from eye-tracking data collected from poorly cooperating participants. The library includes preprocessing and SRT analysis routines. The preprocessing routines (i.e., moving median filter and interpolation) are designed to remove technical artifacts and missing samples from raw eye-tracking data. The SRTs are detected by a simple algorithm that identifies the last point of gaze in the area of interest, but, critically, the extracted SRTs are further subjected to a number of postanalysis verification checks to exclude values contaminated by artifacts. Example analyses of data from 5- to 11-month-old infants demonstrated that SRTs extracted with the proposed routines were in high agreement with SRTs obtained manually from video records, robust against potential sources of artifact, and exhibited moderate to high test-retest stability. We propose that the present library has wide utility in standardizing and automating SRT-based cognitive testing in various populations. The MATLAB routines are open source and can be downloaded from http://www.uta.fi/med/icl/methods.html .

  5. Vitamin D Deficiency in Children Undergoing Vertical Expandable Prosthetic Titanium Rib Treatment.

    Science.gov (United States)

    Li, Ying; Jong, Nahbee; Caird, Michelle S; Tenfelde, Allison; Nowicki, Philip; Shedden, Kerby; Nelson, Virginia S; Farley, Frances A

    2015-12-01

    Vitamin D deficiency is prevalent in the pediatric population and multiple risk factors have been identified. Low vitamin D levels can result in poor bone mineralization and have been associated with a significantly higher risk of forearm fracture in children. Vitamin D deficiency has also been associated with pediatric critical illness. The purpose of this study was to determine whether children undergoing vertical expandable prosthetic titanium rib (VEPTR) treatment have low vitamin D levels. Patients undergoing VEPTR treatment at a single institution were prospectively enrolled (VEPTR). All patients either had a diagnosis of thoracic insufficiency syndrome (TIS), or were at risk of developing TIS secondary to progressive scoliosis or chest wall deformity. Exclusion criteria were patients with rickets and patients receiving vitamin D supplementation at the time of VEPTR insertion. A group of healthy children who presented with fractures during the winter season were used as controls (FX). Vitamin D status and risk factors for vitamin D deficiency were evaluated. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25-OH-D) obesity, or multivitamin use. Low vitamin D levels are common in children undergoing VEPTR treatment. In our series, the prevalence of vitamin D deficiency in this patient population was similar to reported rates in the general pediatric population. Vitamin D status should be routinely monitored in children undergoing VEPTR treatment and supplementation should be initiated if necessary.

  6. Preoperative Thyroid Ultrasound Is Indicated in Patients Undergoing Parathyroidectomy for Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Cletus A. Arciero, Zita S. Shiue, Jeremy D. Gates, George E. Peoples, Alan P. B. Dackiw, Ralph P. Tufano, Steven K. Libutti, Martha A. Zeiger, Alexander Stojadinovic

    2012-01-01

    Full Text Available Background: Primary hyperaparathyroidism (pHPT is often accompanied by underlying thyroid pathology that can confound preoperative parathyroid localization studies and complicate intra-operative decision making. The aim of this study was to examine the utility of preoperative thyroid ultrasonography (US in patients prior to undergoing parathyroidectomy for pHPT.Methods: An Institutional Review Board approved prospective study was undertaken from January 2005 through July 2008. All patients with pHPT meeting inclusion criteria (n=94 underwent preoperative thyroid ultrasound in addition to standard 99mTc-sestamibi scintigraphy for parathyroid localization. Demographics, operative management and final pathology were examined in all cases.Results: Fifty-four of the 94 patients (57% were noted to have a thyroid nodule on preoperative US, of which 30 (56% underwent further examination with fine needle aspiration biopsy. Alteration of the operative plan attributable to underlying thyroid pathology occurred in 16 patients (17%, with patients undergoing either total thyroidectomy (n=9 or thyroid lobectomy (n=7. Thyroid cancer was noted in 33% of patients undergoing thyroid resection, and 6% of all patients with HPT.Conclusions: The routine utilization of preoperative thyroid ultrasound in patients prior to undergoing parathyroid surgery for pHPT is indicated. The added information from this non-invasive modality facilitates timely management of co-incidental, and sometimes malignant, thyroid pathology.

  7. Experience with daptomycin daily dosing in ICU patients undergoing continuous renal replacement therapy.

    Science.gov (United States)

    Preiswerk, B; Rudiger, A; Fehr, J; Corti, N

    2013-04-01

    For critically ill patients undergoing continuous renal replacement therapy (CRRT), daptomycin dosing recommendations are scarce. We, therefore, retrospectively assessed routinely measured daptomycin plasma concentrations, daptomycin dose administered and microbiological data in 11 critically ill patients with Gram-positive infections that had received daptomycin once daily. The retrospective analysis included critically ill patients treated at the intensive care unit (ICU) who had daptomycin plasma concentrations measured. Daptomycin dose ranged from 3 to 8 mg/kg/q24 h in patients undergoing CRRT (n = 7) and 6 to 10 mg/kg/q24 h in patients without CRRT (n = 4). Peak and trough concentrations showed a high intra- and inter-patient variability in both groups, independent of the dosage per kg body weight. No drug accumulation was detected in CRRT patients with once-daily daptomycin dosing. Causative pathogens were Enterococcus faecium (n = 6), coagulase-negative Staphylococcus (n = 2), Staphylococcus aureus (n = 2) and unknown in one patient. Microbiological eradication was successful in 8 of 11 patients. Two of three patients with unsuccessful microbiological eradication and fatal outcome had an Enterococcus faecium infection. In critically ill patients undergoing CRRT, daptomycin exposure with once-daily dosing was similar to ICU patients with normal renal function, but lower compared to healthy volunteers. Our data suggest that daptomycin once-daily dosing is appropriate in patients undergoing CRRT.

  8. Safety and efficacy of multimodal thromboprophylaxis following total knee arthroplasty: a comparative study of preferential aspirin vs. routine coumadin chemoprophylaxis.

    Science.gov (United States)

    Gesell, Mark W; González Della Valle, Alejandro; Bartolomé García, Sergio; Memtsoudis, Stavros G; Ma, Yan; Haas, Steven B; Salvati, Eduardo A

    2013-04-01

    Multimodal thromboprophylaxis encompasses preoperative VTE risk stratification, regional anesthesia, mechanical prophylaxis, and early mobilization. We determined if aspirin can be safely used for adjuvant chemoprophylaxis in patients who have a low thromboembolic risk. 1016 consecutive patients undergoing TKA received multimodal thromboprophylaxis. Aspirin was used in 67% of patients and Coumadin 33% (high risk patients, or who were on Coumadin before surgery). This study group was compared to 1001 consecutive patients who received multimodal thromboprophylaxis and routine Coumadin chemoprophylaxis. There was no significant difference in rates of VTE, PE, bleeding, complications, readmission and 90-day mortality between the two groups. There was a significantly higher rate of wound related complications in the control group (p=0.03). Multimodal thromboprophylaxis with aspirin given to the majority of patients at a low VTE risk is safe and effective in patients undergoing primary TKA. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Energy cost and energy sources of ball routine in rhythmic gymnasts.

    Science.gov (United States)

    Guidetti, L; Baldari, C; Capranica, L; Persichini, C; Figura, F

    2000-04-01

    The energy cost and the different energy sources of competitive rhythmic ball-routines were assessed in nine young elite rhythmic gymnasts (13-16 years of age). The overall energy requirement of ball exercise (VO2eq) was obtained by adding the amount of VO2 during exercise above resting (VO2ex) to the VO2 up to the fast component of recovery (VO2al) and to the energy equivalent of peak blood lactate accumulation (VO2la-) of recovery. The lactate (La) curve up to 25 minutes of recovery always showed La peaks at 3 min after exercise (4.0 +/- 0.4 mmol/l) and values still above rest at 25 min (2.3 +/- 0.5 mmol/l). Although ball routines were short in duration (90 s), the metabolic power requirement was 1.1 times higher than the subject's VO2max. The energy cost (VO2eq) amounted to 81 +/- 5 ml x kg(-1). Higher fractions of VO2eq were VO2ex 49% and VO2al 42%, while the remaining 9% was due to VO2la-. The aerobic source resulted in the most utilized system due to the subjects' high VO2max (52.7 ml x kg(-1) x min(-1)) and anaerobic threshold (LT = 84.4%). The HR and the peak lactate values of ball routine were similar to the values recorded at LT step during treadmill test. Although the HR and VO2 values were significantly correlated (during pre-exercise, exercise, and fast recovery), the exercise intensity derived from HR Kanvonen method during ball routine did not correspond to the % of VO2max.

  10. Use of WGS in Mycobacterium tuberculosis routine diagnosis

    Directory of Open Access Journals (Sweden)

    Daniela M Cirillo

    2016-01-01

    Conclusion: WGS is a rapid, cost-effective technique that promises to integrate and replace the other tests in routine laboratories for an accurate diagnosis of DR-TB, although it is suitable nowadays for cultured samples only.

  11. Unsupervised daily routine and activity discovery in smart homes.

    Science.gov (United States)

    Jie Yin; Qing Zhang; Karunanithi, Mohan

    2015-08-01

    The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

  12. Institutionalized elderly: chronological organization of daily routines and sleep quality

    National Research Council Canada - National Science Library

    Mansano-Schlosser, Thalyta Cristina; dos Santos, Ariene Angelini; Camargo-Rossignolo, Simone de Oliveira; Freitas, Denise Cuoghi de Carvalho Veríssimo; Lorenz, Vera Regina; Ceolim, Maria Filomena

    2014-01-01

    This is a descriptive cross-sectional study, which aimed to identify the perception of nursing home elderly residents related to the chronological organization of their daily routines and to their sleep quality...

  13. Family routines: a structural perspective for viewing family health.

    Science.gov (United States)

    Denham, Sharon A

    2002-06-01

    Although rituals are considered in the anthropological and sociological literature, less attention is given to associated biophysical and health perspectives. Three ethnographic studies were conducted to identify the ways family health was defined and practiced. Findings indicated that routines were an important aspect of family health. Families described routines linked to family health and discussed how they evolved, ways they were modified over time, and how families recreated them when stress and change were encountered. Findings indicated that routines provide a structural perspective for assessments, interventions, and outcome evaluations related to health and useful to nursing practice. This article explains some of what is known about family routines, describes the author's findings, and suggests implications for nursing.

  14. Time to Catch Up on Reading, Writing and Routine Shots

    Science.gov (United States)

    ... fullstory_167436.html Time to Catch Up on Reading, Writing … and Routine Shots Before kids head back ... Health and Human Services. More Health News on Childhood Immunization School Health Recent Health News Related MedlinePlus ...

  15. Routine bladder biopsies in men with bladder outlet obstruction?

    NARCIS (Netherlands)

    Horn, T.; Kortmann, B.B.M.; Holm, N.R.; Smedts, F.; Nordling, J.; Kiemeney, L.A.L.M.; Rosette, J.J.M.H.C. de la

    2004-01-01

    OBJECTIVES: To establish whether routine evaluation of light microscopic changes in bladder biopsies in men with graded bladder outlet obstruction correlates with urodynamic parameters and to evaluate the performance of two pathologists in bladder biopsy interpretation. METHODS: In 63 consecutive

  16. Verification and quality control of routine hematology analyzers

    NARCIS (Netherlands)

    Vis, J Y; Huisman, A|info:eu-repo/dai/nl/255170653

    Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and

  17. Setting the stage for universal financial distress screening in routine cancer care.

    Science.gov (United States)

    Khera, Nandita; Holland, Jimmie C; Griffin, Joan M

    2017-11-01

    Financial burden from cancer treatment is increasingly being recognized as a threat to optimal access, quality, and outcomes of cancer care for patients. Although research in the area is moving at a fast pace, multiple questions remain unanswered, such as how to practically integrate the assessment and management of financial burden into routine health care delivery for patients with cancer. Although psychological distress screening for patients undergoing cancer treatment now is commonplace, the authors raise the provocative idea of universal screening for financial distress to identify and assist vulnerable groups of patients. Herein, the authors outline the arguments to support screening for financial burden in addition to psychological distress, examining it as an independent patient-reported outcome for all patients with cancer at various time points during their treatment. The authors describe the proximal and downstream impact of such a strategy and reflect on some challenges and potential solutions to help integrate this concept into routine cancer care delivery. Cancer 2017;123:4092-4096. © 2017 American Cancer Society. © 2017 American Cancer Society.

  18. The Effect of Heart Disease on Anesthetic Complications During Routine Dental Procedures in Dogs.

    Science.gov (United States)

    Carter, Jennifer E; Motsinger-Reif, Alison A; Krug, William V; Keene, Bruce W

    Dental procedures are a common reason for general anesthesia, and there is widespread concern among veterinarians that heart disease increases the occurrence of anesthetic complications. Anxiety about anesthetizing dogs with heart disease is a common cause of referral to specialty centers. To begin to address the potential effect of heart disease on anesthetic complications in dogs undergoing anesthesia for routine dental procedures, we compared anesthetic complications in 100 dogs with heart disease severe enough to trigger referral to a specialty center (cases) to those found in 100 dogs without cardiac disease (controls) that underwent similar procedures at the same teaching hospital. Medical records were reviewed to evaluate the occurrence of anesthetic complications. No dogs died in either group, and no significant differences were found between the groups in any of the anesthetic complications evaluated, although dogs in the heart disease group were significantly older with higher American Society of Anesthesiologists scores. Midazolam and etomidate were used more frequently, and alpha-2 agonists used less frequently, in the heart disease group compared to controls. This study suggests dogs with heart disease, when anesthetized by trained personnel and carefully monitored during routine dental procedures, are not at significantly increased risk for anesthetic complications.

  19. Routine mini-laparoscopic cholecystectomy: Outcome in 200 patients.

    Science.gov (United States)

    Dammaro, C; Tranchart, H; Gaillard, M; Debelmas, A; Ferretti, S; Lainas, P; Dagher, I

    2017-04-01

    In order to improve the outcome of classical laparoscopic cholecystectomy (CLC), surgeons have attempted to minimize tissue trauma. The aim of this study is to describe the technique of mini-laparoscopic cholecystectomy (MLC) and to report the outcome of this approach when used as a routine procedure. Since January 2012, all consecutive patients undergoing MLC were included in this study. Operative and perioperative data were prospectively collected. Additionally, cost analysis was performed. From 2012 to 2015, 200 MLC were performed (F/M: 132/68, mean age 45±16 years). Mean operative duration was 97±32min for the first 50 patients and 75±25min for the subsequent 150 patients (P50mL) bleeding (n=6). Postoperative morbidity was 4%. The mean global cost for a MLC procedure was 1757±1855 euros. This cost decreased from 2946±3115 euros in the first 50 patients to 1390±1278 euros in the subsequent 150 patients (P=0.001). Mini-laparoscopy can be used for routine elective cholecystectomy. This approach is associated with low morbidity and good cosmetic results. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Dietary habits changes and quality of life in patients undergoing chemotherapy for epithelial ovarian cancer.

    Science.gov (United States)

    Mardas, Marcin; Jamka, Małgorzata; Mądry, Radosław; Walkowiak, Jarosław; Krótkopad, Marietta; Stelmach-Mardas, Marta

    2015-04-01

    The aim of this study was to evaluate dietary habit changes in patients undergoing chemotherapy for epithelial ovarian cancer. Sixty one patients undergoing chemotherapy for epithelial ovarian cancer were enrolled to the study and 44 completed. The dietary intake was evaluated by 7-day food records, and the changes in dietary intake and food-preparing methods were estimated based on a 101-item semiquantitative food frequency questionnaire. Nutritional status was checked with the use of body weight and height, waist and hip circumferences, skinfolds and subjective global assessment tool. Quality of life was measured with the use of EORTC QLQ-C30 and EORTC QLQ-OV28. Despite high average body mass index (BMI) (26.7-28.0 kg/m(2)), malnutrition risk was observed in 43.7 and 10.7 % of patients receiving first-line and subsequent-line chemotherapy, respectively (p life did not differ between the studied groups. A lot of dietary habits changes were observed. Women undergoing subsequent-line chemotherapy consumed more frequently rye bread, pasta, buttermilk, vegetable, fruit, oils, nuts, and juices. Women undergoing first-line chemotherapy consumed more milk, cottage cheese, cream, eggs, fish and seafood, meat offal, salty snacks, and jam. Additionally, women undergoing subsequent-line chemotherapy more often applied cooking in water (p habits in a pro healthy direction, and these changes are more expressed in patients undergoing subsequent-line chemotherapy.

  1. Methodological Aspects in Studies Based on Clinical Routine Data.

    Science.gov (United States)

    Kennes, Lieven Nils

    2017-10-01

    Randomized controlled clinical trials are regarded as the gold standard for comparing different clinical interventions, but generally their conduct is operationally cumbersome, time-consuming, and expensive. Studies and investigations based on clinical routine data on the contrary utilize existing data acquired under real-life conditions and are increasingly popular among practitioners. In this paper, methodological aspects of studies based on clinical routine data are discussed. Important limitations and considerations as well as unique strengths of these types of studies are indicated and exemplarily demonstrated in a recent real-case study based on clinical routine data. In addition two simulation studies reveal the impact of bias in studies based on clinical routine data on the type I error rate and false decision rate in favor of the inferior intervention. It is concluded that correctly analyzing clinical routine data yields a valuable addition to clinical research; however, as a result of a lack of statistical foundation, internal validity, and comparability, generalizing results and inferring properties derived from clinical routine data to all patients of interest has to be considered with extreme caution. Grünenthal GmbH.

  2. A subjective scheduler for subjective dedicated networks

    Science.gov (United States)

    Suherman; Fakhrizal, Said Reza; Al-Akaidi, Marwan

    2017-09-01

    Multiple access technique is one of important techniques within medium access layer in TCP/IP protocol stack. Each network technology implements the selected access method. Priority can be implemented in those methods to differentiate services. Some internet networks are dedicated for specific purpose. Education browsing or tutorial video accesses are preferred in a library hotspot, while entertainment and sport contents could be subjects of limitation. Current solution may use IP address filter or access list. This paper proposes subjective properties of users or applications are used for priority determination in multiple access techniques. The NS-2 simulator is employed to evaluate the method. A video surveillance network using WiMAX is chosen as the object. Subjective priority is implemented on WiMAX scheduler based on traffic properties. Three different traffic sources from monitoring video: palace, park, and market are evaluated. The proposed subjective scheduler prioritizes palace monitoring video that results better quality, xx dB than the later monitoring spots.

  3. WHO HAS TO UNDERGO CANCER GENETIC TESTING? A PERSPECTIVE.

    Directory of Open Access Journals (Sweden)

    Carmen Rinaldi

    2017-10-01

    Full Text Available Genetic testing is a medical tool employed to screen changes in genes linked to cancer and other genetic diseases. Genetic tests are available for breast, ovarian, colon, thyroid, and some other cancers and they represent the main tool for early identification of the “risk” subjects. The choice to undergo genetic testing by a healthy or affected cancer patient with family history of the cancer has to be the fruit of a careful and prudent assessment of the advantages and disadvantages discussed during oncogenetic counselling. The latter, in turn, in the case of a patient's positive and informed choice, must constantly affiliate the genetic testing, in order to preserve the prediction and information role of the test as much as possible.

  4. Aspirin in patients undergoing noncardiac surgery

    DEFF Research Database (Denmark)

    Devereaux, P J; Mrkobrada, Marko; Sessler, Daniel I

    2014-01-01

    BACKGROUND: There is substantial variability in the perioperative administration of aspirin in patients undergoing noncardiac surgery, both among patients who are already on an aspirin regimen and among those who are not. METHODS: Using a 2-by-2 factorial trial design, we randomly assigned 10......,010 patients who were preparing to undergo noncardiac surgery and were at risk for vascular complications to receive aspirin or placebo and clonidine or placebo. The results of the aspirin trial are reported here. The patients were stratified according to whether they had not been taking aspirin before...... the study (initiation stratum, with 5628 patients) or they were already on an aspirin regimen (continuation stratum, with 4382 patients). Patients started taking aspirin (at a dose of 200 mg) or placebo just before surgery and continued it daily (at a dose of 100 mg) for 30 days in the initiation stratum...

  5. Salivary function in patients with chronic renal failure undergoing hemodialysis

    Energy Technology Data Exchange (ETDEWEB)

    Kaya, M.; Cermik, T.F.; Uestuen, F.; Sen, S.; Berkarda, S. [Trakya Univ., Edirne (Turkey). Medical Faculty

    2002-04-01

    The aim of this study was to evaluate the changes in salivary gland function in patients with chronic renal failure (CRF) undergoing hemodialysis. The group consisted of 23 patients with CRF (13 female, 10 male; mean age: 40{+-}13 yr) and 14 healthy control subjects (mean age: 40{+-}13 yr). All underwent dynamic salivary gland scintigraphy with gustatory stimulation. After intravenous administration of {sup 99m}Tc pertechnetate, first, perfusion images at 2 seconds per frame were acquired for 1 minute, then dynamic images at 1 minute per frame were acquired for 45 minutes. At 30 minutes after injection , 10 ml lemon juice was given for 15 minutes as a gustatory stimulus. We obtained time-activity curves derived from regions of interest centered over the four major salivary glands. The following functional indices were calculated for each gland: the time of maximum radioactivity (T{sub max}) for the prestimulated period, the time of minimum radioactivity (T{sub min}), as an indicator of velocity of secretion after stimulation, and the Lem E{sub 5}% value as an indicator of the secretion function. When the patients with CRF undergoing hemodialysis were compared to the controls, there were statistically significant differences in T{sub max}, T{sub min} and Lem E{sub 5}% values for bilateral parotid glands, and T{sub min} values for bilateral submandibular glands (p<0.05), there were no statistically significant differences in T{sub max} and Lem E{sub 5}% values for bilateral submandibular glands. There were also significant differences in T{sub max} and Lem E{sub 5}% values for bilateral parotid glands between mild oral problems and severe oral problems in patients with CRF (undergoing hemodialysis). In this study, prolonged T{sub max} and T{sub min} values, and decreased Lem E{sub 5}% values for parotid glands and prolonged T{sub min} values for submandibular glands on salivary scintigraphy pointed out decreased parenchymatous and excretory function in patients with

  6. Underlying—Disease Risk for Antispasmodic Premedication in Older Patients Undergoing Investigations of the Gastrointestinal Tract

    Directory of Open Access Journals (Sweden)

    Noboru Saito

    2008-01-01

    Full Text Available Purpose Improve risk management of patients undergoing investigations of the gastrointestinal (GI tract, in regard to underlying diseases and choice of premedication. According to a nationwide survey in Japan, 74% of the deaths associated with premedication were patients aged 60 years or over. Methods Subjects were 418 patients undergoing investigations of the GI tract (367 endoscopy, 51 barium contrast radiography between October 2001 and January 2004. Age distribution peaked in the 65-69 years group, and 40% of subjects were aged 65 years and over. Using a questionnaire, each subject was interviewed prior to the investigation to determine contraindications for anticholinergic agents or glucagon preparations. To confirm the risk associated with antispasmodic agents in elderly subjects, the group was subdivided into those aged under 65 years and those aged 65 and over, and compared. Results Anticholinergic agents were contraindicated in more than 50% of subjects aged 65 years and over, and glucagon was contraindicated in 11% of subjects aged 65 years and over. The proportion of elderly subjects in whom antispasmodic agents, including anticholinergics and glucagon, were contraindicated was significantly greater than for subjects aged under 65 years. Conclusions Using a written questionnaire at the time of obtaining informed consent facilitates the identification of underlying diseases and selection of appropriate premedication.

  7. Orthostatic hypotension during postoperative continuous thoracic epidural bupivacaine-morphine in patients undergoing abdominal surgery

    DEFF Research Database (Denmark)

    Crawford, M E; Møiniche, S; Orbæk, Janne

    1996-01-01

    Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were...... hypotension. The results suggest that patients undergoing abdominal surgery and treated with continuous small-dose thoracic epidural bupivacaine-morphine are subjected to a decrease of BP at rest and during mobilization, but not to an extent that seriously impairs ambulation in most patients....

  8. Effects of live music therapy sessions on quality of life indicators, medications administered and hospital length of stay for patients undergoing elective surgical procedures for brain.

    Science.gov (United States)

    Walworth, Darcy; Rumana, Christopher S; Nguyen, Judy; Jarred, Jennifer

    2008-01-01

    The physiological and psychological stress that brain tumor patients undergo during the entire surgical experience can considerably affect several aspects of their hospitalization. The purpose of this study was to examine the effects of live music therapy on quality of life indicators, amount of medications administered and length of stay for persons receiving elective surgical procedures of the brain. Subjects (N = 27) were patients admitted for some type of surgical procedure of the brain. Subjects were randomly assigned to either the control group receiving no music intervention (n = 13) or the experimental group receiving pre and postoperative live music therapy sessions (n = 14). Anxiety, mood, pain, perception of hospitalization or procedure, relaxation, and stress were measured using a self-report Visual Analog Scale (VAS) for each of the variables. The documented administration of postoperative pain medications; the frequency, dosage, type, and how it was given was also compared between groups. Experimental subjects live and interactive music therapy sessions, including a pre-operative session and continuing with daily sessions until the patient was discharged home. Control subjects received routine hospital care without any music therapy intervention. Differences in experimental pretest and posttest scores were analyzed using a Wilcoxon Matched-Pairs Signed-Rank test. Results indicated statistically significant differences for 4 of the 6 quality of life measures: anxiety (p = .03), perception of hospitalization (p = .03), relaxation (p = .001), and stress (p = .001). No statistically significant differences were found for mood (p > .05) or pain (p > .05) levels. Administration amounts of nausea and pain medications were compared with a Two-Way ANOVA with One Repeated Measure resulting in no significant differences between groups and medications, F(1, 51) = 0.03; p > .05. Results indicate no significant differences between groups for length of stay (t = .97

  9. Cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Buell, U.; Winkler, U.

    1983-09-01

    Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases.

  10. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review.

    Science.gov (United States)

    Teles, Kaian Amorim; Medeiros-Souza, Patrícia; Lima, Francisco Aires Correa; Araújo, Bruno Gedeon de; Lima, Rodrigo Aires Correa

    2016-09-17

    Cyclophosphamide (CPM) is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy (pre-ChT), administration of cyclophosphamide, and post-chemotherapy (post-ChT), taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare-but serious-side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system. Copyright © 2016. Published by Elsevier Editora Ltda.

  11. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review

    Directory of Open Access Journals (Sweden)

    Kaian Amorim Teles

    Full Text Available Abstract Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

  12. Social and Demographic Predictors of Preschoolers’ Bedtime Routines

    Science.gov (United States)

    Hale, Lauren; Berger, Lawrence M.; LeBourgeois, Monique K.; Brooks-Gunn, Jeanne

    2009-01-01

    Objective To examine associations of child and family sociodemographic characteristics with preschooler bedtime routines. Method We use parent-report data on 3,217 3-year-old children (48% black; 26% Hispanic; 26% white) from the Fragile Families and Child Wellbeing Study to examine whether child and family characteristics are associated with the presence, time, and consistency of bedtime routines. Results Over 80% of sample children have a bedtime yet only two-thirds follow it. After extensive controls for maternal education, family structure, and other household characteristics, Black and Hispanic children have later bedtimes than white children and reduced odds of using regular bedtimes (by 22% and 29%, respectively) and using bedtime routines (by 47% and 33%, respectively). Low maternal education, increased household size, and poverty are associated with decreased use of parent-child interactive and hygiene-related bedtime routines. Conclusion Children from disadvantaged households are less likely to have consistent bedtime routines than their more advantaged counterparts. This may contribute to later disparities in sleep quality, duration and timing, factors known to be associated with adverse behavioral, cognitive, and health outcomes. PMID:19745760

  13. Social and demographic predictors of preschoolers' bedtime routines.

    Science.gov (United States)

    Hale, Lauren; Berger, Lawrence M; LeBourgeois, Monique K; Brooks-Gunn, Jeanne

    2009-10-01

    To examine the associations of child and family sociodemographic characteristics with preschooler bedtime routines. We use parent-report data of 3217 3-year-old children (48% black, 26% Hispanic, and 22% white) from the Fragile Families and Child Wellbeing Study to examine whether child and family characteristics are associated with the presence, time, and consistency of bedtime routines. More than 80% of sample children have a bedtime yet only two thirds follow it. After extensive controls for maternal education, family structure, and other household characteristics, black and Hispanic children have later bedtimes than white children and reduced odds of using regular bedtimes (by 22% and 29%, respectively) and using bedtime routines (by 47% and 33%, respectively). Low maternal education, increased household size, and poverty are associated with decreased use of parent-child interactive and hygiene-related bedtime routines. Children from disadvantaged households are less likely to have consistent bedtime routines than their more advantaged counterparts. This may contribute to later disparities in sleep quality, duration and timing, factors known to be associated with adverse behavioral, cognitive, and health outcomes.

  14. The effect of valeric on anxiety severity in women undergoing hysterosalpingography.

    Science.gov (United States)

    Gharib, Maryam; Samani, Leila Neisani; Panah, Zahra Elahi; Naseri, Mohsen; Bahrani, Naser; Kiani, Kiandokht

    2015-04-02

    Hysterosalpingography (HSG) is the radiographic evaluation of the uterine cavity and fallopian tubes, which is generally assumed as a stressful and painful procedure. This study aims to determine effect of oral Valeric capsules on anxiety severity in women under Hysterosalpingography. This study, as a double-blind clinical trial, was conducted on 64 infertile women undergoing hysterosalpingography, who referred to radiology ward at Comprehensive Women's hospital. To measure anxiety, visual analog anxiety scale was used 90 minutes before starting procedure, individuals in intervention group (n=32) received a single dose (1,500 mg) of 3 Valeric capsules, together with routine prophylaxy, where routine prophylaxis contains Mefenamic acid 250mg capsules in 30 minutes before procedure, and the same capsules were prescribed to placebo group (n=32) with the same instruction. Anxiety severity before and once 90 minutes after intervention in both groups were measured and compared. There was no difference on anxiety severity before intervention in both groups (p=0.26), and the groups were homogeneous; after intervention, a significant difference on anxiety severity was reported in both groups (panxiety score in intervention group compared to placebo reduced statistically. Present study indicated that Valeric was effective on reducing anxiety in women undergoing hysterosalpingography.

  15. Prediction of coronary artery disease in patients undergoing operations for mitral valve degeneration

    Science.gov (United States)

    Lin, S. S.; Lauer, M. S.; Asher, C. R.; Cosgrove, D. M.; Blackstone, E.; Thomas, J. D.; Garcia, M. J.

    2001-01-01

    OBJECTIVES: We sought to develop and validate a model that estimates the risk of obstructive coronary artery disease in patients undergoing operations for mitral valve degeneration and to demonstrate its potential clinical utility. METHODS: A total of 722 patients (67% men; age, 61 +/- 12 years) without a history of myocardial infarction, ischemic electrocardiographic changes, or angina who underwent routine coronary angiography before mitral valve prolapse operations between 1989 and 1996 were analyzed. A bootstrap-validated logistic regression model on the basis of clinical risk factors was developed to identify low-risk (diabetes mellitus,and hyperlipidemia. Two hundred twenty patients were designated as low risk according to the logistic model. Of these patients, only 3 (1.3%) had single-vessel disease, and none had multivessel disease. The model showed good discrimination, with an area under the receiver-operating characteristic curve of 0.84. Cost analysis indicated that application of this model could safely eliminate 30% of coronary angiograms, corresponding to cost savings of $430,000 per 1000 patients without missing any case of high-risk coronary artery disease. CONCLUSION: A model with standard clinical predictors can reliably estimate the prevalence of obstructive coronary atherosclerosis in patients undergoing mitral valve prolapse operations. This model can identify low-risk patients in whom routine preoperative angiography may be safely avoided.

  16. Prediction of coronary artery disease in patients undergoing operations for mitral valve degeneration

    Science.gov (United States)

    Lin, S. S.; Lauer, M. S.; Asher, C. R.; Cosgrove, D. M.; Blackstone, E.; Thomas, J. D.; Garcia, M. J.

    2001-01-01

    OBJECTIVES: We sought to develop and validate a model that estimates the risk of obstructive coronary artery disease in patients undergoing operations for mitral valve degeneration and to demonstrate its potential clinical utility. METHODS: A total of 722 patients (67% men; age, 61 +/- 12 years) without a history of myocardial infarction, ischemic electrocardiographic changes, or angina who underwent routine coronary angiography before mitral valve prolapse operations between 1989 and 1996 were analyzed. A bootstrap-validated logistic regression model on the basis of clinical risk factors was developed to identify low-risk (disease include age, male sex, hypertension, diabetes mellitus,and hyperlipidemia. Two hundred twenty patients were designated as low risk according to the logistic model. Of these patients, only 3 (1.3%) had single-vessel disease, and none had multivessel disease. The model showed good discrimination, with an area under the receiver-operating characteristic curve of 0.84. Cost analysis indicated that application of this model could safely eliminate 30% of coronary angiograms, corresponding to cost savings of $430,000 per 1000 patients without missing any case of high-risk coronary artery disease. CONCLUSION: A model with standard clinical predictors can reliably estimate the prevalence of obstructive coronary atherosclerosis in patients undergoing mitral valve prolapse operations. This model can identify low-risk patients in whom routine preoperative angiography may be safely avoided.

  17. Do Routine Radiographs Obtained at Initial Outpatient Postoperative Visit Change Management?

    Science.gov (United States)

    Grenier, Eric; Tennent, Dave; Patzkowski, Jean; Hsu, Joseph; Johnson, Anthony

    Routine postoperative radiographs are commonly obtained at the initial postoperative visit. The purpose of this study was to demonstrate the clinical utility of routine postoperative radiographs and quantify the radiation exposure and cost to the health care system. All orthopaedic surgeries performed during 2007 at a level I trauma center were retrospectively analyzed. Surgical procedures that were likely to require follow-up radiographs were included. Analysis demonstrated 878 procedures with 471 procedures (54%) receiving initial postoperative radiographs. Routine radiographs were performed in 455 (96.6%) procedures with 4/455 (0.879%) resulting in a change in management. Nonroutine radiographs were performed in 16 (3.40%) procedures with 2/16 (12.5%) triggering a change in management. Subjects receiving radiographs at the initial postoperative visit obtained a mean of 2.54 radiographs per procedure with a mean exposure of 0.199 mSv with a median cost of $29.98 per radiographic series in 2013 Medicare reimbursement dollars. (Journal of Surgical Orthopaedic Advances.

  18. Early prediction of the need for non-routine discharge planning for the elderly.

    Science.gov (United States)

    Tanaka, Makoto; Yamamoto, Hiromi; Kita, Toru; Yokode, Masayuki

    2008-01-01

    Successful home return from hospital admission is a key issue to provide quality healthcare in a society with numerous older subjects. Therefore, a screening method for early identification of patients who require intensive, non-routine discharge planning needs to be established. We have developed a 7-item screening sheet (the screening sheet at admission: SSA) and conducted a prospective cohort study to examine its usefulness in predicting the need for non-routine discharge planning. The SSA score yielded an area under receiver operating characteristic curve of 0.82. Moreover, a cutoff score of 2 or higher gave sensitivity, specificity and positive and negative predictive values of 0.82, 0.72, 0.13 and 0.99, respectively. A stepwise logistic regression model demonstrated that age of 75 years or more and impairment in basic activities of daily living (ADL) were significantly associated with requirement for non-routine discharge planning in surgical patients, while living alone or with a spouse aged 75 or older and readmission within 1 month were also significant predictors in medical patients. The SSA score may be useful in identifying patients who need further assessment and planning. While the four items were particularly important predictors, differences between medical and surgical patients should also be considered.

  19. Subjective well-being related to satisfaction with daily travel

    NARCIS (Netherlands)

    Jakobsson Bergstad, C.; Gamble, A.; Gärling, T.; Hagman, O.; Polk, M.; Ettema, D.F.; Friman, M.; Olsson, L.E.

    2011-01-01

    Previous research demonstrates an impact on subjective well-being (SWB) of affect associated with routine performance of out-of-home activities. A primary aim of the present study is to investigate whether satisfaction with daily travel has a positive impact on SWB, either directly or indirectly

  20. Salivary Amylase as a Marker of Salivary Gland Function in Patients Undergoing Radiotherapy for Oral Cancer.

    Science.gov (United States)

    Vedam, V K Vaishnavi; Boaz, Karen; Natarajan, Srikant; Ganapathy, Sivadas

    2017-05-01

    The aim of this study was to evaluate salivary amylase in patients with primary oral cancer undergoing radiotherapy as the main modality of treatment. The study was conducted on ten histologically proven cases of oral cancer undergoing radiotherapy. Stimulated whole saliva was collected at three stages of radiotherapy-0, 3, and 6 weeks. Salivary amylase was estimated using Henry-Chiamori method and comparison was made with appropriate age- and gender-matched controls. Salivary amylase levels showed significant decrease in healthy subjects when compared to oral cancer patients (P salivary amylase could be used as a surrogate marker of salivary gland function in patients with oral cancer undergoing radiotherapy as primary treatment. © 2016 Wiley Periodicals, Inc.

  1. Pulse processing routines for neutron time-of-flight data

    CERN Document Server

    Žugec, P; Guerrero, C; Gunsing, F; Vlachoudis, V; Sabate-Gilarte, M; Stamatopoulos, A; Wright, T; Lerendegui-Marco, J; Mingrone, F; Ryan, J A; Warren, S G; Tsinganis, A; Barbagallo, M

    2016-01-01

    A pulse shape analysis framework is described, which was developed for n_TOF-Phase3, the third phase in the operation of the n_TOF facility at CERN. The most notable feature of this new framework is the adoption of generic pulse shape analysis routines, characterized by a minimal number of explicit assumptions about the nature of pulses. The aim of these routines is to be applicable to a wide variety of detectors, thus facilitating the introduction of the new detectors or types of detectors into the analysis framework. The operational details of the routines are suited to the specific requirements of particular detectors by adjusting the set of external input parameters. Pulse recognition, baseline calculation and the pulse shape fitting procedure are described. Special emphasis is put on their computational efficiency, since the most basic implementations of these conceptually simple methods are often computationally inefficient.

  2. Thai Family Health Routines: scale development and psychometric testing.

    Science.gov (United States)

    Kanjanawetang, Jantakan; Yunibhand, Jintana; Chaiyawat, Waraporn; Wu, Yow-Wu Bill; Denham, Sharon A

    2009-05-01

    The aims of the study were to develop and test the psychometric properties of the Thai Family Health Routines (TFHR) scale, a 70-item self-report questionnaire used to measure the health of Thai families through their routine behaviors in daily life. Development of the TFHR was based on the structural domains of Denham's Family Health Model. The TFHR scale was initially composed of 85 items and tested on 1,040 families living in the central region of Thailand. The confirmatory factor analysis, with an acceptable factor structure model, yielded 70 items aligned with six factors: self-care, safety and prevention, mental health behavior, family care, family caregiving, and illness care routines. The preliminary psychometric properties demonstrated that the TFHR scale had satisfactory internal consistency, criterion validity, and construct validity. The test results suggested that the TFHR scale has potential benefits for family and community nurses to assess Thai family health for both research and clinical purposes.

  3. Improvements of the crystal routine for collimation studies

    CERN Document Server

    Mirarchi, D; Scandale, W; Taratin, A M; Yazynin, I

    2014-01-01

    A routine has been implemented to simulate interactions of protons with bent crystals in the collimation version of SixTrack. This routine is optimized in view of producing high-statistics tracking simulations of collimation cleaning assisted by bent crystals. Fine tuning and comparisons with experimental data of coherent effects which a particle can experience in a bent crystal have been carried out. The data taken with 400 GeV beams at the CERN-SPS North Area in the framework of the UA9 experiment are used to benchmark the routine. Further checks on low probability interactions have been made, leading to significant improvements in the description of interactions with crystals. Comparisons with other simulations tools are used to increase our confidence in the scaling to higher energies.

  4. Computer routines for probability distributions, random numbers, and related functions

    Science.gov (United States)

    Kirby, W.

    1983-01-01

    Use of previously coded and tested subroutines simplifies and speeds up program development and testing. This report presents routines that can be used to calculate various probability distributions and other functions of importance in statistical hydrology. The routines are designed as general-purpose Fortran subroutines and functions to be called from user-written main progress. The probability distributions provided include the beta, chi-square, gamma, Gaussian (normal), Pearson Type III (tables and approximation), and Weibull. Also provided are the distributions of the Grubbs-Beck outlier test, Kolmogorov 's and Smirnov 's D, Student 's t, noncentral t (approximate), and Snedecor F. Other mathematical functions include the Bessel function, I sub o, gamma and log-gamma functions, error functions, and exponential integral. Auxiliary services include sorting and printer-plotting. Random number generators for uniform and normal numbers are provided and may be used with some of the above routines to generate numbers from other distributions. (USGS)

  5. A sudden total loss of vision after routine cataract surgery.

    Science.gov (United States)

    Lartey, S; Armah, P; Ampong, A

    2013-06-01

    We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post operative and optic atrophy by 2 months postoperative. This could have been caused by vascular occlusion in an already compromised artherosclerosed vessels. It could also have been due to gentamyin toxicity. Gentamycin injection given subconjunctivally is known to rarely result in severe retinal toxicity. This case illustrates that even though cataract surgery is considerd a simple routine procedure, and is performed in high volumes, it is not without its blinding complications. We recommend that the use of adrenaline in xylocaine should be used with caution in hypertensive patients and also the routine use of subconjunctival gentamycin injection after cataract surgery should be reviewed and other modes of endophthalmitis prophylaxis be considered.

  6. A randomised controlled trial comparing Rapid Rhino Mannheim and Netcell series 5000 packs following routine nasal surgery.

    Science.gov (United States)

    McDonald, S E; Slater, J; Powell, R; Khalil, H S; Garth, R J N

    2009-03-01

    To determine whether there is a difference in discomfort between Netcell Series 5000 and Rapid Rhino Mannheim 8.0 cm (Cat. No. 800) packs used after routine nasal surgery, whilst in situ and during removal. This was tested in a single blind, randomised controlled trial at the ENT Department, Royal Devon & Exeter Hospital. Adults aged 16-65 undergoing nasal septal surgery and trimming of inferior turbinates. Patients were excluded if they were undergoing revision surgery, taking anticoagulants, or had a history of sino-nasal disease or trauma. Thirty nine entered and 32 completed the study. The intervention was a different nasal pack in each side of the nose, removed the morning after surgery. Pain experienced by patients while packs are in situ and on removal as recorded on a standard unmarked 100 mm visual analogue scale. There was no difference in the pain scores whilst in situ. Rapid Rhino Mannheim was more painful on removal (difference = 10.6 mm, p Mannheim packs do not confer a benefit over Netcell Series 5000 packs after routine nasal surgery.

  7. Speech profile of patients undergoing primary palatoplasty.

    Science.gov (United States)

    Menegueti, Katia Ignacio; Mangilli, Laura Davison; Alonso, Nivaldo; Andrade, Claudia Regina Furquim de

    2017-10-26

    To characterize the profile and speech characteristics of patients undergoing primary palatoplasty in a Brazilian university hospital, considering the time of intervention (early, before two years of age; late, after two years of age). Participants were 97 patients of both genders with cleft palate and/or cleft and lip palate, assigned to the Speech-language Pathology Department, who had been submitted to primary palatoplasty and presented no prior history of speech-language therapy. Patients were divided into two groups: early intervention group (EIG) - 43 patients undergoing primary palatoplasty before 2 years of age and late intervention group (LIG) - 54 patients undergoing primary palatoplasty after 2 years of age. All patients underwent speech-language pathology assessment. The following parameters were assessed: resonance classification, presence of nasal turbulence, presence of weak intraoral air pressure, presence of audible nasal air emission, speech understandability, and compensatory articulation disorder (CAD). At statistical significance level of 5% (p≤0.05), no significant difference was observed between the groups in the following parameters: resonance classification (p=0.067); level of hypernasality (p=0.113), presence of nasal turbulence (p=0.179); presence of weak intraoral air pressure (p=0.152); presence of nasal air emission (p=0.369), and speech understandability (p=0.113). The groups differed with respect to presence of compensatory articulation disorders (p=0.020), with the LIG presenting higher occurrence of altered phonemes. It was possible to assess the general profile and speech characteristics of the study participants. Patients submitted to early primary palatoplasty present better speech profile.

  8. Thromboprophylaxis for women undergoing caesarean section.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

    Thromboprophylaxis for women undergoing caesarean section (CS) was introduced in the hospital in 1995. This study audited the use of tinzaparin prophylaxis in a nested cohort of women who screened negative for diabetes mellitus at 28 weeks gestation. All the women had their weight measured and BMI calculated at the first antenatal visit. Of the 284 women, 68 (24%) had a CS and all received tinzaparin. Of the 68, however, 94% received a dose lower than recommended. Compliance with prophylaxis was complete but compliance with the recommended dosage was suboptimal, which may result in venous thromboembolism after CS despite thromboprophylaxis.

  9. Dermatillomania: In patient undergoing orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Adit

    2014-01-01

    Full Text Available Dermatillomania is a disorder in which a person habitually picks their skin, and this is a form of self-injury. It can involve any part of the body, but usually involves the face, neck, arms and shoulders. Symptoms often follow an event that has caused severe emotional distress. A dermatillomania or compulsive skin picking episode may be a conscious response to anxiety or depression but is frequently done as an unconscious habit. In this case report, a patient undergoing orthodontic treatment was found to be suffering from dermatillomania and was treated using psychological counseling.

  10. Oral surgery in patients undergoing chemoradiation therapy.

    Science.gov (United States)

    Demian, Nagi M; Shum, Jonathan W; Kessel, Ivan L; Eid, Ahmed

    2014-05-01

    Oral health care in patients undergoing chemotherapy and/or radiation therapy can be complex. Care delivered by a multidisciplinary approach is timely and streamlines the allocation of resources to provide prompt care and to attain favorable outcomes. A hospital dentist, oral and maxillofacial surgeon, and a maxillofacial prosthodontist must be involved early to prevent avoidable oral complications. Prevention and thorough preparation are vital before the start of chemotherapy and radiation therapy. Oral complications must be addressed immediately and, even with the best management, can cause delays and interruption in treatment, with serious consequences for the outcome and prognosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience.

    Science.gov (United States)

    Nwosu, Betrand O; Eleje, George U; Obi-Nwosu, Amaka L; Ahiarakwem, Ita F; Akujobi, Comfort N; Egwuatu, Chukwudi C; Onyiuke, Chukwudumebi O C

    2015-01-01

    To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening. A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL) test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10. Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34), and mean gestational age was 26.4 weeks (±6.36). Only 15 cases (0.70%) were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05). While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay.

  12. Clinical management of transsexual subjects.

    Science.gov (United States)

    Costa, Elaine Maria Frade; Mendonca, Berenice Bilharinho

    2014-03-01

    Transsexual subjects are individuals who have a desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex, and a wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex. They seek to develop the physical characteristics of the desired gender, and should undergo an effective and safe treatment regimen. The goal of treatment is to rehabilitate the individual as a member of society in the gender he or she identifies with. Sex reassignment procedures necessary for the treatment of transsexual patients are allowed in our country, at Medical Services that have a multidisciplinary team composed of a psychologist, a social worker, a psychiatrist, an endocrinologist and surgeons (gynecologists, plastic surgeons, and urologists). Patients must be between 21 to 75 years old and in psychological and hormonal treatment for at least 2 years. Testosterone is the principal agent used to induce male characteristics in female transsexual patients, and the estrogen is the chosen hormone used to induce the female sexual characteristics in male transsexual patients. Based on our 15 years of experience, we can conclude that testosterone and estradiol treatment in physiological doses are effective and safe in female and male transsexual patients, respectively.

  13. The Role of Linguistic Routines in Early Foreign Language Learning

    Directory of Open Access Journals (Sweden)

    Michele Daloiso

    2009-11-01

    Full Text Available According to recent studies in neuropsychology, when learning a language, young children mainly use“implicit memory”, i.e. the memory of automatic procedures such as riding a bicycle. As an implication forearly foreign language teaching (EFLT, teachers will stimulate the pupils’ implicit memory by exposingthem to routine situations in which specific linguistic expressions are associated with recurring actions andprocedures. This paper will therefore discuss the neuropsychological, linguistic and educational roles ofroutines in EFLT and will provide teachers with methodological principles to manage routine situations ina foreign language.

  14. Estimating Subjective Probabilities

    DEFF Research Database (Denmark)

    Andersen, Steffen; Fountain, John; Harrison, Glenn W.

    Subjective probabilities play a central role in many economic decisions, and act as an immediate confound of inferences about behavior, unless controlled for. Several procedures to recover subjective probabilities have been proposed, but in order to recover the correct latent probability one must...

  15. Estimating Subjective Probabilities

    DEFF Research Database (Denmark)

    Andersen, Steffen; Fountain, John; Harrison, Glenn W.

    2014-01-01

    Subjective probabilities play a central role in many economic decisions and act as an immediate confound of inferences about behavior, unless controlled for. Several procedures to recover subjective probabilities have been proposed, but in order to recover the correct latent probability one must ...

  16. Subjective meaning: an introduction

    NARCIS (Netherlands)

    van Wijnbergen-Huitink, Janneke; van Wijbergen-Huitink, Janneke; Meier, Cécile

    This introductory chapter traces some of the considerations on the basis of which relativistic approaches to subjective meaning became en vogue. In doing so, the chapter provides an overview of the relevant linguistic and philosophical issues when developing a treatment of subjectivity. In addition,

  17. Subjective safety in traffic.

    NARCIS (Netherlands)

    2012-01-01

    The term ‘subjective safety in traffic’ refers to people feeling unsafe in traffic or, more generally, to anxiety regarding being unsafe in traffic for oneself and/or others. Subjective safety in traffic can lead to road users limiting their mobility and social activities, which is one of the

  18. Subjective poverty line definitions

    NARCIS (Netherlands)

    J. Flik; B.M.S. van Praag (Bernard)

    1991-01-01

    textabstractIn this paper we will deal with definitions of subjective poverty lines. To measure a poverty threshold value in terms of household income, which separates the poor from the non-poor, we take into account the opinions of all people in society. Three subjective methods will be discussed

  19. Fitting model-based psychometric functions to simultaneity and temporal-order judgment data: MATLAB and R routines.

    Science.gov (United States)

    Alcalá-Quintana, Rocío; García-Pérez, Miguel A

    2013-12-01

    Research on temporal-order perception uses temporal-order judgment (TOJ) tasks or synchrony judgment (SJ) tasks in their binary SJ2 or ternary SJ3 variants. In all cases, two stimuli are presented with some temporal delay, and observers judge the order of presentation. Arbitrary psychometric functions are typically fitted to obtain performance measures such as sensitivity or the point of subjective simultaneity, but the parameters of these functions are uninterpretable. We describe routines in MATLAB and R that fit model-based functions whose parameters are interpretable in terms of the processes underlying temporal-order and simultaneity judgments and responses. These functions arise from an independent-channels model assuming arrival latencies with exponential distributions and a trichotomous decision space. Different routines fit data separately for SJ2, SJ3, and TOJ tasks, jointly for any two tasks, or also jointly for the three tasks (for common cases in which two or even the three tasks were used with the same stimuli and participants). Additional routines provide bootstrap p-values and confidence intervals for estimated parameters. A further routine is included that obtains performance measures from the fitted functions. An R package for Windows and source code of the MATLAB and R routines are available as Supplementary Files.

  20. Limited significance of routine excretory urography in the follow-up of patients with superficial bladder cancer after transurethral resection.

    Science.gov (United States)

    Miyake, Hideaki; Hara, Isao; Yamanaka, Kazuki; Inoue, Taka-Aki; Fujisawa, Masato

    2006-04-01

    To evaluate the utility of routine excretory intravenous urography (IVU) for detecting subsequent upper urinary tract cancer (UUTC) during the follow-up of patients with superficial bladder cancer. The study included 413 patients who had transurethral resection (TUR) of superficial bladder cancer between January 1986 and December 2003, and were followed for at least 1 year. After TUR, patients were followed by periodic cystoscopy, urinary cytology and IVU. The risk factors for UUT recurrence after TUR were analysed, and based on this outcome, we then determined whether routine IVU should be used for patients with superficial bladder cancer. During the observation period, UUTCs developed in 20 of the 413 patients (4.8%) within a median of 33 months from the initial TUR to the detection of UUTCs. Among several factors examined, only multiplicity was significantly associated with UUT recurrence after TUR. Of the 20 patients with secondary UUTCs, only two, who had multiple superficial bladder cancers at initial presentation, were diagnosed as having UUTCs by routine IVU, while the remaining 18 presented with symptoms suggesting possible UUT recurrence before IVU, including macrohaematuria (10 patients), intravesical recurrence (five), positive urinary cytology (five), abdominal pain (three) and high fever (two). Most patients with recurrent UUTCs presented with some subjective and/or objective symptoms, and routine IVU failed to detect recurrent diseases in such patients. Therefore, routine IVU may not be required for all patients who have TUR of superficial bladder cancer.

  1. Oncology nurses' recognition of supportive care needs and symptoms of their patients undergoing chemotherapy.

    Science.gov (United States)

    Nakaguchi, Tomohiro; Okuyama, Toru; Uchida, Megumi; Ito, Yoshinori; Komatsu, Hirokazu; Wada, Makoto; Akechi, Tatsuo

    2013-04-01

    To assess the accuracy of oncology nurses' recognition of supportive care needs and symptoms of their patients undergoing chemotherapy. The participants comprised randomly selected cancer outpatients receiving chemotherapy in an ambulatory setting and 17 oncology nurses working in two chemotherapy units in Japan. For assessment of the patients' supportive care needs and symptoms, the patients were asked to respond to a validated self-administered questionnaire. The oncology nurses completed a survey in which they indicated their perception of the level of the same set of needs or symptoms. The two data sets obtained from the patients and nurses were compared statistically to assess the accuracy of the oncology nurses' recognition of their patients' needs and symptoms. Complete data sets were available for 439 patients. The most common primary cancers were breast cancer (36.0%), followed by colorectal (24.4%) and lung (12.3%) cancers. Nurses' awareness of their patients' supportive care needs and physical and psychological symptoms were less than optimal in routine care. In particular, psychological symptoms and support needs for these symptoms were markedly under-recognized. Physical symptoms associated with chemotherapy, such as hair loss, appetite loss and fatigue, were better recognized than symptoms not specific to chemotherapy, such as constipation, insomnia, dyspnea and pain. Oncology nurses' recognition may not accurately reflect their patients' supportive care needs and symptoms in routine practice. In clinical practice, it may be beneficial to conduct routine screening of patients' perceived needs and symptoms comprehensively using self-administered questionnaires.

  2. Routine endoscopy for esophageal cancer is suggestive for patients with oral, oropharyngeal and hypopharyngeal cancer.

    Directory of Open Access Journals (Sweden)

    Shih-Han Hung

    Full Text Available This study attempted to reveal the incidence and risk of synchronous and metachronous esophageal cancer in subjects with oral, oropharyngeal and hypopharyngeal cancer based on a population-wide database in Taiwan.We retrieved data for this cross-sectional study from the Taiwanese Longitudinal Health Insurance Database 2000. The study group included 2,965 subjects who had received their first-time diagnosis of oral/oropharyngeal/hypopharyngeal cancer in 2002∼2009. We assigned the date of their first diagnosis of oral/oropharyngeal/hypopharyngeal cancer as the index date. We also randomly retrieved 29,650 comparison subjects matched with the study subjects in terms of gender and age group. We assigned their first medical utilization that occurred in the index year as the index date for the comparison group. We further performed a conditional logistic regression to investigate the association between esophageal cancer and oral cancer.Results showed that prevalences of esophageal cancer within 3 months before and after the index date were respectively 2.19% and 0.04% for the study and comparison groups. A conditional logistic regression revealed that the odds ratio (OR of esophageal cancer for subjects with oral/oropharyngeal/hypopharyngeal cancer was 55.33 (95% confidence interval (CI: 29.86∼102.52 compared to comparison subjects. Furthermore, compared to comparison subjects, ORs for esophageal cancer were respectively 18.41 (95% CI: 8.50-39.85, 40.49 (95% CI: 15.11∼108.64, and 240.96 (95% CI: 125.49-462.69 for study subjects with a malignancy of the oral cavity, oropharynx, and hypopharynx.We concluded that there were relatively high chances for synchronous and metachronous esophageal cancers being detected through panendoscopy in patients with oral, oropharyngeal, and hypopharyngeal cancers. The routine use of panendoscopy in such patients should be encouraged with a higher priority.

  3. Parent routines, child routines, and family demographics associated with obesity in parents and preschool-aged children

    Directory of Open Access Journals (Sweden)

    Blake Lee Jones

    2014-04-01

    Full Text Available Many daily routines and behaviors are related to the prevalence of obesity. This study investigated the association between routines and behaviors that act as protective factors related to lower prevalence of obesity in parents (BMI ≥ 30 kg/m2 and overweight in preschool children (BMI ≥ 85th percentile. Socio-demographic characteristics were assessed in relation to protective routines (PRs, and prevalence of obesity/overweight data from 337 preschool children and their parents. The two PRs assessed with parents included adequate sleep (≥ 7 hours/night and family mealtime routine (scoring higher than the median score. The four PRs assessed in children included adequate sleep (≥ 10 hours/night, family mealtime routine, limiting screen-viewing time (≤ 2 hours/day of TV, video, DVD, and not having a bedroom TV. Overall, 27.9% of parents were obese and 22.8% of children were overweight, and 39.8% of the parents had both parent PRs, and only 11.6% of children had all four child PRs. Results demonstrated that several demographic factors were significantly related to the use of PRs for parents and children. The lack of PRs was related to increased risk for overweight in children, but not for obesity in parents. However, in the adjusted models the overall cumulative benefits of using PRs was not significant in children either. In the multivariate adjusted logistic regression models, the only significant individual PR for children was adequate sleep. In a path analysis model, parent sleep was related to child sleep, which was in turn related to decreased obesity. Overall, findings suggest that parent and child PRs, especially sleep routines, within a family can be associated and may play an important role in the health outcomes of both parents and children. Understanding the mechanisms that influence how and when parents and children use these PRs may be promising for developing targeted family-based obesity-prevention efforts.

  4. Parent routines, child routines, and family demographics associated with obesity in parents and preschool-aged children.

    Science.gov (United States)

    Jones, Blake L; Fiese, Barbara H

    2014-01-01

    Many daily routines and behaviors are related to the prevalence of obesity. This study investigated the association between routines and behaviors that act as protective factors related to lower prevalence of obesity in parents (BMI ≥ 30 kg/m(2)) and overweight in preschool children (BMI ≥ 85th percentile). Socio-demographic characteristics were assessed in relation to protective routines (PRs), and prevalence of obesity/overweight data from 337 preschool children and their parents. The two PRs assessed with parents included adequate sleep (≥7 h/night) and family mealtime routine (scoring higher than the median score). The four PRs assessed in children included adequate sleep (≥10 h/night), family mealtime routine, limiting screen-viewing time (≤2 h/day of TV, video, DVD), and not having a bedroom TV. Overall, 27.9% of parents were obese and 22.8% of children were overweight, and 39.8% of the parents had both parent PRs, and only 11.6% of children had all four child PRs. Results demonstrated that several demographic factors were significantly related to the use of PRs for parents and children. The lack of PRs was related to increased risk for overweight in children, but not for obesity in parents. However, in the adjusted models the overall cumulative benefits of using PRs was not significant in children either. In the multivariate adjusted logistic regression models, the only significant individual PR for children was adequate sleep. In a path analysis model, parent sleep was related to child sleep, which was in turn related to decreased obesity. Overall, findings suggest that parent and child PRs, especially sleep routines, within a family can be associated and may play an important role in the health outcomes of both parents and children. Understanding the mechanisms that influence how and when parents and children use these PRs may be promising for developing targeted family-based obesity-prevention efforts.

  5. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery.

    Science.gov (United States)

    Cordeiro, André Luiz Lisboa; Melo, Thiago Araújo de; Neves, Daniela; Luna, Julianne; Esquivel, Mateus Souza; Guimarães, André Raimundo França; Borges, Daniel Lago; Petto, Jefferson

    2016-04-01

    Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031). We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery.

  6. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    Science.gov (United States)

    Cordeiro, André Luiz Lisboa; de Melo, Thiago Araújo; Neves, Daniela; Luna, Julianne; Esquivel, Mateus Souza; Guimarães, André Raimundo França; Borges, Daniel Lago; Petto, Jefferson

    2016-01-01

    Introduction Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031). Conclusion We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery. PMID:27556313

  7. Unifying Subjectivity and Objectivity

    Directory of Open Access Journals (Sweden)

    Murugesan Chandrasekaran

    2016-10-01

    Full Text Available The contribution of modern science to the progress of civilization is immeasurable. Even its tendency toward exclusive concentration on the objective world has had salutary effects of great value. Modern science has wiped away much that was merely superstitious or speculative. Its rejection of unfounded opinions and prejudices has helped the thinking mind question conventional beliefs, shed preferences and prejudices, and challenge established authority. But modern systems thinking inherited from natural science is the suppression of the subjective dimension of reality. Many complex systems are an attempt to define and represent all subjective experience in physical terms. The modern man has a bias towards objectivity. The powerful influence of sense impressions on his mind and thinking makes him ignore the subjective experience and consider only objective facts as a valid, legitimate and representation of reality. Observing objective factors that are physical is easier than observing subjective factors that are subtle. The mechanistic view of reality has led to the rejection of the role of the individual in social development as insignificant. The individuals determine the development of society. Their social power has its roots both in subjective factors and objective factors. Economy, politics, society, and culture are inseparable dimensions of a single integrated reality. Subject and object constitute an integrated whole. The mind sees them as separate and independent. Or it views one as completely subordinate to the other. Unbiased approach to the study of all human experiences may prove that subject and object are interdependent dimensions or elements of reality.

  8. Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment.

    Science.gov (United States)

    Takaki, Jiro; Hibino, Yuri

    2014-09-02

    The purpose of this study is to investigate how family-related opinions and stressful situations are related to psychological distress in women undergoing infertility treatment. The subjects in this cross-sectional study were recruited from female patients undergoing infertility treatment (n = 2540) at 70 infertility treatment institutions in Japan. Because of non-participation or missing data, the number of subjects included in the analysis was 635 (response rate, 25.0%). The family-related opinions and stressful situations were evaluated using the original questions. Psychological distress was assessed using a self-report measure, the Kessler Six-question Psychological Distress Scale (K6). The K6 scores of the following participants were significantly (p infertility, those with infertility of unknown causes, those living with no child, those having a low joint income with their partner, those with the opinion that "women should devote themselves to their household duties" those who had considered stopping treatment, those without the opinion that "married life without children is favorable" and those who had experienced stressful situations such as inadequate explanation by doctors, frustration of multiple failed attempts, differences of opinion with the partner, and lack of knowledge regarding when to stop treatment. Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment are outlined. The results of this study may contribute to the prevention of and care for psychological distress in female patients undergoing infertility treatment.

  9. Do subjective memory complaints predict senile Alzheimer dementia?

    Science.gov (United States)

    Jungwirth, Susanne; Zehetmayer, Sonja; Weissgram, Silvia; Weber, Germain; Tragl, Karl Heinz; Fischer, Peter

    2008-01-01

    Many elderly complain about their memory and undergo dementia screening by the Mini-Mental State Examination (MMSE). While objective memory impairment always precedes Alzheimer dementia (AD) it is unclear whether subjective memory complaints are predicting AD. We tried to answer this question in a prospective cohort study. The 75-years old non-demented inhabitants of Vienna-Transdanube were investigated for conversion to AD after 30 months. The predictive value of subjective memory complaints was analysed in two groups: subjects with high MMSE-score (28-30) and subjects with low MMSE-score (23-27). Only in subjects with high MMSE univariate analyses showed an association between subjective memory complaints and incident AD. In both groups the verbal memory test was the main predictor of AD in multivariate analyses. We suggest to perform memory testing in subjects complaining about memory irrespective of their performance in a screening procedure like the MMSE.

  10. Accuracy and Quality of Routine Immunisation Data Monitoring ...

    African Journals Online (AJOL)

    Accuracy and Quality of Routine Immunisation Data Monitoring System in two South-Eastern Districts of Nigeria. ... Methods A validated methodology of immunisation Data Quality Audit was used. All the Health Facilities (HFs) conducting immunisation in OGB (28) and ONN (20) as well as the two LGAs' Immunisation Units ...

  11. School bus crash rates on routine and nonroutine routes.

    Science.gov (United States)

    O'Neal, Elizabeth; Ramirez, Marizen; Hamann, Cara; Young, Tracy; Stahlhut, Mary; Peek-Asa, Corinne

    2014-09-01

    Although prior research has established that school buses are a safe form of transportation, crashes can produce catastrophic consequences. School buses have 2 types of routes: predictable, routine routes that take children to and from school and less predictable, nonroutine routes for school events. No studies have examined school bus crash incidence and characteristics by these route types. School bus crashes were identified from the Iowa Department of Transportation Crash Database from mid-2005 through mid-2010. Crash reports did not identify whether the bus was on a routine or nonroutine route, so a protocol to assign these based on day and time was developed. Bus mileage was provided by the Iowa Department of Education. The school bus crash rate was 2.1 times higher on nonroutine routes than on routine routes (95% CI = 1.8-2.3). Most crashes involved an improper action by the driver of another vehicle. In crashes attributed to improper actions of school buses, failure to yield the right-of-way and disregarding traffic signs were more common on routine routes, while losing control, speeding, reckless, or aggressive driving were more common on nonroutine routes. School bus crashes are more likely to occur on nonroutine routes. © 2014, American School Health Association.

  12. Effect of Soccer on Routine Urinalysis and Some Blood Biochemical ...

    African Journals Online (AJOL)

    The effect of soccer on routine urinalysis and some biochemical indices measured in laboratories has been studied, in order to review the changes that may result from such contact exercise. A total of 40 amateur soccer players were used for this study in which urine and arterial blood samples were collected before and ...

  13. Usefulness of Routine Antibacterial Susceptibility Testing Results for ...

    African Journals Online (AJOL)

    The objective was to evaluate the usefulness and reliability of routine antibacterial susceptibility testing data in antibacterial resistance surveillance in Lagos Metropolis. The antibacterial susceptibility testing results of 3,961 clinical isolates of bacteria from four highly rated hospitals in Lagos metropolis were collated and ...

  14. routine radiographic findings in clinically healthy edentulous jaw ...

    African Journals Online (AJOL)

    2012-08-08

    Aug 8, 2012 ... for assessing temporomandibular joint (TMJ) and maxillary sinus pathology, nevertheless, for purposes of routine assessment, significant findings may be deduced which may impact on the final outcome of the complete dentures. Condylar surface changes. (“beaking”, erosion and osteophyte formation (6).

  15. Supporting Classroom Transitions between Daily Routines: Strategies and Tips

    Science.gov (United States)

    Banerjee, Rashida; Horn, Eva

    2013-01-01

    The purpose of this article is to provide tools for preschool professionals to plan for transitions between daily routines, to identify challenging transitions during the day, and to offer strategies to support transitions in classrooms to prevent challenging behaviors from occurring due to frequent changes. Specifically, the authors answer three…

  16. Prehospital endotracheal intubation; need for routine cuff pressure measurement?

    NARCIS (Netherlands)

    Peters, J.H.; Hoogerwerf, N.

    2013-01-01

    In endotracheal intubation, a secured airway includes an insufflated cuff distal to the vocal cords. High cuff pressures may lead to major complications occurring after a short period of time. Cuff pressures are not routinely checked after intubation in the prehospital setting, dealing with a

  17. The quest for sustained data use : Developing organizational routines

    NARCIS (Netherlands)

    Hubers, Mireille D.; Schildkamp, Kim; Poortman, Cindy L.; Pieters, Jules M.

    2017-01-01

    The data team intervention was designed to support schools' data use. The sustainability of schools' data use was investigated by studying the schools' development of the ostensive and performative aspects of organizational routines for: engaging in the data team intervention, acting upon their data

  18. Effect of peer education on timeliness and completeness of routine ...

    African Journals Online (AJOL)

    Journal Home > Vol 3, No 3 (2014) > ... Most children in developing countries who start routine immunization do not ... test was done to evaluate predictive factors for a child being fully immunized; with p-value of £0.05 considered significant.

  19. Circumcision weeks: making circumcision part of routine training ...

    African Journals Online (AJOL)

    Circumcision weeks: making circumcision part of routine training and service delivery at district-level hospitals in South Africa. ... It also helps reduce herpes simplex virus type 2, a key biological co-factor thought to account for some human susceptibility to HIV infection and human papillomavirus. To address these needs ...

  20. Monitoring patients with rheumatoid arthritis in routine care

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Jensen, Dorte Vendelbo; Krogh, Niels Steen

    2014-01-01

    , little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage...

  1. Quality of routine spirometry tests in Dutch general practices.

    NARCIS (Netherlands)

    Schermer, T.R.J.; Crockett, A.J.; Poels, P.J.P.; Dijke, J.J. van; Akkermans, R.P.; Vlek, H.F.; Pieters, W.R.

    2009-01-01

    BACKGROUND: Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. AIM: To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. DESIGN OF STUDY: Analysis

  2. "Your Eye Is Sparkling": Formulaic Expressions and Routines in Turkish.

    Science.gov (United States)

    Dogancay, Seran

    There are certain pre-coded (formulaic) utterances conventionally triggered by certain communication situations, and their use is expected and deemed appropriate because they are seen as part of everyday politeness formulas. Lack of an English equivalent indicates cultural differences governing their use. Some routines are taught explicitly and…

  3. Developing Corpus-Based Materials to Teach Pragmatic Routines

    Science.gov (United States)

    Bardovi-Harlig, Kathleen; Mossman, Sabrina; Vellenga, Heidi E.

    2015-01-01

    This article describes how to develop teaching materials for pragmatics based on authentic language by using a spoken corpus. The authors show how to use the corpus in conjunction with textbooks to identify pragmatic routines for speech acts and how to extract appropriate language samples and adapt them for classroom use. They demonstrate how to…

  4. to Library Operations and Routines in Selected Nigerian Federal

    African Journals Online (AJOL)

    Digital media have revolutionized information sources and advances in Information and Communication Technologies (ICTs) and have dramatically enhanced information provision. The process of library operations and routines has become very challenging and complex. Libraries as centres for learning, teaching and ...

  5. Confrontation visual field testing in routine ophthalmic practice ...

    African Journals Online (AJOL)

    Background: Visual field testing, aids in detecting, localizing and monitoring diseases of the visual pathway. Early detection may help to preserve the patient's sight or life. In some situations, standard perimetry may not be possible. Aim: To highlight the relevance of confrontation visual field testing (CVF) in routine ...

  6. 32 CFR 318.14 - Blanket routine uses.

    Science.gov (United States)

    2010-07-01

    ... interest of simplicity, economy and to avoid redundancy. (b) Routine Use—Law Enforcement. If a system of... to the OMB in connection with the review of private relief legislation as set forth in OMB Circular A-19 at any stage of the legislative coordination and clearance process as set forth in that Circular...

  7. Rethinking the Hidden Curriculum: Daily Routine in Slovene Preschools

    Science.gov (United States)

    Zorec, Marcela Batistic; Došler, Anita Jug

    2016-01-01

    In Slovenia there is a unitary system of early education for all preschool-aged children. Since the vast majority of children attend full-day programmes, the daily routine represents a significant part of life for children in kindergarten. When systemic and curricular reform of preschools was introduced at the end of the twentieth century, lot of…

  8. PMTCT from research to reality - results from a routine service ...

    African Journals Online (AJOL)

    Objectives. Assessment of the efficacy of a prevention of mother-to-child transmission (PMTCT) programme in a routine service setting in comparison to a research environment. Design. Descriptive study over a 13-month period utilising retrospective data obtained from hospital records complemented by prospective data on ...

  9. Antibody response to routine measles vaccination among a ...

    African Journals Online (AJOL)

    owner

    2013-02-08

    Feb 8, 2013 ... Abstract Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vacci- nation in Nigerian children and evaluate vaccine potency.

  10. Interval of Routine Maintenance and Maintenance Performance: A Literature Review

    Directory of Open Access Journals (Sweden)

    Au-Yong Cheong Peng

    2016-01-01

    Full Text Available In high-rise residential buildings, the quality of facilities management services is significant to the normal operation of the facilities. Unfortunately, lack of concern towards building maintenance, especially preventive maintenance, happens in domestic housing industry in Malaysia. Majority of the maintenance operations of condominiums suffer from lack of planning, lack of proactive maintenance plan, and lack of proper implementation. Thus, this paper reviews the implementation of preventive maintenance strategy, routine maintenance in specific. An extensive review of literature published in 1987 to 2014 is performed for the purpose of this research. The publications are sourced from journal articles, conference proceedings and books. The literature analysis confirms that the routine maintenance of facilities and building services is vital and it can be influential towards the maintenance performance. Subsequently, a theoretical framework is developed, which shows the relationship between routine maintenance of building facilities & services and maintenance performance. The building facilities & services are divided into two categories. They are essential facilities & services that ensure the safety, health, habitability, and operability of buildings; while value-added facilities & services deal with property value, return on investment, and quality living of buildings. Based on the findings, a future research is proposed, which aims to identify the appropriate routine of maintenance for the facilities and services in high-rise residential buildings to improve the maintenance performance.

  11. Routine Screening for Hepatitis among Patients with Psychotic Illness

    African Journals Online (AJOL)

    Background: The prevalence of hepatitis B & C is increasing globally, giving rise to a significant increase in morbidity and mortality. Individuals with psychotic disorders are particularly at risk of contracting hepatitis B & C due to lifestyle factors. Routine hepatitis screening among this population is advocated. This study ...

  12. Relevance of routine preoperation laborotary tests before cataract ...

    African Journals Online (AJOL)

    Objective: To investigate the outcome and the relevance of routine laboratory tests, i.e., full blood count (FBC), packed cell volume (PCV), haemoglobin (Hb), and fasting blood sugar (FBS) before cataract and glaucoma surgery. Materials and Methods: A retrospective review of records of all patients who had ...

  13. Rasch Analysis of the Routines-Based Interview Implementation Checklist

    Science.gov (United States)

    Boavida, Tânia; Akers, Kate; McWilliam, R. A.; Jung, Lee Ann

    2015-01-01

    The Routines-­Based Interview (RBI) is useful for developing functional outcomes/goals, for establishing strong relationships with families, and for assessing the family's true needs. In this study, the authors investigated the psychometric properties of the RBI Implementation Checklist, conducted by 120 early intervention professionals,…

  14. Predictors of routine episiotomy in primigravida women in Oman.

    Science.gov (United States)

    Al-Ghammari, Khadija; Al-Riyami, Zainab; Al-Moqbali, Moza; Al-Marjabi, Fatma; Al-Mahrouqi, Basma; Al-Khatri, Amal; Al-Khasawneh, Esra M

    2016-02-01

    Episiotomy is still the most common surgical procedure performed on women, despite the evidence against its routine use. This cross-sectional study was conducted to determine the practice and predictors of routine episiotomy on primigravidae in Oman. Demographic data, reasons for and rate of performing routine episiotomies, and perceptions of 269 obstetricians, midwives and nurses from 11 hospitals in Oman regarding the procedure were recorded and analyzed. The rate of episiotomies was 66%. In terms of performing routine episiotomies (p<0.05): non-Omanis were 4.49 times more likely than Omanis; bachelor's degree-holders were 2.26 more likely than diploma-holders; and regional hospitals were 2.36 times more likely than tertiary hospitals. The majority perceived episiotomies "reduce spontaneous perineal tearing risk", "reduce shoulder dystocia complications", and allow for "easier suturing". The rate of episiotomies was higher than other similar contexts. An urgent intervention is necessary to curb this excessive practice, and create a culture of evidence-based practice to deal with misleading perceptions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. The Effect of Corpus-Based Instruction on Pragmatic Routines

    Science.gov (United States)

    Bardovi-Harlig, Kathleen; Mossman, Sabrina; Su, Yunwen

    2017-01-01

    This study compares the effect of using corpus-based materials and activities for the instruction of pragmatic routines under two conditions: implementing direct corpus searches by learners during classroom instruction and working with teacher-developed corpus-based materials. The outcome is compared to a repeated-test control group. Pragmatic…

  16. Detecting child psychiatric disorders during routine clinic work: A pre ...

    African Journals Online (AJOL)

    A cross-sectional two-stage study in which 350 children aged 7 - 14 years, seen by PCPs in the course of their routine work, were subsequently screened with the ... the children's version of the Schedule for Affective Disorders and Schizophrenia (K-SADS) to establish Diagnostic and Statistical Manual of Mental Disorders, ...

  17. Introducing routine enquiry about domestic violence in a paediatric setting.

    Science.gov (United States)

    Asiegbunam, Nkiru

    2017-07-06

    Implementation of routine enquiry (RE) about domestic abuse in the multidisciplinary Evelina London Guys and St. Thomas Trust (GSTT) Community Health Services (CHS). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Antibody response to routine measles vaccination among a ...

    African Journals Online (AJOL)

    Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vaccination in Nigerian children and evaluate vaccine potency. Methods: A prospective ...

  19. Appraisal of circulation routine duties in academic libraries | Hassan ...

    African Journals Online (AJOL)

    This paper examines the circulation services in the circulation department of academic libraries. It defines circulation services and identifies types of circulation routine duties. Specific mention was made of shelving of consulted books, shelving arrangement, shelf reading, registration of library users, charging system, brown ...

  20. Analysis of routine EEG usage in a general adult ICU.

    LENUS (Irish Health Repository)

    McHugh, J C

    2009-09-01

    Non-convulsive seizures and status epilepticus are common in brain-injured patients in intensive care units. Continuous electroencephalography (cEEG) monitoring is the most sensitive means of their detection. In centres where cEEG is unavailable, routine EEG is often utilized for diagnosis although its sensitivity is lower.

  1. Validity of routine clinical diagnoses in acute psychiatric inpatients.

    Science.gov (United States)

    Zander, Eduard; Wyder, Lea; Holtforth, Martin Grosse; Schnyder, Ulrich; Hepp, Urs; Stulz, Niklaus

    2018-01-01

    To examine the validity of diagnoses obtained by clinicians during routine clinical examination on acute psychiatric inpatient wards. N=100 inpatients with a broad spectrum of major mental disorders were randomly selected in a mental hospital's department of general psychiatry. Patients were diagnosed by independent assessors within Md = 5 (Range: 1-18) days of admission using the SCID I in order to examine the validity of the diagnoses given by the clinical staff based on routine assessments. The commonly used clinical examination technique had good overall agreement with the SCID I assessments regarding primary diagnoses at the level of ICD-10 main categories (F2, F30-31, F32-F33, F4; κ = 0.65). However, agreement between routine clinical diagnoses and the SCID I diagnoses tended to be low for some specific mental disorders (e.g., depressive disorders) and for secondary diagnoses. The validity of routine clinical diagnoses established in acute inpatient settings is limited and should be improved. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Attitude and perceptions of women on routine antenatal ultrasound ...

    African Journals Online (AJOL)

    This is a cross sectional survey of 212 consecutive pregnant women attending antenatal clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi to determine the attitude and perceptions of pregnant women towards routine ultrasound examination in pregnancy. One hundred and ninety-eight (93.4%) of the ...

  3. A problem-solving routine for improving hospital operations.

    Science.gov (United States)

    Ghosh, Manimay; Sobek Ii, Durward K

    2015-01-01

    The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

  4. Care routines, feeding assistive robotics and the disabled body

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt

    Care routines, feeding assistive robotics and the disabled body Niels Christian Mossfeldt NickelsenAbstract for 4S, Barcelona, track 62. Short abstract 300 signs including spacesSeveral feeding assistive robotics are described in the literature, but few studies have explored the reception. I report...

  5. Pitfalls in the routine diagnosis of Staphylococcus aureus | Bello ...

    African Journals Online (AJOL)

    Two hundred isolates of Presumed Staphylococcus aureus from routine clinical specimens, collected from two government hospitals in Abha, Saudi Arabia, had their identity verified. We used the tube coagulase test as our gold standard. Twenty (10%) of the isolates were mis-identified. Reliance by the two laboratories on ...

  6. A new generation videokymography for routine clinical vocal fold examination

    NARCIS (Netherlands)

    Qiu, Qingjun; Schutte, Harm K.

    2006-01-01

    Objective. This study aims to introduce a new-generation videokymographic system, which provides simultaneous laryngoscopic and kymographic image, for routine clinical vocal fold examination. Study Design: The authors explored a new imaging method for diagnosis and evaluation of voice disorders.

  7. Routine Violence Risk Assessment in Community Forensic Mental Healthcare

    NARCIS (Netherlands)

    van den Brink, Rob H. S.; Hooijschuur, Alex; van Os, Titus W. D. P.; Savenije, Wim; Wiersma, Durk

    2010-01-01

    We developed a method for periodic monitoring of violence risk, as part of routine community forensic mental healthcare. The feasibility of the method was tested, as well as its predictive validity for violent and risk enhancing behavior in the subsequent months. Participants were 83 clients who

  8. Routine histologic demonstration of helicobacter pylori in gastric ...

    African Journals Online (AJOL)

    This study aims to evaluate the effectiveness of the consideration of replacing routine use of Giemsa with immunohistochemistry. Method: Thirty-five consecutive endoscopic gastric biopsies obtained from dyspeptic patients, having a histological diagnosis of chronic gastritis were reviewed. Giemsa and IHC were applied ...

  9. Acceptability of routine HIV counselling and testing among a sample ...

    African Journals Online (AJOL)

    Routine HIV counseling and testing (RCT) is a necessary first step in accessing health care for persons who may test HIV-positive. Despite the availability of RCT in many South African settings, uptake has often been low. We sought to determine whether the main components of the Health Belief Model (HBM), namely ...

  10. Routine antenatal syphilis screening in South West Nigeria - a ...

    African Journals Online (AJOL)

    years (± 5.34) and the mean gestational age 26.4 weeks (±6.36). The modal parity was 0. Only three patients were found to be reactive for syphilis giving a prevalence of 0.13%. Conclusion: The sero- prevalence value in this study is quite low and may justify the call to discontinue routine antenatal syphilis screening.

  11. ACCEPTABILITY OF ROUTINE OFFER OF HIV TESTING (OPT-OUT ...

    African Journals Online (AJOL)

    2011-03-01

    Mar 1, 2011 ... SUMMARY. Background: With the introduction of the opt out HIV testing policy in Ghana, the HIV test is offered rou- tinely to all pregnant women unless they decline test- ing. Objective: To assess acceptability of the routine offer of HIV testing antenatal clinic (ANC) clients in the Wa municipality, Ghana.

  12. Literature Review Lifestyles and routine activities of South African ...

    African Journals Online (AJOL)

    The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of ...

  13. a sudden total loss of vision after routine cataract surgery

    African Journals Online (AJOL)

    David Ofori-Adjei

    2013-06-01

    Jun 1, 2013 ... June 2013. Volume 47, Number 2. GHANA MEDICAL JOURNAL. 96. A SUDDEN TOTAL LOSS OF VISION AFTER ROUTINE CATARACT. SURGERY. S. LARTEY1, P. ... Cataract surgery has its complications. The most feared ... mm Hg on oral nifedipine 40 mg daily who presented with 6/36 vision in both ...

  14. A Sudden Total Loss of Vision After Routine Cataract Surgery ...

    African Journals Online (AJOL)

    We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post ...

  15. RUSSIAN LAW SUBJECTS

    Directory of Open Access Journals (Sweden)

    D.N. Bakhrakh

    2006-03-01

    Full Text Available The question about the subjects of law branches is concerning the number of most important and difficult in law science. Its right decision influences on the subject of law regulation, precise definition of addressees of law norms, the volume of their rights and duties, the limits of action of norms of Main part of the branch, its principles. Scientific investigations, dedicated to law subjects system, promote the development of recommendations for the legislative and law applying activity; they are needed for scientific work organization and student training, for preparing qualified lawyers.

  16. The Feasibility and Time Required for Routine Health Literacy Assessment in Surgical Practice and Effect on Patient Satisfaction.

    Science.gov (United States)

    Eubanks, Ryan D; Nodora, Jesse N; Hsu, Chiu-Hsieh; Bagley, Marian; Bouton, Marcia E; Martinez, Maria Elena; Komenaka, Ian K

    2017-05-01

    Patients with limited health literacy (HL) have higher likelihood of problems with communication and may decrease patient satisfaction. This study was performed to determine the time required for routine HL assessment and its effect on patient satisfaction. Retrospective review over four years of consecutive patients who attended a breast clinic who underwent HL assessment as part of routine care. A total of 3126 consecutive patients from 2010 to 2014. Of the 3126 patients (96.9%), 3030 of were capable of undergoing HL assessment. No patients refused assessment, but one patient was inadvertently missed [3029 of 3030 patients (99.9%)]. The average age was 45 years and 10.5 years of education. The average time required was 1:57 minutes. Only 19 per cent of patients had adequate HL. Per each 1000 patients the time decreased (2:07, 1:58, 1:47; P < 0.001). Newest Vital Sign score did not change with time (1.6, 1.8, 1.7; P = NS). Patient satisfaction ratings increased during each subsequent year of HL assessments (P = 0.002). Routine HL assessment is feasible in surgical practice. HL assessment allows for identification of patients at risk for miscommunication. Implementation of communication strategies as described on the AMA website can improve patient-clinician communication and improve patient satisfaction.

  17. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1995-06-15

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  18. Examining the cost of delivering routine immunization in Honduras.

    Science.gov (United States)

    Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

    2015-05-07

    Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

  19. Benchmarking routine psychological services: a discussion of challenges and methods.

    Science.gov (United States)

    Delgadillo, Jaime; McMillan, Dean; Leach, Chris; Lucock, Mike; Gilbody, Simon; Wood, Nick

    2014-01-01

    Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

  20. Evaluation of Idiopathic Choroidal Neovascularization with Indocyanine Green Angiography in Patients Undergoing Bevacizumab Therapy

    Directory of Open Access Journals (Sweden)

    Ryan B. Rush

    2015-01-01

    Full Text Available Purpose. To examine the clinical implications of change in choroidal neovascularization (CNV size on indocyanine green (ICG angiography in subjects with idiopathic CNV undergoing bevacizumab therapy. Methods. The charts of subjects with an idiopathic CNV treated by a modified PRN regimen with intravitreal bevacizumab over a 12-month period were retrospectively reviewed. Results. There were 34 subjects included in the analysis. Baseline CNV sizes of less than 1.0 mm2 on ICG angiography correlated with complete CNV resolution (P=0.0404, fewer injections delivered (P=0.0002, and better Snellen visual acuity (P=0.0098 at 12 months. Subjects that experienced a 33% or more reduction in CNV size on ICG angiography at 2 months had complete CNV resolution (P=0.0047 and fewer injections (P<0.0001 at 12 months compared to subjects that did not experience a 33% or more reduction in CNV size on ICG angiography at 2 months. Conclusions. Smaller baseline CNV size on ICG angiography resulted in better visual acuity and fewer injections at 12 months, and a reduction of 33% or more in CNV size after 2 months may predict a better clinical course in subjects with idiopathic CNV undergoing bevacizumab therapy.

  1. Routine needle biopsy during vertebral augmentation procedures. Is it necessary?

    OpenAIRE

    Pneumaticos, Spiros G; Sofia N. Chatziioannou; Savvidou, Christiana; Pilichou, Anastasia; Rontogianni, Dimitra; Korres, Dimitrios S

    2010-01-01

    Vertebral augmentation procedures are currently widely performed to treat vertebral compression fractures. The purpose of this study was to determine the frequency of underlying previously unrecognized etiology in a consecutive series of patients undergoing kyphoplasty to treat vertebral compression fractures. A prospective histological evaluation of vertebral body biopsy specimens from presumed osteoporotic vertebral compression fractures were performed in order to identify aforementioned ca...

  2. Assessment of pediatrics radiation dose from routine x-ray ...

    African Journals Online (AJOL)

    Background: Given the fact that children are more sensitive to ionizing radiation than adults,with an increased risk of developing radiation-induced cancer,special care should be taken when they undergo X-ray examinations. The main aim of the current study was to determine Entrance Surface Dose (ESD) to pediatric ...

  3. [Nutritional status of patients undergoing peritoneal dialysis].

    Science.gov (United States)

    Bober, Joanna; Mazur, Olech; Gołembiewska, Edyta; Bogacka, Anna; Sznabel, Karina; Stańkowska-Walczak, Dobrosława; Kabat-Koperska, Joanna; Stachowska, Ewa

    2015-01-01

    The main causes of death in patients undergoing dialysis are cardiovascular diseases. Their presence is related to the nutritional status of patients treated with peritoneal dialysis, and has a predicted value in this kind of patient. Long-term therapy entails unfavourable changes, from which a clinically significant complication is protein-energy malnutrition and intensification of inflammatory processes. The aim of the study was to assess the nutritional status of patients with chronic kidney disease treated with peritoneal dialysis based on anthropometric, biochemical parameters analysis, a survey, as well as the determination of changes in measured parameters occurring over time. The study involved 40 people undergoing peritoneal dialysis (PD) and 30 healthy people. For dialyzed patients testing material was collected twice, every 6 months. Proteins, albumins, prealbumins, C-reactive protein and glucose levels were measured. Anthropometric measurements included body height, body weight, triceps skinfold and subscapular skinfold thickness. Body mass index (BMI) value and exponent of tissue protein source were calculated. The examined patients completed the questionnaire, which included, among other factors, the daily intake of nutrients, and lifestyle information. During the 6 month observation of the PD group a stastically significant increase in the energy value of intake food and amount of calories intake from carbohydrates was found. Analysis of nutritional status dependent on the BMI showed that overweight and obese patients are characterized by higher concentrations of the C-reactive protein and glucose, as well as lower concentrations of prealbumin compared to patients with normal body weight. At the same time, the energy value of food and the amount of protein in the group with BMI > 25 were smaller than in the other groups. During the 6 month observation a decrease the concentration of prealbumin and an increase in C-reactive protein in BMI > 25 group

  4. The Data Subject

    DEFF Research Database (Denmark)

    Blume, Peter

    2015-01-01

    This article considers whether it is fortunate that data protection rules, as a starting point, apply to all physical persons as data subjects, or whether it would be better to differentiate between kinds of persons on grounds of their ability to act as a data subject. In order to protect all...... persons, it is argued that a principle of care should be part of data protection law....

  5. Artificial neural networks to predict presence of significant pathology in patients presenting to routine colorectal clinics.

    Science.gov (United States)

    Maslekar, S; Gardiner, A B; Monson, J R T; Duthie, G S

    2010-12-01

    Artificial neural networks (ANNs) are computer programs used to identify complex relations within data. Routine predictions of presence of colorectal pathology based on population statistics have little meaning for individual patient. This results in large number of unnecessary lower gastrointestinal endoscopies (LGEs - colonoscopies and flexible sigmoidoscopies). We aimed to develop a neural network algorithm that can accurately predict presence of significant pathology in patients attending routine outpatient clinics for gastrointestinal symptoms. Ethics approval was obtained and the study was monitored according to International Committee on Harmonisation - Good Clinical Practice (ICH-GCP) standards. Three-hundred patients undergoing LGE prospectively completed a specifically developed questionnaire, which included 40 variables based on clinical symptoms, signs, past- and family history. Complete data sets of 100 patients were used to train the ANN; the remaining data was used for internal validation. The primary output used was positive finding on LGE, including polyps, cancer, diverticular disease or colitis. For external validation, the ANN was applied to data from 50 patients in primary care and also compared with the predictions of four clinicians. Clear correlation between actual data value and ANN predictions were found (r = 0.931; P = 0.0001). The predictive accuracy of ANN was 95% in training group and 90% (95% CI 84-96) in the internal validation set and this was significantly higher than the clinical accuracy (75%). ANN also showed high accuracy in the external validation group (89%). Artificial neural networks offer the possibility of personal prediction of outcome for individual patients presenting in clinics with colorectal symptoms, making it possible to make more appropriate requests for lower gastrointestinal endoscopy. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

  6. Routine Shunting During Carotid Endarterectomy in Patients With Acute Watershed Stroke.

    Science.gov (United States)

    Perini, Paolo; Bonifati, Domenico Marco; Tasselli, Sebastiano; Sogaro, Filippo

    2017-07-01

    To evaluate the protective role of routine shunting in patients with acute watershed stroke (WS) undergoing carotid endarterectomy (CEA). A total of 138 patients with symptomatic carotid stenosis (SCS) who underwent CEA after acute ischemic stroke from March 2008 to March 2015 were included in this study. Transient ischemic attacks were excluded. These patients were divided into 2 groups according to the topographic pattern of the stroke on magnetic resonance imaging: group 1, territorial strokes (TS) caused by emboli of carotid origin, and group 2, WS caused by a hemodynamic mechanism related to an SCS. Primary end points were 30-day mortality and postoperative neurological morbidity. The insertion of a Pruitt carotid shunt was performed systematically. Ninety (65.2%) patients presented a TS of carotid origin and were included in group 1, and 48 (34.8%) of the 138 patients had a WS related to an SCS and were included in group 2. The median time between clinical onset of the cerebral ischemic event and surgery was 9 days (range: 0-89 days). Postoperative mortality was 0%. Seven (5.1%) patients had an aggravation of the neurological status during the postoperative period, of whom 2 presented a complete regression of the symptoms in less than 1 hour (definitive postoperative neurologic morbidity: 3.6%). Postoperative neurologic morbidity rate was significantly higher in the TS group (7 of 90; 7.8%) compared to the WS group (0 of 48; P = .04). No other independent predictive factor of neurologic morbidity after CEA for an SCS was found. Our results suggest that routine shunting should be considered in case of acute WS since it may play a protective role. Further studies are eagerly awaited to better define the timing and the best treatment option for both acute WS and TS related to an SCS in order to reduce postoperative neurologic morbidity.

  7. Value of routine investigations to predict loop diuretic down-titration success in stable heart failure.

    Science.gov (United States)

    Martens, Pieter; Verbrugge, Frederik H; Boonen, Levinia; Nijst, Petra; Dupont, Matthias; Mullens, Wilfried

    2018-01-01

    Guidelines advocate down-titration of loop diuretics in chronic heart failure (CHF) when patients have no signs of volume overload. Limited data are available on the expected success rate of this practice or how routine diagnostic tests might help steering this process. Fifty ambulatory CHF-patients on stable neurohumoral blocker/diuretic therapy for at least 3months without any clinical sign of volume overload were prospectively included to undergo loop diuretic down-titration. All patients underwent a similar pre-down-titration evaluation consisting of a dyspnea scoring, physical examination, transthoracic echocardiography (diastolic function, right ventricular function, cardiac filling pressures and valvular disease), blood sample (serum creatinine, plasma NT-pro-BNP and neurohormones). Loop diuretic maintenance dose was subsequently reduced by 50% or stopped if dose was ≤40mg furosemide equivalents. Successful down-titration was defined as a persistent dose reduction after 30days without weight increase >1.5kg or new-onset symptoms of worsening heart failure. At 30-day follow-up, down-titration was successful in 62% (n=31). In 12/19 patients exhibiting down-titration failure, this occurred within the first week. Physical examination, transthoracic echocardiography and laboratory analysis had limited predictive capability to detect patients with down-titration success/failure (positive likelihood-ratios below 1.5, or area under the curve [AUC] non-statically different from AUC=0.5). Loop diuretic down-titration is feasible in a majority of stable CHF patients in which the treating clinician felt continuation of loops was unnecessary to sustain euvolemia. Importantly, routine diagnostics which suggest euvolemia, have limited diagnostic impact on the post-test probability. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Thermodynamics of a qubit undergoing dephasing

    Science.gov (United States)

    Marcantoni, S.

    2017-05-01

    The thermodynamics of a qubit undergoing dephasing due to the coupling with the external environment is discussed. First of all, we assume the dynamics of the system to be described by a master equation in Lindblad form. In this framework, we review a standard formulation of the first and second law of thermodynamics that has been known in literature for a long time. After that, we explicitly model the environment with a set of quantum harmonic oscillators choosing the interaction such that the global dynamics of system and bath is analytically solvable and the Lindblad master equation is recovered in the weak-coupling limit. In this generalized setting, we can show that the correlations between system and bath play a fundamental role in the heat exchange. Moreover, the internal entropy production of the qubit is proven to be positive for arbitrary coupling strength.

  9. Economic Impact of Routine Cavity Margins Versus Standard Partial Mastectomy in Breast Cancer Patients

    Science.gov (United States)

    Chagpar, Anees B.; Horowitz, Nina R.; Killelea, Brigid K.; Tsangaris, Theodore; Longley, Peter; Grizzle, Sonia; Loftus, Michael; Li, Fangyong; Butler, Meghan; Stavris, Karen; Yao, Xiaopan; Harigopal, Malini; Bossuyt, Veerle; Lannin, Donald R.; Pusztai, Lajos; Davidoff, Amy J.; Gross, Cary P.

    2017-01-01

    Objective The aim of the study was to compare costs associated with excision of routine cavity shave margins (CSM) versus standard partial mastectomy (PM) in patients with breast cancer. Background Excision of CSM reduces re-excision rates by more than 50%. The economic implications of this is, however, unclear. Methods Between October 21, 2011 and November 25, 2013, 235 women undergoing PM for Stage 0–III breast cancer were randomized to undergo either standard PM (“no shave”, n = 116) or have additional CSM taken (“shave”, n = 119). Costs from both a payer and a hospital perspective were measured for index surgery and breast cancer surgery–related care through subsequent 90 days. Results The 2 groups were well-matched in terms of baseline characteristics. Those in the “shave” group had a longer operative time at the initial surgery (median 76 vs 66 min, P margins (13/119 = 10.9% vs 32/116 = 27.6%, P < 0.01). Actual direct hospital costs associated with operating room time ($1315 vs. $1137, P = 0.03) and pathology costs ($1195 vs $795, P < 0.01) were greater for the initial surgery in patients in the “shave” group. Taking into account the index surgery and the subsequent 90 days, there was no significant difference in cost from either the payer ($10,476 vs $11,219, P = 0.40) or hospital perspective ($5090 vs $5116, P = 0.37) between the “shave” and “no shave” groups. Conclusions Overall costs were not significantly different between the “shave” and “no shave” groups due to significantly fewer reoperative surgeries in the former. PMID:27192352

  10. Randomized controlled trial: effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization.

    Science.gov (United States)

    Moy, Irene; Milad, Magdy P; Barnes, Randall; Confino, Edmond; Kazer, Ralph R; Zhang, Xingqi

    2011-02-01

    To evaluate the influence of "true" versus "sham" acupuncture on pregnancy rates (PRs) in women undergoing IVF. Randomized controlled trial, double-blinded with independent observer. Academic infertility clinic. One hundred sixty patients acupuncture 25 minutes before and after ET. Subjects completed a McGill Pain Questionnaire regarding their clinical symptoms during ET. Clinical PR and clinical symptoms during ET. While the overall clinical PR was 51.25%, there was no significant difference between the arms of the study (true = 45.3% vs. sham = 52.7%); 33.1% of the patients had ultrasound-documented singleton pregnancy, and 15% of patients had twin gestations, while one patient in the true arm had a triplet gestation. There were significant differences in the subjective, affective, and total pain experience between both arms. The subjects in the true arm described their acupuncture session as being more "tiring" and "fearful" and experienced more "achiness" compared with their sham counterparts. There was no statistically significant difference in the clinical or chemical PRs between both groups. Patients undergoing true acupuncture had differing sensory experiences compared with patients in the sham arm. There were no significant adverse effects observed during the study, suggesting that acupuncture is safe for women undergoing ET. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Effectiveness of Nursing Interventions on Physical and Psychological Outcome among Cancer Patients Undergoing Chemotherapy

    Directory of Open Access Journals (Sweden)

    T. Sivabalan

    2016-04-01

    Full Text Available Background: Cancer patient's undergoing chemotherapy experiences a variety of side effects which has influence on prognosis of illness, activity of daily living and the quality of life. There is a need of nursing care interventions for management and prevention of problem among cancer patients. Aim & Objectives: The present study aimed to assess the effectiveness of nursing interventions on physical and psychological outcome among cancer patients undergoing chemotherapy. Material and Methods: A true experimental study, post test only design with control group approach was conducted among 130 cancer patients undergoing chemotherapy at oncology ward of Pravara Rural Hospital, Loni (Bk, Ahmednagar, Maharashtra. Cancer patients who are 18 years old or older were selected with systematic random sampling method. Pre tested semi structured interview schedule was used to gather data. The assessment of health status before start of chemotherapy was carried out, followed by the nursing interventions was implemented based on patient needs and problems, and the post test was conducted after the period of interventions. The collected data was tabulated and analyzed using appropriate statistical methods wherever required. Results: The results revealed that the cancer patients experienced a wide range of physical and psychological problems prior to chemotherapy treatment. Cancer patients who received nursing interventions had improved post test mean scores on chemotherapy symptoms, pain and fatigue; emotional well being, anxiety and depression than the patients who received routine care, notably it was statistically significant at p<0.05 level. A significant association was observed between physical, psychological outcome variables and the socio demographic characteristics like sex, site of cancer, stage of cancer, duration of cancer, metastasis of cancer and the regimen of chemotherapy at p<0.05 level. Conclusion: This study demonstrated that the nursing

  12. Safety and immunogenicity of a novel quadrivalent meningococcal CRM-conjugate vaccine given concomitantly with routine vaccinations in infants.

    Science.gov (United States)

    Klein, Nicola P; Reisinger, Keith S; Johnston, William; Odrljin, Tatjana; Gill, Christopher J; Bedell, Lisa; Dull, Peter

    2012-01-01

    In phase II studies, MenACWY-CRM elicited robust immunologic responses in young infants. We now present results from our pivotal phase III infant immunogenicity/safety study. In this open-label phase III study, we randomized full-term 2-month-old infants to 4 doses of MenACWY-CRM coadministered with routine vaccines at 2, 4, 6, and 12 months of age or with routine vaccines alone. We monitored for local and systemic reactions and serious adverse events among all study participants and evaluated for sufficiency of the immune responses to MenACWY-CRM through serum bactericidal activity assay with human complement. Bactericidal antibodies were present in 94% to 100% of subjects against each of the serogroups in MenACWY-CRM after the 4-dose series and were 67% to 97% after the first 3 doses. Geometric mean titers were higher after the fourth dose of MenACWY-CRM compared with a single dose of MenACWY-CRM at 12 months of age for all serogroups (range of ratios, 4.5-38). Responses to 3 doses of routine vaccines coadministered with MenACWY-CRM were noninferior to routine vaccinations alone, except for small differences in pneumococcal serotype 6B responses after dose 3 but not dose 4 and pertactin after dose 3. Inclusion of MenACWY-CRM did not affect the safety or reactogenicity profiles of the routine infant vaccine series. A 4-dose series of MenACWY-CRM was highly immunogenic and well tolerated in young infants, and it can be coadministered with routine infant vaccines. Substantial immunity was conferred after the first 3 doses administered at 2, 4, and 6 months of age.

  13. SVM detection of epileptiform activity in routine EEG.

    LENUS (Irish Health Repository)

    Kelleher, Daniel

    2010-01-01

    Routine electroencephalogram (EEG) is an important test in aiding the diagnosis of patients with suspected epilepsy. These recordings typically last 20-40 minutes, during which signs of abnormal activity (spikes, sharp waves) are looked for in the EEG trace. It is essential that events of short duration are detected during the routine EEG test. The work presented in this paper examines the effect of changing a range of input values to the detection system on its ability to distinguish between normal and abnormal EEG activity. It is shown that the length of analysis window in the range of 0.5s to 1s are well suited to the task. Additionally, it is reported that patient specific systems should be used where possible due to their better performance.

  14. Unusual radiographic finding during routine periodontal maintenance: a case report.

    Science.gov (United States)

    El-Halaby, Ahmed; Furtado Araújo, Michel V

    2014-04-01

    This case report describes the presence of a radiopaque artifact appearing in multiple intraoral periapical and bitewing radiographs during routine periodontal maintenance, in an edentulous area with a history of a ridge preservation procedure. Clinical examination of the area showed a normal soft tissue appearance. Upon further investigation of the patient's recent past medical history, it was found that the artifact was due to the presence of a dermal filler (Radiesse--Merz Aesthetics, San Mateo, CA), which remained after a facial cosmetic procedure. This unusual finding is an indication that clinicians should consider facial cosmetic dermal fillers as part of the differential diagnosis when unusual radiopaque objects are found during routine dental radiographs.

  15. Routine referrals: A possible solution for transplantation shortages

    Directory of Open Access Journals (Sweden)

    Bonnie Venter

    2017-07-01

    Full Text Available Transplantation is the only therapeutic option for terminal organ failure. The principle that donation should be a routine component of endof-life care is recognised in many countries, but only 38% of them have official deceased-donor programmes, and South Africa (SA does not have one. Scrutinising the policies in countries such as Spain, the UK and the USA (Pennsylvania, where official referral programmes exist, could help to determine which option will be best suited to SA. It is concluded that the best basic step to start with in SA would be if the Department of Health could implement a routine-referral policy document, compelling physicians to refer every death to be evaluated for the possibility of organ retrieval.

  16. Subject (of documents)

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2017-01-01

    such as concepts, aboutness, topic, isness and ofness are also briefly presented. The conclusion is that the most fruitful way of defining “subject” (of a document) is the documents informative or epistemological potentials, that is, the documents potentials of informing users and advance the development......This article presents and discuss the concept “subject” or subject matter (of documents) as it has been examined in library and information science (LIS) for more than 100 years. Different theoretical positions are outlined and it is found that the most important distinction is between document......-oriented views versus request-oriented views. The document-oriented view conceive subject as something inherent in documents, whereas the request-oriented view (or the policy based view) understand subject as an attribution made to documents in order to facilitate certain uses of them. Related concepts...

  17. Science of the subjective.

    Science.gov (United States)

    Jahn, R G; Dunne, B J

    2007-01-01

    Over the greater portion of its long scholarly history, the particular form of human observation, reasoning, and technical deployment we properly term "science" has relied at least as much on subjective experience and inspiration as it has on objective experiments and theories. Only over the past few centuries has subjectivity been progressively excluded from the practice of science, leaving an essentially secular analytical paradigm. Quite recently, however, a compounding constellation of newly inexplicable physical evidence, coupled with a growing scholarly interest in the nature and capability of human consciousness, are beginning to suggest that this sterilization of science may have been excessive and could ultimately limit its epistemological reach and cultural relevance. In particular, an array of demonstrable consciousness-related anomalous physical phenomena, a persistent pattern of biological and medical anomalies, systematic studies of mind/brain relationships and the mechanics of human creativity, and a burgeoning catalogue of human factors effects within contemporary information processing technologies, all display empirical correlations with subjective aspects that greatly complicate, and in many cases preclude, their comprehension on strictly objective grounds. However, any disciplined re-admission of subjective elements into rigorous scientific methodology will hinge on the precision with which they can be defined, measured, and represented, and on the resilience of established scientific techniques to their inclusion. For example, any neo-subjective science, while retaining the logical rigor, empirical/theoretical dialogue, and cultural purpose of its rigidly objective predecessor, would have the following requirements: acknowledgment of a proactive role for human consciousness; more explicit and profound use of interdisciplinary metaphors; more generous interpretations of measurability, replicability, and resonance; a reduction of ontological

  18. Good Quality - the Routinization of Sperm Banking in China

    DEFF Research Database (Denmark)

    Wahlberg, Ayo

    Good Quality is an assemblage ethnography of how sperm banking came to be routinized in China. Based on 8 years of episodic fieldwork at China’s oldest and largest sperm bank in Changsha, Hunan province, the book meticulously chronicles how, beginning in the early 1980s, a unique style of sperm b...... banking would emerge in China, shaped by the cultural, juridical, economic and social configurations that make up China’s restrictive reproductive complex....

  19. Optimization techniques for OpenCL-based linear algebra routines

    Science.gov (United States)

    Kozacik, Stephen; Fox, Paul; Humphrey, John; Kuller, Aryeh; Kelmelis, Eric; Prather, Dennis W.

    2014-06-01

    The OpenCL standard for general-purpose parallel programming allows a developer to target highly parallel computations towards graphics processing units (GPUs), CPUs, co-processing devices, and field programmable gate arrays (FPGAs). The computationally intense domains of linear algebra and image processing have shown significant speedups when implemented in the OpenCL environment. A major benefit of OpenCL is that a routine written for one device can be run across many different devices and architectures; however, a kernel optimized for one device may not exhibit high performance when executed on a different device. For this reason kernels must typically be hand-optimized for every target device family. Due to the large number of parameters that can affect performance, hand tuning for every possible device is impractical and often produces suboptimal results. For this work, we focused on optimizing the general matrix multiplication routine. General matrix multiplication is used as a building block for many linear algebra routines and often comprises a large portion of the run-time. Prior work has shown this routine to be a good candidate for high-performance implementation in OpenCL. We selected several candidate algorithms from the literature that are suitable for parameterization. We then developed parameterized kernels implementing these algorithms using only portable OpenCL features. Our implementation queries device information supplied by the OpenCL runtime and utilizes this as well as user input to generate a search space that satisfies device and algorithmic constraints. Preliminary results from our work confirm that optimizations are not portable from one device to the next, and show the benefits of automatic tuning. Using a standard set of tuning parameters seen in the literature for the NVIDIA Fermi architecture achieves a performance of 1.6 TFLOPS on an AMD 7970 device, while automatically tuning achieves a peak of 2.7 TFLOPS

  20. Routine Amoxicillin for Uncomplicated Severe Acute Malnutrition in Children.

    Science.gov (United States)

    Isanaka, Sheila; Langendorf, Céline; Berthé, Fatou; Gnegne, Smaila; Li, Nan; Ousmane, Nassirou; Harouna, Souley; Hassane, Hamidine; Schaefer, Myrto; Adehossi, Eric; Grais, Rebecca F

    2016-02-04

    High-quality evidence supporting a community-based treatment protocol for children with severe acute malnutrition, including routine antibiotic use at admission to a nutritional treatment program, remains limited. In view of the costs and consequences of emerging resistance associated with routine antibiotic use, more evidence is required to support this practice. In a double-blind, placebo-controlled trial in Niger, we randomly assigned children who were 6 to 59 months of age and had uncomplicated severe acute malnutrition to receive amoxicillin or placebo for 7 days. The primary outcome was nutritional recovery at or before week 8. A total of 2412 children underwent randomization, and 2399 children were included in the analysis. Nutritional recovery occurred in 65.9% of children in the amoxicillin group (790 of 1199) and in 62.7% of children in the placebo group (752 of 1200). There was no significant difference in the likelihood of nutritional recovery (risk ratio for amoxicillin vs. placebo, 1.05; 95% confidence interval [CI], 0.99 to 1.12; P=0.10). In secondary analyses, amoxicillin decreased the risk of transfer to inpatient care by 14% (26.4% in the amoxicillin group vs. 30.7% in the placebo group; risk ratio, 0.86; 95% CI, 0.76 to 0.98; P=0.02). We found no benefit of routine antibiotic use with respect to nutritional recovery from uncomplicated severe acute malnutrition in Niger. In regions with adequate infrastructure for surveillance and management of complications, health care facilities could consider eliminating the routine use of antibiotics in protocols for the treatment of uncomplicated severe acute malnutrition. (Funded by Médecins sans Frontières Operational Center Paris; ClinicalTrials.gov number, NCT01613547.).

  1. [Routine application of HLA class II oligotyping. Value of automatization].

    Science.gov (United States)

    Caillat-Zucman, S; Bach, J F

    1992-12-02

    HLA class II typing by DNA amplification and hybridization with allele-specific oligonucleotides has led to an improvement of the overall typing accuracy. In an attempt to apply this procedure to a large-scale analysis, we sought to implement an automation system using the Biomek 1,000 robotic work-station. This system allows a rapid preparation of many consecutive samples and avoids the risk of human errors. It is now routinely used in several laboratories.

  2. Master schedule for CY-1977 Hanford Environmental Surveillance Routine Program

    Energy Technology Data Exchange (ETDEWEB)

    Blumer, P.J.; Myers, D.A.; Fix, J.J.

    1976-12-01

    Data are presented from the routine environmental surveillance program at the Hanford Site as conducted by the Environmental Evaluation Section of Battelle, Pacific Northwest Laboratory for ERDA. Tables are presented to show levels of radioactive and nonradioactive pollution in the Columbia River, sanitary water, surface water, ground water, foods, wildlife, soil, and vegetation. Data are also presented for external radiation measurements using thermoluminescent dosimeters, results of portable instrument surveys, and monitoring of waste disposal sites. (HLW)

  3. Burst suppression in sleep in a routine outpatient EEG

    Directory of Open Access Journals (Sweden)

    Ammar Kheder

    2014-01-01

    Full Text Available Burst suppression (BS is an electroencephalogram (EEG pattern that is characterized by brief bursts of spikes, sharp waves, or slow waves of relatively high amplitude alternating with periods of relatively flat EEG or isoelectric periods. The pattern is usually associated with coma, severe encephalopathy of various etiologies, or general anesthesia. We describe an unusual case of anoxic brain injury in which a BS pattern was seen during behaviorally defined sleep during a routine outpatient EEG study.

  4. The Subjectivity of Participation

    DEFF Research Database (Denmark)

    Nissen, Morten

    What is a 'we' – a collective – and how can we use such communal self-knowledge to help people? This book is about collectivity, participation, and subjectivity – and about the social theories that may help us understand these matters. It also seeks to learn from the innovative practices and ideas...... practices. Through this dialogue, it develops an original trans-disciplinary critical theory and practice of collective subjectivity for which the ongoing construction and overcoming of common sense, or ideology, is central. It also points to ways of relating discourse with agency, and fertilizing insights...... from interactionism and ideology theories in a cultural-historical framework....

  5. CERES: A Set of Automated Routines for Echelle Spectra

    Science.gov (United States)

    Brahm, Rafael; Jordán, Andrés; Espinoza, Néstor

    2017-03-01

    We present the Collection of Elemental Routines for Echelle Spectra (CERES). These routines were developed for the construction of automated pipelines for the reduction, extraction, and analysis of spectra acquired with different instruments, allowing the obtention of homogeneous and standardized results. This modular code includes tools for handling the different steps of the processing: CCD image reductions; identification and tracing of the echelle orders; optimal and rectangular extraction; computation of the wavelength solution; estimation of radial velocities; and rough and fast estimation of the atmospheric parameters. Currently, CERES has been used to develop automated pipelines for 13 different spectrographs, namely CORALIE, FEROS, HARPS, ESPaDOnS, FIES, PUCHEROS, FIDEOS, CAFE, DuPont/Echelle, Magellan/Mike, Keck/HIRES, Magellan/PFS, and APO/ARCES, but the routines can be easily used to deal with data coming from other spectrographs. We show the high precision in radial velocity that CERES achieves for some of these instruments, and we briefly summarize some results that have already been obtained using the CERES pipelines.

  6. An Automatic Cavity Phasing Routine for HIE-ISOLDE

    CERN Document Server

    Haastrup, S

    2014-01-01

    The broad experimental programme at ISOLDE means that the same beam species and energy are rarely studied twice and the cavities of the linac must be scaled or re-phased for each experiment. In order to expedite machine set-up a software routine that automatically calculates the cavity phases has been developed. The routine takes as input the beam parameters, the state of the linac (the available cavities and their condition) and the desired final energy, and calculates the necessary phases and voltages to be applied to each cavity. Different algorithms for partitioning the voltage were implemented. A beam dynamics error study was carried out in order to better understand the challenges facing the automatic phasing routine. The effects of a variety of different errors on the efficacy of the phasing application were studied, leading to a specification of the tolerances required for the calibration of the rf system and the accuracy of the survey system that monitors the positions of the cavities.

  7. Exploring routine hospital antenatal care consultations - An ethnographic study.

    Science.gov (United States)

    Wright, Diane; Pincombe, Jan; McKellar, Lois

    2017-09-29

    Listening to women as part of their antenatal care has been recognized as valuable in understanding the woman's needs. Conversations as part of routine antenatal interactions offer ideal opportunities for women to express themselves and for midwives to learn about the woman's issues and concerns. The antenatal visit and the convention of antenatal consultations for midwives have not been well explored or defined and much of what takes place replicate medical consultative processes. As a consequence, there is little to assist midwives construct woman-centred care consultations for their routine antenatal care practice. This study showed how some practices were better in promoting the woman's voice and woman-centred care in the hospital setting. Contemporary focused ethnography using both interview and observations, explored how midwives from six different public antenatal clinics in South Australia organized their antenatal care consultations with pregnant women. Thematic analysis of the data provided insights into professional interpretation of woman-centred practice. How midwives interacted with women during routine antenatal care events demonstrated that some practices in a hospital setting could either support or undermine a woman-centred philosophy. Individual midwives adopted practices according to their own perceptions of actions and behaviors that were considered to be in accordance with the philosophy of woman-centred care. Information arising from this study has shown ways midwives may arrange antenatal care consultations to maximize women's participation. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  8. Physicians slow to e-mail routinely with patients.

    Science.gov (United States)

    Boukus, Ellyn R; Grossman, Joy M; O'Malley, Ann S

    2010-10-01

    Some experts view e-mail between physicians and patients as a potential tool to improve physician-patient communication and, ultimately, patient care. Despite indications that many patients want to e-mail their physicians, physician adoption and use of e-mail with patients remains uncommon--only 6.7 percent of office-based physicians routinely e-mailed patients in 2008, according to a new national study from the Center for Studying Health System Change (HSC). Overall, about one-third of office-based physicians reported that information technology (IT) was available in their practice for e-mailing patients about clinical issues. Of those, fewer than one in five reported using e-mail with patients routinely; the remaining physicians were roughly evenly split between occasional users and non-users. Physicians in practices with access to electronic medical records and those working in health maintenance organizations (HMOs) or medical school settings were more likely to adopt and use e-mail to communicate with patients compared with other physicians. However, even among the highest users--physicians in group/staff-model HMOs--only 50.6 percent reported routinely e-mailing patients.

  9. Occupations, habits, and routines: perspectives from persons with diabetes.

    Science.gov (United States)

    Thompson, Maryellen

    2014-03-01

    Almost all of the management of diabetes is the direct responsibility of the person with diabetes. While many studies have attempted to examine issues of management of diabetes and compliance with medical recommendations, little has been done to examine daily diabetic care from an occupational perspective. The purpose of this research was to examine and describe how persons with diabetes perceive the occupations related to the management of their diabetes. A qualitative methods approach was used including photo elicitation and interviews. A team of student researchers recruited participants for a sample of convenience. The following themes emerged from qualitative cross-case analysis: "Changes over time"; "What to eat"; "Habits and routines"; and "Family: Occupational impacts". Findings highlight the importance of considering the individual experience of diabetes self-management occupations and the need to develop habits and routines to support management of diabetes. Further research is needed to expand our understanding of how daily routines and habits can affect health in persons with diabetes.

  10. Examining daily activity routines of older adults using workflow.

    Science.gov (United States)

    Chung, Jane; Ozkaynak, Mustafa; Demiris, George

    2017-07-01

    We evaluated the value of workflow analysis supported by a novel visualization technique to better understand the daily routines of older adults and highlight their patterns of daily activities and normal variability in physical functions. We used a self-reported activity diary to obtain data from six community-dwelling older adults for 14 consecutive days. Workflow for daily routine was analyzed using the EventFlow tool, which aggregates workflow information to highlight patterns and variabilities. A total of 1453 events were included in the data analysis. To demonstrate the patterns and variability of each individual's daily activities, participant activity workflows were visualized and compared. The workflow analysis revealed great variability in activity types, regularity, frequency, duration, and timing of performing certain activities across individuals. Also, when workflow approach was applied to spatial information of activities, the analysis revealed the ability to provide meaningful data on individuals' mobility in different levels of life spaces from home to community. Results suggest that using workflows to characterize the daily activities of older adults will be helpful for clinicians and researchers in understanding their daily routines and preparing education and prevention strategies tailored to each individual's activity level. This tool also has the potential to be integrated into consumer informatics technologies, such as patient portals or personal health records, so that consumers may be encouraged to become actively involved in monitoring and managing their health. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Transmissivity iterative calculation routine: theory and numerical implementation

    Energy Technology Data Exchange (ETDEWEB)

    Cearlock, D.B.; Kipp, K.L.; Friedrichs, D.R.

    1975-05-01

    A computer routine, the Transmissivity Iterative Routine (TIR), has been developed for calculating the hydraulic conductivity distribution in highly heterogeneous aquifers where characterization by field measurement methods alone would be prohibitive in cost. The routine yields the two-dimensional distribution of hydraulic conductivity averaged over the aquifer thickness. The agreement between the calculated and actual average conductivity is dependent on the degree to which the groundwater system satisfies the Dupuit assumption. The program was written for an interactive computer system with a light-pen, CRT display and graphical digitizer, which allow rapid reinterpretation and evaluation of groundwater contours. Testing of the computer program on a synthetic surface identified a set of control parameters that resulted in a maximum computational error of +-5 percent. This maximum error occurred as streamtubes passed near stagnation points where the groundwater hydraulic potential gradients and radii of curvature were small. Sensitivity tests on the Hanford unconfined aquifer indicated that the hydraulic conductivity calculation is not particularly sensitive to errors in the storage coefficient distribution over much of the aquifer. These tests also illustrated the power of the TIR method to evaluate the validity of field data.

  12. Family routines and rituals when a parent has cancer.

    Science.gov (United States)

    Buchbinder, Mara; Longhofer, Jeffrey; McCue, Kathleen

    2009-09-01

    A growing literature has drawn attention to the psychosocial impact of cancer on families with young children. However, to help families develop adaptive responses to chronic illness, recent scholarship has begun to advocate a shift in orientation from a deficit to a strengths perspective. In this article, the authors examine the reorganization of family life after cancer diagnosis by reporting findings from a qualitative study of families with young children (ages 2-9) dealing with a parent's cancer. The authors focus specifically on parents' self-reports of how their families developed and experienced new routines and rituals while one parent underwent cancer treatment. Despite significant upheaval in family life, the families in this study found ways to stabilize routines and maintain a sense of normalcy. Although cancer compels disruptions to existing routines and rituals, families demonstrated creative resilience in their capacity to incorporate cancer care into the formation of new family traditions, habits, and practices. By considering how families manage cancer as a joint endeavor, the authors hope to illuminate the ways in which cancer can bring families together as well as pull them apart.

  13. Level-3 Cholesky Factorization Routines Improve Performance of Many Cholesky Algorithms

    DEFF Research Database (Denmark)

    Gustavson, Fred G.; Wasniewski, Jerzy; Dongarra, Jack J.

    2013-01-01

    Four routines called DPOTF3i, i = a,b,c,d, are presented. DPOTF3i are a novel type of level-3 BLAS for use by BPF (Blocked Packed Format) Cholesky factorization and LAPACK routine DPOTRF. Performance of routines DPOTF3i are still increasing when the performance of Level-2 routine DPOTF2 of LAPACK...

  14. Editor's Choice - Renal complications after EVAR with suprarenal versus infrarenal fixation among all users and routine users.

    Science.gov (United States)

    Zettervall, S L; Deery, S E; Soden, P A; Shean, K; Siracuse, J J; Alef, M; Patel, V I; Schermerhorn, M L

    2017-09-01

    Previous studies comparing endografts with suprarenal and infrarenal fixation for endovascular abdominal aortic aneurysm repair (EVAR) have found conflicting results and did not account for differences in patient selection. This study aims to evaluate the differences in outcomes among surgeons who routinely use either suprarenal or infrarenal fixation, as well as all surgeons in the Vascular Study Group of New England (VSGNE). All patients undergoing EVAR in the VSGNE from 2003 to 2014 were identified. All ruptured aneurysms, repairs with concomitant procedures, and infrequently used stent grafts (80% of cases, as well as all surgeons. Multivariate regression and Cox hazard models were utilised to account for patient demographics, comorbidities, operative differences, and procedure year. This study identified 2574 patients (suprarenal, 1264; infrarenal, 1310) with 888 endografts placed by routine users (suprarenal, 409; infrarenal, 479). There were no differences in baseline comorbidities, including the estimated glomerular filtration rate, between suprarenal and infrarenal fixation, or between patients with endografts placed by routine and non-routine users. Patients treated with suprarenal endografts received more contrast than all users (102 mL vs. 100 mL, p = .01) and routine users (110 mL vs. 88 mL, p users, patients treated with suprarenal grafts had higher rates of creatinine increase >.5 mg/dL (3.7% vs. 2.0%, p = .01), length of stay >2 days (27% vs. 19%, p users, suprarenal fixation was also associated with higher rates of renal dysfunction (3.7% vs. 1.3%, p = .02; OR 2.9; 95% CI 1.1-7.8). Despite potential differences in patient selection, endografts with suprarenal fixation among all users and routine users were associated with higher rates of renal deterioration and longer length of hospital stay. Longer-term data are needed to determine the duration and severity of renal function decline and to identify potential benefits of decreased

  15. Culture confirmation of gonococcal infection by recall of subjects found to be positive by nucleic acid amplification tests in general practice

    DEFF Research Database (Denmark)

    Møller, Jens Kjølseth

    2010-01-01

    To evaluate a routine notification of general practitioners to recall nucleic acid amplification test (NAAT)-positive subjects for culture of Neisseria gonorrhoeae to confirm gonococcal infection in the community.......To evaluate a routine notification of general practitioners to recall nucleic acid amplification test (NAAT)-positive subjects for culture of Neisseria gonorrhoeae to confirm gonococcal infection in the community....

  16. Should Finasteride Be Routinely Given Preoperatively for TURP?

    OpenAIRE

    Kynaston, H. G.; Hughes, O.; Turner, K; Wedderburn, A; Aslam, M. Z.; Aboumarzouk, O. M.

    2013-01-01

    Objective. The aim of the review was to compare the use of finasteride to placebo in patients undergoing TURP procedures. Material & Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966–November 2011), EMBASE (1980–November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles, and abstracts from conference proceedings without language restriction for studies comparing finasteride to placebo patients needing TURPs. Results. ...

  17. Paying Hypertension Research Subjects

    Science.gov (United States)

    Casarett, David; Karlawish, Jason; Asch, David A

    2002-01-01

    CONTEXT Cash payments are often used to compensate subjects who participate in research. However, ethicists have argued that these payments might constitute an undue inducement. OBJECTIVES To determine whether potential subjects agree with theoretical arguments that a payment could be an undue inducement. DESIGN/SETTING/PARTICIPANTS Survey of 350 prospective jurors. MAIN OUTCOME MEASURES Belief that a $500 payment for research participation would impair their own, and others' ability to think carefully about the risks and benefits of a clinical trial. RESULTS Two hundred sixty-one jurors (74.6%) believed that a $500 payment would impair subjects' ability to think carefully about the risks and benefits of research. Ninety-six of 120 (80%) expressed this concern about subjects with a low income ($50,000). In contrast, only 69 (19.7%) of jurors believed that a $500 payment would influence them. Jurors who believed that this payment would influence them reported lower incomes and less education. CONCLUSION Members of the general public share ethical concerns about the influence of payments for research, although they believe that these concerns are more applicable to others than to themselves.

  18. Subjects, Models, Languages, Transformations

    NARCIS (Netherlands)

    Rensink, Arend; Bézivin, J.; Heckel, R.

    2005-01-01

    Discussions about model-driven approaches tend to be hampered by terminological confusion. This is at least partially caused by a lack of formal precision in defining the basic concepts, including that of "model" and "thing being modelled" - which we call subject in this paper. We propose a minimal

  19. Subjective Duration and Psychophysics

    Science.gov (United States)

    Eisler, Hannes

    1975-01-01

    Three models are proposed to describe the strategy applied by a subject when he is confronted with two successive time intervals and is required to deal with some relation between them, for example, by telling which was the longer by adjusting the second to match the first. (Author)

  20. Barron's SAT subject test

    CERN Document Server

    Jansen, MA, Robert

    2016-01-01

    Includes one diagnostic test and three complete tests, all questions answered and explained, self-assessment guides, and subject reviews. Also features test strategies, QR codes to short instructional videos, and a detailed appendix with equations, physical constants, and a basic math review.

  1. Routine pelvic examination during front-line chemotherapy for ovarian cancer: should it play a role?

    Science.gov (United States)

    Argenta, Peter A; Ormsby, Rebekah R; Downs, Levi S; Judson, Patricia L; Ghebre, Rahel; Carson, Linda F

    2008-01-01

    To determine if pelvic examination affected management in patients undergoing first-line chemotherapy for ovarian cancer and to determine a threshold of change in tumor size reliably detectable by pelvic examination. We reviewed 501 encounters among 47 women with ovarian cancer to see if pelvic examination prompted a management change. Clinicians then evaluated synthetic model "tumors" and were retested at intervals of 3-48 hours to determine change needed for reliable detection. The median number of examinations was 3 during 8 cycles of chemotherapy. Fifteen examinations (10.5%) revealed palpable anomalies, attributable to known tumor in 10 instances. The most common events preceding management change were elevation in serum CA-125 (57%) or chemotherapy toxicity (20%). No changes were made based on pelvic examination alone. When assessing "tumor" volume in a model, estimates ranged from 33-309% of actual volume. Determination of volume change following a delay was poor. No reliable threshold of detection of volume change was established. Pelvic examination findings rarely dictated management changes in this study. Further, our results call into question the potential of routine pelvic examination to add significantly to clinical management during initial treatment given the wide range of error in "tumor" size estimates.

  2. Do Routine Preoperative and Intraoperative Urine Cultures Benefit Pediatric Vesicoureteral Reflux Surgery?

    Directory of Open Access Journals (Sweden)

    Daniel R. Hettel

    2017-01-01

    Full Text Available Objective. To determine if routine preoperative and intraoperative urine cultures (UCx are necessary in pediatric vesicoureteral (VUR reflux surgery by identifying their association with each other, preoperative symptoms, and surgical outcomes. Materials and Methods. A retrospective review of patients undergoing ureteral reimplant(s for primary VUR at a tertiary academic medical center between years 2000 and 2014 was done. Preoperative UCx were defined as those within 30 days before surgery. A positive culture was defined as >50,000 colony forming units of a single organism. Results. A total of 185 patients were identified and 87/185 (47.0% met inclusion criteria. Of those, 39/87 (45% completed a preoperative UCx. Only 3/39 (8% preoperative cultures returned positive, and all of those patients were preoperatively symptomatic. No preoperatively asymptomatic patients had positive preoperative cultures. Intraoperative cultures were obtained in 21/87 (24.1% patients; all were negative. No associations were found between preoperative culture results and intraoperative cultures or between culture result and postoperative complications. Conclusions. In asymptomatic patients, no associations were found between the completion of a preoperative or intraoperative UCx and surgical outcomes, suggesting that not all patients may require preoperative screening. Children presenting with symptoms of urinary tract infection (UTI prior to ureteral reimplantation may benefit from preoperative UCx.

  3. Low-dose intranasal versus oral midazolam for routine body MRI of claustrophobic patients

    Energy Technology Data Exchange (ETDEWEB)

    Tschirch, Frank T.C.; Goepfert, Kerstin; Brunner, Genevieve; Weishaupt, Dominik [University Hospital Zuerich, Institute of Diagnostic Radiology, Zuerich (Switzerland); Froehlich, Johannes M. [Klus-Apotheke, Zuerich (Switzerland)

    2007-06-15

    The purpose of this study was to assess prospectively the potential of low-dose intranasal midazolam compared to oral midazolam in claustrophobic patients undergoing routine body magnetic resonance imaging (MRI). Seventy-two adult claustrophobic patients referred for body MRI were randomly assigned to one of two treatment groups (TG1 and TG2). The 36 patients of TG1 received 7.5 mg midazolam orally 15 min before MRI, whereas the 36 patients of TG2 received one (or, if necessary, two) pumps of a midazolam nasal spray into each nostril immediately prior to MRI (in total, 1 or 2 mg). Patients' tolerance, anxiety and sedation were assessed using a questionnaire and a visual analogue scale immediately before and after MRI. Image quality was evaluated using a five-point-scale. In TG1, 18/36 MRI examinations (50%) had to be cancelled, the reduction of anxiety was insufficient in 12/18 remaining patients (67%). In TG2, 35/36 MRI examinations (97%) were completed successfully, without relevant adverse effects. MRI image quality was rated higher among patients of TG2 compared to TG1 (p<0.001). Low-dose intranasal midazolam is an effective and patient-friendly solution to overcome anxiety in claustrophobic patients in a broad spectrum of body MRI. Its anxiolytic effect is superior to that of the orally administrated form. (orig.)

  4. Routine daily physical activity and glucose variations are strongly coupled in adults with T1DM.

    Science.gov (United States)

    Farabi, Sarah S; Carley, David W; Cinar, Ali; Quinn, Lauretta

    2015-12-01

    Type 1 Diabetes (T1DM) is characterized by altered glucose homeostasis resulting in wide glucose variations throughout a 24-h period. The relationship between routine daily physical activity and glucose variations has not been systematically investigated in adults with T1DM. The objectives of this study were to characterize and quantify the relationship between routine daily activity and glucose variations in a small group of adults with T1DM. Adults with T1DM treated with an insulin pump were recruited for the study. Over a 3-day period, glucose variations were monitored with a continuous glucose monitoring system (CGMS) and routine daily physical activity was assessed using an accelerometer-based physical activity-monitoring band. Simultaneous glucose and physical activity data for one 24-h period were used for analysis. Cross-correlation function and wavelet coherence analyses were employed to quantify the coupling between physical activity and glucose. Twelve subjects were included in the analysis. Cross-correlation function analysis revealed strong coupling between activity and glucose. Wavelet Coherence demonstrated that slower oscillations (120-340 min) of glucose and physical activity exhibited significantly greater coherence (F = 12.6, P < 0.0001) than faster oscillations (10 and 120 min). Physical activity and glucose demonstrate strong time and frequency-dependent coupling throughout a 24-h time period in adults with T1DM. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  5. Myoinositol Improves Embryo Development in PCOS Patients Undergoing ICSI

    Directory of Open Access Journals (Sweden)

    Artur Wdowiak

    2016-01-01

    Full Text Available The aim of this study was to investigate the activity of myoinositol, in a court of 217 PCOS women undergoing intracytoplasmic sperm injection (ICSI, on pregnancy rate, embryo development, estradiol, and progesterone concentration in blood serum, superoxide dismutase (SOD, and catalase (CAT in follicular fluid. Concerning the court of patient, 112 (groups I and II out of 217 were PCOS women, whereas group III consisted of healthy subjects (not PCOS. Group I patients were treated with 400 μg of folic acid per day for 3 months before ICSI, whereas group II patients received 4000 mg of myoinositol and 400 μg of folic acid per day for 3 months before ICSI. Group II revealed a shorter embryo/blastocyst development period between microinjection and 5-cell stage compared to group I. The difference in SOD concentration between groups I and II and between groups II and III was statistically significant. In group II, 34.62% of pregnancies were obtained, whereas in group I this number reached 20% (NS. Myoinositol increased embryo development dynamics and accelerated blastocyst stage reaching time; however, no effect was shown on clinical pregnancy. Furthermore, it restored SOD concentration, lowered in PCOS women, but did not exert any effect on CAT concentration.

  6. Heart-Kidney Biomarkers in Patients Undergoing Cardiac Stress Testing

    Directory of Open Access Journals (Sweden)

    Mikko Haapio

    2011-01-01

    Full Text Available We examined association of inducible myocardial perfusion defects with cardiorenal biomarkers, and of diminished left ventricular ejection fraction (LVEF with kidney injury marker plasma neutrophil gelatinase-associated lipocalin (NGAL. Patients undergoing nuclear myocardial perfusion stress imaging were divided into 2 groups. Biomarkers were analyzed pre- and poststress testing. Compared to the patients in the low ischemia group (n=16, the patients in the high ischemia group (n=18 demonstrated a significantly greater rise in cardiac biomarkers plasma BNP, NT-proBNP and cTnI. Subjects were also categorized based on pre- or poststress test detectable plasma NGAL. With stress, the group with no detectable NGAL had a segmental defect score 4.2 compared to 8.2 (P=.06 in the detectable NGAL group, and 0.9 vs. 3.8 (P=.03 at rest. BNP rose with stress to a greater degree in patients with detectable NGAL (10.2 vs. 3.5 pg/mL, P=.03. LVEF at rest and with stress was significantly lower in the detectable NGAL group; 55.8 versus 65.0 (P=.03 and 55.1 vs. 63.8 (P=.04, respectively. Myocardial perfusion defects associate with biomarkers of cardiac stress, and detectable plasma NGAL with significantly lower LVEF, suggesting a specific heart-kidney link.

  7. Audiotaped social comparison information for cancer patients undergoing radiotherapy : Differential effects of procedural, emotional and coping information

    NARCIS (Netherlands)

    Bennenbroek, FTC; Buunk, BP; Stiegelis, HE; Hagedoorn, M; Sanderman, R; Van den Bergh, ACM; Botke, G; Buunk, Abraham (Bram)

    The present study focused on the effects of social comparison information on subjective understanding of radiation therapy, validation of emotions, and self-efficacy of cancer patients undergoing radiation therapy. The effects of three different audiotapes, containing different kinds of social

  8. Yoga effects on mood and quality of life in Chinese women undergoing heroin detoxification: a randomized controlled trial.

    Science.gov (United States)

    Zhuang, Shu-mei; An, Shi-hui; Zhao, Yue

    2013-01-01

    Yoga, as a mind-body therapy, is effective in improving quality of life for patients with chronic diseases, yet little is known about its effectiveness in female heroin addicts. The aim of this study was to evaluate the effects of yoga on mood status and quality of life among women undergoing detoxification for heroin dependence in China. This study was a randomized controlled trial. Seventy-five women aged 20-37 years undergoing detoxification for heroin dependence at AnKang Hospital were allocated randomly into an intervention or a control group. Women in the intervention group received a 6-month yoga intervention in addition to hospital routine care, and women in the control group received hospital routine care only. Mood status and quality of life were assessed using the Profile of Mood States and Medical Outcomes Study 36-item Short-Form Health Survey at baseline and following 3 and 6 months of treatment. Repeated-measures analysis of variance was used to evaluate treatment and time effects on mood and quality of life. Most female heroin addicts were young and single, with a low education level. Most had used heroin by injection. Mood state and quality of life of female heroin addicts were poor. The intervention group showed a significant improvement in mood status and quality of life over time compared with their counterparts in the control group. Yoga may improve mood status and quality of life for women undergoing detoxification for heroin dependence. Yoga can be used as an auxiliary treatment with traditional hospital routine care for these women.

  9. Factors Affecting Patients Undergoing Cosmetic Surgery in Bushehr, Southern Iran

    OpenAIRE

    Salehahmadi, Zeinab; Rafie, Seyyed Reza

    2012-01-01

    BACKGROUND Although, there have been extensive research on the motivations driving patient to undergo cosmetic procedures, there is still a big question mark on the persuasive factors which may lead individuals to undergo cosmetic surgery. The present study evaluated various factors affecting patients undergoing cosmetic surgery in Bushehr, Southern Iran. METHODS From 24th March 2011 to 24th March 2012, eighty-one women and 20 men who wished to be operated in Fatemeh Zahra Hospital in Bushehr...

  10. Concomitant atrial fibrillation surgery for people undergoing cardiac surgery

    Science.gov (United States)

    Huffman, Mark D; Karmali, Kunal N; Berendsen, Mark A; Andrei, Adin-Cristian; Kruse, Jane; McCarthy, Patrick M; Malaisrie, S C

    2016-01-01

    -effects model when heterogeneity was high (I2 > 50%). We evaluated the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to create a ‘Summary of findings’ table. Main results We found 34 reports of 22 trials (1899 participants) with five additional ongoing studies and three studies awaiting classification. All included studies were assessed as having high risk of bias across at least one domain. The effect of concomitant AF surgery on all-cause mortality was uncertain when compared with no concomitant AF surgery (7.0% versus 6.6%, RR 1.14, 95% CI 0.81 to 1.59, I2 = 0%, 20 trials, 1829 participants, low-quality evidence), but the intervention increased freedom from atrial fibrillation, atrial flutter, or atrial tachycardia off antiarrhythmic medications > three months (51.0% versus 24.1%, RR 2.04, 95% CI 1.63 to 2.55, I2 = 0%, eight trials, 649 participants, moderate-quality evidence). The effect of concomitant AF surgery on 30-day mortality was uncertain (2.3% versus 3.1%, RR 1.25 95% CI 0.71 to 2.20, I2 = 0%, 18 trials, 1566 participants, low-quality evidence), but the intervention increased the risk of permanent pacemaker implantation (6.0% versus 4.1%, RR 1.69, 95% CI 1.12 to 2.54, I2 = 0%, 18 trials, 1726 participants, moderate-quality evidence). Investigator-defined adverse events, including but limited to, need for surgical re-exploration or mediastinitis, were not routinely reported but were not different between the two groups (other adverse events: 24.8% versus 23.6%, RR 1.07, 95% CI 0.85 to 1.34, I2 = 45%, nine trials, 858 participants), but the quality of this evidence was very low. Authors’ conclusions For patients with AF undergoing cardiac surgery, there is moderate-quality evidence that concomitant AF surgery approximately doubles the risk of freedom from atrial fibrillation, atrial flutter, or atrial tachycardia off anti-arrhythmic drugs while increasing the risk of permanent pacemaker

  11. [Subjective cognition in schizophrenia].

    Science.gov (United States)

    Potvin, S; Aubin, G; Stip, E

    2017-02-01

    Given the extent, magnitude and functional significance of the neurocognitive deficits of schizophrenia, growing attention has been paid recently to patients' self-awareness of their own deficits. Thus far, the literature has shown either that patients fail to recognize their cognitive deficits or that the association between subjective and objective cognition is weak in schizophrenia. The reasons for this lack of consistency remain unexplained but may have to do, among others, with the influence of potential confounding clinical variables and the choice of the scale used to measure self-awareness of cognitive deficits. In the current study, we sought to examine the relationships between subjective and objective cognitive performance in schizophrenia, while controlling for the influence of sociodemographic and psychiatric variables. Eighty-two patients with a schizophrenia-spectrum disorder (DSM-IV criteria) were recruited. Patients' subjective cognitive complaints were evaluated with the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS), the most frequently used scale to measure self-awareness of cognitive deficits in schizophrenia. Neurocognition was evaluated with working memory, planning and visual learning tasks taken from Cambridge Neuropsychological Tests Automated Battery. The Stroop Color-Word test was also administered. Psychiatric symptoms were evaluated with the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia. The relationships between subjective and objective cognition were evaluated with multivariate hierarchic linear regression analyses, taking into consideration potential confounders such as sociodemographic and psychiatric variables. Finally, a factor analysis of the SSTICS was performed. For the SSTICS total score, the regression analysis produced a model including two predictors, namely visual learning and Stoop interference performance, explaining a moderate portion of the variance

  12. Value of routine angiography before traumatic lower-limb reconstruction with microvascular free tissue transplantation.

    Science.gov (United States)

    Lutz, B S; Ng, S H; Cabailo, R; Lin, C H; Wei, F C

    1998-04-01

    From November 1993 to June 1997, long-bone defects in 40 trauma patients were reconstructed with free osteoseptocutaneous fibula flaps. To determine the necessity of routine angiography in traumatized lower limbs before free flap transplantation, a prospective study was carried out. The study subjects were 34 patients, 25 males and 9 females, with an average age of 40.6 years. Reconstruction was performed primarily for bone defects after Gustillo type III b open fractures in 17 patients and secondarily for malunion and osteomyelitis in 17 patients. Reconstructed bone defects included 25 tibias and 9 femurs. Normal pedal pulses were palpable in 31 patients. Angiographic findings were abnormal in seven patients. In the three patients with abnormal pedal pulses, the particular nonpalpable pulses correlated with the vascular lesions shown in the angiograms (one in the tibial anterior artery and two in the tibial posterior artery). Four patients with either injury of the peroneal artery (three cases) or pseudoaneurysm of the tibial anterior artery (one case) had normal pedal pulses. In all patients, microvascular transplantations were performed successfully. Our study demonstrates the importance of thorough clinical evaluation. Preoperative angiography of the injured lower limbs did not provide relevant additional informations in this series. Familiarity with all available techniques makes it possible to cope with almost any difficult posttraumatic vascular condition. Routine recipient-site angiography before microsurgical reconstruction, therefore, seems unjustified.

  13. The deep infrapatellar bursa: prevalence and morphology on routine magnetic resonance imaging of the knee.

    Science.gov (United States)

    Aydingoz, Ustun; Oguz, Berna; Aydingoz, Onder; Comert, Ruhi Baris; Akgun, Isik

    2004-01-01

    To evaluate the presence, location, and dimensions of the deep infrapatellar bursa on routine magnetic resonance (MR) imaging of the knee. The study group consisted of 213 knees in 204 consecutive individuals who had undergone routine MR imaging examination of the knee within a 365-day period. Magnetic resonance examinations consisted of T1-, proton-density-, and T2-weighted sagittal; spectral presaturation inversion recovery coronal; and T2*-weighted transverse sequences. Exclusion criteria were previous knee arthroscopy or surgery or the presence of a mass lesion infiltrating the infrapatellar fat pad. The presence, location, and dimensions of the deep infrapatellar bursa were studied. The bursa was also analyzed with regard to knee joint synovial effusion (absent, mild, or marked). The deep infrapatellar bursa was detected in 68% of the knees, most commonly on the lateral paramedian sagittal MR images. There was no statistically significant difference between male and female subjects or between the knee sides with regard to the detection of the deep infrapatellar bursa (P > 0.05). No correlation was found between synovial effusion and the presence of the deep infrapatellar bursa. The mean anteroposterior and craniocaudal dimensions of the deep infrapatellar bursa on sagittal T2-weighted MR images were 2.1-2.7 mm and 7.3-9.1 mm, respectively, on its lateral, central, or medial location within the sagittal MR image stack. An awareness of the dimensions and location of the deep infrapatellar bursa is important in distinguishing it from pathologic lesions (eg, bursitis).

  14. Routine scale and polish for periodontal health in adults.

    Science.gov (United States)

    Worthington, Helen V; Clarkson, Jan E; Bryan, Gemma; Beirne, Paul V

    2013-11-07

    Many dentists or hygienists provide scaling and polishing for patients at regular intervals, even if those patients are considered to be at low risk of developing periodontal disease. There is debate over the clinical effectiveness and cost effectiveness of 'routine scaling and polishing' and the 'optimal' frequency at which it should be provided for healthy adults.A 'routine scale and polish' treatment is defined as scaling or polishing or both of the crown and root surfaces of teeth to remove local irritational factors (plaque, calculus, debris and staining), that does not involve periodontal surgery or any form of adjunctive periodontal therapy such as the use of chemotherapeutic agents or root planing. The objectives were: 1) to determine the beneficial and harmful effects of routine scaling and polishing for periodontal health; 2) to determine the beneficial and harmful effects of providing routine scaling and polishing at different time intervals on periodontal health; 3) to compare the effects of routine scaling and polishing with or without oral hygiene instruction (OHI) on periodontal health; and 4) to compare the effects of routine scaling and polishing provided by a dentist or dental care professional (dental therapist or dental hygienist) on periodontal health. We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 15 July 2013), CENTRAL (The Cochrane Library 2013, Issue 6), MEDLINE via OVID (1946 to 15 July 2013) and EMBASE via OVID (1980 to 15 July 2013). We searched the metaRegister of Controlled Trials and the US National Institutes of Health Clinical Trials Register (clinicaltrials.gov) for ongoing and completed studies to July 2013. There were no restrictions regarding language or date of publication. Randomised controlled trials of routine scale and polish treatments (excluding split-mouth trials) with and without OHI in healthy dentate adults, without severe periodontitis. Two review authors screened

  15. Interaction, transference, and subjectivity

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda

    2012-01-01

    Fieldwork is one of the important methods in educational, social, and organisational research. In fieldwork, the researcher takes residence for a shorter or longer period amongst the subjects and settings to be studied. The aim of this is to study the culture of people: how people seem to make...... sense of their lives and which moral, professional, and ethical values seem to guide their behaviour and attitudes. In fieldwork, the researcher has to balance participation and observation in her attempts at representation. Consequently, the researcher’s academic and life-historical subjectivity...... are important filters for fieldwork. In general, fieldwork can be understood as processes where field reports and field analysis are determined by how the researcher interacts with and experiences the field, the events and informants in it, and how she subsequently develops an ethnography. However, fieldwork...

  16. Writing and the 'Subject'

    DEFF Research Database (Denmark)

    Greve, Charlotte

    /reading subject) manifests itself in the material mark on the page. The study shows how this indexical reference to a ‘subject’ is manipulated and used as a mask through which a writer/painter can perform a certain ‘subject’. Through analyses of the various levels on which the ‘subject’ is represented...... in the early as well as the contemporary avant-garde, it becomes clear that the ‘subject’ is an unstable category that can be exposed to manipulation and play. Handwriting is performing as a signature (as an index), but is at the same time similar to the signature of a subject (an icon) and a verbal construct...

  17. Prediction of coronary artery disease in patients undergoing operations for mitral valve degeneration

    Science.gov (United States)

    Lin, S. S.; Lauer, M. S.; Asher, C. R.; Cosgrove, D. M.; Blackstone, E.; Thomas, J. D.; Garcia, M. J.

    2001-01-01

    OBJECTIVES: We sought to develop and validate a model that estimates the risk of obstructive coronary artery disease in patients undergoing operations for mitral valve degeneration and to demonstrate its potential clinical utility. METHODS: A total of 722 patients (67% men; age, 61 +/- 12 years) without a history of myocardial infarction, ischemic electrocardiographic changes, or angina who underwent routine coronary angiography before mitral valve prolapse operations between 1989 and 1996 were analyzed. A bootstrap-validated logistic regression model on the basis of clinical risk factors was developed to identify low-risk (coronary atherosclerosis was defined as 50% or more luminal narrowing in one or more major epicardial vessels, as determined by means of coronary angiography. RESULTS: One hundred thirty-nine (19%) patients had obstructive coronary atherosclerosis. Independent predictors of coronary artery disease include age, male sex, hypertension, diabetes mellitus,and hyperlipidemia. Two hundred twenty patients were designated as low risk according to the logistic model. Of these patients, only 3 (1.3%) had single-vessel disease, and none had multivessel disease. The model showed good discrimination, with an area under the receiver-operating characteristic curve of 0.84. Cost analysis indicated that application of this model could safely eliminate 30% of coronary angiograms, corresponding to cost savings of $430,000 per 1000 patients without missing any case of high-risk coronary artery disease. CONCLUSION: A model with standard clinical predictors can reliably estimate the prevalence of obstructive coronary atherosclerosis in patients undergoing mitral valve prolapse operations. This model can identify low-risk patients in whom routine preoperative angiography may be safely avoided.

  18. Preoperative information needs of children undergoing tonsillectomy.

    LENUS (Irish Health Repository)

    Buckley, Aoife

    2012-02-01

    AIMS AND OBJECTIVES: To identify the information needs of children undergoing tonsillectomy with reference to content of information, method of delivery, information providers and timing of information provision. BACKGROUND: Tonsillectomy can be anxiety provoking for children and preoperative preparation programmes are long recognised to reduce anxiety. However, few have been designed from the perspectives of children and to date little is known about how best to prepare children in terms of what to tell them, how to convey information to them, who can best provide information and what is the best timing for information provision. DESIGN: A qualitative descriptive study. METHOD: Data were collected from nine children (aged 6-9) using interviews supported by a write and draw technique. Data were coded and categorised into themes reflecting content, method, providers and timing of information. RESULTS: Children openly communicated their information needs especially on what to tell them to expect when facing a tonsillectomy. Their principal concerns were about operation procedures, experiencing \\'soreness\\' and discomfort postoperatively and parental presence. Mothers were viewed as best situated to provide them with information. Children were uncertain about what method of information and timing would be most helpful to them. CONCLUSION: Preoperative educational interventions need to take account of children\\'s information needs so that they are prepared for surgery in ways that are meaningful and relevant to them. Future research is needed in this area. RELEVANCE TO CLINICAL PRACTICE: Practical steps towards informing children about having a tonsillectomy include asking them what they need to know and addressing their queries accordingly. Child-centred information leaflets using a question and answer format could also be helpful to children.

  19. Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

    Directory of Open Access Journals (Sweden)

    Poll Ludger W

    2010-04-01

    Full Text Available Abstract Background Imaging studies of bones in patients with sensory deficits are scarce. Aim To investigate bone MR images of the lower limb in diabetic patients with severe sensory polyneuropathy, and in control subjects without sensory deficits. Methods Routine T1 weighted and T2-fat-suppressed-STIR-sequences without contrast media were performed of the asymptomatic foot in 10 diabetic patients with polyneuropathy and unilateral inactive Charcot foot, and in 10 matched and 10 younger, non-obese unmatched control subjects. Simultaneously, a Gadolinium containing phantom was also assessed for reference. T1 weighted signal intensity (SI was recorded at representative regions of interest at the peritendineal soft tissue, the tibia, the calcaneus, and at the phantom. Any abnormal skeletal morphology was also recorded. Results Mean SI at the soft tissue, the calcaneus, and the tibia, respectively, was 105%, 105% and 84% of that at the phantom in the matched and unmatched control subjects, compared to 102% (soft tissue, 112% (calcaneus and 64% (tibia in the patients; differences of tibia vs. calcaneus or soft tissue were highly significant (p Conclusion MR imaging did not reveal grossly abnormal bone marrow signalling in the limbs with severe sensory polyneuropathy, but occult sequelae of previous traumatic injuries.

  20. The fragile X-chromosome : an evaluation of the results in a routine cytogenetic laboratory in the period 1981-1986

    NARCIS (Netherlands)

    Veenema, H; Beverstock, G C; de Koning, T; Pearson, P L; van de Kamp, J J

    We report on the cytogenetic studies, performed in a routine cytogenetic laboratory between 1981 and 1986, on 428 subjects: 291 probands with non-specific mental retardation, 101 first-degree relatives of fra(X) positive patients and 36 non-retarded patients, referred for other reasons. As a rule 50

  1. Quality of routine spirometry tests in Dutch general practices

    Science.gov (United States)

    Schermer, Tjard RJ; Crockett, Alan J; Poels, Patrick JP; van Dijke, Jacob J; Akkermans, Reinier P; Vlek, Hans F; Pieters, Willem R

    2009-01-01

    Background Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. Aim To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. Design of study Analysis of routine spirometry test records. Setting Fifteen general practices which had a working agreement with a local hospital pulmonary function laboratory for spirometry assessment regarding test quality and interpretation. Method Spirometry tests were judged by a pulmonary function technician and a chest physician. Proportions of test adequacy were analysed using markers for manoeuvre acceptability and test reproducibility derived from the 1994 American Thoracic Society spirometry guideline. Associations between quality markers and age, sex, and severity of obstruction were examined using logistic regression. Results Practices performed a mean of four (standard deviation = 2) spirometry tests per week; 1271 tests from 1091 adult patients were analysed; 96.4% (95% confidence interval [CI] = 95.6 to 97.2) of all tests consisted of ≥3 blows. With 60.6% of tests, forced expiratory time was the marker with the lowest acceptability rate. An overall 38.8% (95% CI = 36.0 to 41.6) of the tests met the acceptability as well as reproducibility criteria. Age, sex, and severity of obstruction were associated with test quality markers. Conclusion The quality of routine spirometry tests was better than in previous reports from primary care research settings, but there is still substantial room for improvement. Sufficient duration of forced expiratory time is the quality marker with the highest rate of inadequacy. Primary care professionals should be aware of patient characteristics that may diminish the quality of their spirometry tests. Further research is needed to establish to what extent spirometry tests that are inadequate, according to stringent international expert criteria

  2. Cost-effectiveness of routine imaging of suspected appendicitis.

    Science.gov (United States)

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

    2018-01-01

    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  3. Correlates of completing routine vaccination among children in Mysore, India.

    Science.gov (United States)

    Mukherjee, Soumyadeep; Madhivanan, Purnima; Li, Tan; Albatineh, Ahmed; Srinivas, Vijaya; Jaykrishna, Poornima; Arun, Anjali; Krupp, Karl

    2015-01-01

    More than half of the over 18 million incompletely vaccinated children worldwide in 2011 lived in India (32%), Nigeria (14%) and Indonesia (7%). Overall immunization coverage in India was 61% in 2009. Few studies have explored the role of parental attitudes in children's vaccination. To explore the correlates of completion of routine vaccination among children in Mysore City, India. A two-stage probability sample of 800 girls aged 11-15 years was selected from 12 schools in Mysore to take home questionnaires to be completed by their parents. The questionnaire elicited information on socio-demographic characteristics, attitudes and practices relevant to vaccination. Bivariate and multivariable logistic regression analyses were performed to identify factors independently associated with completion of routine vaccination. Of the 797 (99.6%) parents who completed questionnaires, 29.9% reported completing all routine vaccinations for their children. Parents who had obtained optional vaccinations for their children (adjusted odds ratio [AOR]: 4.56; 95% confidence interval [CI]: 3.09-6.74), who believed in vaccines' effectiveness (2.50; 1.19-5.28) and who asked doctors or nurses about vaccination (2.07; 1.10-3.90) were significantly more likely to report complete vaccination, after controlling for all other factors. Belief that the disease was more protective than vaccination was independently associated with lower likelihood of vaccination series completion (0.71; 0.52-0.96). No other attitudinal or socio-demographic factors were associated with vaccine completion. Interest and belief in vaccine effectiveness are important facilitators motivating parents to obtain full vaccination for their children in India. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  4. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Lagisetty, Jyothi [Memorial Hermann Medical Center, Emergency Medicine Department, Houston, TX (United States); Slovis, Thomas [Wayne State University School of Medicine, Department of Radiology, Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Thomas, Ronald [Children' s Hospital of Michigan, Wayne State University of Medicine, Department of Pediatrics, Detroit, MI (United States); Knazik, Stephen; Stankovic, Curt [Wayne State University of Medicine, Division of Emergency Medicine, Children' s Hospital of Michigan, Detroit, MI (United States)

    2012-07-15

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  5. A large, multicentre, observational, post-marketing surveillance study of the 2:1 formulation of follitropin alfa and lutropin alfa in routine clinical practice for assisted reproductive technology.

    Science.gov (United States)

    Bühler, Klaus; Naether, Olaf G J; Bilger, Wilma

    2014-01-14

    Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) both have a role to play in follicular development during the natural menstrual cycle. LH supplementation during controlled ovarian stimulation (COS) for assisted reproductive technology (ART) is used for patients with hypogonadotropic hypogonadism. However, the use of exogenous LH in COS in normogonadotropic women undergoing ART is the subject of debate. The aim of this study was to investigate characteristics of infertile women who received the 2:1 formulation of follitropin alfa and lutropin alfa (indicated for stimulation of follicular development in women with severe LH and FSH deficiency) in German clinical practice. A 3-year, multicentre, open-label, observational/non-interventional, post-marketing surveillance study of women (21-45 years) undergoing ART. Primary endpoint: reason for prescribing the 2:1 formulation of follitropin alfa and lutropin alfa. Secondary variables included: COS duration/dose; oocytes retrieved; fertilization; clinical pregnancy; ovarian hyperstimulation syndrome (OHSS). In total, 2220 cycles were assessed; at least one reason for prescribing the 2:1 formulation was given in 1834/2220 (82.6%) cycles. Most common reasons were: poor ovarian response (POR) (39.4%), low baseline LH (17.8%), and age (13.8%). COS: mean dose of the 2:1 formulation on first day, 183.1/91.5 IU; mean duration, 10.8 days. In 2173/2220 (97.9%) cycles, human chorionic gonadotrophin was administered. Oocyte pick-up (OPU) was attempted in 2108/2220 (95.0%) cycles; mean (standard deviation) 8.0 (5.4) oocytes retrieved/OPU cycle. Fertilization (≥1 oocyte fertilized) rates: in vitro fertilization (IVF), 391/439 (89.1%) cycles; intracytoplasmic sperm injection (ICSI)/IVF + ICSI, 1524/1613 (94.5%) cycles. Clinical pregnancy rate: all cycles, 25.9%; embryo transfer cycles, 31.3%. OHSS: hospitalization for OHSS, 8 (0.36%) cycles, Grade 2, 60 (2.7%), and Grade 3, 1 (0.05%). In German routine clinical

  6. Prolonged sedation requiring mechanical ventilation and continuous flumazenil infusion after routine doses of clorazepam for alcohol withdrawal syndrome.

    Science.gov (United States)

    Guglielminotti, J; Maury, E; Alzieu, M; Delhotal Landes, B; Becquemont, L; Guidet, B; Offenstadt, G

    1999-12-01

    We report the cases of two patients who developed prolonged sedation after routine doses of clorazepam for alcohol withdrawal syndrome. They required prolonged mechanical ventilation (10 days for both patients) followed by continuous flumazenil infusion (16 days for one patient and 3 days for the other) to avoid reintubation. In the two patients, nordazepam accumulation (main active metabolite of clorazepam) was demonstrated as the cause of the coma. This accumulation could be attributed, in one case, to impaired hepatic cytochrome P 450 3A4 activity. Caution is required when prescribing benzodiazepines to alcoholic patients and the use of benzodiazepine which do not undergo hepatic oxidation by cytochrome P 450 such as oxazepam or lorazepam is suggested.

  7. Politics of schism: routinization and social control in the International Socialists/Socialist Workers' Party

    Energy Technology Data Exchange (ETDEWEB)

    Rayner, S.

    1985-01-01

    The received wisdom of social science holds that voluntary organizations founded on egalitarian principles, can only survive by undergoing transformation into hierarchical systems. The underlying logic of Weber, Michels and Toennies' descriptions is that social organizations sustain themselves over time by generating increasingly complex systems of rules that become sources of inequality. This article argues that routinization in voluntary groups does not consist of a gradual accumulation of rules that promote internal inequality. Instead, two analytically distinct steps are proposed: (1) construction of a distinctive organizational boundary, which is a necessary condition for (2) the ultimate imposition of a complex organizational hierarchy. The case used to illustrate this argument is drawn from the history of the British Trotskyist movement prior to 1978. The argument itself is framed within a formal model of the sociology of knowledge called grid/group analysis.

  8. Evaluation of two yellow fever vaccines for routine immunization programs in Argentina.

    Science.gov (United States)

    Ripoll, Carlos; Ponce, Amalia; Wilson, Mario M; Sharif, Norma; Vides, José B; Armoni, Judith; Teuwen, Dirk E

    2008-01-01

    Although highly effective vaccines have been available for almost 70 years, an estimated 200,000 cases of YF, including 30,000 deaths, still occur annually. This study evaluated the safety of two yellow fever (YF) vaccines [Stamaril and Vacina Contra Febre Amarela (VCFA)]. A total of 2,514 subjects were randomized equally to receive Stamaril or VCFA. Immediate reactions occurring within 30 minutes after vaccination, and solicited local and systemic reactions occurring within eight days, were monitored. Unsolicited local, systemic adverse events and serious adverse events (SAE) were recorded for 21 days after vaccination. Solicited local and systemic adverse reactions were reported by 15.3-17.6% and 30.4-31.6% of the Stamaril and VCFA groups, respectively. Only 56 of the 2,514 study subjects (2.2%) reported a severe solicited adverse reaction, 25 in the Stamaril group (1.99%) and 31 in the VFCA group (2.49%), (p=0.403). Ten subjects (0.8%) in each group reported at least one severe solicited local reaction (p = 0.988). A total of 18 Stamaril subjects (1.43%) and 21 VCFA subjects (1.68%) reported at least one severe solicited systemic reaction (p = 0.617) One SAE considered related to vaccination occurred, polymyalgia in the VCFA group. No immediate reactions to vaccination were seen. Vaccine-related unsolicited events were infrequent, 1.4% in the Stamaril group and 2.0% VCFA group, generally of mild or moderate intensity. We conclude that the safety profiles of Stamaril and VCFA support routine vaccination to prevent YF in residents of and travelers to endemic areas of South America and Africa.

  9. Factors related to pain during routine photodynamic therapy

    DEFF Research Database (Denmark)

    Miller, I M; Nielsen, J S; Lophaven, S

    2011-01-01

    -reducing interventions in routine use. We studied the frequency as well as level of pain-reducing intervention. METHODS: Descriptive data from PDT treated patients. The level of pain-reducing intervention was graded 0, no intervention; +, cold water spray and ++, pause or nerve block. RESULTS: Data from 983 PDT......, the more frequent the intervention. Lesion size did not, however, appear associated with the level of intervention. Intervention was most frequently required when treating the scalp/forehead and the extremities. The scalp/forehead also required the highest level of intervention. No significant association...

  10. Routine patch testing with the preservative system Kathon CG.

    Science.gov (United States)

    Groot, A C; Bruynzeel, D P; Schroeff, J G; Bos, J D

    1988-04-01

    Synopsis Of 1620 patients routinely patch tested with Kathon CG 100 p.p.m. aqua for suspected allergic contact dermatitis, 81 (5.0%) had a positive reaction. Sixty-two reactions (3.8%) were relevant for the dermatitis for which the patient consulted the dermatologist. Most patients were females who presented with dermatitis of the hands and/or face. Forty-six per cent of the patients had become sensitized by using cosmetic products on healthy skin. The other 54% had pre-existing dermatitis, especially atopic dermatitis and irritant dermatitis. Most reactions were caused by moisturizing creams.

  11. Molecular Diagnosis of Chrysanthemum stunt viroid for Routine Indexing

    Directory of Open Access Journals (Sweden)

    L. Tomassoli

    2004-08-01

    Full Text Available In 2002, a two-year study was started to check for Chrysanthemum stunt viroid (CSVd during the production and selective breeding of new chrysanthemum varieties in a central-Italy flower-growing farm. Two molecular techniques, one-tube RT-PCR and tissue printing for hybridization assays, were improved for their effectiveness in viroid detection at different stages of plant selection. Both molecular techniques proved sensitive, reliable and easy to apply in a programme of routine indexing for the production of new and healthy chrysanthemum varieties.

  12. Evaluation of Routine Atmospheric Sounding Measurements using Unmanned Systems (ERASMUS)

    Energy Technology Data Exchange (ETDEWEB)

    Bland, Geoffrey [NASA Goddard Space Flight Center (GSFC), Greenbelt, MD (United States)

    2016-06-30

    The use of small unmanned aircraft systems (sUAS) with miniature sensor systems for atmospheric research is an important capability to develop. The Evaluation of Routine Atmospheric Sounding Measurements using Unmanned Systems (ERASMUS) project, lead by Dr. Gijs de Boer of the Cooperative Institute for Research in Environmental Sciences (CIRES- a partnership of NOAA and CU-Boulder), is a significant milestone in realizing this new potential. This project has clearly demonstrated that the concept of sUAS utilization is valid, and miniature instrumentation can be used to further our understanding of the atmospheric boundary layer in the arctic.

  13. The birth and routinization of IVF in China

    DEFF Research Database (Denmark)

    Wahlberg, Ayo

    2016-01-01

    How can it be that China today is home to some of the world’s largest IVF clinics, carrying out as many as 30,000 cycles annually? In this article, I address how IVF was developed in China during the early 1980s only to be routinized during the exact same period that one of the world’s most...... comprehensive family planning programmes aimed at preventing birth was being rolled out. IVF was not merely imported into China, rather it was experimentally developed within China into a form suitable for its restrictive family planning regulations. As a result, IVF and other assisted reproductive technologies...

  14. Master schedule for CY-1980 Hanford Environmental Surveillance Routine Program

    Energy Technology Data Exchange (ETDEWEB)

    Blumer, P.J.; Houston, J.R.; Eddy, P.A.

    1979-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is presented. The enviromental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Data are reported on the following topics: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurement; portable instrument surveys; and surveillance of waste disposal sites;

  15. Routine patellar resurfacing using an inset patellar technique.

    LENUS (Irish Health Repository)

    Hurson, Conor

    2012-02-01

    The management of the patella in total knee arthroplasty still causes controversy. Whether or not to resurface the patella in primary total knee arthroplasty remains unclear. In this study we examined 220 consecutive total knee replacements, by a single surgeon, where the patella was routinely resurfaced using the inset technique. All patellae were suitable for resurfacing. Patellar thickness was not altered in 54.5% of patellae. In 97.2% the patella was within 2 mm of the original thickness. There were no significant complications. In this study we have found that the inset technique of patella resurfacing in total knee replacement is a simple and safe resurfacing procedure.

  16. [Benefits of routine psychological counselling for patients living with HIV].

    Science.gov (United States)

    Toma, S; Sartori, M; Moayedoddin, B; Weber, K; Toutous Trellu, L; Canuto, A; Calmy, A

    2013-02-13

    Despite improvement of life expectancy of human immunodeficiency virus (HIV) infected people since the implementation of antiretroviral treatment, psychological suffering prevails and needs to be considered as part of the treatment to guarantee its efficiency. Mental disorders and social stigmatization substantially affect patients' quality of life and their adherence to treatment. The article details the benefits of a routine screening for mental disorders within this population, who is often reluctant to consult psychiatric services. The different treatments provided by the Geneva University Hospital (HUG) are introduced. A clinical case report illustrates the relevance of a multidisciplinary care program and the role of the liaison psychiatry in this field.

  17. Routine environmental audit of Ames Laboratory, Ames, Iowa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-09-01

    This document contains the findings identified during the routine environmental audit of Ames Laboratory, Ames, Iowa, conducted September 12--23, 1994. The audit included a review of all Ames Laboratory operations and facilities supporting DOE-sponsored activities. The audit`s objective is to advise the Secretary of Energy, through the Assistant Secretary for Environment, Safety and Health, as to the adequacy of the environmental protection programs established at Ames Laboratory to ensure the protection of the environment, and compliance with Federal, state, and DOE requirements.

  18. Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience

    Directory of Open Access Journals (Sweden)

    Nwosu BO

    2015-01-01

    Full Text Available Betrand O Nwosu,1 George U Eleje,1 Amaka L Obi-Nwosu,2 Ita F Ahiarakwem,3 Comfort N Akujobi,4 Chukwudi C Egwuatu,4 Chukwudumebi O Onyiuke5 1Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria; 2Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria; 3Department of Medical Microbiology, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria; 4Department of Medical Microbiology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria; 5Department of Medical Microbiology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, NigeriaObjective: To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening.Methods: A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10.Results: Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34, and mean gestational age was 26.4 weeks (±6.36. Only 15 cases (0.70% were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05.Conclusion: While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or

  19. Subjective assessment of contact lens wear by army aircrew.

    Science.gov (United States)

    Lattimore, M R; Cornum, R L

    1993-07-01

    Because 23% of Army aviators are ametropic, contact lenses have drawn increased attention as a spectacle substitute to solve system compatibility problems. From November 1988 until October 1991, a series of contact lens research protocols were conducted to develop a comprehensive database on contact lens wear in varied environments. Questionnaires were used to assess suitability and acceptability of routine contact lens wear. Responses from 202 subjects were obtained from September 1989 through September 1991. The questions explored operational and safety of flight issues of contact lens wear. Subjects overwhelmingly approved of contact lens use in all settings: 95% expressed greater combat readiness and effectiveness with contact lenses, 98% felt contact lens use (and maintenance) in the cockpit had no adverse impact on safety of flight, and 98% endorsed the routine use of contact lenses. These data highlight Army aircrew acceptance of contact lens use.

  20. Routine screening for α-thalassaemia using an immunochromatographic strip assay for haemoglobin Bart's.

    Science.gov (United States)

    Prayalaw, Patcharawadee; Fucharoen, Goonnapa; Fucharoen, Supan

    2014-09-01

    To evaluate an immunochromatographic (IC) strip assay for Hb Bart's as a routine screening test for α-thalassaemia in area with a high prevalence of thalassaemia and haemoglobinopathies. A total of 300 adult screen positive blood specimens were collected at an ongoing thalassaemia screening programme in northeast Thailand. Routine screening was done using red blood cell indices, osmotic fragility, and dichlorophenolindophenol tests. The IC strip assay for haemoglobin Bart's was performed on all samples. The result was evaluated against thalassaemia genotypes determined using standard haemoglobin and DNA analyses. Of 300 subjects investigated, Hb and DNA analyses identified 32 with normal genotype. The remaining subjects carried thalassaemia with as many as 16 different genotypes. Hb Bart's was detected in all cases, with several α(0)-thalassaemia (SEA type) related disorders. Of cases with α(+)-thalassaemia, 86.1% showed a positive result; 100 out of 103 Hb E carriers, all homozygous Hb E and β-thalassaemia trait were negative. Nine out of 17 cases with β-thalassaemia/Hb E disease, and one case of double heterozygote for Hb Q-Thailand and Hb E returned positive results. The overall sensitivity and specificity of the IC strip assay for detecting α(0)-thalassaemia were 100% and 73.1%, respectively. The results showed a high sensitivity for screening for α(0)-thalassaemia using IC strip assay for Hb Bart's. This simple method, used in combination with conventional screening protocols, should lead to a significant reduction in the number of referral cases for DNA analysis. Cost effectiveness in each population should be taken into consideration. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Has the time come to use near-infrared spectroscopy as a routine clinical tool in preterm infants undergoing intensive care?

    DEFF Research Database (Denmark)

    Greisen, Gorm; Leung, Terence; Wolf, Martin

    2011-01-01

    Several instruments implementing spatially resolved near-infrared spectroscopy (NIRS) to monitor tissue oxygenation are now approved for clinical use. The neonatal brain is readily assessible by NIRS and neurodevelopmental impairment is common in children who were in need of intensive care during...... methods. Is it a window of opportunity for the establishment of a rational basis before another technology is added to an already overly complex newborn intensive care?...

  2. Family planning choices in couples using contraception without knowing they are infertile: should newly-wed men undergo a routine spermiogram?

    Science.gov (United States)

    Kiran, Hakan; Arikan, Deniz Cemgil; Coskun, Ayhan; Kaplanoglu, Mustafa; Kiran, Gurkan; Ozdemir, Ozgur; Cetin, M Turan

    2012-01-01

    Newly-weds choose to use contraception either to spend the first years of their marriage more freely, because of economic reasons or because of the increase in working career women. We studied the reasons for infertility and the rate of contraception use in the first years of marriage among couples with primary infertility and evaluated the use of a spermiogram as a screening test in newly-wed men. In this cross-sectional study, 302 couples with primary infertility who were treated at our infertility clinic were included in the study. The couples were divided into 2 groups: group 1 (infertile couples who have used contraception) consisted of 67 couples and group 2 (infertile couples who did not use contraception) consisted of 235 couples. Sixty-seven (22.5%) infertile couples stated that they had used no contraception in the first years of their marriage. In group 1, 35.8% of couples were diagnosed as having unexplained infertility, while 28.4% of them had male factor, 31.3% female factor and 4.5% a combination of male and female factor infertility. Sixteen men with male factor infertility used coitus interruptus (3-36 months) or condoms (6-12 months) unnecessarily. Infertility counseling in the early days of marriage and a spermiogram performed at that time could be beneficial for the newly-wed couples even if they do not want a child at the time. To perform a spermiogram as a screening test in all newly-wed men should be discussed. Copyright © 2011 S. Karger AG, Basel.

  3. Has the time come to use near-infrared spectroscopy as a routine clinical tool in preterm infants undergoing intensive care?

    DEFF Research Database (Denmark)

    Greisen, Gorm; Leung, Terence; Wolf, Martin

    2011-01-01

    Several instruments implementing spatially resolved near-infrared spectroscopy (NIRS) to monitor tissue oxygenation are now approved for clinical use. The neonatal brain is readily assessible by NIRS and neurodevelopmental impairment is common in children who were in need of intensive care during...... relevant endpoint, such as death or neurodevelopmental handicap. We estimate that such a trial should recruit about 4000 infants to have the power to detect a reduction in brain injury by one-fifth. This illustrates the formidable task of providing first-grade evidence for the clinical value of diagnostic...

  4. Elevated prothrombin time on routine preoperative laboratory results in a healthy infant undergoing craniosynostosis repair: Diagnosis and perioperative management of congenital factor VII deficiency

    Directory of Open Access Journals (Sweden)

    Kareen L. Jones

    2016-01-01

    Conclusion: A thorough history and physical examination with a high clinical suspicion are vital in preventing hemorrhage during surgeries in children with coagulopathies. Abnormal preoperative lab values should always be confirmed and addressed before proceeding with high-risk surgery. A multidisciplinary discussion is essential to optimize the risk-benefit ratio during the perioperative period.

  5. A randomized controlled trial of the effectiveness of an educational intervention on outcomes of parents and their children undergoing inpatient elective surgery: study protocol.

    Science.gov (United States)

    He, Hong-Gu; Zhu, Lixia; Chan, Wai-Chi Sally; Xiao, Chunxiang; Klainin-Yobas, Piyanee; Wang, Wenru; Cheng, Kin Fong Karis; Luo, Nan

    2015-03-01

    To report a study protocol that tests the effectiveness of an educational intervention on outcomes of parents and their children who undergo inpatient elective surgery. Inadequate children's postoperative pain management remains a global problem. Parents are required to be involved in their child's pain assessment and management, yet they often lack relevant knowledge and skills. Education is an effective strategy for enhancing a person's knowledge, attitudes and behaviour. However, few studies have examined its effectiveness in parents and their children undergoing inpatient elective surgery. Randomized controlled trial and embedded qualitative process evaluation. One hundred and sixty-two pairs of participants (each comprised of one parent and his/her child undergoing inpatient elective surgery) will be recruited (protocol approved in January 2013). Participants will be randomized to either a Control group (routine care), an Intervention group 1 (routine care and an educational intervention with face-to-face teaching), or an Intervention group 2 (routine care and an educational intervention without face-to-face teaching). Outcome measures will include parents' knowledge, attitude and behaviour related to postoperative pain management; their child's postoperative pain; and parents' satisfaction with their child's pain management at baseline and around 6, 12 and 24 hours after the operation. A standardized educational intervention protocol and detailed study procedure have been developed in this study to improve parents' knowledge, attitude and behaviour related to postoperative pain management and reduce their child's postoperative pain. © 2014 John Wiley & Sons Ltd.

  6. Subject Sensitive Invariantism: In Memoriam

    NARCIS (Netherlands)

    Blaauw, M.J.

    2008-01-01

    Subject sensitive invariantism is the view that whether a subject knows depends on what is at stake for that subject: the truth-value of a knowledge-attribution is sensitive to the subject's practical interests. I argue that subject sensitive invariantism cannot accept a very plausible principle for

  7. Elevated risk of an intermediate or high SYNTAX score in subjects with impaired fasting glucose.

    Science.gov (United States)

    Yang, Xishan; Liu, Hui; Yang, Fangfang; Dong, Pingshuan; Fa, Xianen; Zhang, Qingyong; Li, Li; Wang, Zhikuan; Zhao, Di

    2015-01-01

    This study was designed to determine the SYNTAX score under different fasting plasma glucose (FPG) states in Chinese patients undergoing coronary angiography, particularly subjects with impaired FPG. Four hundred and forty-six subjects undergoing coronary angiography were enrolled in this study and divided into four groups based on the FPG level or a history of type 2 diabetes mellitus (T2DM): normal FPG, impaired FPG, known and previously unknown T2DM. The angiographic SYNTAX scores were higher in the subjects with known (pimportance of achieving better glycemic control in order to prevent coronary atherosclerosis and improve the cardiovascular prognosis.

  8. Subjective well-being related to satisfaction with daily travel

    OpenAIRE

    Jakobsson Bergstad, C.; Gamble, A; Gärling, T.; Hagman, O.; Polk, M.; Ettema, D.F.; Friman, M.; Olsson, L.E.

    2011-01-01

    Previous research demonstrates an impact on subjective well-being (SWB) of affect associated with routine performance of out-of-home activities. A primary aim of the present study is to investigate whether satisfaction with daily travel has a positive impact on SWB, either directly or indirectly through facilitating the performance of out-of-home activities. A secondary aim is to determine whether emotional-symbolic or instrumental reasons for car use results in higher satisfaction with daily...

  9. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Makino, Masahiro [Kyoto Prefectural Univ. of Medicine (Japan). Research Inst. for Neurological Diseases and Geriatrics

    2001-12-01

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9{+-}9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with {>=}50% luminal narrowing was detected in 29.2% of the subjects, and that with {>=}75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing {>=}50% luminal narrowing was detected in 38.2% of subjects, and that showing {>=}75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid

  10. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Pastromas, Georgios, E-mail: geopastromas@gmail.com; Spiliopoulos, Stavros, E-mail: stavspiliop@upatras.gr; Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com; Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr; Siablis, Dimitrios, E-mail: siablis@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece)

    2013-12-15

    Purpose: To investigate the incidence and clinical significance of platelet responsiveness in patients receiving clopidogrel after peripheral angioplasty procedures. Materials and Methods: This prospective study included patients receiving antiplatelet therapy with clopidogrel 75 mg after infrainguinal angioplasty or stenting and who presented to our department during routine follow-up. Clopidogrel responsiveness was tested using the VerifyNow P2Y12 Assay. Patients with residual platelet reactivity units (PRU) {>=} 235 were considered as nonresponders (NR group NR), whereas patients with PRU < 235 were considered as normal (responders [group R]). Primary end points were incidence of resistance to clopidogrel and target limb reintervention (TLR)-free survival, whereas secondary end points included limb salvage rates and the identification of any independent predictors influencing clinical outcomes. Results: In total, 113 consecutive patients (mean age 69 {+-} 8 years) with 139 limbs were enrolled. After clopidogrel responsiveness analysis, 61 patients (53.9 %) with 73 limbs (52.5 %) were assigned to group R and 52 patients (46.1 %) with 66 limbs (47.5 %) to group NR. Mean follow-up interval was 27.7 {+-} 22.9 months (range 3-95). Diabetes mellitus, critical limb ischemia, and renal disease were associated with clopidogrel resistance (Fisher's exact test; p < 0.05). According to Kaplan-Meier analysis, TLR-free survival was significantly superior in group R compared with group NR (20.7 vs. 1.9 %, respectively, at 7-year follow-up; p = 0.001), whereas resistance to clopidogrel was identified as the only independent predictor of decreased TLR-free survival (hazard rate 0.536, 95 % confidence interval 0.31-0.90; p = 0.01). Cumulative TLR rate was significantly increased in group NR compared with group R (71.2 % [52 of 73] vs. 31.8 % [21 of 66], respectively; p < 0.001). Limb salvage was similar in both groups. Conclusion: Clopidogrel resistance was related with

  11. Preoperative Electrocardiogram Score for Predicting New-Onset Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

    Science.gov (United States)

    Gu, Jiwei; Andreasen, Jan J; Melgaard, Jacob; Lundbye-Christensen, Søren; Hansen, John; Schmidt, Erik B; Thorsteinsson, Kristinn; Graff, Claus

    2017-02-01

    To investigate if electrocardiogram (ECG) markers from routine preoperative ECGs can be used in combination with clinical data to predict new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Retrospective observational case-control study. Single-center university hospital. One hundred consecutive adult patients (50 POAF, 50 without POAF) who underwent coronary artery bypass grafting, valve surgery, or combinations. Retrospective review of medical records and registration of POAF. Clinical data and demographics were retrieved from the Western Denmark Heart Registry and patient records. Paper tracings of preoperative ECGs were collected from patient records, and ECG measurements were read by two independent readers blinded to outcome. A subset of four clinical variables (age, gender, body mass index, and type of surgery) were selected to form a multivariate clinical prediction model for POAF and five ECG variables (QRS duration, PR interval, P-wave duration, left atrial enlargement, and left ventricular hypertrophy) were used in a multivariate ECG model. Adding ECG variables to the clinical prediction model significantly improved the area under the receiver operating characteristic curve from 0.54 to 0.67 (with cross-validation). The best predictive model for POAF was a combined clinical and ECG model with the following four variables: age, PR-interval, QRS duration, and left atrial enlargement. ECG markers obtained from a routine preoperative ECG may be helpful in predicting new-onset POAF in patients undergoing cardiac surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Rate of occult specimen provenance complications in routine clinical practice.

    Science.gov (United States)

    Pfeifer, John D; Liu, Jingxia

    2013-01-01

    Occult specimen provenance complications (SPCs), which occur when there is an absence of any direct or indirect indication that a specimen switch or contamination may have occurred, constitute a significant patient safety and medical-legal problem because they can lead to misdiagnosis. However, the rate at which occult SPCs occur is unknown because, by definition, this category of errors is not identified by standard laboratory practices. In this study, we evaluated a data set comprising almost 13,000 prostate biopsies that were prospectively tested for specimen provenance errors as part of routine clinical practice. The frequency of occult type 1 errors (a complete transposition between patients) and type 2 errors (contamination of the patient's tissue with 1 or more unrelated patients) was 0.26% and 0.67%, respectively; every urology practice setting and surgical pathology laboratory type with a representative sample size experienced at least 1 type 1 and 1 type 2 error during the study period. Overall, the mean frequency of SPCs across practice settings was 0.22% for type 1 errors and 1.69% for type 2 errors. The type 1 rate showed no correlation with a surgical pathology laboratory setting or urologic practice group setting; the type 2 rate correlated solely with a surgical pathology laboratory setting. The occult SPC rate in this limited data set provides an estimate of the scope of the problem of potential misdiagnosis as a result of occult specimen provenance errors in routine clinical practice.

  13. Routines and Concerns in Conduct of Everyday Life

    DEFF Research Database (Denmark)

    Hybholt, Lisbeth

    2015-01-01

    In this paper, I explore the concept conduct of everyday life, namely routines and real life, as they are confronted with empirical observations. The observations are from a study of changes in the conduct of everyday life for individuals who attended a patient education course. The course was a ...... analysis to perceive all conduct of everyday life as having profound personal meaning and to analyse the individuals' concerns in relation to their social selfunderstanding and localisation at a certain time.......In this paper, I explore the concept conduct of everyday life, namely routines and real life, as they are confronted with empirical observations. The observations are from a study of changes in the conduct of everyday life for individuals who attended a patient education course. The course...... was a part of their treatment after a hospitalisation with depression in a psychiatric ward. I use analysis of the main individual, Steven’s, conduct of everyday life and illustrate my points with models of conduct of everyday life made using beads. The conceptualisation of conduct of everyday life...

  14. The utility of routine histological examination of gunshot wounds.

    Science.gov (United States)

    Perez, Danielo B; Molina, D Kimberley

    2012-09-01

    Determining the range of fire is a crucial part of a forensic examination of gunshot wound victims. Traditionally, this has been accomplished by noting the gross appearance of soot or powder around the wound. This study was undertaken to determine the utility of routine histological examination of gunshot wounds as related to range-of-fire determination. A prospective study was performed, and a total of 69 gunshot wounds were examined both macroscopically and microscopically. Of the 45 entrance wounds examined, there was 100% concordance between macroscopic and microscopic analysis for the close-range wounds and 67% concordance for the distant wounds, with 33% of these wounds showing no evidence of soot or powder grossly but where residue was seen microscopically. In addition, 21% of the exit wounds examined showed microscopic evidence of soot/powder residues when none were visible macroscopically. As described in previous studies, it can be assumed that the bullet itself can deposit small residues along the wound track (bullet wipe) that can be seen microscopically and is unrelated to the range of fire. Therefore, the authors conclude there is no utility in the routine histological examination of gunshot wounds for the determination of range of fire.

  15. Is routine human papillomavirus vaccination an option for ghana?

    Science.gov (United States)

    Edwin, A K

    2010-06-01

    Cervical cancer remains an important public health problem in developing countries where over 80% of the global burden occurs annually but screening has been ineffective. In a polygamous country like Ghana with a high incidence of cervical cancer but no national screening program, the Human Papilloma Virus (HPV) vaccine presents a unique opportunity to reduce the burden of HPV infection and cervical cancer in Ghanaian women. The evidence so far indicates that the vaccines are safe and efficacious. Although routine HPV vaccination of girls raises several religious, political, socioeconomic and ethical challenges, the emphasis of this paper will be on addressing the ethical challenges using the principles of autonomy, beneficence, non-maleficence and justice as a framework. Parental autonomy can be preserved with judicious exemptions for those who decline the vaccine on religious and philosophical grounds. This promotes public health without trampling parental authority. Routine HPV vaccination confers several benefits to individuals and society by preventing HPV infection. Instead of causing harm; it reduces harm by preventing the development of about 70% of cervical cancers and removing the negative physical and psychological impact of a cervical cancer diagnosis. It also has the potential to reduce the disparities in cervical cancer rates and its cost effectiveness will ensure considerable cost savings in terms of the money spent on diagnosis and treatment. Consequently, the HPV vaccine is an important public health landmark and achievement in women's health that must be heralded, especially in developing countries where the bulk of the disease and death occur.

  16. Operationalizing a frailty index using routine blood and urine tests

    Science.gov (United States)

    Ritt, Martin; Jäger, Jakob; Ritt, Julia Isabel; Sieber, Cornel Christian; Gaßmann, Karl-Günter

    2017-01-01

    Background Uncomplicated frailty instruments are desirable for use in a busy clinical setting. The aim of this study was to operationalize a frailty index (FI) from routine blood and urine tests, and to evaluate the properties of this FI compared to other frailty instruments. Materials and methods We conducted a secondary analysis of a prospective cohort study on 306 patients aged ≥65 years hospitalized on geriatric wards. An FI comprising 22 routine blood parameters and one standard urine parameter (FI-Lab), a 50-item FI based on a comprehensive geriatric assessment (FI-CGA), a combined FI (FI-combined [items from the FI-Lab + others from the FI-CGA]), the Clinical Frailty Scale, rule-based frailty definition, and frailty phenotype were operationalized from data obtained during patients’ hospital stays (ie, before discharge [baseline examination]). Follow-up data were obtained up to 1 year after the baseline examination. Results The mean FI-Lab score was 0.34±15, with an upper limit of 0.74. The FI-Lab was correlated with all the other frailty instruments (all Pfrailty measure or in combination with/in addition to other frailty instruments. PMID:28721031

  17. Hyperventilation during routine electroencephalography: are three minutes really necessary?

    Science.gov (United States)

    Watemberg, Nathan; Farkash, Michael; Har-Gil, Miki; Sezer, Taner; Goldberg-Stern, Hadassah; Alehan, Füsun

    2015-04-01

    Hyperventilation induces absence seizures in children with absence epilepsy, and routine electroencephalography studies include three minutes of hyperventilation. We studied the duration of hyperventilation required to provoke a first absence seizure to determine whether three minutes of the procedure are indeed necessary. Electroencephalography records of children who experienced absence seizures during hyperventilation were reviewed. The time from hyperventilation onset to a first and further seizure(s) was measured, and the occurrence of absences during the posthyperventilation phase was also noted. Sixty-two studies were evaluated. Mean time from hyperventilation onset to a first absence was 52 seconds (median 32 seconds). The vast majority (85.5%) had an absence within 90 seconds. Most (68%) children sustained a single event. All eight children with posthyperventilation seizures had experienced at least one event during hyperventilation. Our findings suggest that current guidelines for routine pediatric electroencephalography recording requiring three minutes of hyperventilation may not be clinically necessary. We found that the vast majority of children referred for suspected absence seizures experience a seizure less than 90 seconds after hyperventilation onset, and even more so by 120 seconds. Hence, a larger prospective study is warranted to establish more accurate hyperventilation duration parameters. We also suggest that once an absence seizure has been recorded at any time during hyperventilation, this procedure could be stopped, thus reducing the amount of discomfort for the child. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The prevalence of adrenal incidentaloma in routine clinical practice.

    LENUS (Irish Health Repository)

    Davenport, Colin

    2012-02-01

    The prevalence of adrenal incidentaloma (AI) on computed tomography (CT) in the general population has been reported to be as high as 4.2%. However, many of the previous studies in this field utilised a prospective approach with analysis of CT scans performed by one or more radiologists with a specialist interest in adrenal tumours and a specific focus on identifying the presence of an adrenal mass. A typical radiology department, with a focus on the patient\\'s presenting complaint as opposed to the adrenal gland, may not be expected to diagnose as many adrenal incidentalomas as would be identified in a dedicated research protocol. We hypothesised that the number of AI reported in routine clinical practice is significantly lower than the published figures would suggest. We retrospectively reviewed the reports of all CT thorax and abdomen scans performed in our hospital over a 2 year period. 3,099 patients underwent imaging, with 3,705 scans performed. The median age was 63 years (range 18-98). Thirty-seven true AI were diagnosed during the time period studied. Twenty-two were diagnosed by CT abdomen (22\\/2,227) and 12 by CT thorax (12\\/1,478), a prevalence of 0.98 and 0.81% with CT abdomen and thorax, respectively, for AI in routine clinical practice.

  19. The prevalence of adrenal incidentaloma in routine clinical practice.

    LENUS (Irish Health Repository)

    Davenport, Colin

    2011-03-10

    The prevalence of adrenal incidentaloma (AI) on computed tomography (CT) in the general population has been reported to be as high as 4.2%. However, many of the previous studies in this field utilised a prospective approach with analysis of CT scans performed by one or more radiologists with a specialist interest in adrenal tumours and a specific focus on identifying the presence of an adrenal mass. A typical radiology department, with a focus on the patient\\'s presenting complaint as opposed to the adrenal gland, may not be expected to diagnose as many adrenal incidentalomas as would be identified in a dedicated research protocol. We hypothesised that the number of AI reported in routine clinical practice is significantly lower than the published figures would suggest. We retrospectively reviewed the reports of all CT thorax and abdomen scans performed in our hospital over a 2 year period. 3,099 patients underwent imaging, with 3,705 scans performed. The median age was 63 years (range 18-98). Thirty-seven true AI were diagnosed during the time period studied. Twenty-two were diagnosed by CT abdomen (22\\/2,227) and 12 by CT thorax (12\\/1,478), a prevalence of 0.98 and 0.81% with CT abdomen and thorax, respectively, for AI in routine clinical practice.

  20. Obesity paradox in patients undergoing coronary intervention: A review

    OpenAIRE

    Patel, Nirav; Elsaid, Ossama; Shenoy, Abhishek; Sharma, Abhishek; McFarlane, Samy I.

    2017-01-01

    There is strong relationship exist between obesity and cardiovascular disease including coronary artery disease (CAD). However, better outcomes noted in obese patients undergoing percutaneous cardiovascular interventions for CAD, a phenomenon known as the obesity paradox. In this review, we performed extensive search for obesity paradox in obese patients undergoing percutaneous coronary intervention and discussed possible mechanism and disparities in different race and sex.

  1. Factors that affect the likelihood of undergoing cosmetic surgery.

    Science.gov (United States)

    Brown, Amy; Furnham, Adrian; Glanville, Louise; Swami, Viren

    2007-01-01

    With the rise in popularity of plastic surgery, it is useful to consider those factors that may increase the likelihood of undergoing cosmetic surgery in a nonpatient population. A study was conducted to determine those factors that might motivate a nonclinical, nonpatient population to undergo cosmetic surgery. A sample of 119 women and 89 men, ages 18 to 59, was recruited from public spaces and asked to complete a questionnaire measuring how likely they were to consider undergoing the most common cosmetic procedures. Women reported greater likelihood of undergoing cosmetic surgery than men, older men expressed less desire to undergo cosmetic surgery than younger men, and lower self-ratings of physical attractiveness predicted higher likelihood of undergoing cosmetic surgery. The vicarious experience of cosmetic surgery (via family and friends) increased the likelihood of undergoing cosmetic surgery for women, but not for men. Media exposure did not influence likelihood for either sex. Factors that affect the likelihood of undergoing cosmetic surgery vary with procedure; thus it would be valuable for future studies to use a scale that measures responses separately for different procedures. Lower self-ratings of physical attractiveness lead to consideration of cosmetic surgery; future studies may explore satisfaction levels of those who have undergone surgery.

  2. Safety of an Enhanced Recovery Pathway for Patients Undergoing Open Hepatic Resection.

    Directory of Open Access Journals (Sweden)

    Clancy J Clark

    Full Text Available Enhanced recovery pathways (ERP have not been widely implemented for hepatic surgery. The aim of this study was to evaluate the safety of an ERP for patients undergoing open hepatic resection.A single-surgeon, retrospective observational cohort study was performed comparing the clinical outcomes of patients undergoing open hepatic resection treated before and after implementation of an ERP. Morbidity, mortality, and length of hospital stay (LOS were compared between pre-ERP and ERP groups.126 patients (pre-ERP n = 73, ERP n = 53 were identified for the study. Patient characteristics and operative details were similar between groups. Overall complication rate was similar between pre-ERP and ERP groups (37% vs. 28%, p = 0.343. Before and after pathway implementation, the median LOS was similar, 5 (IQR 4-7 vs. 5 (IQR 4-6 days, p = 0.708. After adjusting for age, type of liver resection, and ASA, the ERP group had no increased risk of major complication (OR 0.38, 95% CI 0.14-1.02, p = 0.055 or LOS greater than 5 days (OR 1.21, 95% CI 0.56-2.62, p = 0.627.Routine use of a multimodal ERP is safe and is not associated with increased postoperative morbidity after open hepatic resection.

  3. A quality improvement project to reduce hypothermia in infants undergoing MRI scanning.

    Science.gov (United States)

    Dalal, Priti G; Porath, Janelle; Parekh, Uma; Dhar, Padmani; Wang, Ming; Hulse, Michael; Mujsce, Dennis; McQuillan, Patrick M

    2016-07-01

    Hypothermia prevention strategies during MRI scanning under general anesthesia in infants may pose a challenge due to the MRI scanner's technical constraints. Previous studies have demonstrated conflicting results related to increase or decrease in post-scan temperatures in children. We noted occurrences of post-scan hypothermia in anesthetized infants despite the use of routine passive warming techniques. The aims of our quality improvement project were (a) to identify variables associated with post-scan hypothermia in infants and (b) to develop and implement processes to reduce occurrence of hypothermia in neonatal intensive care unit (NICU) infants undergoing MRI. One hundred sixty-four infants undergoing MRI scanning were prospectively audited for post-scan body temperatures. A multidisciplinary team identified potential variables associated with post-scan hypothermia and designed preventative strategies: protocol development, risk factor identification, vigilance and use of a vacuum immobilizer. Another audit was performed, specifically focusing on NICU infants. In the initial phase, we found that younger age (P = 0.002), lower weight (P = 0.005), lower pre-scan temperature (P sedation/general anesthesia. Implementation of strategies to prevent hypothermia in infants may be challenging in the high-risk MRI environment. We were able to minimize this problem in clinical practice by applying quality improvement principles.

  4. Assessment of nutritional parameter outcome in laryngeal cancer patients undergoing laryngectomy

    Directory of Open Access Journals (Sweden)

    Mohamad Taghi Khorsandi Ashtiani

    2010-10-01

    Full Text Available Introduction: Laryngectomy in patients with laryngeal cancer can lead to the reduction of nutritional parameters. Supportive treatments and supplementary nutritional supports are recommended in all patients undergoing laryngectomy, even with acceptable preoperative nutritional indices.The aim of this study was to evaluate postoperative changes in nutritional parameters in patients with laryngeal cancer undergoing laryngectomy. Materials and Methods: In a prospective study from 2005 to 2007, 30 candidate patients for total laryngectomy in Amir Alam Hospital in Tehran were included for final diagnosis of squamous cell carcinoma (stage T4. Nutritional parameters including body mass index (BMI, serum levels of albumin, hemoglobin, total protein concentration, total lymphocyte number and percentage were assessed one week before and one month after laryngectomy. All patients used their routine dietary regimens and those who received nutritional supplementation after surgery were excluded from the study. Results: Except for white blood cell count, a significant reduction was found in BMI, lymphocyte count, serum hemoglobin, total protein and albumin levels after surgery (P

  5. Routine oro/nasopharyngeal suction versus no suction at birth.

    Science.gov (United States)

    Foster, Jann P; Dawson, Jennifer A; Davis, Peter G; Dahlen, Hannah G

    2017-04-18

    Oro/nasopharyngeal suction is a method used to clear secretions from the oropharynx and nasopharynx through the application of negative pressure via a suction catheter or bulb syringe. Traditionally, airway oro/nasopharyngeal suction at birth has been used routinely to remove fluid rapidly from the oropharynx and nasopharynx in vigorous and non-vigorous infants at birth. Concerns relating to the reported adverse effects of oro/nasopharyngeal suctioning led to a practice review and routine oro/nasopharyngeal suctioning is no longer recommended for vigorous infants. However, it is important to know whether there is any clear benefit or harm for infants whose oro/nasopharyngeal airway is suctioned compared to infants who are not suctioned. To evaluate the effect of routine oropharyngeal/nasopharyngeal suction compared to no suction on mortality and morbidity in newly born infants. We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 3), MEDLINE via PubMed (1966 to April 18, 2016), Embase (1980 to April 18, 2016), and CINAHL (1982 to April 18, 2016). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised, quasi-randomised controlled trials and cluster randomised trials that evaluated the effect of routine oropharyngeal/nasopharyngeal suction compared to no suction on mortality and morbidity in newly born infants with and without meconium-stained amniotic fluid. The review authors extracted from the reports of the clinical trials, data regarding clinical outcomes including mortality, need for resuscitation, admission to neonatal intensive care, five minute Apgar score, episodes of apnoea and length of hospital stay. Eight randomised controlled trials met the inclusion criteria and only included term infants (n = 4011). Five studies

  6. Seriously clowning: Medical clowning interaction with children undergoing invasive examinations in hospitals.

    Science.gov (United States)

    Tener, Dafna; Ofir, Shoshi; Lev-Wiesel, Rachel; Franco, Nessia L; On, Avi

    2016-04-01

    This qualitative study examined the subjective experience of children undergoing an invasive examination in the hospital when accompanied by a medical clown. In-depth semi-structured interviews were conducted with nine such children and nine of their accompanying parents. The children were patients in two outpatient departments (Pediatric Gastroenterology and a Center for the Sexually Abused) in a hospital in Israel. Interviews were coded thematically using an Atlas.ti software program. Analysis of the interviews indicated that the intervention of the clown positively changed the children's perceptions of the hospital, of experiencing the examination, and of their life narrative. Medical clowns thus appear to be a central, meaningful, and therapeutic source for children undergoing invasive examinations in hospital, as well as for their parents. Therefore, it may be advisable to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include the clowns in all stages of the hospital visit.

  7. [The evaluation of the level of hope of elderly chronic kidney disease patients undergoing hemodialysis].

    Science.gov (United States)

    Orlandi, Fabiana de Souza; Pepino, Barbara Garbelotti; Pavarini, Sofia Cristina Iost; Dos Santos, Damiana Aparecida; de Mendiondo, Marisa Silvana Zazzetta

    2012-08-01

    The objective of the present study was to evaluate the level of hope of elderly chronic kidney disease patients undergoing hemodialysis, using the Herth Hope Scale (HHS). This cross-sectional descriptive study was performed at a Renal Replacement Therapy Unit located in upstate São Paulo. The sample consisted of 50 elderly patients currently undergoing hemodialysis treatment. After obtaining the participants' consent to participate, individual interviews were performed with the elderly individuals, utilizing a characterization instrument and the Herth Hope Scale. All of the ethical premises were complied with (protocol 512/2009). Regarding the results, most participants were male (60%) and their mean age was 70.20 (±6.1) years. The mean score on the Herth Hope Scale was 36.20 (±2.90). In conclusion, compared with the Brazilian study regarding the validation of the Herth Hope Scale, the subjects' level of hope was lower, thus indicating a need to intervene regarding this feeling.

  8. The relationship of household routines to morbidity outcomes in childhood asthma.

    Science.gov (United States)

    Peterson-Sweeney, Kathleen

    2009-01-01

    The major purpose of this study was to explore the effect of routines on asthma management and morbidity outcomes for children with asthma and their parents. This study is a secondary data analysis in a sample of 150 children, which was originally used for an intervention study. Parents who had fewer routines in their homes had lower quality-of-life scores and higher burden of asthma scores when compared to parents in households with more routines. More routines were associated with improved asthma morbidity outcomes as measured by nurse rankings of routines. Assisting families to establish routines may result in improved asthma morbidity outcomes.

  9. Safety of a quadrivalent meningococcal serogroups A, C, W and Y conjugate vaccine (MenACWY-CRM) administered with routine infant vaccinations: results of an open-label, randomized, phase 3b controlled study in healthy infants.

    Science.gov (United States)

    Abdelnour, Arturo; Silas, Peter E; Lamas, Marta Raquel Valdés; Aragón, Carlos Fernándo Grazioso; Chiu, Nan-Chang; Chiu, Cheng-Hsun; Acuña, Teobaldo Herrera; Castrejón, Tirza De León; Izu, Allen; Odrljin, Tatjana; Smolenov, Igor; Hohenboken, Matthew; Dull, Peter M

    2014-02-12

    The highest risk for invasive meningococcal disease (IMD) is in infants aged CRM, a quadrivalent meningococcal conjugate vaccine, concomitantly administered with routine vaccinations to healthy infants. Two-month-old infants were randomized 3:1 to receive MenACWY-CRM with routine vaccines or routine vaccines alone at ages 2, 4, 6 and 12 months. Adverse events (AEs) that were medically attended and serious adverse events (SAEs) were collected from all subjects from enrollment through 18 months of age. In a subset, detailed safety data (local and systemic solicited reactions and all AEs) were collected for 7 days post vaccination. The primary objective was a non-inferiority comparison of the percentages of subjects with ≥1 severe systemic reaction during Days 1-7 after any vaccination of MenACWY-CRM plus routine vaccinations versus routine vaccinations alone (criterion: upper limit of 95% confidence interval [CI] of group difference CRM plus routine vaccines and 13% after routine vaccines alone (group difference 3.0% (95% CI -0.8, 6.4%). Although the non-inferiority criterion was not met, post hoc analysis controlling for significant center and group-by-center differences revealed that MenACWY-CRM plus routine vaccinations was non-inferior to routine vaccinations alone (group difference -0.1% [95% CI -4.9%, 4.7%]). Rates of solicited AEs, medically attended AEs, and SAEs were similar across groups. In a large multinational safety study, a 4-dose series of MenACWY-CRM concomitantly administered with routine vaccines was clinically acceptable with a similar safety profile to routine vaccines given alone. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Role of dissection of secondary branches of splenic pedicle in portal hypertension cases undergoing splenectomy.

    Science.gov (United States)

    Liu, Ying-bin; Kong, Ying; Wang, Xu-an; Wang, Jian-wei; Li, Jiang-tao; Wang, Yong; Chen, Yan; Chen, De-qing; Weng, Wei-hong; Zhang, Zhi-ping; Wu, Xiang-song; Fei, Xiao-zhou; Quan, Zhi-wei; Li, Song-gang; Li, Ji-yu; Cao, Li-ping; Peng, Shu-you

    2008-11-20

    It is well known that conventional splenectomy, which requires careful handling and ligation of tissue of the splenic hilum, can easily cause complications such as splenic fever and pancreatic fistula. Here, we use the technique of dissection of the secondary branches of the splenic pedicle to handle the hilum in the portal hypertension patients who are subjected to splenectomy. We retrospectively compared and analyzed the complications, postoperative hospital stay, operative time, and occurrence of hemorrhage in 121 patients with portal hypertension undergoing splenectomy and devascularization of the gastric cardia from January 1999 to December 2007. The selected cases consisted of 51 patients undergoing conventional splenectomy and 70 patients undergoing dissection of secondary branches of the splenic pedicle. In addition, we analyzed the relationship between size of the spleen and occurrence of complications. The incidence of pancreatic fistula and splenic fever (0/70 and 9/70) was lower in patients undergoing dissection of secondary branches of the splenic pedicle as compared with that of the conventional group (5/51 and 18/51 respectively). In addition, there was no significant difference in operative time and volume of blood loss between two groups. The spleen thickness of those patients who had pancreatic fistula and splenic fever was significantly greater than those without complications. These results indicate that dissection of secondary branches of the splenic pedicle in portal hypertension patients undergoing splenectomy can decrease the incidence of splenic fever and pancreatic fistula, and shorten the postoperative hospital stay, especially in the patients with a large spleen. So dissection of secondary branches of the splenic pedicle is a valuable technique for splenectomy.

  11. INTESTINAL MALROTATION IN PATIENTS UNDERGOING BARIATRIC SURGERY.

    Science.gov (United States)

    Vidal, Eduardo Arevalo; Rendon, Francisco Abarca; Zambrano, Trino Andrade; García, Yudoco Andrade; Viteri, Mario Ferrin; Campos, Josemberg Marins; Ramos, Manoela Galvão; Ramos, Almino Cardoso

    Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients. Five cases (0,025%) of intestinal malrotation were found. All of them were males, aging 45, 49, 37,52 and 39 years; BMI 35, 42, 49, 47 and 52 kg/m2, all of them with a past medical history of morbid obesity. The patient with BMI 35 kg/m2 suffered from type 2 diabetes also. All procedures were completed by laparoscopic approach, with no conversions. In one patient was not possible to move the jejunum to the upper abdomen in order to establish the gastrojejunostomy and a sleeve gastrectomy was performed. In another patient was not possible to fully recognize the anatomy due to bowel adhesions and a single anastomosis gastric bypass was preferred. No leaks or bleeding were identified. There were no perioperative complications. All patients were discharged 72 h after the procedure and no immediate 30-day complications were reported. Patients with malrotation can successfully undergo laparoscopic bariatric surgery. May be necessary changes in the surgical original strategy regarding the malrotation. Surgeons must check full abdominal anatomical condition prior to start the division of the stomach. Má-rotação intestinal é rara anomalia congênita em adultos de difícil reconhecimento devido à falta de sintomas. O diagnóstico é feito geralmente incidentalmente durante procedimentos cirúrgicos ou durante autópsia. Verificar a ocorrência e reconhecimento não eventual

  12. Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review.

    Science.gov (United States)

    Pacis, Michelle M; Fortin, Chelsea N; Zarek, Shvetha M; Mumford, Sunni L; Segars, James H

    2015-03-01

    To review the current literature regarding the role of vitamin D status in pregnancy outcomes in women undergoing assisted reproductive technology (ART) and to assess cost-effectiveness of routine vitamin D deficiency screening and repletion prior to initiation of ART. A systematic literature review was conducted using PubMed. Relevant study outcomes were compared among the selected studies. A cost-benefit analysis was performed using a decision tree mathematical model with sensitivity analyses from the perspective of direct societal cost. Published data were used to estimate probabilities and costs in 2014 US dollars. Thirty-four articles were retrieved, of which eight met inclusion criteria. One study demonstrated a negative relationship between vitamin D status and ART outcomes, while two studies showed no association. The remaining five studies concluded that ART outcomes improved after vitamin D repletion. The majority of reviewed studies reported a decrement in ART outcomes in patients with vitamin D deficiency. Cost-benefit analyses suggested that screening and supplementing vitamin D prior to ART might be cost effective, but further evidence is needed. Given the absence of Level I evidence regarding vitamin D status and ART outcomes, full endorsement of routine vitamin D screening and supplementation prior to ART is premature.

  13. Incidental findings during routine pathological evaluation of gallbladder specimens: review of 1,747 elective laparoscopic cholecystectomy cases

    Science.gov (United States)

    Basak, F; Hasbahceci, M; Canbak, T; Sisik, A; Acar, A; Yucel, M; Bas, G; Alimoglu, O

    2016-01-01

    Introduction Cholecystectomy for benign gallbladder diseases can lead to previously undiagnosed gallbladder cancer during histopathological evaluation. Despite some controversy over its usefulness, histopathological evaluation of all gallbladder specimens is common in most hospitals. We evaluated the results of routine pathology of the gallbladder after cholecystectomy for benign gallbladder diseases with regard to unexpected primary gallbladder cancer (UPGC). Methods Patients undergoing cholecystectomy because of benign gallbladder diseases between 2009 and 2013 were enrolled in this study. All gallbladder specimens were sent to the pathology department, and histopathological reports were examined in detail. The impact of demographic features on pathological diagnoses and prevalence of UPGC assessed. Data on additional interventions and postoperative survival for patients with UPGC were collected. Results We enrolled 1,747 patients (mean age, 48.7±13.6 years). Chronic cholecystitis was the most common diagnosis (96.3%) and was associated significantly with being female (p=0.001). Four patients had UPGC (0.23%); one was stage T3 at the time of surgery, and the remaining three cases were stage T2. Conclusions Routine histopathological examination of the gallbladder is valuable for identification of cancer that requires further postoperative management. PMID:26924485

  14. The Impact of an Interactive Computer Game on the Quality of Life of Children Undergoing Chemotherapy

    Science.gov (United States)

    Fazelniya, Zahra; Najafi, Mostafa; Moafi, Alireza; Talakoub, Sedigheh

    2017-01-01

    Background: Quality of life (QOL) of children with cancer reduces right from the diagnosis of disease and the start of treatment. Computer games in medicine are utilized to interact with patients and to improve their health-related behaviors. This study aimed to investigate the effect of an interactive computer game on the QOL of children undergoing chemotherapy. Materials and Methods: In this clinical trial, 64 children with cancer aged between 8 and12 years were selected through convenience sampling and randomly assigned to experimental or control group. The experimental group played a computer game for 3 hours a week for 4 consecutive weeks and the control group only received routine care. The data collection tool was the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module Child self-report designed for children aged between 8 to 12 years. Data were analyzed using descriptive and inferential statistics in SPSS software. Results: Before intervention, there was no significant difference between the two groups in terms of mean total QOL score (p = 0.87). However, immediately after the intervention (p = 0.02) and 1 month after the intervention (p < 0.001), the overall mean QOL score was significantly higher in the intervention group than the control group. Conclusions: Based on the findings, computer games seem to be effective as a tool in influencing health-related behavior and improving the QOL of children undergoing chemotherapy. Therefore, according to the findings of this study, computer games can be used to improve the QOL of children undergoing chemotherapy. PMID:29184580

  15. Family-Related Opinions and Stressful Situations Associated with Psychological Distress in Women Undergoing Infertility Treatment

    Directory of Open Access Journals (Sweden)

    Jiro Takaki

    2014-09-01

    Full Text Available The purpose of this study is to investigate how family-related opinions and stressful situations are related to psychological distress in women undergoing infertility treatment. The subjects in this cross-sectional study were recruited from female patients undergoing infertility treatment (n = 2540 at 70 infertility treatment institutions in Japan. Because of non-participation or missing data, the number of subjects included in the analysis was 635 (response rate, 25.0%. The family-related opinions and stressful situations were evaluated using the original questions. Psychological distress was assessed using a self-report measure, the Kessler Six-question Psychological Distress Scale (K6. The K6 scores of the following participants were significantly (p < 0.05 and independently high: those with more frequent miscarriage/stillbirth/abortions, those with repeated miscarriages as the cause of infertility, those with infertility of unknown causes, those living with no child, those having a low joint income with their partner, those with the opinion that “women should devote themselves to their household duties” those who had considered stopping treatment, those without the opinion that “married life without children is favorable” and those who had experienced stressful situations such as inadequate explanation by doctors, frustration of multiple failed attempts, differences of opinion with the partner, and lack of knowledge regarding when to stop treatment. Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment are outlined. The results of this study may contribute to the prevention of and care for psychological distress in female patients undergoing infertility treatment.

  16. [Evaluation of psychological fear in children undergoing head-up tilt test].

    Science.gov (United States)

    Chu, Wei-Hong; Wu, Li-Jia; Wang, Cheng; Lin, Ping; Li, Fang; Zhu, Li-Ping; Ran, Jing; Zou, Run-Mei; Liu, De-Yu

    2014-03-01

    To investigate the effects of different tilt angles of head-up tilt test (HUTT) and different responses to HUTT on the psychological fear in children undergoing the test. HUTT was performed on children with unexplained syncope or pre-syncope (107 cases: 52 males and 55 females), aged 5.5-17.8 years (mean 12.0±2.8 years). All subjects were randomly assigned to undergo HUTT at an angle of 60°, 70° or 80°; the negative cases underwent sublingual nitroglycerin-provocation HUTT at the same tilt angle. The Wong-Baker Faces Pain Rating Scale was used for self-assessment of psychological fear in subjects during HUTT at the end point of the test. The positive rate, hemodynamic changes and distribution of response types showed no significant differences between children at tilt angles of 60°, 70° and 80° (P>0.05). The greater the tilt angle, the higher the degree of psychological fear in children undergoing the test, but there were no significant differences between them (P>0.05). The degree of psychological fear in children who showed a positive response to HUTT (n=76) was significantly higher than that in children who showed a negative response (n=31) (Ppsychological fear in children undergoing the test, and the degree of psychological fear increases in children tested at tilt angles from 60° to 80°, but the differences have no statistical significance. A positive response to HUTT can significantly increase the psychological fear in children.

  17. Routine supplementation does not warrant the nutritional status of vitamin d adequate after gastric bypass Roux-en-Y.

    Science.gov (United States)

    da Rosa, Cintia Leticia; Dames Olivieri Saubermann, Ana Paula; Jacqueline, Jacqueline; Pereira, Silvia Elaine; Saboya, Carlos; Ramalho, Andréa

    2013-01-01

    Bariatric surgery can lead to nutritional deficiencies, including those related to bone loss. The aim of this study was to evaluate serum concentrations of calcium, vitamin D and PTH in obese adults before and six months after gastric bypass surgery in Roux-en-Y (RYGB) and evaluate the doses of calcium and vitamin D supplementation after surgery. Retrospective longitudinal study of adult patients of both sexes undergoing RYGB. We obtained data on weight, height, BMI and serum concentrations of 25-hydroxyvitamin D, ionized calcium and PTH. Following surgery, patients received dietary supplementation daily 500 mg calcium carbonate and 400 IU vitamin D. We studied 56 women and 27 men. Preoperative serum concentrations of vitamin D were inadequate in 45% of women and 37% of men, while in the postoperative period 91% of women and 85% of men had deficiency of this vitamin. No change in serum calcium was found before and after surgery. Serum PTH preoperatively remained adequate in 89% of individuals of both sexes. After surgery serum concentrations remained adequate and 89% women and 83% men evaluated. Obesity appears to be a risk factor for the development of vitamin D. The results show that supplementation routine postoperative was unable to treat and prevent vitamin D deficiency in obese adults undergoing RYGB. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  18. Impact of routine crossover balloon occlusion technique on access-related vascular complications following transfemoral transcatheter aortic valve replacement.

    Science.gov (United States)

    Zaman, Sarah; Gooley, Robert; Cheng, Victoria; McCormick, Liam; Meredith, Ian T

    2016-08-01

    To determine the impact of incorporating routine crossover balloon occlusion technique (CBOT) for vascular access closure following transcatheter aortic valve replacement (TAVR) on major access-site-related complications. Vascular complications are associated with increased mortality following TAVR. The CBOT involves passage of a balloon catheter from the contralateral femoral artery to enable controlled closure of large-sheath access-sites. Consecutive patients who underwent transfemoral TAVR as part of three clinical trials were prospectively recruited. Patients who had routine CBOT (CBOT group, n = 55) were compared to preceding patients who did not undergo CBOT (control group, n = 43). The primary endpoint was 30-day occurrence of access-site-related Valve Academic Research Consortium (VARC)-2 defined major vascular and/or bleeding complications. CBOT was successfully performed in 96% with 2% occurrence of a minor CBOT-related complication. At 30-days access-site-related major vascular and/or bleeding occurred in 5.5% and 18.6% of the CBOT and control group, respectively (P = 0.042). This consisted of VARC-2 major vascular events in 3.6% and 16.3% (P = 0.036) and VARC-2 major/life-threatening bleeding events in 5.5% and 14.0% (P = 0.137) of the CBOT and control group, respectively. Transfusion of ≥2 units of packed red blood cells were required in 10.9% and 30.2% of the CBOT and control group, respectively (P = 0.016). There was no significant difference in contrast load, procedure time, and kidney injury between the two groups. Routine CBOT for TAVR access-site closure has a high success rate and is associated with a significant reduction in VARC-2 major vascular and bleeding complications compared to TAVR performed without CBOT. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Clinical utility and cost analysis of routine postoperative head CT in elective aneurysm clippings.

    Science.gov (United States)

    Zygourakis, Corinna C; Winkler, Ethan; Pitts, Lawrence; Hannegan, Lisa; Franc, Benjamin; Lawton, Michael T

    2017-02-01

    OBJECTIVE Postoperative head CT scanning is performed routinely at the authors' institution on all neurosurgical patients after elective aneurysm clippings. The goal of this study was to determine how often these scans influence medical management and to quantify the associated imaging costs. METHODS The authors reviewed the medical records and accounting database of 304 patients who underwent elective (i.e., nonruptured) aneurysm clipping performed by 1 surgeon (M.T.L.) from 2010 to 2014 at the University of California, San Francisco. Specifically, the total number of postoperative head CT scans, radiographic findings, and the effect of these studies on patient management were determined. The authors obtained the total hospital costs for these patients, including the cost of imaging studies, from the hospital accounting database. RESULTS Overall, postoperative CT findings influenced clinical management in 3.6% of cases; specifically, they led to permissive hypertension in 4 patients for possible ischemia, administration of mannitol for edema and high-flow oxygen for pneumocephalus in 2 patients each, seizure prophylaxis in 1 patient, Plavix readjustment in 1 patient, and return to the operating room for an asymptomatic epidural hematoma evacuation in 1 patient. When patients were stratified on the basis of postoperative neurological examination, findings on CT scans altered management in 1.1%, 4.8%, and 9.0% of patients with no new neurological deficits, a nonfocal examination, and focal deficits, respectively. The mean total hospital cost for treating patients who undergo elective aneurysm clipping was $72,227 (± $53,966) (all values are US dollars), and the cost of obtaining a noncontrast head CT scan was $292. Neurologically intact patients required 99 head CT scans, at a cost of $28,908, to obtain 1 head CT scan that influenced medical management. In contrast, patients with a focal neurological deficit required only 11 head CT scans, at a cost of $3212, to

  20. Reliability of Routinely Collected Hospital Data for Child Maltreatment Surveillance

    Directory of Open Access Journals (Sweden)

    Campbell Margaret

    2011-01-01

    Full Text Available Abstract Background Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. Methods A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. Results In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible versus no maltreatment being assigned (unintentional injury, giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data. The maltreatment types which were the most 'under-coded' by the original coder